Dealing With Grief After Cancer
- “007” actor Pierce Brosnan, 70, is leading a new action movie roughly a decade after losing his daughter to ovarian cancer at age 41. He also lost his first wife in 1991 to the same disease.
- Brosnan admitted struggles while coping with the loss of his daughter and wife. He credits his second wife for supporting him through the grief. The grieving process comes in stages: denial, anger, bargaining, depression, and acceptance. These labels help us frame and identify what we may be feeling, and these stages can occur in any order.
- Ovarian cancer is often harder to catch in its early stages because of its subtle symptoms, such as bloating, weight gain, and abdominal pain that can mimic regular menstrual cycle fluctuations.
- Ovarian cancer recurrence happens in “almost 25 percent of cases with early-stage diseases and in more than 80 percent with more advanced stages,” according to research published in Gland Surgery medical journal.
- After ovarian cancer patients complete initial treatment, maintenance therapy may be recommended to try and delay possible recurrence.
- Genetic testing helps doctors determine the most effective maintenance therapy.
“OO7” actor Pierce Brosnan, 70, best known for his portrayal of James Bond, is leading a new action-packed thriller nearly a decade after facing one of the most challenging times in his life. In 2013, he lost his daughter, Charlotte, after a battle with ovarian cancer. The same disease also impacted his first wife, Cassandra Smith, who was diagnosed in 1991 and died a few years later following a tough battle with the disease. It took the actor, who often presents a stoic demeanor in his films, a while to cope with both hardships.
View this post on InstagramRead MoreBrosnan’s new film “Fast Charlie” hits theaters in a few weeks. Brosnan plays the character “Charlie Swift,” who acts as a hired hitman responsible for identifying a thug he was paid to take out. The film is par for the course for Brosnan, whose resume includes “Golden Eye” and “The Thomas Crown Affair” and a recurring role during the ‘80s television series “Remington Steele.”
Off-screen, Pierce would continue to grieve and heal from losing his wife and daughter.
“From day one, we really had a fight on our hands,” Brosnan said of Cassandra’s disease during a 1992 interview with People Weekly.
“This wasn’t a shadow or a small tumor this had invaded Cassie’s being,” he added.
Cassandra underwent eight surgeries and a year and a half of chemo for treatment.
“I never asked Cassie if she was scared. I regret that. I didn’t want to ask because she had so much fight.”
However, Brosnan admitted there were times she told him, “I need you,” and those moments “cut like a knife.”
Towards the end of Cassandra’s cancer journey, Brosnan said, “She was comforting me. She said, ‘Please, darling, don’t worry. It’s just a life winding down…up until then, there was always something, some new treatment. But then the options got fewer and fewer.”
Helping You Cope with Grief and Cancer
Brosnan’s second wife, Keely Shaye Smith, has been supportive amid moments of grief because of his first wife and daughter.
“Keely has always been kind and compassionate and encouraged me to mourn Cassie. … I suppose Keely is my North Star, always looking out for me,” Brosnan told the Irish Central during an interview.
How to Cope After Losing a Loved One to Cancer
Those unfamiliar with Brosnan’s personal life may find it woefully heartwrenching that he dealt with such a profound and personal loss because of cancer. If you have lost a loved one, SurvirorNet wants you to know that grief may look different for everyone.
The stages of grief are denial, anger, bargaining, depression, and acceptance. These labels help us frame and identify what we may be feeling. These stages can also occur in any order.
The time it takes to navigate these stages can also vary, so giving yourself grace and patience while navigating your feelings is important.
“It often gets better over time, but on certain days, it can look like depression, and on other days, people look perfectly normal and can function,” Dr. Scott Irwin, a board-certified psychiatrist and Director of Supportive Care Services at Cedars-Sinai Medical Center, previously told SurvivorNet.
Dr. Irwin added that grieving people are coming to terms with “the change in their life; the future they had imagined is now different.”
Ovarian Cancer Can Evade Detection Due to Its Sneaky Symptoms
“Ovarian cancer does not have any specific symptoms,” Dr. Beth Karlan, a gynecologic oncologist at UCLA Medical Center, told SurvivorNet.
“It’s often referred to as the ‘cancer that whispers’ in that it has symptoms that are really very vague and nothing that may bring your attention directly to the ovaries.
WATCH: Signs of ovarian cancer.
“The symptoms include things like feeling full earlier than you usually would when your appetite is strong and feeling bloated. Some changes in your bowel habits. Some pain in the pelvis. These are symptoms women may have every month. These are not very specific. But what we’ve found from multiple studies, it’s this constellation of symptoms,” Dr. Karlan added.
How Ovarian Cancer Is Treated
The standard of care for ovarian cancer patients is chemotherapy, which helps many patients reach remission.
Ovarian cancer recurrence happens in “almost 25 percent of cases with early-stage diseases and in more than 80 percent with more advanced stages,” according to research published in Gland Surgery medical journal. With recurrence a strong possibility for this disease, especially in the later stages of ovarian cancer, certain drug treatments to deal with it are giving many women hope.
RELATED: Dealing with recurrence.
WATCH: Treating ovarian cancer.
Ovarian cancer is sub-categorized into two groups.
Platinum-Sensitive Ovarian Cancer: Your cancer does not return for more than six months after treatment with platinum-based chemotherapies, like carboplatin and cisplatin.
Platinum-Resistant Ovarian Cancer: Your cancer returns within six months of treatment with platinum-based chemotherapies, like carboplatin and cisplatin.
“The mechanism that causes platinum resistance will cause someone to be resistant to other chemotherapies, as well. That’s why we’re looking for what we call targeted therapies – precision medicine,” Dr. Noelle Cloven from Texas Oncology-Fort Worth Cancer Center explained.
Targeted therapies or precision medicine specifically target the proteins controlling cancer cells’ growth, division, and spread.
Maintenance Therapy for Ovarian Cancer
Maintenance therapy is continued treatment after the patient finishes their initial treatment. After an ovarian cancer patient completes a round of treatments — such as surgery and chemotherapy — her doctor may recommend some form of maintenance therapy to try and delay possible recurrence. Maintenance therapy can involve taking an oral pill called a PARP inhibitor every day after chemotherapy and can keep cancer in remission longer.
Genetic testing helps doctors determine the best maintenance therapy.
“The biggest question is: How do you choose between bevacizumab (brand name, Avastin) or a PARP inhibitor for maintenance therapy?” Dr. Alpa Nick, a gynecological oncologist with Tennessee Oncology in Nashville, tells SurvivorNet.
The drugs have very different ways of combatting cancer cells. PARP inhibitors prevent cancer cells from repairing their DNA, while Avastin blocks the formation of new blood vessels, starving tumors of nutrients.
The Food and Drug Administration approved bevacizumab (Avastin) to be used in conjunction with olaparib (brand name LYNPARZA) in HRD (Homologous Recombination Deficiency) positive women who show a response to platinum-based chemotherapy. During clinical trials, the drug combination showed an increase in progression-free survival from an average of 17 months to 37 months.
“A patient really has to make a decision upfront, or near the beginning of their treatment, that they want bevacizumab maintenance treatment because they’ll have it with their primary chemotherapy,” Dr. Nick explains.
The drug is administered intravenously and can be given in combination with other chemotherapy drugs. Avastin affects the growth of blood vessels, starving tumors of the blood they need as nourishment.
The American Society of Clinical Oncology (ASCO) guidelines recommend PARP inhibitors be offered to women, with or without genetic mutations, who are newly diagnosed with stage III or IV ovarian cancer and have improved with chemotherapy.
Surgery offers another important decision point. “When patients have their surgery, we can test their tumor to decide if their tumor has a homologous recombination deficiency,” known as HRD. If it does, that also suggests they would benefit from PARP inhibitor maintenance therapy,” says Dr. Nick.
Elahere (molecular name mirvetuximab) is an FDA-approved targeted therapy providing much-needed hope for patients with platinum-resistant ovarian cancer. This drug treatment is for women who test positive for a molecular factor called folate-receptor alpha (FRα). While many ovarian cancers test positive for the folate receptor, to be eligible for Elahere, you must have very high levels (>75%) of the folate receptor-alpha (FRα).
It is an antibody-drug conjugate. This kind of new anti-cancer drugs, known as “biological missiles,” is leading a new era of targeted cancer therapy.
Dr Lyons explains, “What that means is that the antibody part of the drug conjugate binds to the folate receptor on the tumor cells, and then that gets taken up into the tumor cell. And then the drug that is conjugated with is the part that actually kills the tumor cells, by affecting the tumor cells ability to divide.”
Questions for Your Doctor
If you have been diagnosed with ovarian cancer and need guidance to further educate yourself on the disease and treatment, consider these questions for your doctor.
- What type of ovarian cancer do I have?
- What stage is my cancer in?
- Do you recommend I get genetic testing for any gene mutations, such as the BRCA gene mutation?
- What initial treatment options do you recommend?
- What are the possible side effects of the recommended treatment, and how to cope with them?
- Will insurance help cover my recommended treatment?