Puzzling symptoms
Matthews, 58, sits at her dining room table over coffee, emanating a deeply positive attitude that's quietly spoken, not greeting-card flowery. When she says, "I am blessed"—and she says it frequently—it's clear she means it. Recently, she recounted the delayed diagnosis of her ovarian cancer, her subsequent treatment with surgery and chemotherapy, and two recurrences of the disease.
In the spring of 2001, Matthews noticed on-and-off abdominal pain and pressure in her rectum. The symptoms did not alarm her or prompt her doctor to suspect an unlikely cancer. An intestinal specialist didn't find anything amiss and suggested she might have a benign cyst in an ovary. Since she had no pain when she saw him, he didn't suggest taking the matter further unless the pain returned.
This scenario is the hallmark of early ovarian cancer: no symptoms, or ones that come and go or are associated with much more common conditions that aren't dangerous, like indigestion or irritable bowel syndrome.
"This is very typical," notes Dr. Matulonis, Matthews' medical oncologist. "A woman notices abdominal fullness or bloating, constipation, pain, and other symptoms caused by the pressure of the growing tumor, yet the exam may be benign until the cancer is advanced." In fact, 70 percent of ovarian cancers are in advanced stages when diagnosed.
By late summer, Matthews' discomfort returned. This time, her primary care doctor noticed fullness in her pelvis, ordered an ultrasound, followed by a CT scan, and referred her to a gynecologic oncologist. Some five months after her first symptoms, the picture snapped into focus. "We're talking definite malignancy here," the specialist told her. The tumor had spread to the lining of her abdomen, putting her in the third of four stages of the cancer's progression.
