The cancer spreads
Clare Matthews' diagnosis prompted an appointment with Ross Berkowitz, MD, director of Gynecologic Oncology Services at the Dana-Farber/Brigham and Women's Cancer Center, who would perform her surgery. "The shock had hit me, and Dr. Berkowitz was incredible: He was so calming," she recalls. "He didn't sugarcoat the situation, but asked questions. He spent well over an hour with me, and I had a date for surgery before I walked out of the office."
Stages of ovarian cancer
Stage 1: Cancer is confined to one or both ovaries.
Stage II: Cancer is found in one or both ovaries and/or has spread to the uterus and/or fallopian tubes and/or other tissues within the pelvis.
Stage III: Cancer is found in one or both ovaries and has spread to lymph nodes or to other tissues inside the abdomen, such as the surface of the liver or intestine.
Stage IV: Cancer has spread outside the abdomen or has spread to the inside of the liver.
(Source: National Cancer Institute)
Dr. Berkowitz performed the usual oophorectomy (removal of ovaries and tubes) and hysterectomy (removal of the uterus) for ovarian cancer and succeeded in removing the solid tumor. However, he also found small tumors on her omentum (a layer of tissue that covers the stomach and intestines), and fluid washed from her abdomen revealed rogue cancer cells outside the ovaries. Because her cancer was in Stage III, she would need chemotherapy to thwart a recurrence.
One of the standard chemotherapy regimens for ovarian cancer is a combination of carboplatin and taxol, which makes some women miserable while others have less severe side effects. Matthews underwent six rounds of chemo—once every three weeks—in the fall and winter of 2002. Antinausea agents kept her feeling well enough to continue working with her partner in an environmental consulting business that requires travel. She also enrolled in a mind-body stress reduction study for ovarian cancer patients, which she found "wonderful."
After treatment, Matthews returned to DFCI every three months for imaging scans and measurements of CA 125, which can signal a recurrence of cancer if it climbs after treatment. After five months, Matthews' CA 125 blood levels did rise, and a CT scan detected a regrowth of her cancer. Repeated chemotherapy succeeded in beating the cancer back, but five months after the treatment ended, Matthews had another recurrence. Again she underwent chemotherapy, finishing in January 2004.
