Continuing the Journey with Olaparib

It has now been one month since taking Olaparib.  16 pills per day for 30 days.  Morning and night.  Thank goodness for alarms on phones.  Before I take Olaparib I take another pill one hour before in preparation.  Then after the Olaparib I must wait 2 more hours to take some other pills I was taking before. So many pills.  In my former like (before cancer), I did not take any pills except for vitamins which I still take.

I have not had many side effects from this medication.  I have some fatigue from time to time but it is pretty minor.  Whether this treatment is working or not will not be known until after a CT Scan scheduled for July 25th.

My main issue is with ascites which has not subsided.  I have had 2 more paracentesis since my last blog entry where they drained off 4 litres of fluid each time.  That is 8 pounds that I was carrying around.  My clothes do not fit properly and it is just damn uncomfortable.  Instead of going to Toronto once per month for a check in I need to go every 2 weeks so they can keep tabs on the ascites.  I hope these pill are doing the job as intended and that the ascites subsides.  Makes it quite difficult to plan a wardrobe that does not include waistless garments.......

Enough of my whining......  A close acquaintance is in Toronto who is close to the end of life.  She has suffered with Ovarian Cancer for the past 4 or 5 years.  A Canadian living in Spain, this past winter she decided to come back to Ontario for continued treatment at Princess Margaret.  Unfortunately, she developed an obstruction in the small intestine and has been mostly in hospital for this.  She has been on TPN with no food or fluids by mouth.

We met through mutual friends and family while in Barcelona a couple of years ago.  She was healthier and vibrant at that time.  She took time out of her schedule and showed us some of the sights which we will forever remember.    I wish I could have known her better but life waits for no one and we must do our living while we can.

Beautiful resort town of Sitges

There is Nothing Permanent Except Change.

This past week I received the results of my April 5th CT Scan.  The lesion they follow for the purposes of the clinical trial is still showing no progression which is good news but the scan also shows evidence of ascites build up.  It is not so much but 5 days later I can definitely feel it and it is uncomfortable.  Also my CA 125 has been on the rise for the last few months.  It is now 219 as of April 19th from a record low of 13 on August 15, 2015.  The upswing in values has rapidly increased since February.  In other words it is now rising quickly.  All this evidence is pointing to the fact that treatment from this clinical trial is not as effective as it has been in the past.  I can't complain though.  I have had a good long run.  One year actually.  That is the longest any treatment has kept the beast down.

The good folks at Princess Margaret are lining up the next line of defence.  We have applied to AstraZeneca to their Managed Access Program for Olaparib which is something called a PARP inhibitor.  PARP inhibitors can destroy cancer cells that have abnormal BRCA genes, but do not destroy normal cells.  I have the BRCA2 mutation.

Olaparib has not been approved by Health Canada but it has been in the U.S. by the FDA.  This access is provided internationally for those countries where it is not yet approved.  Once approved it will be available via prescription, however, I understand that it is very expensive and many drug plans may not pay for it.

This approval for Managed Access may take a month or so and then I will be part of a new study. In the meantime I am continuing on the trial because of the good results of the scan although the ascites is building up.  This is something we can deal with although I never feel it is frequent enough.  Most hospitals will not perform a paracentesis unless there is a considerable amount of fluid to drain.

Once it is deemed that disease progression is occurring then I will switch over to Olaparib treatment which consists of taking about 16 capsules a day and monthly clinic visits.  Much better than going to Toronto for weekly chemo treatment........

A couple of weeks ago my daughter and I went to Toronto for a few days to be tourists.  We had a good time and had some good quality time together.

Aquarium

 St. Lawrence Market

Aquarium

Royal Ontario Museum

Another good scan

My life has taken on this rhythm:  1 treatment per week for 3 weeks then one week off and then 3 more treatments then a CT Scan.  And another week off.  Cycle starts over as long as CT Scan shows stable disease.  This means not more then 20 % increase in visible disease and a bunch of other criteria that is studied by the technologist and the reasearch team at PMH.   Most of my disease locations are about 1.3 cm to 2.5 cm.  Also there is sprinkling of small spots within the peritoneum.  These are not measurable but exist as is typical with ovarian cancer.

There is also the CA 125 tumour marker measurement that is taken once a month.  This measurement has been creeping up the last several months but taken on its own merit is not 100% foolproof.  Current reading is up to 88.  It is also a test that is considered along with the CT Scans, my physical examinations and my verbal account of my general well being.  Nothing is simple.

Angel knows how to relax......

My scans of December 21st, 2015 and February 9th, 2016 were both good and progression of disease is classed as 'no progression'.  This is very good news and although I continue to worry I try not to think about it and look forward to my one week off when I do not have treatment and do not have to travel to Toronto!  I can't believe I have just started cycle 13.  It is almost a year of treatment on this clinical trial.

On the weeks of treatment my week is up and down in terms of my reaction to chemo and trial drug.  Wednesday and Thursday I am fairly wired and can do all the things I need to do around the house in terms of meals, laundry, cleaning, etc.  Those mornings I can get up @ 4:00 am and enjoy some tea while the house sleeps.  I try and get back to bed by 6:00 am to get some much needed sleep but sometimes it is impossible.  This is all the effect of dexamethasone which is a type of steroid.  By Friday I seem to crash and that day is ususally a down day.  A day to catch up on my shows that I have been recording.

One appointment that I went to in January was to the 'Pain and Sympton Management' department or 'Palliative Care' a name they don't like to use with someone like me who is still high functioning while managing through cancer.  ( I don't like to say fighting cancer.)  They are there to ensure cancer patients have the best quality of life.  And they are also there for the loved ones.  They are team which includes doctors, nurses, occupational therapists, physiotherapists, pharmacists, psychiatrists, social workers, spriritual care provider, and volunteers.

For me we discussed my current challenges with some discomforts and the doctor adjusted some of my meds and prescribed some others. We also discussed the merits of medical marijuana which is a part of their therapies.  These substances, which are also available in pill form without the highs, are most suited for patients with nausea, vomiting and chronic pain.  Luckily for me these are not major concerns for me and I take other good meds for these right now.  I next see them in April.

So I am very happy to be under their care as well are my primary medical team which are more focussed on my physical self, side effects and my emotional well being as a result of the clinical trial.  They are there to to help me deal with the cancer itself and how we manage through the disease with appropriate treatments.

Our 11 year old Cyrus!

Good News.......

I have been participating in this trial for several months and have successfully completed 4 cycles.  My CT Scan in May showed very little disease and my most current CA 125 indicates I am in normal range.  Normal range!  I have never been in normal range since the beginning of this journey!  This treatment is really doing something and I hope it continues.  I am feeling very well and am physically strong.

In June we traveled to Italy for 16 days.  We visited Sicily and then spent time in Rome and then the home town of my mother's.  It was a wonderful time and I am grateful to have had the chance to go to Europe once again.

Typical street in Ortigia

View from our terrace in Ortigia

Street level near our apartment in Ortigia

Fountain in Archimede's Square in Ortigia

Results from Mt. Etna erruption

One of the Silvestri craters

Market in Catania

View of Mt. Etna from Taormina

Another view of Mt. Etna

Clinical Trial Hopeful

Well I am back on track to enter the clinical trial I described back in October 2014.  Now that the Taxol is less than effective the disease seems to be active and is clearly visible on the CT Scan.  As I mentioned before there is also ascites.  I've already had one paracentesis and they removed 3.25 litres of fluid (Feb 27).  Of course the fluid doesn't not stop building up unless there is some chemo treatment or something.

My appointment this past Monday (Mar 2nd) at Princess Margaret confirmed the active disease and the need to get me into that clinical trial as soon as possible.  I have a date for a biopsy (Mar 17).  This is one of the criteria of the trial and other diagnostics that have to take place before treatment can begin.  So I have a bit of time to nip down to Florida and visit with my Mom and Uncle and Aunt.  Franca is also going and I will be grateful for a bit of warmth and sunshine.
Hopefully I will be starting my trial treatment on March 25th.  It will be a start to a new journey!

The November 7th scan is showing stable disease which means the visible disease has not changed significantly since the September 29th scan.  This is good news.  The only problem at this point is the development of ascites.  As usual this fluid accumulated very rapidly.  I know my clothes started to feel tight on November 7th and by the November 17th appointment at Princess Margaret I could not wear my regular clothes.  Elastic waist bands are the fashion of the day.  

At the meeting on November 17th we discussed the CT Scan results which were favourable but we needed to deal with the ascites and talk about start of trial.  Starting the trial right away would help with the ascites but would interfere with our holiday in December.  Once I start the trial I have to adhere to the protocols and appointments which means frequent travel to Toronto.  If we just treat the ascites then I can wait until the new year to begin trial and focus on that.  I chose to wait to start the trial and my best option right now is to start weekly chemo of Taxol for 3 weeks.  The usual protocol is one infusion every 3 weeks so I will be getting a third of the infusion every week for 3 weeks.  You get the picture.  This is a stop gap measure and I should hopefully experience minimal side effects.  The best part is I can have this done at Grand River Cancer Centre and I do not need to travel to Toronto until the new year.

I met with my oncologist at Grand River on the 19th (appointment previously booked) and we discussed the more immediate treatment plan.  She is in agreement and started the ball rolling to get the chemo scheduled this week.  We discussed potential issues such as low blood counts and maybe some hair loss.  We will deal with issues as they come up.  She also wants to schedule a paracentesis.  A paracentesis will be a relief I can tell you!  I look about 7 months pregnant and it is not very comfortable.  Walking any distance is physically taxing.

So far my chemo is scheduled for this Friday on the 21st.  Still waiting to hear about the paracentesis.  Hoping it might be today!

We are getting dumped on with snow and it is cold.........

Solo2 Clinical Trial

Princess Margaret Cancer Centre is a busy place.  I had to wait an hour to get my bloodwork done and then found out I was in the wrong place.  I have a port-a-cath and should have gone to Ambulatory Care for blood work.  Next time.

My appointment was for 10:30 but did not see doctor until 12:30 pm.  They are quite busy seeing the multitudes.  We left Princess Margaret at 2:30 pm.  We were there a full 5 and 1/2 hours.  I hope you never have to see an oncologist or the inside of a cancer centre.  Chances are you will because as people live longer their cells go haywire and cancer develops.

This was considered a first meeting and after discussing my medical situation the doctor seemed to think that I may be a suitable candidate for the Solo2 clinical trial.  This was not before he had to leave several times to confer with various researchers.  Seems most of my ducks are getting in order:  recurrent ovarian cancer, favourable response to a platinum drug (Cisplatin), BRCA2 carrier (they need to still see my genetic report from 2011), and CT Scans show some visible evidence of disease (they will have to verify this more).

They also decided I should finish up with my chemo treatments.  Usually a course of chemo is 6 infusions.  I have 2 more to go.  The study requires patients to begin the trial within 8 weeks of chemo ending.  Therefore, my last chemo should be the week of September 22nd and if accepted into trial I would begin no later than week of November 17th.  That is according to my calculations.

The drug they are testing is Olaparib.  As I stated in a previous post it is a drug that inhibits a cancer cell from repairing itself.  It is considered a maintenance drug which keeps the cancer from growing so that it lengthens the period of 'remission'.  That is what we are always trying to achieve although technically I have not been in remission since 2011.

Solo2 is a phase III trial and they are recruiting 264 people all over the world.  Because the researchers have not yet decided whether I qualify they wanted me to get registered in case the study closes between now and November.  If the study closes then I can still participate.  Of course they still have to definitively accept me into the study and I have to consent.  I was given a 23 page Study Information and Consent Form to read.  It is quite extensive in introducing the study, its purpose, a thorough explanation regarding its experimental status, charts explaining how often I need to visit hospital for tests and follow ups, all the potential side effects, my responsibilities as a participant, confidentiality, risks, etc.  I can drop out of study at any time.

On the one hand I hope to be accepted into this trial.  It is cutting edge science and could help me to attain some degree of remission.  Cost is picked up by drug company (AstraZeneca).  This study, if successful, could provide oncologists with another tool for maintenance treatment in future ovarian cancer cases.  On the other hand it is experimental.  Long term side effects are unknown.  Side effects while on drug could be unpleasant but maybe not.  At least with chemo my experience is a week of unpleasantness and a couple of weeks of normalcy of sorts.  And I could end up in the placebo group and get no benefit at all.  I still have several questions I want to ask of my assigned trial nurse and I have some time to fully consider this trial.

4th Treatment of Cisplatin

Yesterday I had the 4th and perhaps the last infusion of Cisplatin.  My oncologist received correspondence from Princess Margaret in reply to her inquiry regarding my good results from Cisplatin.  My CA 125 numbers have been steadily decreasing from a high of 597 in May to 60 on August 11th!  Very good response which means I am platinum sensitive!  Also, my CT Scan is showing shrinkage in my tumours which is also good.

Princess Margaret would like to speak to me regarding the Solo2 Clinical Trial.  This trial is for women with recurrent disease and with a BRCA1 or BRCA2 mutation.  Just waiting to hear for an appointment.  I am quite happy to hear about this but also full of questions.  It is a double blind study so I may end up in the group without actual medication just the placebo.

Next few days will be quiet while I relax with my side effects.  Right now I am still wired from the medications but I know I will be crashing later today and dealing with some nausea.  Good thing I have some great meds for that!

Update:  Appointment for Princess Margaret is August 25th.  That was quick!

Appointment at Princess Margaret

On Monday, April 14th I traveled to Toronto for an appointment at Princess Margaret Cancer Centre (PMCC).  I was to meet with Dr. Amit Oza to discuss clinical trials.  I actually met with Dr. Les Levin who is a member of the gynecological cancer team.  We had a great chat for about 1/2 hour.

He came to the meeting fully versed in my condition with the help of the summary provided by Grand River Cancer Centre.  He said it was a very good summary and the team had reviewed it.  I also brought with me the last 4 CT Scans and he had already reviewed those as well.

Basically, the end result of our discussion is that he and the team decided that it was unclear whether I am 'platinum sensitive' or 'platinum resistant'.  This is a very key criteria for the studies they conduct at PMCC.  I was unclear what these terms meant but he explained it very well.

Platinum sensitive:  When given a series of treatments of platinum based chemotherapy drug and a patient is disease free (not visible in a CT Scan)  for a period of 6 months or more months.  One drug of this type is Carboplatin.

Platinum resistant:  After being given a series of treatment of platinum based chemotherapy and patient shows growth of visible disease within 6 or less months.  The patient is said to be resistant to the treatment.

In my situation the team at PMCC doesn't know according to the information in my file.  My last treatment of Carboplatin in June 2013 resulted in a severe allergic reaction.  This was my second treatment in the series and my doctor and I decided we should stop treatment and take a break.  By September of 2013 my CA 125 was up 40 points to 386 and a CT Scan in October showed visible evidence of disease.  My doctor and I discussed using a different drug to avoid further allergic reactions and this is when I started the first of 5 treatments of Doxil.  When reviewing this information it is unclear whether I am 'platinum sensitive' because the number of treatments I had with Carboplatin were too few to determine what effect they had.  On the other had could I be 'platinum resistant' because I started treatment so soon after the last one but again it was only 2 treatments.  Perplexing as Dr. Levin expressed.....

Clinical trials are very regimented and almost of a military form.  The studies have to follow strict guidelines or else the researchers cannot draw meaningful conclusions which is what we want from clinical trials and the advancement of medicine.  So for this reason I currently do not qualify for any of their studies.  However, in his opinion, I currently do not show much disease growth in my CT Scans from January to March and thinks I should just take a break from treatment.  ( I am all for this.  My side effects are subsiding quite nicely.)

As a clinician he is suggesting my oncologist try another platinum based chemotherapy the next time (Cisplatin).  There is the risk of another allergic reaction but it would be administered while admitted to hospital.  This will help me in terms of disease management and to determine whether I am 'platinum sensitive'or 'platinum resistant'. In fact there are still many other drugs for the treatment of ovarian cancer that have not been used.  He mentioned gemcitabine, topotecan, etc.  I felt he listened to me and he answered all my questions.  I left there feeling quite optimistic and made my way in the rain to the nearest Winners store to shop before hopping the train back home.

Turn in the Road

Just heard from my oncologist.  She just called me to let me know that my CA 125 reading is 270, up from 186 in one month.  So this is disconcerting.  No chemo with Doxil today.  In her opinion Doxil has done it's job and it's time to look at other treatments.  No point getting another dose with no improvement only to deal with the side effects for nothing.

She also has heard from Dr. Bedard at Princess Margaret.  He said they have lots of stuff going on that I could get involved with but in his opinion the best one is a study using PARP inhibitor which Dr. Welch is conducting out of London.  I am all for getting into a trial with a PARP inhibitor.  This is leading edge treatment these days for ovarian cancer and other cancers but still in trial phase.  This particular treatment has shown good results with people having positive mutation with  BRCA1 and BRCA2 (mine) in their DNA.

First off she is sending me for another CT Scan even though I just had one in January.  Remember that one. So full of promise when it came back with no visible signs of disease.  Well something is happening.......  And you cannot enter into a trial without visible disease.  How can they tell otherwise that it is working?

So in the meantime I sit tight and wait for hospital personnel to call me with an appointment for CT Scan.  I will meet with the oncologist to discuss the results and next plan of action.  The best thing is that these side effects should slowly resolve themselves so that I return to some sort of normalcy.

Oncologist Visit Today

Tomorrow I am scheduled for my 7th infusion for Doxil but at this point I am not sure I will get it.  Let me back up a little.

A month ago when I had my blood work done in preparation for my 6th treatment of Doxil on February 7th,  my CA 125 number had jumped up to 186.  Imagine my surprise!  It had been coming down for the past 6 months from 304 and stabilized at 114.  And my CT Scan last month indciated very good results with no visible signs of disease.  Today I had a chance to discuss this with my oncologist and she is troubled by it.  If today's blood work shows an increase in this number again then she might stop the Doxil treatment and switch me to a different treatment.

So now I am concerned that Doxil is not working for me.  How strange is that?  My CT Scan was good but somewhere in my body microscopic cancer cells are emitting certain proteins that are being picked up by the CA 125.  It is maddening to say the least.

Well if it is not working anymore then the best course of action is to stop. It may be for the best.  There is a world wide shortage of Doxil and hospitals are prioritizing who gets the treatment based on how effective it is for those people.  If it is no longer working for me then someone else can get it and I move onto another treatment.

I will know tomorrow just before I get treatment whether it is a go or not.

We also discussed my meeting with Dr. Welch.  Unfortunately, my oncologist has not received his notes yet so I summarized our meeting.  You have already read how my meeting went in my last post.  Based on our conversation Dr. Califaretti has already contacted someone at Princess Margaret to keep me in the loop for clinical trials.  Hopefully something will come of that in the near future.

Beast is Back.....

When I am dancing with NED (no evidence of disease) you may notice that I don't post very often.  While I am living my life I don't always  relay all the good things about living life to it's fullest.  Things like the warm sun on your face, the smell of fresh cut grass, the look on your dog's face when you ask if it is time for a walk, the taste of a well crafted cocktail, the thrill of an upcoming vacation, a good laugh with family and friends, good food, etc, etc,......

These are the things I love and try to experience and enjoy everyday.  Then something comes along to knock you down.  And I hate to sound like a downer but sometimes it just pisses me off.......

The Highline

My last follow up appointment with the oncologist was April 25th.  My bloodwork indicated the CA 125 marker came back elevated.  This warranted a CT Scan which was scheduled for May16th.  By the way on May 17th we headed for New York with Dylan for the long weekend.  We had a great time and although the weather did not cooperate we did not let that stop us.  Unfortunately, Corina did not come with us.  She has finished her college program and is looking for work.  Anyone know of a health administration job opening?

Freedom Tower

Near Battery Park and NJ in the background

Dylan 

On May 22nd my oncologist let me know that the cancer was back once again.  There is a 3.5 cm tumour on the upper left hand side of my abdomen and some nodules through out the peritoneum.  Next we had the discussion of treatment which she wanted to begin right away.  I also wanted to start right away because we are leaving for Europe on June 7th and I want to have some semblance of health to enjoy ourselves.

My treatment protocol has been Taxol/Carboplatin regiment.  Very common and widely used for ovarian cancer all over the world.  However, like many people the Taxol has been debilitating to my body and so it is no longer an option.  It has left me with neuropathy in my hands.  Thankfully not my feet like some people.  Having more Taxol would only ensure further nerve damage in my hands and then my feet.  Not a good thing!  The treatment of cancer involves toxic chemicals that build toxicity in the body.  Major drawback...

Another factor in the treatment discussion is the length of time since my last treatment.  Last time I had chemo was September 2012.  In the chemo world the treatment is considered ineffective if there is less than 6 months since the last treatment.  I am at the 7th month mark and my oncologist had to decide whether to give me Carboplatin alone or with something else.  In addition you may recall from my earlier post that I reacted to Carboplatin the last time.  The answer to this is an extended infusion period to mitigate any reaction.

We decided together to go with Carbo only and very next day I had a call from hospital at 2:30 pm to ask me to come around 4:00 pm to be admitted so chemo could be administered all the next day.  How to make a dull situation a little more lively?  There is not much that can be done.  When I was not passed out from the benedryl I was fully awake and able to read.  I had several room mates during my time at hospital but I know from past experience that other cancer patients are not that chatty and I was not either.  I finally got to go home @ 9:30 Friday night.  Good news is that I did not have any reaction.  Just bored out of my mind.....

We Have Remission

Sorry for the long absence.....  This post has been in draft since November 2012.  I have not been able to put together the words to relay what my life is all about until now.

After my 6th chemo treatment on September 26th I went for a CT Scan on October 12th to determine if there was any visible cancer left.  This would determine whether I would need another chemo treatment at this time.  I returned to the hospital on October 16th to consult with my oncologist.  This meeting set off a major turning point to my life.

The oncologist, Dr. Califaretti, delivered the news that the CT Scan did not show any visible cancer which is great.  This is technically a remission.  So the series of treatments from June to September did the job they were supposed to do.  All good.  I forgot to mention that during my last treatment on September 26th and in receipt of the last chemo drug, Carboplatin, I had an allergic reaction.  After receiving it 11 times in the last couple of years my body decided it did not want it.  After easing off the dosage and giving me some drugs to help me along I finally finished treatment that day.  Can you imagine that my doctor reminded me that I had experienced this?  I had totally forgotten between September 26th and October 16th.  The mind does some crazy things in times of anxiety.

Back to our discussion on October 16th.  During our discussion my doctor, in a no-nonsense way, strongly suggested that I not return to work.  This startled me as I was fully expecting to go back.  But life has a way of reminding you of your immortality.......

This cancer is unrelenting and she fully expects it will come back within the next 15 months or so.  This is because my last recurrence came within this timeframe.  Medically speaking recurrence does not generally extend itself beyond this.  Is she correct?  Only time will tell.

So my decision not to return to work was a difficult one.  On the one hand I like working and it provides satisfaction in getting things done and having clients who are happy with my work. There is also the social aspect of the workplace which I always value.  But on the other hand work can be stressful and demanding.  Client commitments, sales targets, professional development and other business demands can be challenging.  The demands on your personal time is a given and I have always been of the opinion, required, if promotion and success is your ambition.  Alas these things are not quite as important to me any more......

So now I am a lady of leisure.  I have all the time in the world to do what I want!  Well my days are full and I wonder now how I fit a career in there.....  Strange.  I spend most of my time with the family naturally.

Here is a picture from last October when Hurricane Sandy hit the New York area.  This is right in front of my sister's apartment.  A huge tree just toppled over and luckily landed on the side walk and not the house.  Even though her home is inland Hurricane Sandy did much damage to the neighbourhood.  The area closer to the shore was very badly damaged and the clean up continues still.  The area of New York City near the shoreline in pictures.

Let's hope these lives can be put back together.

3rd Chemo Session

On Friday November 12th we went to hospital for the last round of chemo before my surgery which is scheduled for December 8th in London.  Dylan accompanied us as well so he missed a couple of periods of school that day.  He wanted to see what happens in chemotherapy.  I am sure it was mostly boring for him but it is now less mysterious. 

I am given a cocktail of drugs before the actual chemo and they make me quite drowsy.  I will sleep for short periods and then wake up a bit groggy and incoherent.  At one point I had been dreaming and woke up laughing about something.  Dylan found this quite amusing. 

Since chemo I have been feeling the usual flu like symptoms but I also have been prescribed a higher dosage of Gabapentin to relieve the inevitable pain in the leg muscles and joints.  It seems to be working. Doctor also suggested Ibuprofen and as a back up a prescription of Tylenol 3 just in case.

On November 16th I went to hospital for a CT Scan.  This is in preparation of the surgery. What a zoo.  They were backed up due to emergencies so the wait was excruciating.  I wasn't feeling well due to chemo and for CT Scan you must drink 2 big glasses of contrasting liquid in one hour.  To me it tastes like pool water.  They certainly don't dress it up or anything.  At least at St. Mary's hospital it was a flavoured smoothie that was at least drinkable.  They also inject iodine via an IV during the procedure.  While in the apparatus this gives you a metal taste in your mouth (which I already have), makes you feel hot and you feel like you are peeing yourself (which you are not).  Eventually it was all over - actual scan procedure takes only 5 minutes.  The whole thing was 3 1/2 hours and I was finally out of there.  One final comment.... the nurses who were very busy did a great job of getting patients organized and ready for procedure while being very gracious and conscious of the delays.  They did they best to hurry things along.  It is a difficult job.

Symptoms and Diagnosis

This entry is intended to provide you with an account of symptoms that alerted me that something was wrong and the progression of a diagnosis by our health care system.  It is somewhat long so grab a drink.

Early August there was a day at work where I experienced a sharp pain in my lower left side.  It was quite painful and I decided to go home at noon to lie down.  Pain was mostly gone by next day and I returned to work.  Decided to call the doctor's office anyway to ask them to book an annual checkup.  I was several months overdue and this was as good a time as any.  Appointment was booked for October 14th.  Busy office.

Life went on as usual.  The only symptoms I recall is feeling bloated much of the time and my belly was expanded somewhat.  Sometime early to mid August I recall that we played a round of golf at Puslinch and we walked the course.  It was a hot day, one of many this past summer, and I recall complaining about the heat.  Nothing out of the ordinary!

Most of the time I didn't have pain per se but I was bloated and gaseous.  I made the decision I was becoming intolerant to some sort of food item and made some effort to remove wheat from my diet to see if anything changed.  I studied up food intolerances and tried substituting for wheat. This went on for a number of days but nothing changed and I was getting larger and more uncomfortable.

On August 22nd we were scheduled to participate in a golf tournament.  By now I was experiencing heaviness in the lower belly, walking was painful and looked 4 or 5 months pregnant!   Oh joy.....There was no way I could do this even with a cart and I suddenly realized I needed to go to the doctor.  Of course, it was the weekend so I went to the clinic.  After some blood work, urine analysis, x-rays and physical examination they could not give me any diagnosis.  There appeared to be some heaviness in the pelvic area and it was probably because I was constipated.  I was given a prescription for some stool softener and an appointment for an ultrasound for August 31st, which was the next step.

We spent the following 5 days at Pat and Suzanne's cottage.  It was during this time that I really came to terms with my inability to walk very far.  We would go for walks and I would end up way behind of everyone and holding my belly.  I couldn't wait to sit down again.  Back pain began as well.

The ultrasound results were available very quickly and my own doctor called August 31st to tell me that there is a sizable tumour close to my ovaries.  She was very sorry to be delivering this news via the phone but thought that I would want to know.  She had also arranged for a CT Scan and appointment was set for September 3rd.  She also arranged an appointment at London Health Sciences Hospital with Dr. Monique Bertrand, Gynecological Oncologist upon the recommendation from the Grand River Cancer Centre.  Things started to happen very fast now.  Both David and I were stunned as you can imagine and quickly had to come to terms of what this meant.

On September 7th we met with Dr. Bertrand.  In her opinion, based on the results of all the diagnostic tests and her physical examination she was quite sure it was cancer.  In the back of our minds we were still hoping it was nothing but we knew.  However, to be 100% sure she requested a biopsy with a oncologist radiologist scheduled for September 17th in London.

She described the treatment plan for ovarian cancer which would begin as soon as possible.  Good news is that I can do this in Kitchener at the Grand River Hosp.  There would be 3 treatments of chemotherapy 3 weeks apart.  Then she will do surgery to remove as much as she can.  After this 3 more treatments to get rid of the remainder missed by surgery.

She didn't think there is one mass as originally thought but several smaller ones.  All in the area of the ovaries.  There was also a possibility of cancer on the peritoneum.  This is the lining of the abdomen.  Treatment is the same for both types of cancer.

This was all confirmed with the biopsy.

Physically, I felt fine as long as I was sitting.  My belly had expanded quite a bit because of something called ascites.  This fluid will reduce with chemotherapy.  My regular clothes do not fit around the waist.


Dr. Bertrand called me at work on September 22nd to discuss the results of the biospy.  She confirmed it was grade 3 ovarian and peritoneal cancer.  Next steps was to send all test results to Grand River Hospital who would get in touch with me for a preliminary meeting.

So on September 29th we met with Dr. Califaretti, oncologist  and my nurse coordinator, Pat to discuss my diagnosis and treatment plan in more detail.  They were wonderful and caring.  Any questions we had were encouraged and they were completely accommodating.  Appointment for first treatment was set for the very next day @ 8:30 am.  My journey is only beginning.......