One night after dinner last year, I experienced pain on my shoulder and under my right rib case. At first, I thought it might be my gall bladder acting up (even though I was slim and followed a low-fat, vegetarian and organic diet). I'd had indigestion for a while, so I’d cut back on what I was eating, and had lost some weight.

I was on postmenopausal hormones, and thought that was the reason my belly was so round. My recent gynecological exam had come back normal and I didn't come from a family with a big cancer history. So I didn’t think I needed to be concerned about cancer. But I was about to be very concerned . . .

Blood tests and an upper abdomen ultrasound came back normal, and medicine helped calm down the indigestion. Then I developed a severe burning pain under my right rib cage, which I thought was an ulcer (many women diagnosed with ovarian cancer first undergo evaluation for digestive tract symptoms). By the end of the week, I had a hernia on my right side. A CAT scan showed an 11-centimeter mass on my right ovary with fluid in my abdomen. The results were in: I had stage III ovarian cancer and neither the CAT scan nor the ultrasound had been sensitive enough to pick up the cause of the pain, a metastases on my liver and my right diaphragm.

Ovarian cancer is called the silent killer, because its symptoms are so nonspecific, there is no good screening test for it, and it is rarely discovered until it is advanced. Approximately 1 in 80 women will develop ovarian cancer in their lifetime. A family history of prostate, colon or uterine cancer increases the risk, as does using fertility medications, and taking hormone replacement therapy for longer than six years after menopause. Oddly enough, the risk for ovarian cancer goes down the longer a woman is on birth control pills. Women who have the BRCA 1 gene have a 50 percent risk of ovarian cancer over a lifetime.

The most lifesaving step is to get the most thorough surgery possible when ovarian cancer is found at stage III (metastasized). If every metastases is reducible to invisible or at least less than a centimeter in size there is a 50 to 60 percent chance of survival past 5 years. Within a week I had major surgery to remove my hernia, plus my uterus, ovaries, appendix, the connective tissue that attaches to the whole of the stomach and intestines and all visible metastases. My surgeons were truly gifted; Dr. Glen Hiss, a gynecologist and Dr. Elizabeth Gerson, a gynecologist oncologist. Ovarian cancer can be highly aggressive so I started chemotherapy twelve days after the surgery. After consulting with my oncologist, Dr. Jay Wittenkeller, I choose the standard treatment: Taxol and Carboplatinum with an additional new drug on an experimental protocol, adding two more cycles than usual for the full treatment.

The Healing Begins

To jumpstart my shocked intestines after surgery, I began getting acupuncture and gentle cranial-sacral osteopathic treatments, and followed a homeopathic treatment for recovery from trauma, which included a rice based protein supplement with Astragalus (to enhance immunity) and Milk Thistle (to improve liver function). I took a multivitamin, Vitamin E and Coenzyme Q10 throughout treatment and also discovered the power of Alpha-lipoic Acid and Evening Primrose Oil to treat diabetic neuropathy.

I lost all my hair and became very tired and moderately anemic after each chemotherapy cycle, so I learned how to give myself shots with Nuepegen, the bone marrow stimulant for white blood cells. But thankfully, I never had a major infection and was even able to do a bit on our little farm with my husband's supportive help. We would take a short trip on my “good week” before the next chemo cycle.

To maintain my strength and flexibility I did yoga every day that I could. I also made tapes that focused on the healing abilities of my surgeons to get rid of the cancer cells, and played one during my surgery. The love of my husband, family and friends has been tremendously supportive. One friend had 1000 lamps lit for me in a Tibetan Buddhist temple in Nepal. Another friend organized meal delivery to us two to three times a week. I have always been a very self-sufficient person so I had to learn how to graciously accept all the help offered.

I was fortunate because the cancer was discovered before it invaded any major organ or vessel. It is now a year since my surgery and six months since I had my last chemotherapy treatment, and I am doing better every day. My neuropathy is slowly improving. My hair has grown back in gray (a sign of wisdom) and very curly (the world's most expensive perm). Next month will be one year since I was diagnosed. I am in the process of opening my own practice with a focus on acupuncture, and coping with chronic illnesses, including cancer. And I’ve learned perhaps the greatest lesson of any life threatening illness.

Every healthy day is truly a gift.
And I deeply appreciate every day
of my life that I’m cancer free.
- M Ream

Marilyn Ream, MD is a family physician who has practiced at Group Health Cooperative in Spokane, WA for 15 years.