New Hope for the ‘Silent’ Cancer

It’s vital to pay attention to ovarian cancer symptoms and risk

Celebrating life

Sabilla “Cookie” Lightcap is a vibrant survivor of ovarian cancer, thanks to a new treatment she received when it was still experimental. She’s doing her spring plant-shopping at Dan Schantz Greenhouses in Allentown.

Ovarian Cancer Symptoms

• Pelvic/abdominal pain or discomfort
• Nausea, gas, diarrhea, constipation, pressure, cramps, indigestion
• Frequent urination
• Weight gain or loss
• Pelvic/abdominal swelling, bloating or feeling of fullness
• No appetite
• Abnormal vaginal bleeding
• Ongoing unusual fatigue
• Changes in bowel habits

It felt like sharp pinches in her lower abdomen — but by the time Sabilla “Cookie” Lightcap had registered the feeling, it was gone. She also was gaining weight around the middle and urinating more frequently. After three months of subtle symptoms like these, the 64-year-old Kutztown woman told her doctor something wasn’t right.

It was November 1999, and Lightcap and her family prayed a lot that Thanksgiving. Today, they’re giving thanks that she’s beaten the odds and is living a full life, thanks in part to treatment recently endorsed by the National Cancer Institute (NCI). What she thought might be a cyst turned out to be stage III (advanced) ovarian cancer.

Her experience is unfortunately common, says gynecologic oncologist (women's reproductive cancer specialist) Martin Martino, M.D., of Lehigh Valley Hospital and Health Network. “Nearly 70 percent of women with ovarian cancer are not diagnosed until the cancer is at an advanced stage,” he says. The five-year survival rate in these cases is 20-30 percent, compared to nearly 90 percent for stage I disease.

“Ovarian cancer is a ‘silent’ disease because early symptoms are vague or non-existent. Currently we have no reliable screening tests,” Martino says. “If you experience symptoms that are constant or get progressively worse over four to six weeks, see your doctor and ask about your ovarian cancer risk factors.”

All women are at some risk for developing ovarian cancer, especially as they age, says Martino’s colleague, Waleed Shalaby, M.D. You may be at higher risk if you’ve never been pregnant, have never used birth control pills or have taken estrogen. But the greatest risk comes through your genes.

“Your risk increases if you have a family history of breast, ovarian, endometrial, prostate or colon cancer, or you carry a gene mutation called BRCA1 or BRCA2,” Shalaby says. “If you carry that gene, you’re not only three to seven times more at risk for breast cancer, you also have about a 40 percent chance of developing ovarian cancer.”

Because this cancer is so hard to detect early, you may want to consider genetic testing if you have ovarian cancer in your family. “If you do have the gene, you’re alerted to watch for symptoms, have yearly pelvic exams and closely monitor your breast health,” Shalaby says. “Women carrying BRCA (1 or 2) also may consider having their ovaries and tubes removed preventively. This has been shown to reduce risk by 96 percent if disease has not occurred.”

Ovarian cancer in the early stages is treated with chemotherapy. In advanced cases, surgery is performed first to remove as much of the cancer as possible. The NCI now recommends that when possible, patients receive chemotherapy directly in the abdomen (intraperitoneal, or IP) as well as the traditional intravenous (IV). A major study has shown that on average, women with advanced cancer receiving IP and IV chemotherapy lived about 16 months longer than those on IV alone. Lightcap was part of the study.

“I knew I might not make it,” she says, “but I hoped they would learn from my experience, and that could help other women. It was rough, but here I am, living proof that miracles happen and science works.”

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