Lisa Finucane and ovarian cancer: 'Listen to your body'

Cancer is still our bogey monster.

It can come out of nowhere – the fittest, most sugar-free, meat-free, fat-free, smoke-free people get hit. And the efficacy of treatment varies from person to person – success seems random. Cancer is the troll under the bridge that puts the fear of whatever god(dess) you do or don’t believe in, into you.

Last September, 12 years since I was first diagnosed with ovarian cancer, and following five operations removing, over the course of time: ovaries, uterus, cervix, omentum, spleen and parts of the liver, bladder, bowel and vaginal vault, two courses of chemo, two different hormone blockers (non-steroidal aromatase inhibitors), and a multitude of MRIs, CTs and blood tests, my low grade serous ovarian cancer ramped up. Yes, it’s serous not serious, but this was serious too.

No more operations, drugs not working, tumours spreading, cancer antigen 125 (CA125) markers moving from a respectable 14 to 480. The prognosis was gloomy. Good night, nurse.

Along with fast tracking a bucket list (a new front door edged out a return to Torquay) I started another course of chemo (six rounds at three-weekly intervals) along with a drug called Avastin – this one about $8,000 a pop until a threshold is reached, then it’s paid for by the drug company. Health insurance covered the first round.

“It doesn’t usually work for your type of cancer,” said the oncologist. “But there’s not much else so we’ll give it a try.”

Chemo isn’t a great experience, though being bald, sans eyebrows and eyelashes, does encourage kindness in random strangers. Exhaustion, ‘chemo brain’ and a constant vile taste are among the more sharable ones but with a hearty peasant-like constitution my tolerance is high – sometimes luck has been on my side.

And, luck seemed to kick in again. Not a cure by any means but the treatment, for the moment at least, has slowed things down and even reversed the severity, with tumours shrinking and the CA125 marker now a less scary 70 and falling.

Fun fact: University of Auckland Vice-Chancellor Professor Dawn Freshwater’s early days as a researcher in London were in ovarian cancer. She was part of the team that discovered the mutation CA125, which is a marker used for early detection and for ongoing monitoring of the progression of the disease.

So, in March I energetically celebrated a significant decade birthday, Torquay is back on the travel plans, and the front door surrounds might even get painted. This leads to the reasons I love my alma mater: its research (putting a plug in here for a bit of focus on the gynae cancers, particularly ovarian, please Auckland Cancer Research Centre). And a plug for Old Government House – an amazing venue on the City Campus for a special birthday party. There aren’t many places where you can dance surrounded by a great art collection.

The trouble with research, as colleagues will be too aware, is that it needs funding. And some areas get a bit more support than others. Breast cancer and even prostate cancer benefit from huge profile raising and related funding. Good on the drivers of this but, without begrudging them, it’s challenging to think that treatment for low grade serous ovarian hasn’t changed in the 13 years I’ve had it – largely because the funding isn’t there for research and development. And there’s the issue of women’s cancers being overlooked and gynaecological cancers being harder to bring into the public space (face it, you probably cringed a bit at the earlier mention of vaginal vaults).

Not very fun fact: ovarian cancer takes the life of one woman in New Zealand every 48 hours.

Unfortunately, it’s likely that more than half of women incorrectly believe a pap smear can detect it, and symptoms are often put down to menopause, irritable bowel syndrome, or just ‘women’s issues’ (yes, still). Often by the time it’s diagnosed, it’s at stage three or four, where the outcome is not ideal.

Broadly speaking, symptoms include bloating, feeling full, pain in the abdomen, pelvis or back, and needing to pee more. Others might include indigestion, painful intercourse, tiredness, unexpected weight loss, changes in bowel habits and abnormal bleeding. The best detection is listening to your body and talking to your GP, ensuring they take ovarian cancer seriously as a possible cause.

Of course there is work going on in this space: about five clinical trials for women with ovarian cancer in Aotearoa, more than 40 in Australia and hundreds around the rest of the world. There are some amazing women in the medical profession (big shout-out to University of Auckland honorary senior lecturer and clinical research fellow, Dr Michelle Wilson) and in private life who are driving awareness raising and fund raising – mainly because of personal experience. (For further information and support, see two good websites, cureourovariancancer.org and talkpeach.org.nz)

And yes, I know I’m writing from a position of health insurance, extraordinary support and a privileged background that equips me to challenge professionals, seek alternatives and understand options presented. I’m pretty relaxed discussing reproductive organs in mixed company, even when the company is not so thrilled with the topic. Not everyone has these advantages. Even with them, ovarian cancer – any cancer – is not for the faint hearted.