Like any grandparent helping a daughter with a new baby and two active toddlers, Barbara Shellow was busy: changing diapers, giving baths, reading stories and playing games. The routine had her huffing and puffing, out of sorts, tired, losing weight.
But the Bel-Air grandmother didn't give much thought to those symptoms 11 years ago. It was Idaho, in winter. "I blamed it on the altitude, the weather, and running around after three little kids," she says.
Like the majority of women who are eventually diagnosed with ovarian cancer, Shellow's symptoms -- fatigue, bloating, stomach upset, changes in bowel habits, loss of appetite -- were as vague as they are common. She chalked them up to life and, like so many women with the disease, waited too long to go to the doctor.
The very banality of this cancer's early symptoms is what makes it so deadly -- that and the fact that there is no early-screening tool, such as a mammogram for breast cancer or a Pap smear test for cervical cancer, to either reassure women that they're healthy or find cells at early and highly curable stages.
As a result, the majority of women diagnosed with ovarian cancer are already in the late stages, 3 or 4, meaning it has already escaped the ovaries.
"Ovarian cancer is our albatross in ob-gyn oncology," says Dr. Beth Karlan, director of the Women's Cancer Research Institute at Cedars-Sinai Medical Center. But with care, some patients will see more years than they dreamed possible when they first heard the dreaded diagnosis.
"Ten additional years is nothing to sneeze at," Karlan says. "And the beauty of it is seeing how some of these women live each and every day of those added years."
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Silent invader
Ovarian cancer's stealthy onset makes it far more worrisome than its prevalence would indicate. There are 22,000 cases diagnosed each year, and a woman's lifetime risk of ovarian cancer is about 1 in 70. That compares with a 1 in 8 lifetime risk of breast cancer. "It's an infrequent disease," says Dr. Carmel J. Cohen, professor of gynecology at the Mount Sinai School of Medicine and co-chairman of the Ovarian Cancer Research Fund.
But compared with breast cancer, the risk of dying from ovarian cancer hasn't improved much in the last 30 years. From the late 1970s to today, the five-year survival rate for breast cancer rose from 75% to 89%. In that same time, five-year survival rates for ovarian cancer went from 38% to 46% today.
