Examine Yourself: 'I thought I was too young to have cancer'

Examine Yourself: 'I thought I was too young to have cancer'
Marian Duggan, Cahir, Co Tipperary, who was diagnosed with ovarian cancer when she was 26. She is now five years cancer-free. Picture: John D Kelly

Marian Duggan was in her 20s and could not imagine that her symptoms could be so serious, not even when a tennis-ball-size cyst was removed from her left ovary, says Helen O’Callaghan.

MARIAN Duggan celebrated her five-year, cancer-free milestone this month by going to the novena at Holy Cross Abbey with her mother, Teresa.

“I’m not overly religious, but I’d also gone there the weekend after I was diagnosed with ovarian cancer,” says the 31-year-old primary schoolteacher. She was in her mid-20s when she was diagnosed and hadn’t thought that her symptoms at that age could indicate cancer.

“That’s the scary thing,” she says. 

You doubt yourself at that age — you think, ‘ah, I’m grand’. And the doctors tend to see you as too young, too.

For about a year pre-diagnosis, Marian, from Cahir, Co Tipperary, had felt full really quickly when eating. She had pelvic pain (“a kind of drag, a low pelvic pull”) and frequent urination. She attributed some of this to irritable bowel syndrome, but the frequent urination was “jumping out” at her.

“If I had to go on a car journey for an hour, I’d go to the toilet before leaving and again during the journey. It was this that made me say it to the doctor. I genuinely felt there was something amiss inside me, something off, but I never thought cancer.” Referred for ultrasound, the scan found a large mass on her left ovary. Following laparoscopy, doctors told her they’d removed a cyst the size of a tennis ball. “It alarmed me that it had been that size,” says Marian, who took her gynaecologist’s advice to “go home and recover.”

Back at school, her principal summoned her one day. “I walked into her office and my sister, Elaine, was there. I got such a fright. I knew by her something was up. I asked about every member of my family — and then there was only me left.”

Her sister explained that the hospital had tried phoning Marian, had spoken to the girls’ dad and he’d wanted Marian to know before the hospital rang again. “Elaine said, ‘they’re after finding something a little nasty, but you’ll be fine’.” Marian had never suspected that the cyst they’d removed — when biopsied — would reveal cancer. “I was in complete and utter shock. It was like it was happening to someone on the other side of the world, far away from me.”

Her dad, Michael, accompanied her to the doctor. “The doctor was lovely, very gentle. He explained that what they’d taken from the ovary was a tumour. It was stage one and localised to just that area, which was a blessing.” Marian had further surgery to remove her left ovary and fallopian tube.

A biopsy was taken to make sure nothing had spread from the previous surgery. “I was very emotional and very hard on myself at that time. I kept telling myself I should be more grateful, but I felt a void, a loss, a grief for that part of my womanhood.”

Marian — who goes for check-ups every six months and will soon go just once a year — says she’s only starting to regain confidence now.

“For the last few years, I was constantly worrying if I had any little pain. I was in and out of the doctor like a yo-yo. I still worry about fertility, but I’ve been told I’ve as good a chance as anyone else.” Her advice to other women is to listen to your body and trust your instincts. “If something’s niggling at you, just go to the doctor.” Approximately 400 women in Ireland are diagnosed with ovarian cancer every year. Sadly, it has a high mortality rate: 270 women die from it annually.

EARLY detection is vital, but it’s a difficult-to-detect cancer, because — unlike bowel or breast cancer — there’s no screening tool for it, says consultant medical oncologist at CUH, Professor Seamus O’Reilly. “When most people present, they have symptoms, unless it’s found by accident.”

According to Joan Kelly, Irish Cancer Society cancer support manager, risk factors for ovarian cancer include: getting older — it’s most common in women aged over 65; inherited faulty genes — five to 15 out of 100 ovarian cancers are due to this; women with a mother/sister diagnosed with ovarian cancer have around three times the risk of ovarian cancer, compared to women without family history; about four percent of ovarian cancers are linked to HRT — however, the increase in risk is small and HRT is helpful for many women with menopausal symptoms.

O’Reilly says that while 50% of all cancer is preventable — e.g. 85% of lung cancer is due to smoking and cervical cancer is 100% due to the HPV virus — only four or five percent of ovarian cancers are preventable, mainly by identifying families at risk.

Ovarian cancer symptoms include a bloated feeling, reduced appetite, feeling full more quickly, abdominal or pelvic pain most days, and changes in bowel or bladder habits, e.g. constipation or needing to pass water urgently.

“Symptoms are often vague and can be mistaken for other things,” says O’Reilly, adding that there is some good news about new treatments: PaRP inhibitors prevent cancer cells from being able to repair themselves and new immunotherapy drugs are available to patients in clinical trials.

- Visit https://www.cancer.ie/cancer-information/ovarian-cancer#sthash.H1yC9WBF.dpbs.

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