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Janice Paulshock I Live with Ovarian Cancer Four surgeries later, Janice Paulshock feels very fortunate. Seems odd considering she has battled ovarian cancer since 1999. What she is grateful for is advances in radiology, surgery and chemotherapy and the Johns Hopkins doctors who know how to use them. “They are the reason I am alive today,” she says emphatically. When she was first diagnosed at a community hospital with stage III ovarian cancer, her doctor didn’t offer her much hope. After surgery, a CT scan showed that her cancer was gone. However, her CA-125 blood test, which measures a blood protein that is usually elevated in a woman who has ovarian cancer, began to rise. Her doctor chose to watch and wait. Janice chose not to and headed to Johns Hopkins and a consultation with Robert Bristow, director of gynecologic oncology. “Don’t tell me how bad it is. I’ve heard all of that. Just tell me what you’re going do to fix it,” she told him. Giving up had never entered Bristow’s mind. He ordered a PET (positron emission tomography) scan, a more specialized and detailed scan, and a new tumor was found. Bristow performed surgery to remove the tumor and referred Janice to ovarian cancer expert Deborah Armstrong for chemotherapy with paclitaxel. Paclitaxel was one of the great research discoveries in ovarian cancer. In the mid-1980s, it was Kimmel Cancer Center researchers who developed delivery methods that allowed the drug to be tolerated by humans. After a series of clinical trials, it was hailed as the most promising new cancer agent in more than a decade. It is now part of standard therapy for ovarian cancer. The CA-125 blood test was another key development in ovarian cancer research, and now the so-called silent cancer was making some noise that resulted in earlier detection of both new and recurrent disease. In 2002, Janice had her third recurrence. By this time, however, laboratory research had revealed a new understanding of the biology of tumors. Understanding the specific characteristics of tumors allows clinicians to identify anticancer drugs to specifically target the biological mechanisms of tumors, killing cancer cells with far fewer side effects. This was the case with Janice. Bristow and Armstrong ordered an extensive study of her tumor and, based on the results, ordered outpatient chemotherapy with the drug gemcitabine. In 2005, Janice’s CA-125 began to rise slightly from 12 to 16. Even though it was within the normal range of 35 or less, Bristow sent her for a PET scan. He told her about research done by a Johns Hopkins fellow that found PET useful in detecting ovarian cancers when patients’ CA-125 rises three points or more, as hers had. Sure enough, the scan uncovered two small ovarian tumors. Janice recently completed the last of a 12-cycle outpatient treatment with another biologic therapy. “I feel great. I’m very active,” she says. “Life goes on. I know I have cancer, but I am active and feel healthy. I feel so good that sometimes I forget about my appointments until I look at the calendar. People need to understand that cancer is no longer this horrible, debilitating disease. It’s something you can live with.”
Rebecca Coder My ovarian cancer adventure began in late August of 2005. I had strange symptoms that I had never experienced – bloating of my stomach, shooting pain up and down my right side, indigestion and finally a slight fever on Saturday, August 27. My mother always said, “don’t mess around with a fever,” so off to the local ER my husband, Christopher, and I ventured. I was convinced I had an appendicitis. When the ER doctor returned with the blood results and said that was not the case, he gave me two options – either I could go home or I could have a CAT scan. I just knew something was not right and opted for the CAT scan. The result was an image that showed a large pelvic mass. The ER put me through some other pelvic tests and a sonogram. Finally, ten hours after arriving at the ER, Christopher and I departed with this rather cryptic diagnosis and instructions to schedule an appointment immediately with a gyno-oncologist. We gave the grapefruit-sized tumor a nickname, “sassy the massy.” We had a good cry that night and then Sunday got up and got to work. My family has two rules about dealing with potentially serious illnesses – always get at least two opinions and ensure the doctor is the best in the field. I began tapping my network of friends, family and doctors. I put together the short list of those who came highly recommended, all located in my home town of I met with the gyno-oncologist connected to the ER that Tuesday. He delivered the bad news, “more than likely ovarian cancer.” On Wednesday, I met with I was in surgery on Tuesday, September 6. Sassy the massy had spread. After eight hours of surgery, Dr. G and his team removed sassy and all the visible cancer -- optimal debulking as it is called. The final diagnosis, epithelial serous ovarian cancer, stage 3c. I was in the hospital for a week with a wonderfully caring and professional nursing team. The surgery, hospital recovery and first few weeks at home were a blur. I don’t think I was even able to read a newspaper until about week two after the surgery. And before I knew it chemotherapy started the third week of September. I was put on a three week cycle for a total of six treatments. Week one included an over night stay at Hopkins for the “big drip,” a 24 hour IV of Taxol followed by a four hour IP of Cisplatin so dubbed the “turkey basting” because at its completion, I had to spend 15 minutes on each side to ensure the chemo coated the entire abdominal cavity. Week two was outpatient turkey basting. Week three was freedom! After about eight weeks – six weeks for post surgery recovery and a few weeks of getting used to the effects of chemo, I began to add back in the normal aspects of life including returning to work. Of course, there were new experiences thanks to the chemo side effects. My top ten included:
Losing one’s hair is the most visible badge of honor many of us will have in fighting cancer. I deemed it “my science experiment.” After returning home from surgery and prior to starting chemo, I visited Luigi, my Italian hair therapist, who gave me a short do. Very cute actually. I think this step was harder for my mother than me. “Doesn’t this bother you?” she asked between tears. “Mom, I am happy to be breathing, talking and enjoying normal bodily functions.” Vanity was not top of my list at this point. Each evening, I would comb through the short do, watching a little more come out. I finally got to the point where endearing nicknames given by my husband became the norm. Most notable include:
Currently, I am in round two or what I like to call “chemo light” to kill a tiny cancerous microorganism found during my second look surgery. These chemo side effects don’t compare to round one. I walk to work every day. Jog on the weekends. Enjoy dinners out. Most of the time, I forget that I am fighting this, and then in a moment it hits me. “Holy Christmas, am I really going through this?” The most anxious times come when I am set to get results of some sort, especially the CA-125 -- currently a four (yeah!). Inspiration for me really comes from the depth of love, prayers and support from my fabulous husband, family, friends, co-workers and the team at And, I have a few quotes that I like to tap that puts it all in perspective for me… “It’s not whether you get knocked down, it’s whether you get up.” Vince Lombardi (1913-1970) “Yesterday is a canceled check: forget it. Tomorrow is a promissory note: Don’t count on it. Today is ready cash. Use it!” “Life shrinks or expands in proportion to one’s courage.” Anais Nin (1903 – 1977) So here I am, looking forward to seeing what the adventure of life holds next.
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