Stories of Hope
Ovarian Cancer Survivor Finds Hope in Clinical Trial
Article date: August 8, 2007
"You just do what you have to do."
In December 1999, Irene Rathermel couldn't button her pants, and it wasn't because she had been eating too many holiday treats. She felt bloated and tired, and didn't have much of an appetite.
Where others might have ignored these symptoms, chalking them up to seasonal overindulgence, or at least put off an appointment until the New Year, Rathermel, then in her mid-60s, decided to get checked out.
She had worked for years as a patient accounts representative in physician's billing at The University of Wisconsin Medical Foundation in Madison, WI, and while there, she had learned the value of paying attention to warning signs. "If you don't take care of you," she says, "no one else will."
Rathermel called her doctor's office at the University of Wisconsin and made an appointment for the next day. It turned out to be a smart move.
A Difficult Season
In the exam room, Rathermel's doctor discovered a large amount of fluid around her stomach and immediately ordered an ultrasound. Soon after, Rathermel learned she had stage III ovarian cancer. Instead of enjoying the holidays with her family, she would soon be facing surgery.
That January, Rathermel had a hysterectomy; her ovaries and a sizable portion of her omentum, the membrane that lines some of the organs in the abdominal cavity, were also removed. Because the cancer had spread throughout her abdomen, her doctor also performed cytoreductive surgery, or debulking, in which he removed as much cancerous tissue as possible, priming the area to better receive chemotherapy or radiation. The only good news was that the cancer had not yet reached her lymph nodes or distant sites in the body.
Ovarian cancer is very treatable when it's caught early, but unfortunately, the vast majority of cases aren't diagnosed until it's too late, mainly because the symptoms of ovarian cancer are vague and often confused with other conditions.
Even though Rathermel did the right thing by reporting her symptom to her doctor, her cancer had already spread significantly.
About 76% of women with ovarian cancer survive at least 1 year after diagnosis, and only 45% survive longer than 5 years after diagnosis. Rathermel's prognosis wasn't good.
Hope on the Horizon
At the suggestion of her physician and with the blessing of her family, Rathermel decided to look into clinical trials. Her doctor had heard about a large trial involving intraperitoneal (IP) chemotherapy. She decided to go for it.
Unlike the standard intravenous (IV) method of delivering chemo, IP therapy is given directly into the abdomen. In Rathermel's case, a catheter and pecan-sized port were placed directly into the left side of her abdomen. She was also given standard IV chemo.
The combined effect was very hard to tolerate, but Rathermel didn't look back. "You just do what you have to do," she says of the chemo.
She lost her hair and her energy, but through it all, Rathermel stayed positive. "I have strong family ties and a strong spiritual life. I never doubted things would be OK."
Her optimism paid off. Rathermel is cancer-free after 8 years.
Her work experience also taught her the value of follow-up care. "You've got to stay on top of it," she says.
Every three months, she goes in for a CA-125 test, a blood test of a tumor marker for ovarian cancer. While there's some controversy about using CA-125 as a screening tool because it can be elevated by conditions other than ovarian cancer, there is considerable evidence that the amount of this protein in the blood is higher in many women in advanced stages of the disease.
In fact, in 2002, it was this test that tipped her doctor off to the presence of some cancer cells in her right abdomen. This time, Rathermel took altretamine (Hexalen), a type of oral chemotherapy, for 6 months, and continued to work all the while. Her CA-125 levels have now returned to normal levels.
A 'Walking Miracle'
And while she considers herself a "walking miracle," it's clear that her extraordinary vigilance, optimism, and strength played no small part in beating the odds. Ms. Rathermel is currently enjoying retirement in Friendship, WI, and plans on getting more involved in expanding the network of survivors in her area.