Raising awareness about ovarian cancer: Prevention: If physicians had paid attention to Gail Purtan's concerns, she might have avoided disease or benefited from earlier detection.

January 17, 1999|By Patricia Anstett | Patricia Anstett,Knight Ridder/Tribune

Gail Purtan is such a private woman that she'd put a sheet over her head if it would help her go unnoticed, one of her daughters says.

A family-first kind of woman, she has spent her life supporting others' accomplishments, notably those of her husband, Dick, one of Detroit's most beloved radio personalities, and their six daughters.

But 18 months ago, Purtan's diagnosis with an advanced case of ovarian cancer changed her profile. "I feel I have no right to stay quiet when there is so much to tell women," she says.

Because she was diagnosed so late, she has a 1-in-5 chance of being alive five years after her diagnosis. She has lived 17 of those 60 months.

What's notable -- and important to relay to others -- is that Purtan got ovarian cancer even though she had surgery to remove her ovaries in 1993. An aunt had died of the disease and Purtan wanted her ovaries out as a safeguard. No one told her to get a simple blood test, called the CA125, one of the few tools to find the cancer. It often is wrong, so doctors don't routinely recommend it, unless a patient's mother or sister has had ovarian cancer.

Purtan's doctor refused her request to remove her ovaries 10 years ago when she had a hysterectomy. She can't help but wonder if she would have developed cancer had they been removed then.

Purtan's cancer was discovered after she had a sharp pain in her side. She went from doctor to doctor. Finally, a gastrointestinal specialist told her to have a CAT scan. The first scan didn't find it; the second did.

Purtan gave herself a day to mourn, then resolved to rid herself of every trace of cancer. Her surgeon, whose daughter died of ovarian cancer at 32, removed every tumor he could find that was the size of a dime or bigger.

But surgery often can't remove traces of cancer that can dot the abdominal lining, or peritoneum, adjacent to the ovary. That's how a woman without ovaries can get ovarian cancer.

Dr. Vainutis Vaitkevicius, an expert at the Barbara Ann Karmanos Cancer Institute in Detroit, says as much as 85 percent of ovarian cancer occurs in the surface lining of the ovary or the adjacent peritoneum, not the ovary itself. Surgery to remove ovaries as a safeguard, as Purtan had, can leave a smidgen of cancer, he says.

Purtan underwent four arduous rounds of chemotherapy that kept her tied to an intravenous pole five to six hours a day for most of six months. That was followed by exploratory surgery to be sure the cancer was gone.

Her husband is a prostate cancer survivor with a similar tale of physician misguidance. His urologist told him not to worry about an elevated reading on the prostate specific antigen blood test. After three elevations, he went to the Mayo Clinic for surgery in 1992. "We both fell through the cracks," he says.

The experience has made them activists. She urges women, particularly those with a family history of ovarian cancer, to get the CA125 test. It costs $60 to $125 and isn't covered by many health insurance plans.

Four tests can find ovarian cancer or indicate it might be present: vaginal ultrasound; the CA-125 blood test, which tracks a marker released from ovarian cells; a transvaginal color flow Doppler to locate blood vessels to cancer tumors; and a laparoscopy -- a surgical look into the abdomen.

Purtan decries the fact that the federal government's $20 million allocation for ovarian cancer research is $30 million less than the $50 million it will spend for Medicare recipients taking Viagra, the impotence drug. To make a difference, the Purtans have set up the Gail Purtan Ovarian Cancer Research Fund.

In the meantime, her wish for good health is elusive. "The further away from treatment, the more frightened you get," she says. "But I have not stopped living."

CUTTING RISKS

No one knows why women develop ovarian cancer, but Dr. Richard Barakat, a gynecologic oncologist at Memorial Sloan-Kettering Cancer Center, says the constant damage and repair caused by monthly ovulation may contribute.

Fertility drugs that trigger multiple ovulation may slightly increase risk, says Dr. M. Steven Piver, co-author of "Gilda's Disease," a book about ovarian cancer.

Breast-feeding is one preventive step, because it stops ovulation or suppresses other hormones.

"Taking regular birth- control pills reduces the risk by 40 percent to 50 percent," Barakat says, probably because they suppress ovulation.

So does pregnancy, which reduces risk by 40 percent the first time and by 14 percent for each subsequent pregnancy, says Piver.

-- New York Daily News

RESOURCES ON OVARIAN CANCER

* Conversations! newsletter. Diagnosed 6 1/2 years ago with Stage 3 ovarian cancer, Cindy Melancom began networking and founded this monthly newsletter, which offers hope, humor, tips on treatments and clinical trials. Call 806-355-2565, or write P.O. Box 7948, Amarillo, Texas 79114.

* National Ovarian Cancer Coalition: For educating women and doctors. 888-682-7426.

* Ovarian Cancer National Alliance: For information and advocacy for research funds. 202-530-2900. Web site: www .ovariancancer.org

* Ovarian Cancer Research Fund Hotline: 800-873-9569

* Gail Purtan Ovarian Cancer Research Fund: at Barbara Ann Karmanos Cancer Institute in Detroit, 800-527-6266, 8 a.m.-7 p.m. weekdays.

-- From wire reports

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