|
|
|
|
Current Issue |
|
|
On the Edge - Page 1 At almost every twist and
turn of Sean Patrick's unique odyssey through the land of ovarian cancer,
traveling the beaten path would have been a deadly decision. Instead, in a
relentless search for answers, she found options where none initially seemed
to exist and managed to beat the odds. Sean Patrick, a business
strategist and extreme sports enthusiast from Yet Patrick noticed that
her stomach was no longer flat. She awoke in the morning hours suffering
severe indigestion. She was aware of ovarian cancer. Could that be the cause?
As part of her search for an answer, she called her internist and insisted on
a blood test for CA-125, a protein that is often found at elevated levels in
ovarian cancer and some other conditions, including endometriosis and benign
ovarian cysts. Patrick's doctor warned her that the test was hardly
definitive, but went ahead anyway; her resulting measurement was a mere point
above normal. A subsequent ultrasound showed some normal cysts, apparently in
the process of resolution. That explained the discomfort, and the blood test,
too, her doctor said. The next year another
ultrasound revealed new cysts and Patrick's CA-125 levels soared some 20
points. She continued to feel sick and in 1997 insisted on testing her CA-125
again. With the level still rising, Patrick badgered doctors to conduct
exploratory surgery to see what might be wrong. "They didn't think it
was warranted," she says, "so I had my lawyers draft an agreement
that would protect them, and they finally agreed." Malignant tumors were
found in the peritoneal cavity and the small bowel, and her ovaries tested
positive for cancer. Now Sean Patrick had a diagnosis: a rare form of ovarian
cancer, micro-papillary serous carcinoma, stage IIIc. Her oncologist told her
that immediate chemotherapy was her only hope, but Patrick decided to take a
couple of weeks to decide. She purchased a compilation of scientific
literature, making a list of experts studying her type of cancer, which had
re-cently been identified at the For this kind of cancer,
said Kurman, standard chemotherapy, the sort other
doctors recommended, had little chance of helping at all. The reason was
simple: The chemo, given every three weeks, worked by killing cancer cells as
they divided. It could be given only so many times before a cancer became
resistant and would not respond. Because normal ovarian cancer cells divided
rapidly, the standard schedule of chemo was able to eliminate a significant
portion of a tumor with each new dose. But because low-grade micropapillary serous carcinoma divides so slowly, only
18 percent of the original cells would be gone before the therapy had run its
course; with the remaining cells resistant, the therapy would no longer be of
use. Outside the Box Grasping the reality of
her situation, Patrick promptly fired her oncologist and hired another
doctor, Keith I. Block, M.D., with a reputation for thinking outside the box.
Medical director of the By the time Patrick
arrived at Block's office in 1998, her CA-125 level had continued its upward
march yet again. First he suggested that she enter a clinical trial run out
of Realizing her cancer was
estrogen-receptor-positive (stimulated by exposure to estrogen), Block also put her on the estrogen-blocker tamoxifen. Finally, he prescribed thalidomide, a drug
once banned because it causes birth defects but more recently found to block
a tumor's supply of blood, thus slowing its growth. The combination therapy,
along with a program of nutrition, exercise and stress-reduction seemed to
work. Patrick did well and her CA-125 levels remained in check. Flight to Life Then, in 2001, while
Patrick was in training at |
|
|
|
|
|
Patrick
got on the phone and began hunting for options, eventually arranging to have herself airlifted on a "Flight to Life" jet to
the "He
said my scans looked really bad, and growth was everywhere," Patrick
recalls. Montz said he could put tubes in Patrick,
and she could live out her allotted weeks like that. Or he could try to
remove the tumor and resolve the obstruction, in which case the odds were
that she would die during surgery itself. Patrick thought about it, and concluded
she'd rather die under anesthesia than survive just weeks longer in a state
she hardly considered living. "Let's go for it," she said. Montz agreed. Patrick
did almost die as a result of the surgery. But after hovering between life
and death in intensive care, she pulled through. "If I hadn't taken the
risk, if I hadn't had a doctor willing to take the risk with me," she
says, "I wouldn't be here today." Neither
Patrick nor her doctors know why she's doing so well, but her disease remains
stable. She takes Aromasin, an aromatase
inhibitor, to suppress production of estrogen. And she also takes Celebrex, which may block key proteins essential to
cancer cell replication. A recent scan shows Patrick's cancer hasn't grown in
more than four years. If
Sean Patrick is any example, living with uncertainty about the future isn't
the same as giving up hope. A slim chance doesn't equal no
chance and, as Patrick states, "doing the homework" can often
increase one's odds. "I
don't think you can blindly go along when you are diagnosed with a cancer
beyond the early stage and just hope that treatment will cure you,"
Patrick sums up. "My life may depend in the future on keeping abreast of
the latest developments now." |
|
