it whispers.

I haven't written recently....I've been applying to jobs, contemplating oncology nursing, and missing family. And, unfortunately, worrying. Last night my aunt - my only aunt - was diagnosed with ovarian cancer and primary peritoneal carcinoma. PPC is similar to epithelial ovarian cancer, it reacts the same to treatment, etc. It's just in the peritoneum, or the lining of the abdominal cavity. Her surgery - TAH +BSO, and any debulking, will be done tuesday, and we should know the Stage better by then....although the doctors have hinted of spread. She had 7 pounds of ascites drained from her abdomen....and the docs said it will likely come back. This can be a sign of advanced disease. 

She went to her doctor a few months ago, with a bloated abdomen, fatigue, constipation....and like many doctors, he didn't suspect ovarian cancer. He told her it was likely high cortisol levels from her stressful job. He didn't do a transvaginal ultrasound or anything - most docs don't. As they say in medicine, "when you hear hoofbeats, think horses, not zebras." Unfortunately, ovarian cancer is a bit of a zebra. Many women are told their symptoms are just part of getting older, or stress, or they're worked up for GI problems....this is why the majority of women who are diagnosed with ovarian cancer present with advanced disease. It's been said that ovarian cancer "whispers", because its symptoms are so quiet and nonspecific.  

I am struggling with not saying too much to my cousin, her son, who seems to think she's Stage I or II. Of course he wants to believe this - he needs to. He's going to be a father in a month, and needs his mother to be around and well. I am fighting to choose hope. I keep reminding myself statistics are just numbers. I am hoping for optimal debulking. I am hoping the chemotherapy that we have - most likely, I assume she'll be treated with a platinum-based drug, like carboplatin/cisplatin, and paclitaxel - isn't too harsh and will actually do its job. Like Jerome Groopman has written, "It is hard to be a person of faith and a person of science." I struggle with that all the time, and even more so now. 

But honestly? My first reaction is neither mature or logical. My first reaction is what the fuck? Two people in my family in less than a year are diagnosed with cancer? This has got to be some sort of mistake. My family is not that big to have these statistics. My first reaction is to rail against G-d, to turn my back on prayer and faith, and to get angry. But then I settle down, and I know that G-d did not do this, that renegade cells did this, and prayer might help. 

Seriously, things like this reinforce my drive to be an oncologist. This is surreal. And, of course, now, when I got to doctors, I now have ovarian and breast cancer in my family. But they're on opposite sides of the family, and my aunt is not Jewish, so I doubt there's a risk of BRCA, since my grandmother tested negative. 

So, please, if you read this, please keep my aunt in your thoughts and prayers - I know you all did that for my grandmother, and she's doing super. :)  thanks.