Silent No More

Ovarian cancer has long been known as the “Silent Disease”

One day in the fall of 2010, Barbara Eshelbrenner noticed some bloating. It as right around her belly, a trouble spot for many women, and she remembers thinking, “Oooh, I need to stop eating so many desserts.”

She is a lean woman, fit and trim at 63, but it’s not surprising that she ignored it. Who doesn’t get a little puffy from time to time? What Barbara shrugged off as casual weight gain, however, turned out to be the first warning sign of ovarian cancer. “And I didn’t even have a clue,” she says.

It was two months later, on Thanksgiving Day, when more troubling signs emerged after Barbara had dinner with her family.

When she got home and hauled the dishes of leftovers inside, she was out of breath. “Like I’d run up a flight of stairs,” she says.

The sensation was puzzling, because Barbara is normally as healthy as an ox. She likes to brag that she’s never been sick in her life. She has the indomitable, can-do spirit of a woman who’s very accustomed to getting things done. She has two adult sons and runs a FASTSIGNS business in Dallas with her husband, David, one son, and a daughter-in-law. And yet, for the next three days, she struggled to breathe.

On Monday, she went to her doctor and was shocked to find herself whisked off to the emergency room of a south Dallas hospital. What initially looked like a collapsed lung turned out to be something more troublesome. Subsequent events are a blur: There were long needles and various attendants and a battery of tests. Eventually, her doctor delivered the news: ovarian cancer, stage 4. Her tumor was the size of a baseball and had spread to the lining of her lungs.

Barbara was thunderstruck. “How is that even possible?” she thought. “How can you have a tumor that big when you don’t even feel a thing?”

What’s normal?

Ovarian cancer has long been known as the “silent disease” for this very reason. But more recently, studies have revealed there are indeed warning signs.

Unfortunately, they are so common they are often ignored or misdiagnosed: bloating; changes in urinary habits; abdominal or pelvic pain; feeling full easily.

It can be confusing. What constitutes normal behavior, and what constitutes a concern you should discuss with your gynecologist?

“Look at the number of days it’s occurring,” advises Debra Richardson, M.D., Assistant Professor of Obstetrics and Gynecology at UT Southwestern, who would eventually treat Barbara. “We’re looking for an acute change. For example, you never had any bloating before, or just a few days a month, and now you feel bloated most days of the month.”

The incidence of ovarian cancer nationwide is about one in 70 females. Meanwhile, breast cancer’s incidence is one in eight, which is partly why it’s become part of the national conversation. But raising awareness about ovarian cancer is key to fighting it. More than 22,000 women in the United States will be diagnosed with ovarian cancer this year, and another 15,500 will die from the disease, according to the American Cancer Society (ACS).

To date, there has been no effective screening exam developed for ovarian cancer, so it’s often caught in its late stages, when treatment is less effective. A woman diagnosed with early stage ovarian cancer has a five-year survival rate of about 90 percent, according to the ACS. For a woman diagnosed with advanced-stage ovarian cancer, the five-year survival rate falls to about 30 percent.

That’s what Barbara had, and she was terrified. Five years didn’t sound like a long time. “The first thing I thought of was my husband,” she says, starting to cry again, just thinking of the shock. “We’ve been married 42 years, and I thought, I can’t celebrate our 50th wedding anniversary. I have a granddaughter who’s 3 1/2. I can’t watch her grow up.”

She had a complete hysterectomy at a medical facility in Dallas and was told that most of the cancer was gone, but not all of it. What did that mean? What should she do next? She was confused and in the dark. Before launching into chemotherapy treatments, she decided to seek a second opinion at UT Southwestern — and that’s when the clouds started to part.

Remarkable results

Barbara’s face lights up when she talks about Dr. Richardson. She had the kind of clarity and expertise that Barbara desperately needed. Trained in gynecologic oncology at The Ohio State University, Dr. Richardson held Barbara’s hand and told her exactly how she thought they should proceed: a clinical trial to aggressively treat her late-stage cancer with weekly chemotherapy sessions and bevacizumab (Avastin), a medication that disrupts the growth of cancer cells.

The results were remarkable. Barbara didn’t even get sick from the chemo. The scariest thing was that she lost her hair. “I looked like an alien,” she says, remembering the clumps that fell out in the shower, a small price to pay for the gift of life. She got a good wig. She got over it. Two years after her diagnosis, Barbara can’t believe how wonderful she feels. Her numbers are good. The small amount of cancer that remains in her body has not grown.

“I always tease and say, they must have me mixed up. I don’t really have this. Because I feel too good!” Barbara says.

She and David have been traveling, enjoying their time together. They rode Harleys around Arizona. They took a boat ride in the Ozarks. They visited friends and family in Florida and California.

What Barbara wants now is for other women to know what she did not. “The other day I was watching the Cowboys game, and I saw pink ribbons everywhere,” she says. Barbara is trying to tinge the world in teal, the color of ovarian cancer awareness. She wears a teal bracelet around her wrist. Recently, she participated in a fundraising walk for the National Ovarian Cancer Coalition, and her daughter-in-law made brownies with a teal ribbon on top.

She wants women to talk about the symptoms that could indicate ovarian cancer and wonders why some gynecologists don’t raise the issue.

“I know they don’t want to freak people out,” she reasons. “People get paranoid. But why don’t they stick that information in the back of your mind?”

Bloating. Changes in urinary habits. Abdominal or pelvic pain. Feeling full easily.

That’s the message that Barbara wants to send to the world — awareness. This past Thanksgiving, two years after her world cratered, she had a lot to be thankful for.