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Ovarian cancer, the silent killer
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By Ernest Gurulé

It’s easy to understand why patients at Denver’s Clinica Tepeyac are so comfortable with Dr. Patrick Huffer. He has that combination of kindness and compassion that patients can only hope for. It comes in handy when the job is really hard, like those times when he has to deliver bad news. Really bad news.

“Once I have a sense of where the patients is at, both emotionally and knowledge-based, then I can share the news.” But nothing, said Huffer, is harder or as sad as when the diagnosis he must deliver is ovarian cancer, the deadliest form of gynecological cancer among women in the U.S. and the fifth leading cause of cancer deaths among women.

While these conversations between himself and his patients have been infrequent, when this kind of diagnosis needs to be held, Huffer said “we do it in a way that respects the gravity of what we’re talking about” and “in a place where I won’t be interrupted so I can answer all the questions they may have.”

This year ovarian cancer will kill around 14,000 women in the U.S. The overwhelming number of new cases will be diagnosed at an advanced stage. The National Ovarian Cancer Coalition says that one in 78 women between the ages of 35-74 will be diagnosed with this condition this year.

Ovarian cancer will also have a disproportionate impact on Latinas, especially immigrant Latinas. Awareness of this strain of cancer, called ‘the silent cancer,’ is often higher in these communities because of a lack of basic anatomy knowledge, risk factors, genetics and health options available to them. Breaking through language differences between doctors and patients also presents a fundamental problem. Clinica’s Dr. Huffer is bilingual and speaks to many of his clients in Spanish.

Cancer begins when abnormal or mutant cells gain a foothold in the body. These cells’ behavior is the reverse of normal cells whose job is to simply replace older or worn out ones. But when cancerous cells take over, they grow or mutate uncontrollably and can spread to other parts of the body.

There is a pretty simple reason why ovarian cancer is often found so late. “It has to do with the fact that a lot of the symptoms that women have are so non-specific,” said Huffer. It’s often masked by “other routine illnesses they might get from time to time,” things as common as constipation or abdominal bloating, even digestive issues. “People can go along with their life and really not know,” he said.

Ovarian cancer has other precursors that doctors warn should not be ignored. They include abdominal pain or pressure, loss of appetite and feeling full too quickly, irritated bowel, frequent urination and unexplained vaginal bleeding.

Too often with ovarian cancer, detection is just the beginning of a sad ending. Survival rates in these cases, Huffer said, can be less than 25 percent at five years. On the other hand, with a cancer like this, there are a few silver linings. Caught early, survival rates, he said, “can be over ninety percent over five years.”

There are a number of forms of cancer whose survival rates have improved markedly over the last twenty years, including breast, colon cancer and melanoma. But experts says there is a day/night difference between early and late detection.

A study conducted in the United Kingdom found an 80 percent survival rate of at least 10 years for those diagnosed with a stage one cancer. Those whose diagnosis was made at stage four had only a five percent survival rate.

Today there are routine cancer tests that have yielded dramatic improvements and extended lifespans for countless numbers of victims. That, however, has not been the case with ovarian cancer. “It’s just challenging to screen for,” said Huffer.

Because it is such a stealth form of the disease, Huffer said it’s important for women to be proactive in guarding their own health. “For anyone who has had ovarian cancer in the family, it’s important to bring it up” with their doctor. But, he added, providers should also ask questions.

Ovarian cancer has long befuddled and frustrated science but a just released study by the University of Colorado may provide a ray of light and offer hope in this seemingly endless war. The study seems to show a decrease in ovarian cancer among women who use IUDs for birth control. The study was published in the scientific journal, Obstetrics and Gynecology. It indicates that the use of hormonal or metal-based IUDs show a reduced risk of cancer by 15 to 32 percent.

“We were obviously very pleased,” said Dr. Saketh R. Guntupalli who designed and conducted the study. The study took place “over several months” and involved more than 500 trials, said Guntupalli. But he cautioned that the study is not reassurance that the IUD can prevent ovarian cancer. “As we spend more time and money on these type of things we’ll know more. We need to invest in research.”





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