If anybody would be surprised by a health problem, it would be Nadine Kenkel.
“I was the picture of health,” said Kenkel, 55. “I exercised six, seven days a week for 45 minutes. I got my blood-analysis screening done every year. I had my yearly mammogram. I had my yearly Pap smear and pelvic exam.
Some of the potential signs and symptoms:
» Pelvic or abdominal pain
» Trouble eating or feeling full quickly
» Feeling the need to urinate urgently or often
Other symptoms can include:
» Upset stomach or heartburn
» Back pain
» Pain during sex
» Constipation or menstrual changes
If symptoms persist for more than two weeks, the coalition recommends that women see their physicians.
“I knew I was doing everything in my power to monitor myself for disease and to prevent disease. I ate a fairly decent diet. And I was a registered nurse for 31 years at the time.”
But in April 2010, she was diagnosed with stage 4 ovarian cancer.
Ovarian cancer sneaks up on many women because symptoms, especially early in the disease, are vague and not intense. And there's no screening test for the disease. By the time most cases are identified, ovarian cancer is in an advanced stage, when five-year survival rates are low.
This year, the American Cancer Society estimates, more than 22,000 new cases of ovarian cancer will be diagnosed in the U.S., and about 14,000 women will die of the cancer. It's the fifth-leading cause of cancer death in women but is the deadliest of gynecologic cancers.
Kenkel has decided to share her story with other women in hopes that getting them to pay attention to symptoms they otherwise might dismiss — persistent bloating, pain or fatigue, for example — will help them avoid her condition.
The Earling, Iowa, mother of two has spoken to about 600 women at various small and large gatherings over the last year and a half. And she has started a group called Kenkel Kure that has raised money to increase awareness.
Kenkel must start a third round of chemotherapy sometime, but she said she's feeling good now. Proceeding with chemo right away or waiting until a scan shows a change in her cancer won't alter her long-term prognosis, she said.
Dr. David Crotzer, a gynecologic oncologist who is Kenkel's doctor, said the main risk factor for the cancer is age. As women get older, he said, they're more likely to get ovarian cancer. Obesity, a family history of ovarian, breast or colorectal cancer, estrogen therapy and having never had a baby also are among the risk factors. Use of oral contraceptives, having had a tubal ligation or hysterectomy, breastfeeding and a low-fat diet have been shown to lower the risk by varying degrees.
Researchers from MD Anderson Cancer Center in Houston reported in the journal Cancer last month that a two-step screening strategy may hold promise for early identification of the cancer among postmenopausal women. The approach involves long-term monitoring of changes in levels of carbohydrate antigen 125, a tumor marker, followed by transvaginal ultrasounds if indicated.
The trial's principal investigator and co-author, Dr. Karen Lu, said in an interview on MD Anderson's website that while encouraging, the study results aren't definitive or sufficient to change current practice. Researchers, she said, must wait until 2015 to review results of a large, randomized trial underway in the United Kingdom that uses the same risk-evaluation method.
Kenkel was at Methodist Hospital this week to offer support to a friend, Holli Fessler of Omaha, who also has ovarian cancer. The two hit it off when they met at an ovarian cancer survivor support group meeting, and both joked with the group about the colostomies their cancer surgeries had required.
Fessler, 53, is on her fourth round of chemo. She spearheaded the organization of the support group, which she said has provided her with useful information and an emotional lift. It also has allowed her to make new friends, such as Nadine, who has experienced similar struggles.
“It's just nice to have her come in and sit with me and visit,” Fessler said. “Having that personal touch there is pretty darn nice. It means a lot more than I can say.”
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• Nadine Kenkel supports Colleen's Dream
• Find out more about ovarian cancer and the fight against it: National Ovarian Cancer Coalition