A Day of Poking, Prodding, and Cancerhead

Today was a fun-filled day at the hospital for pre-op tests and an ultrasound.

I've been feeling good since my bleeding episode a few weeks ago. In fact, I pretty much feel normal and for the first time in months, I've actually been able to exercise without bleeding. So, I went into the ultrasound mostly relaxed. (For ladies who haven't had one yet-- it's a virtually painless procedure, despite the fact that there is a camera up your hoo-hoo). And I stayed relaxed until the ultrasound technician brought the radiologist  in the room, and he asked me,

"Have you had a CT scan or an MRI?"

A perfectly reasonable question. However, to a cancer patient, "cancerhead" thinking obscures a rational response.

"CT scans and a MRI?! They must have found something suspicious. Has the cancer metastasized? They must have found something or else they wouldn't be asking me that, What did they find?! Do I have 24 hours to live?"

All of those thoughts ran through my head before I answered "No, not yet."

What did they actually find?

• two simple cysts on my ovaries (no concern, not cancer)
• A big-ass fibroid that is attached to my uterus like a conjoined twin.  

What did they not find?

• Evidence that I'm dying tomorrow 

An important reminder -- just because you've been diagnosed with cancer, doesn't mean that cancerhead is right. 

Update on the Skin Biopsy

The mole my oncologist/gyno found on Friday is not cancer, but they did find a few atypia cells, so they are going to remove it during the surgery. Most of these moles are benign, but in some cases they can turn cancerous, so it's best to just get rid of it.

She recommended that I go see a dermatologist for annual checkups, since I do have a heightened risk for atypia skin cells. I suppose that's the price to pay when your Cover Girl skin foundation is the same color as Elmer's Glue.

The Game Plan

I met with my surgeon today.  August 12th I will be parting from my uterus. 

Good riddance, I say.

The surgeon (gynecological oncologist) was just as awesome as the OB/GYN who found my cancer.  She was compassionate, answered all my questions, and was incredibly thorough. She's going to perform a robotic hysterectomy, which is far less invasive than the old "C-section/abdominal" surgery. I will only need to stay overnight, and she says I'll likely be back to driving in about a week (though I can't lift anything heavy and generally need to take it easy for 6 weeks). My doctor has done over 500 of these procedures.
 
Good news:

• My PAP was normal. Negative for HPV, no abnormal endometrial cells.
• The initial biopsy turned up normal for Lynch Syndrome -- a genetic predisposition for endometrial cancer, ovarian cancer, and colon cancer. Testing positive would mean that I have a much higher risk of getting these cancers in my life. They will retest after the surgery just to be certain.
• I lost 5 pounds since my last visit. 30 pounds total this year.

During my pelvic exam, she did found a suspicious pigmented area on my skin and did a punch biopsy to rule out skin cancer. It's very possibly it's a scar from something that didn't heal or something benign. She says it doesn't look like melanoma, but it could be something like basal cell carcinoma (a type of skin cancer that usually doesn't spread or metastasize).  If it is, she can remove it during the surgery.

In 2 weeks I have an ultrasound, a meeting with the anesthesiologist, and an EKG. And then -- bye, bye uterus. 

If any of you Boston ladies are looking for OB/.GYN care, I highly recommend Tufts Medical Center, Women's Health.  I've been extremely satisfied with my care so far. They have a South Shore office as well. 

Thanks to friend Jenny....

for this outstanding meme that sums up my feelings perfectly.   :) 

The World is Still Spinning...

In Fran Drescher's book, Cancer Schmancer, she said that the world doesn't stop spinning when you have cancer -- only your world does.  The rest of the world goes on as normal. This week, I've learned that there is a lot of comfort in that.

The last two days I have been in a deep, Edgar Allan Poe-worthy funk. Cancer is very isolating, even when you have a big group of people supporting you and cheering you on. The fear of the unknown takes on a whole new meaning when you have something growing in your body that can kill you, and my thoughts traveled to depths I didn't even know I had (and I'm a horror writer).

A lot of very wise and well-meaning people have tried to give me advice over the past two weeks, and most of the time my inner-voice has screamed like a stubborn child, "What could you possibly know about what I'm going through?!" or "That's easy to say when you've never had cancer."  Both of those things are true. Like every other hardship in life, until you are there, you can't fully "get it." But I'm also filtering my entire life through Cancer Goggles, and that's not an accurate world-view either. After I shut up the little stubborn-child voice, oftentimes this well-meaning advice reminds me that the world is still spinning, there is more to life than my cancer, and whatever happens, I am more than capable of dealing with it. 

Lights! Cameras!....Hold up, I Need to Sit.

I'm not sure if the Megace failed me, or I failed the Megace.

All last week, I had no bleeding (thanks to the Megace), and I felt great. I was super productive, did a ton of cooking, and even made way in my living room for a new couch. .I'm the producer of a short film that is filming through September, so I informed the director that I was feeling great, and I would be there for the shoot on Sunday.  And for a good 3/4s of the day, I felt great.

Then the back pain started.
And a familar fullness in my abdomen screamed at me.
And then...."hello bleeding, my old friend."

It wasn't awful -- I've certainly coped with worse --  but it was bad enough for me worry that it could get worse, and I was an hour away from my home. I sat off set for awhile, hoping it would go away. I did take my Megace about 2 hours later than normal in the morning, so I thought perhaps that my body just needed some time for the dose to catch up. When it didn't stop, I realized that I probably pushed myself too far. I wasn't doing anything super strenuous, but I was standing for long periods of time probably putting a lot of pressure on my rancid uterus. I took regular "sit" breaks, but apparently it was not enough.

I ended up leaving set early.  I spent the rest of the night on my couch, and I canceled my plans to go meet another freelance writer in the city today, because I did not want a repeat incident on the subway or during my walk to the restaurant.  The symptoms are slowing down, so my guess is by tomorrow or Wednesday, I'll be fine again.

People keep asking me if I'm nervous about surgery. Honestly, I wish it was tomorrow. Yes, I do have the normal cancer fears of waking up after surgery hearing "We were wrong -- it's much, much worse than we thought." (Note: this is not very likely.  Endometrial cancer stage often does increase after surgery, but fortunately it's usually not an extreme jump. It's far more common to see a jump from stage 1A to a 1B than from a very early stage to late stage, because the doctors can get a pretty good grasp of what they're dealing with from the biopsy. It does happen -- I've seen stories of women who thought they were Stage 1 jump to Stage III after surgery -- but it's not the norm)  But more than the fear of waking up in the recovery room and hearing bad news, I can't WAIT to be able to go somewhere and not need to keep a constant eye on the ladies room, or walk into the grocery store and think, "Will I be able to make it to the other end of the store and through the cashier in time?"  I can't wait not to worry about standing or walking too much, and I'll be thrilled to do my TaeBo tape without worrying that I'll pay for it later. I can't wait to feel like I'm living again, not just doing the absolute minimum to get by.

Pre-Surgery Cook Off

I haven't posted much this week, because there isn't a whole lot to report. I'm meeting with my surgeon on Friday to discuss the plan, so until then I'm doing what I can to prepare for the surgery. The last few days I've been cooking up a storm, so I have a fully stocked freezer of ready-to-go meals during my recovery. As mentioned in my first post, I'm a pescetarian, which is easily defined as vegetarian+fish, so here are the veggie-friendly options I'm whipping up so far:

Vegetable Lasagna 
A standard "quick and easy" meal for me, I prefer to use whole-grain lasagna noodles (I'm a bit pathological about my whole grain intake. Yay for fiber!) I layer part-skim ricotta cheese for the bottom layer (I keep this layer pretty thin just to keep the fat content down). My top layer is oregano, spaghetti sauce, whatever vegetables I have on hand (the pre-chopped mixed veggies in the produce section are an easy option), and a little Parm cheese to help it stick together. I usually cook the veggies in the sauce for 15 minutes on the stove first before adding them to the lasagna. 

Mushroom and Black Bean "Risotto"
Another one-pot dish that freezes well. It's a fake risotto, because it uses barley instead of rice, and I undercook the barley just a tad so it doesn't get gummy in the freezer (you can finish cooking the barley during reheating). On medium heat, toss chopped mushrooms, carrots, onions, and cooked black beans in a pan with butter/oil for about 5 minutes then toss in the uncooked barley for about 2 minutes. Add a cup of sodium-free veggie stock and cook it off. Repeat with the stock until  the barley is cooked (or slightly undercooked, if you're freezing).  Mix in Parm cheese and a few teaspoons of chopped parsley and serve (or freeze).

Pumpkin Chili
This is a fall staple for me and a hearty one-pot meal. It does not taste like pumpkin at all, but the pumpkin gives the chili a creaminess and a mild harvest flavor (plus, it's a great way to squeeze in an extra vegetable.)

Here is my base for the chili. This makes a BIG pot (enough for a family, plus leftovers for freezing --  so feel free to cut down the recipe. Note -- Cook this the day before serving, because it tastes pretty bland right off the stove.It takes awhile for the spices to reach peak flavor.)

• 2-3 onions, chopped (red or white) 
• 2 red peppers, chopped
• 1 can pumpkin (or 2 cups fresh pumpkin) 
• 2 regular boxes of grape tomatoes or cherry tomatoes 
• 1 BIG can (0r 2 regular cans) of diced, chopped, or peeled tomatoes  
• 2 BIG cans (or 4 normal cans), drained, of any beans you want (chick peas are awesome – I recommend ½ chick peas and ½ black beans) 
• Box of frozen corn
• 1 can (or 2 cups) low-sodium stock (chicken, beef, or vegetable). 
• 1 Tablespoon cinnamon 
• Chili powder (to taste. I sprinkle a generous coating on top)
• Cumin (to taste. I add equal amounts of cumin and chili powder. You don't want to skimp on either, or you'll have a bland chili) 
• 1 Tablespoon minced garlic
• Salt and pepper to taste 

Toss it all in the crockpot and cook.

How Long Does It Take for Megace to Stop The Bleeding?

Megestrol

As I mentioned last week, I was prescribed Megace, commonly known as megestrol, to decrease the bleeding associated with my endometrial cancer. Megestrol is a steroid form of progesterone.  I scanned the web to try to find an answer to the "when does it stop the heavy bleeding? " question, but I couldn't find a clear-cut answer. So for any ladies who came here looking for the same answer, for me the answer was 6 days on a 160 milligram daily dose.

I noticed a significant improvement after 24 hours, and I could carry out most of my normal functions by Day 3 without fear of excessive bleeding. By Day 7, I was rearranging furniture in my living room to prepare for the delivery of my new surgery recovery couch (that's my excuse for buying a new couch, and I'm sticking with it) without bleeding at all. In fact, I feel better than I have in a few months. I had some mild side effects the first few days -- mostly sleepiness (lasted about an hour or so each day) and some mild brain fogginess, but they decreased as my body adjusted to the medication.  I haven't experienced the extreme hunger associated with this medication  (megestrol is also used as an appetite stimulant for people with cancer, AIDS, and other chronic conditions), but I occasionally feel hungrier than normal before meal times. I hear that symptoms can intensify with chronic use (using it for months), so it's very possible that I have not been using it long enough to experience any major symptoms yet.

Don't Assume it's "Just Uterine Fibroids" (even if you have them)

Shortly after starting this blog, a nurse friend of mine called me up, and told me how happy she was that my doctor insisted on a biopsy, even though I was convinced that I didn't need one, because I surely " just had fibroids." She recalled a story of a friend who was diagnosed with fibroids in her early 20s. In her 30s, her cycles started to get very heavy and clotty. An ultrasound found that the fibroids grew, which was determined to be the cause of her bleeding. She was given hormones and sent on her way. For almost a decade she dealt with these symptoms, under the guise of "it's just fibroids." When she finally had enough, she went in for a hysterectomy. Her surgeon was surprised to find advanced endometrial cancer in addition to the fibroids. 

There are two morals to this story:    

1) Demand a biopsy if you have a change in pelvic pain or bleeding, even if you have fibroids. An ultrasound can not reliably detect endometrial cancer. It can show a thickened uterine lining, which can be caused by many different things (including fibroids, cancer, hyperplasia, etc). To detect cancer, you need one of two procedures: 

• An Endometrial biopsy: A simple, quick procedure that can be done in the doctor's office. A small sample of endometrial tissue is taken and looked at under a microscope. This procedure has a high success rate (around 90% or so).
• A D+C procedure (dilation and curettage). This is done under anesthesia and can be used to both diagnose and treat the cause of heavy bleeding. The lining of the uterus is scraped to reduce the size of the lining (relieving symptoms) and to evaluate the tissue. D+C procedures have an even higher accuracy, because a larger sample of tissue is taken. If I wanted to keep my uterus for fertility, my treatment would be hormone therapy to control the tumor growth and regular D+Cs to monitor the cancer.

Pap Smears are NOT a reliable test for endometrial cancer, but they can occasionally catch it. As I understand, it's pretty rare for these cancers to detect early-stage endometrial cancer, so don't assume you are cancer-free if your Pap smears have always been clean. (I have never had an abnormal Pap Smear.)

2) Don't walk away with a bottle of hormones, without knowing what's wrong with you (or having a plan to find the cause).  During her decade of obscene bleeding, my friend's friend spent a lot of time in urgicare and the ER trying to get it to stop. Most of the time, if you come to these places for heavy bleeding, they will give you medication to control your symptoms, possibly do an ultrasound to rule out fibroids or thickened uterine lining, and insist that you visit your OB/GYN to find a cause.  Her gyno already diagnosed her with fibroids and never sent her for further tests, so she was in a Catch 22.

Fran Drescher, who wrote the book Cancer Schmancer after her young and surprising diagnosis of endometrial cancer, went to 8 different doctors over 2 years before someone gave her a D+C procedure. She was a healthy weight and entering peri-menopause age, so her symptoms were passed off as "age-related changes." She mentions in the book that if she had educated herself on the proper tests/procedures to ask for, she may have received her diagnosis quicker. (Fortunately, hers was still at an early stage, because uterine cancer usually grows very slow).

Hormone pills can treat the condition, but they don't tell you what's wrong with you. Even if the hormones work, it shouldn't just be assumed that you have"just a hormone imbalance." A confirmation test should always be given and cancer or pre-cancerous conditions should ALWAYS be ruled out. Endometrial biopsies are  recommended for any woman over the age of 35 who has irregular bleeding. So speak up and ask for a biopsy, even if you don't have the typical risk factors for this cancer. It will give you peace of mind and it just may save your life.

My Personal Cancer-Sniffing Dog

(Another obligatory cute picture of Maxie. This was in the car on the family trip to D.C. over Memorial Day weekend. She has little regard for my need for leg room,)

My plan for a fun-filled Fourth of July with the family ended up in the shitter pretty quickly.

It all started when I needed to change my progesterone treatment. Hormone pills are a common treatment for endometrial cancer, because they can reduce the tumor and may even push it into remission. Progesterone also helps to control excess bleeding, which is the major symptom of endometrial cancer and has been the bane of my existence this month.

Before the results of my tests even came back, my doctor put me on norethindrone to control my symptoms. This is a taper-down progesterone (you start with 3 a day, and gradually reduce until you're down to 1 a day). It worked OK -- my symptoms improved enough that I could actually carry out my daily functions -- but, after about a week, its effectiveness declined. I feared that it would just get worse (especially because my cycle was due), so right before the 4th of July holiday, I called my doctor's office and they gave me a  prescription for Megace -- a super-dee-duper steroid form of progesterone. My doctor told me that it will stop the bleeding dead, which gave me peace of mind for my upcoming holiday weekend with my parents and Maxie.

Super-dee-duper progesterone worked for me as advertised, but it took about a day and a half to achieve any effect. Since I had stopped the norethindrone the day before (doctor's orders), I had no effective progesterone control until the Megace fully kicked in, and my symptoms came back almost full force. I was completely unable to go to dinner with my parents on 4th of July, so they brought me a lovely takeout fish dinner, and I ate at the kitchen table with my concerned parents and Maxie.

There have been a handful of studies about dogs who can actually detect cancer in humans due to changes in body fluid scent or body odor. These studies are preliminary and typically have small sample sizes, so I don't expect cancer centers across the country to start building dog laboratories any time soon. That said, Maxie definitely knows there is something wrong with me. Maxie is a feisty, 25-pound terrier mix who saw no problem with jumping on my chest with a squeaky toy in her mouth when I (and most everyone this past winter) came down with a demonic respiratory infection that I affectionately named "I Can't Believe it's Not Tuberculosis!" But when I was lying on the couch this Friday, drained from the new meds, tired from the bleeding, and frustrated with the whole situation, this little high-spirited terrier became Nurse Maxie, periodically nudging me with her little scruffy head to see if I was OK, pawing at my hand, and finally, curling up in the little hole between my bent knees and the back of the couch for the entire evening. Now, if she could only learn to retrieve the Netflix remote...

Happy Fourth of July!

This is Maxie. She's my date for Fourth of July.

Maxie is my parents' dog.  My parents live a good 500 miles from me, yet it never really seems that far. My family loves to travel (Maxie included), so we see each other every month or two. I've had to put off traveling recently due to my symptoms and diagnosis, but now that my awesome medical team has my symptoms under control (I feel better than I have in months), and I have a full two weeks until I meet my surgeon, I'm planning on enjoying the holiday weekend with friends, family, and pooch.

Have a healthy, safe, and fun Fourth!

Something is Rotten in the State of Denmark

One thing I’ve been thinking about over the last few days is: Could I have caught this in an early, precancerous stage?  Were there early signs that I missed? And the answer I keep coming up with is, “Not really.”  

My cycles always came and went like clockwork. 4-5 days, no trouble. They were completely normal last year, EXCEPT for December. December was an oddball. It came exactly when it was supposed to, but it was unusually heavy. However, it only lasted 2 days. I passed it off as stress, because I was under an extreme amount of pressure during that time. January and February came like normal, so I just assumed that December was an off beat. Hindsight is 20/20, and I know now that December was the first sign that something was not right.   

Why didn't I run to the doctor in December? Because anyone who has a uterus knows that they can be unpredictable at times. Most women wouldn’t run to the doctor for one unusual cycle, because every woman has had them. In fact, many doctors won't even request you come in until there was some sort of pattern (usually 3 months of irregularity) or your symptoms were extreme. There is good reason for this -- many, many things affect women’s cycles, like stress, diet, exercise patterns, etc., so one slightly unusual cycle doesn’t really tell a doctor anything. Also, many gynecological conditions cause the exact same symptoms, and cancer is the least likely cause for most women. It certainly is for a woman my age.

Knowing what I know now, I would have started to keep a calendar after my oddball cycle in December. Maybe I  wouldn’t have caught anything, but perhaps I may have seen something off in early 2014. So, learn from my mistakes. Even if you think everything is OK, keep track of your cycles and days you have discharge (record the type, flow, color, etc.), and talk to your doctor if there seems to be a significant change. If you have a smartphone, there are a few apps that can help you keep track of your cycle. Or use the wall calendar in the kitchen to keep track, and give your periods a weird code name just to confuse the hell out of your family.

A Phone Call With My Mom

Mom: So, i need to buy you a present when you go into the hospital.

Me: Oh?

Mom: But the last time you went in for surgery, you were 8 years old, and I bought you My Little Ponies and Star Wars figures. What do you want now?

Me: My Little Ponies and Star Wars figures.

The First 48 Hours

So I’m about 48 hours into my cancer diagnosis, and I’ve learned two things:

Bad News Can Be Good News

Being told you have cancer -- whatever the stage -- is scary, but the overwhelming emotion for me right now is relief.  I finally know what's wrong with me.  Type in "heavy menstrual bleeding" into your search bar sometime, and you'll be shocked to learn that there is a significant  percentage of women who have gone through every test under the Sun and still do not know what's wrong with them.

My symptoms were so awful and came on so quick,  I really braced myself for something truly awful like “you have 24 hours to live,” even though my highly left-brained head knew that this was pretty unlikely. Receiving news that I have a highly curable, early disease -- even if it's cancer -- is far, far better than being told, "we couldn't find anything wrong with you."

Support Goes Both Ways

I called Mom yesterday afternoon just to ask her how she was coping. 

“You shouldn’t be taking care of me,” she said, “You should be taking care of yourself.”

Well, that's true. And I am. But I am also quite aware that this news is far easier to deal with when you are the patient, because you have the control. You talk to the doctors, you agree to the treatment plan, and you are the one who can make lifestyle choices to improve your chances of success. The rest of the people in my life are the helpless spectators. It’s less nerve-wracking to be the player on the field than to be the fan in the grandstands. So, yes, I do want to check in on them if only to remind them that I’m fine and doing well at the moment. There will be a time in the near future when I’m worn out, tired, and don’t want to play any more, and that's when I’ll need them to give me a pep talk.

My Uterus: The Problem Child

My uterus was always my problem child. I’ve known since I was 13 that I didn’t want children, so I’ve often said that it was a useless organ that only exists to cause discomfort every month. As it turns out, my uterus is sensitive to name-calling. 

Yesterday, I was diagnosed with endometrial cancer. It is very early and slow growing, and my doctor is confident that after my hysterectomy, I will not need any future treatment.  It is natural to think “what did I do to cause this?” when you receive any potentially serious diagnosis. Here’s what I came up with:    

Strikes against me:

• My weight: Women who are overweight have an increased risk. I’ve gone up and down my whole life (though in the last 5 years, it’s headed consistently downward.)
• Never having kids: Women who have never had children have an increased risk.
• Limited use of birth control:  I have been romantically unattached for large portions of my adult life, so I didn’t use birth control pills when I didn’t need them. Birth control pills can lower the risk of this cancer in women who have other risk factors.

Factors that gave me a false sense of security that I did not have cancer:

• My age:  I’m 37 years old. Less than 5% of these cancers occur in premenopausal women, and very few cases occur before age 40, even in women who have risk factors.  My doctor was shocked.
• My cycles: I’ve always had pretty normal cycles. Most of the time, I could predict them to the day. Women who have irregular cycles have an increased risk.  
• Exercise: I am a medical and science writer, so I have a sedentary job (that is a risk factor), but I’ve always made exercise a priority. Walking, cardio kickboxing, Pilates, whatever -- I make a point to move every day.
• My diet: My refrigerator looks like a damn farmer’s market. I’m a fishitarian -- 90% of the time I eat vegetarian and a couple times a week I eat fish.  The official term for fishitarian is “pescetarian,” but when I tell people that, they assume I belong to a cult.  

A word to anyone who considers themselves to be an Internet-taught nutrition professional: Before you try to tell me that I need to eat such-and-such food or take such-and-such supplement to prevent/treat cancer, please note that I went to school for 5 years for nutrition, I have a Bachelor’s and a Master’s degree in the field, and my degrees are in Dietetics, so I can practice nutrition clinically. That trumps whatever ”education” can be gained from reading non-credible, scientifically unsound, HOLY SHIT, EVERYTHING IS TOXIC! websites. In fact, let’s just assume that my personal nutrition is the one thing I am more than qualified to take care of. We now return to our regularly scheduled post.

What do women need to watch out for? 

Abnormal bleeding is the most common symptom, and it appears early. For some women, it’s just irregular spotting and for others it’s Niagara Falls. The severity of the symptoms does not necessarily correlate to severity of the disease. 

Other early signs include pelvic pain, unusual discharge (pink discharge or unusual clear watery discharge).

It’s important to note, that these are the exact same symptoms caused by a lot of other conditions, including fibroids (that was the original thought for me, because I have a strong family history of them), hyperplasia, polyps, and hormone imbalances.  There is absolutely no way to tell what you have without going to the doctor. Trust me, if there was a way for a non-doctor to tell the difference just by symptoms, I would surely have found it during my constant researching of symptoms these last few weeks.

How bad was the endometrial biopsy?

This varies from woman to woman, so if you need one, ignore the horror stories. Some women have claimed it was the worst pain they have ever felt. I felt almost nothing. A little cramping, and that’s it. (It should be noted that I may be impervious to pain, like the villain in Goldeneye. I had no pain after my wisdom tooth removal, either, and never took any pain medication for it.)  My doctor explained that women who are bleeding heavy during the procedure usually have a much easier time of it, so if you’re having a biopsy because you’re bleeding abnormally (the symptom seen in 90% of endometrial cancers), don’t work yourself up and assume the procedure will be awful. It simply may not be true for you. Even if you do experience pain, the procedure is very quick. It’s over in seconds.

Also, this was a surprise biopsy, so I took no pain killers beforehand, and I still did not have any pain. If you have the opportunity to schedule a biopsy, some doctors do prescribe a pain killer ahead of time to help with pain.

Three things I feel very fortunate for: 

• My symptoms were absolutely awful. Bleeding was my only symptom, but it was awful. I’ve only had symptoms for 3 months, but during the last two weeks waiting for my appointment, I could barely leave the house. This is not true for many women in the early stages. Some women receive their diagnosis after years of mild irregular spotting and some receive it just from unusual discharge. If my symptoms were mild, I might have passed them off as age-related changes and not visited my doctor until the symptoms worsened and the disease was more advanced.  So, ladies, ANY unusual symptoms -- even mild ones -- talk to your doctor.
• My doctor was incredibly thorough. Due to my strong family history of fibroids (and my symptoms aligning very close with other women in my family who had them), I almost passed on the biopsy until after the ultrasound (the test used to detect fibroids).  My doctor insisted I have one done. Due to my age, not all doctors would have insisted, because it was far more likely to be other things.  I will be forever grateful to her for being insistent. If your doctor is not insistent, or passes it off, YOU have to be the one who is insistent.  
• My support group.  Calling up my parents, brother, and friends and telling them I have cancer was the hardest thing I ever had to do, but the response I’ve received was incredible. I especially appreciate that everyone realized that I would have no tolerance for the “poor, poor you” comments and instead responded with humor. For all of you who have sent me pictures of uterus costumes to wear to my surgeon’s appointment, recipes for ovary-shaped cookies, and whatever the hell this is….. 

I salute you.