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Maria Verbeck said she wasn't sure whether to believe her doctors' words after a 20-pound tumor was found attached to her right ovary.
"He said, 'Maria, this is not a death sentence. We can beat this.'"
That was almost 10 years ago. Today, the Modesto woman has no signs of the ovarian cancer, and doctors have said she has a good chance of remaining free of the disease that claimed the lives of Coretta Scott King and comedian Gilda Radner.
Verbeck, 45, is a founding board member of the Ovarian Cancer Alliance of California. The doctor who gave her courage and removed the tumor was Ronald Kimball, a former associate of Dr. Babak Edraki of Modesto.
Edraki treats many women who suffer from cancers of the reproductive organs.
The alliance pushes for doctors to be more aware of ovarian cancer and be aggressive in trying to catch it early. According to Edraki, Verbeck's case is a good example of why that is important.
Verbeck said she had the classic symptoms for several months but they were not properly diagnosed.
Verbeck, who is a large woman, said she was bloated and would throw up just about everything she ate. Also suffering from anemia, she finally was sent to a hematologist for a blood test and he discovered the tumor.
"He palpated my stomach and asked if I was pregnant," Verbeck recalled. "I said I wasn't, and he realized I had a mass in my belly."
In the time it took before she got an accurate diagnosis, the most common forms of ovarian cancer can spread to other parts of the body. But her type was more rare.
During the surgery, doctors learned that the cancer was contained inside the tumor. Verbeck, a community service officer for the Stockton Police Department, later had surgery to remove a second tumor that developed. She said she has been cancer-free since 1998.
Ovarian cancer is difficult to treat because often it is in the advanced stages by the time it is diagnosed, Edraki said.
Often the symptoms are mild; about two-thirds of patients learn they have it after the malignancy has spread through the abdominal cavity or to other parts of the body.
Only about 45 percent of patients live more than five years, according to the National Cancer Institute.
Women who have ovarian and breast cancers in their family histories should be alert to the signs, which may include indigestion, nausea, pain and swelling of the abdomen and vaginal bleeding.
Edraki said women should be concerned if the symptoms persist. He advised women to seek medical attention and insist on a pelvic examination, including an ultrasound or CT scan.
Even then, screening techniques are not adequate. The specialist said he has seen the cancer develop and become advanced three months after a patient had a pelvic exam.
Women in high-risk categories can have a test for two genes believed to cause ovarian and breast cancer. Genetics is a factor in about 10 percent of ovarian cancer cases, experts believe.
In some instances, patients who have tested positive for the genes and have close relatives who had the cancer have chosen surgery to remove their reproductive organs, Edraki said.
As for treatment, the National Cancer Institute in January called for wider use of abdominal chemotherapy, after a study showed that it extended the lives of patients an average of 16months or more.
Instead of giving the chemotherapy drugs through an intravenous line, the medications are pumped through a port into the abdominal cavity to target the cancer more directly.
The NCI listed Edraki's Cypress Women's Cancer Treatment Center as one of the few places in California that provides the treatment, also known as intraperitoneal chemotherapy. The procedure was developed 30 years ago and has improved over time.
Edraki said he implants the ports in two or three patients a year, but he believes there will be increased demand for the treatment.
Patients should be selected carefully, he said. Much depends on the amount of scarring after surgery. Moreover, about 40percent to 60percent of patients will be unable to complete the treatment, because the side effects are more severe and may include permanent nerve damage.
More doctors and nurses will need to be trained in the technique, he added.
The most effective treatment for ovarian cancer, Edraki said, is an aggressive surgery to remove the cancer completely, if possible.
Stockton resident Bonnie Mitchell, one of Edraki's patients, credits the surgery with enabling her to survive the cancer for four years.
Mitchell, 54, is also a big believer in support groups to help patients who just have received the terrifying diagnosis. Emotional support helps build a positive attitude needed for healing and recovery, she said.
Patients with advanced ovar-ian cancer may consider clinical trials that test new drugs or procedures, she added.
"A lot of people are afraid of clinical trials because they think they will be given a placebo," Mitchell said. "With cancer, that is unethical. The trials compare one type of treatment with another type of treatment."
For more information about the Ovarian Cancer Alliance of California and its Modesto support group, call the 24-hour voice mailat 567-3112. An alliance member will return the call. Information about a Stockton support group is available at 598-5211.
Bee staff writer Ken Carlson can be reached at 578-2321or kcarlson@modbee.com
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