Too young to die

Cox News Service WEST PALM BEACH, Fla. -- The end of October, breast cancer awareness month, doesn't signal the end of the growing concern about women's cancers.

For women with cancer, it signals the end only of public efforts to educate. This month is a mass of days on the calendar when others are encouraged to learn about what they must face daily.

But if there were months for all women's cancers, at least eight months out of the year would be dedicated to awareness of these cancers: cervical, endometrial, ovarian, uterine, vaginal and vulvar, in addition to breast cancer and other tumors.

Endometrial cancer is the fourth most common cancer among women in the United States. Happily, the Pap smear has made cervical one of the most preventable cancers.

Shelly Rozenberg is one of those women whose life is affected by a "female" disease. Unlike most women, however, she works all year to make others aware of a particular type of cancer: ovarian, a nasty disease that is usually not diagnosed until late in its development.

Not that she has it. She has the gene for it. And that predisposes her to get it and other cancers, breast cancer included. Her mother died of ovarian cancer 29 years ago at the age of 48.

Rozenberg, the director of the National Ovarian Cancer Coalition in Boca Raton, just turned 50. Six years of seesawing after finding out she had the mutated gene for the disease culminated with her decision to have surgery in September. She didn't have children, and she said she wasn't going to have them, anyway. She had her ovaries and fallopian tubes removed.

"I was faced with all these possibilities," she says. "When do you stop taking out organs? Was I better off not knowing (about the defective gene)? I put a mental note in my mind -- 50. I would have it done: an oophorectomy (removal of the ovaries.)"

She has greatly reduced her risk for ovarian cancer with the operation, by up to 95 percent.

Though the risk is low, doctors say women who have had their ovaries removed can still get ovarian cancer in leftover tissue.

It's called peritoneal carcinoma.

"I did whatever (preventive tests) I could do without the surgery," Rozenberg said. But she decided now was the time. And because her risk of breast cancer is high, she gets an MRI every six months. Still, she is thinking about having both breasts removed. "I will continue to contemplate the surgical option," she says.

But she is glad she had her ovaries and fallopian tubes taken out.

"I have a great sense of relief," she says. "My pathology (test) was clear. I'm happy the decision was made."

She wants women to know that Pap tests don't show ovarian cancer, and the one test that was thought to detect it, the CA 125 blood test, is not considered definitive.

But what happens when the diagnosis is definitive?

Making a decision for surgical removal of your organs, even when you know you have cancer, is difficult.

Janeen McKenzie was diagnosed with breast cancer in 2004 at 36 and had her breasts removed.

It was a hard choice for a young single mother -- her son is now 20. But she's glad she did it.

"If I hadn't been as adamant about it, I wouldn't be here," she says. "It was Stage 3 (out of four stages). I got the double mastectomy. I did eight treatments of chemotherapy and had 14 surgeries. And reconstruction.

"I was very aggressive about it. It had metastasized to my lymph nodes."

A West Palm Beach resident, she works as a paramedic in Pompano Beach and was faced with being unable to work for 17 months.

But her long-term recovery would have been doubly difficult if her 200 "brothers and sisters" at Pompano Beach Fire Rescue hadn't donated vacation and sick time "so I never missed a paycheck. I was overwhelmed. I didn't expect it, and I can't repay this personally to any of them."

Now 39, McKenzie is taking a drug, Herceptin, to keep her cancer from returning.

And she is taking action to help other women who may not have insurance or the ability to get medical treatment for their cancers.

Her third annual Breast Cancer Awareness/Benefit Halloween party Sunday, starting at noon at Nothin' Fancy Bar & Grill on Gun Club Road in West Palm Beach, will raise money for this cause. Last year she raised $6,000 for the American Cancer Society.

"I had a lot of people helping me. I'm trying to pay it back."

And that's how Olympic figure skater Peggy Fleming feels.

In 1998, on the 30th anniversary of her gold medal in Grenoble, France, she was diagnosed with breast cancer.

Fortunately, it was caught early -- at stage 1 -- and it was small and slow-growing. That allowed her to have a lumpectomy and six weeks of radiation. She never needed chemotherapy.

"It's not so bad as if it had been (caught) at a later stage," she said from her California home, where she lives with her husband of 36 years.

She, too, believes that paying back -- talking about her cancer and raising money -- is important.

"I think women sharing stories makes us more aware. We're not alone. And I don't want anybody to be a statistic. We shouldn't procrastinate getting checkups and mammograms. You've got to do the maintenance."

She recently spoke at Boca Raton Community Hospital Foundation's 2006 Go Pink Luncheon, which raised money for the Center for Breast Care at Boca Raton Community Hospital.

She also has appeared on TV's "20/20," "Oprah" and "The Rosie O'Donnell Show" to promote breast cancer awareness.

"Cancer pulled us all together," she says of her family. "I am so grateful that I got early detection."

Adds Rozenberg, who carries the gene that could cause her to develop ovarian cancer, "After learning I was BRCA1 positive, I often felt angry that I even had this information. I would suppress my feelings and look the other way. I had convinced myself it was perfectly OK not to make a decision."

But now that she has had preventative surgery, she says, "I feel blessed and look forward to many more healthy years, and the ability to educate others."

Carolyn Susman writes for The Palm Beach Post. E-mail: csusman AT pbpost.com

Cancer Prevention 101: Did you know that .?.?.

1. Most cervical cancers can be prevented. Finding abnormal cell changes early with a Pap test can be life-saving. Cervical cancer is rare today in women who get their Pap tests, which can be done every two years with the newer liquid-based Pap test. After 30, if you have had three normal tests results in a row, you may be tested every 2 to 3 years.

2. Fish is a rich source of omega-3 fatty acids. Studies in animals have found that these fatty acids suppress cancer formation or slow cancer progression, though there is limited evidence of a possible benefit in humans. Women who are pregnant, breast-feeding or planning to become pregnant should not eat swordfish, tilefish, shark or king mackerel because of the possibility of high levels of mercury, dioxins and other environmental pollutants.

3. For breast-cancer detection, women at high risk and over the age of 40 should have yearly mammograms and clinical breast exams.

Those age 20 to 39 can have clinical exams every three years but should promptly report any changes to their doctors.

4. Watch for and report any abnormal vaginal bleeding or spotting after menopause, which can be a sign of endometrial cancer.

5. If your mother, sister or daughter has had ovarian cancer or breast cancer, or if your parent, sibling or child has had colorectal cancer, you are at high risk for ovarian cancer. There are no effective and proven tests for early detection of ovarian cancer. Symptoms are difficult to pin down and may have other causes. They include abdominal swelling, vaginal bleeding, back or leg pain and chronic stomach pain.

Source: American Cancer Society