It's Time You Knew: The Power of Your Choices to Prevent Women's Cancer

By Valena Wright

Your annual doctor visit isn't enough to prevent disease and cancer—you have the power to protect your health with the right conversations.

When women's cancer surgeon Valena Wright, MD lost her older sister to Stage IC Ovarian Cancer, she knew she had to speak up. Her younger sister was saved through cancer prevention measures—but nobody was explaining how those measures could save more women.

Information on healthy choices for women is overwhelming. What prevents cancer? How can you spot early warning signs? What symptoms mean you should call your doctor and seek medical care? Daily health and lifestyle choices are the key to cancer prevention and early detection. But what choices?

In It's Time You Knew learn from a gynecologic oncologist with over 25 years of experience about:

• Twenty-eight women's stories of patient experiences from symptoms to diagnosis and the path they took to cancer recovery.
• The types of testing that your doctor may not have told you about but could save your life.
• The daily and annual habits to adopt to lower your chance for disease, including the role weight, diet, sleep, and exercise play.
• The wisdom to speak up when it matters—it just may save your life or the life of your loved ones.

Family history isn't the only factor when it comes to women's cancer. Listen to your body and take control of your health with 28 lessons straight from an oncology doctor. Committing to your health daily could be the simple step to cancer prevention. Buy It's Time You Knew and uncover how to decrease your risk of women's cancer through daily choices and ultimately protect your greatest asset: your health!

• Language: English
• Publisher: Irish Moss Press
• Release date: Feb 18, 2021
• ISBN: 9781736008614

Book preview

Author’s Note

The stories I tell here are real case histories of women I have had the privilege to know in my role as a gynecologic cancer surgeon. I hope that their stories will inspire you to speak up and seek medical care when your intuition tells you something is wrong. The names and some identifying details have been altered to respect these amazing women’s confidentiality.

Please read the medical disclaimer on page 191.

Introduction

Some things in life are inevitable—like getting cancer, right?

Wrong.

You have cancer is a phrase that I have said far too many times in my 25-plus years as a doctor. I am a gynecologic oncologist, specializing in the treatment of women’s cancers. I trained in the Harvard teaching hospitals and work in the major academic medical centers in Boston. I see patients, train the next generation of physicians and surgeons, and work to integrate new technology, such as robotic surgery, to improve women‘s health. I have dedicated my professional life to this field, and I know I do not need to repeat this phrase as often as I do. But the reasons why might surprise you.

We often hear that in order to prevent cancer we should give up smoking, get regular checkups, eat right, exercise, get enough sleep, wear sunscreen, etc. Those are all true. Yet many women don’t know the two most important choices they can make to prevent most cancer because those choices don’t get discussed:

Don’tdenyyoursymptoms.

Get them checked out right away. Symptoms are your body’s nudge to pay attention.

Don’ttolerateyour pain.

Be your own best advocate when something hurts. Learn to communicate with your doctor to get the best health care possible.

I’ve seen too many women suffer with cancer because they lacked access to medical care or despite access failed to take action when symptoms first showed up. They didn’t realize how their lives would have changed if they had paid attention to their bodies, addressed their concerns when something felt off, and known how to talk to their doctors to get the tests they needed.

My hope is to create change in memory of all women who have suffered a preventable cancer diagnosis so their voices are not diminished. I am committed to improving women’s health care experiences because we deserve better.

Find Your Power and Know How to Use It

You may avoid going to the doctor for various reasons. If you’re like a lot of women, you take care of everyone else before you take care of yourself. Or maybe you’re afraid to learn that any weird symptoms, an unhealthy lifestyle, or your genetic risk factors mean you’re destined for cancer and that you’ll die. Perhaps, you don’t want to be judged and you don’t want your doctor to talk down to you. Maybe you’d be more willing to seek care if you trusted your doctor and felt a real sense of partnership with them.

The two most important actions you can focus on are:

Addressing your symptoms as soon as they show up, which could help you avoid a cancer diagnosis altogether.

Speaking up for yourself in the world of physicians and medicine, to receive the care you deserve.

Learning from real women’s real life stories will illustrate what symptoms never to ignore, when you absolutely need to see your doctor, and when to schedule risk reducing cancer screening tests. Have a conversation with your doctor to understand your personal risk factors and the choices you have to reduce your risk. Notice what is real for you, take notes—write in the margins!

Chapter 1

Your Body Wants You to Listen

Many women still believe that cancer is either going to get them or it isn’t and they can do nothing about such an expectation. But the truth I’ve learned from my practice as a gynecologic cancer surgeon is that cancer is easier to prevent than treat and the earlier a diagnosis is made the better.

If, for example, you were to visit to my office with a biopsy¹ that had come back positive for cancer, we’d talk about your options and make a plan of action. But if you had come in when the symptoms first showed up, after having regular health visits and screening, we might not have ever had that conversation—we may have caught the problem before it ever became cancer.

Misconception: Precancer is the same thing as cancer.

Truth: Precancer, when caught and monitored, rarely becomes cancer.

Your body communicates when something is not right. Either through symptoms or pain, it gives you a signal that you need to stop and pay attention. When it does, it’s time to get yourself checked out. If you read nothing more than that, you have learned the most important message I will offer.

Women receive so many negative messages about their bodies, so how can we judge a woman who is reluctant to pay loving attention to her own? Women deserve better health care. Listening to our bodies is the first step to achieving better health.

You can find wonderful doctors out there worthy of your trust and capable of guiding you to the healthy life you desire. But you will also find doctors who may dismiss your concerns, fail to take into account your particular circumstances, or simply don’t know as much about a woman’s body and health concerns as they should.

For example, it is a sobering fact that the increasing US maternal mortality rate, which was 17.4 deaths per 100,000 live births in 2018, makes the US one of the most dangerous places in the developed world for a woman to have a baby.² Why, in a country as wealthy and innovative as the US, are American women three times more likely to die having a baby than their Canadian neighbors across the northern border?³

Human Rights Watch World Report 2018 draws attention to Alabama‘s cervical cancer mortality rate (3.9 of every 100,000 women dying from cervical cancer) as the highest in any US state and twice the national average.⁴ Black women in Alabama suffer an unfair burden of poor health and death from cervical cancer at nearly twice the rate of white women. In Canada, the cervical cancer mortality rate has been fewer than 2 per 100,000 women since 2002.⁵ Equitable and quality health care requires all of us to see the disparities, study the societal causes, and actively combat systemic racism. A woman living in the developed world should not die of cervical cancer.

This is why you need to see yourself as the leading advocate for your own health. I realize there are things you don’t know, and it can be intimidating to speak to a doctor from that vantage point. But I am going to simplify things by giving you questions to ask, tests to request, and expectations you should have as you navigate your way to your healthiest life.

Learning from Each Other

The women I will introduce in this book are patients whose health journeys are full of lessons for all of us. They illustrate how differently things can turn out with an early versus a too-late checkup. Their ages, symptoms, risk factors, and behaviors vary, but you might see yourself or someone you love in the dilemmas they faced. By witnessing how well, or not so well, they navigated their experiences, you’ll learn how you may avoid a deadly cancer diagnosis in your own life.

Some of these women smoked. Some were overweight. Some had a history of gynecological problems, and some had genetic risk factors. Many had never received the vaccine to prevent human papilloma virus (HPV) related cancers. And yet, the biggest factor in their favor was how quickly they got help when a symptom showed up.

I take the position that as women, we can—and must—help each other overcome our reluctance to being in charge of our own bodies. Being in charge of our own bodies means paying attention, scheduling screening tests (such as mammograms), recognizing abnormal symptoms early, and seeking medical care. Though we may feel embarrassed or afraid, ignoring symptoms won‘t change anything but may delay potentially life-saving treatment.

Being in charge of our own bodies also means recognizing how our daily habits can give us the best chance of living a long, healthy life. What we do is more important than what we say. If you’re a mother, for example, this means being a role model for your kids.

And, finally, being in charge means standing up for our own health the way we do for our kids, our spouses, our parents, or even our pets. Women’s health issues haven’t gotten the same focus as men’s, and the only way that is going to change is if we ask for what we need.

For 25 years, I have treated and cured women suffering from cancer. It’s the reason I do what I do. But the unfortunate trade-off is bearing witness when some of my patients suffer and die. It makes me angry knowing many of these cases could have been prevented, and I’m saddened by the burden it places on women and their families. That’s why I want to change the conversation and help you prevent a cancer diagnosis in the first place.

I will share my family story, as well as stories of other amazing women I have had the privilege to know. Their experiences can help you see the simple, but powerful, steps you can take to prevent cancer from being an inevitable fact of life:

Learn the most common symptoms that should never be tolerated or ignored.

Learn what tests to ask your doctor for and when.

Learn why the HPV vaccine is one of our most potent weapons to fight five different types of cancer.

Learn the risk factors for cancer and why they affect your health the way they do.

Learn that being in tune with your own body is the most powerful thing you can do.

First, I want to introduce you to my sister, Debbie. She was my hero.

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1 Look for the medical terms in bold throughout the book. They are included in the medical terms section, listed in alphabetical order.

2 https://www.cdc.gov.nchs/maternal-mortality/index.htm.

3 Kassebaum, RM et al Global, regional and national levels of maternal mortality,1990-2015:a systemic analysis for the Global Burden of Disease Study 2015. Lancet 2016;388:1775-1812.

4 https://www.hrw.org/report/2018/11/29/

it-should-not-happen/alabamas-failure-prevent-

cervical-cancer-death-black-belt ; It Should Not Happen.

5 https://www.canada.ca/en/public-health/services

/chronic-diseases/cancer/cervical.

Chapter 2

My Sisters and I

About 10 years ago, the unthinkable happened. I learned my older sister, Debbie, had been diagnosed with ovarian cancer at age 48.

I instantly felt like a child again. I had learned so much from watching Debbie blaze her own trail, with two years on me. She was always defiant, often broke the rules, and regularly took the blame for things I did, simply because she was my big sister.

When Debbie fell in love with her high school sweetheart, my mother had refused to let her get married until she finished her education. Debbie took a secretarial course at the local college to satisfy Mom’s demand so she could to marry the man of her dreams.

Debbie and her husband, Bill, lived in many different parts of the world. Despite the distance, she always had time to be my sister, to listen and be supportive, and to not judge but simply to be present. She was a beloved friend, as well as a sister.

Debbie was preparing to return to home from Germany when an ultrasound revealed an ovarian cyst. She didn’t think it was serious so she didn’t follow up right away. She didn’t even tell me, a gynecologic oncologist, about it.

Nothing seemed to be interfering with her daily activities. She was busy moving home from Germany, settling her teenage kids in college, and preparing for the family Christmas holiday. She had noticed the need to urinate more frequently and some occasional pelvic pressure, but she was busy and she ignored these symptoms.

It wasn’t until the two moved back to Ottawa six months later that she learned the cyst had grown from 4 cm to 20 cm. That was when I got the call.

The Tables Turned

Up until that point, I’d been the doctor delivering bad news. But now I saw things from the other side of the table. I may not have been the one with the diagnosis but it was terrifying to know my sister would soon be in a fight for her life.

Debbie was diagnosed with serous ovarian cancer, the most common type of ovarian cancer, which accounts for more than half of the diagnoses. Some women, like Debbie, don’t recognize or experience symptoms until the cancer grows large enough to cause pressure on the bladder or bowel, or they feel bloated or full from the metastasis (the development of secondary malignant growths at a distance from the primary site of the cancer).

Debbie was confused because she felt fine. She wasn’t aware of any symptoms, so she had a hard time understanding the seriousness of her diagnosis. Her mind was on the cruise she had planned over Christmas, so she decided to put off surgery until