Kay McGuire

June 2019

This is my favorite photo of my granddaughter and me. We were at the “Bring your Mother or Grandmother to Jujitsu” event for Mother’s Day, May 2018. So there I was wrestling and rolling around on the floor, with no idea that there was a grapefruit-sized tumor on my right ovary.

My girl “Ruby,” my Welsh Pembrook Corgi, was also along for the ride! As the months progressed, taking a puppy for walks twice a day was getting harder and harder. I had trips planned, flights booked, and lifetime events to attend, yet I was constantly battling fatigue and diminished appetite, which was trying to take its toll.

In October of 2018 I had plans to return to the Bay Area for my 40th nursing school reunion. I decided to get my yearly gynecologic check-up there, with my gynecologist, who I had seen for 35 years. I was a couple months overdue. When she examined me, I noted this sudden change of facial expression as her jaw dropped. She palpated the tumor on the right ovary and pursued our discussion of how I was feeling. Yes, I had been experiencing frequent urination, severe constipation, mild bloating, diminished appetite, and a slight weight loss.

I had a pelvic ultrasound performed several days later. The following day I went to my reunion but decided to drive back to Oregon ASAP. While on the drive, my gynecologist called me and gave the results of the ultrasound: I had a large right adnexal mass that looked suspicious for malignancy. That was too much to think about and decide at that time. Where should I go, and what should I do?

A referral was made to a GYN Oncologist in Portland who saw me within a few days. I had a CT scan of pelvis and abdomen with contrast which confirmed the presence of a large cystic and solid pelvic mass associated with vaginal cuff, non-specific, and concerning for malignancy.

In November 2018 I had laparoscopic surgery to actually make the diagnosis. The tumor had grown and spread to distant sites in my abdomen. The pathology report confirmed a noninvasive implant of serous borderline tumor, Stage IIIA, at multiple sites with calcifications and mesothelial hyperplasia*. I woke up from my surgery relieved to find that I did not have a Foley catheter in place!!! (Everyone has their priorities!) I must have been loopy from the medications because I told the night shift nurses that I was in disguise, ready to do a Joint Commission Evaluation of the unit!!

These findings were reviewed at the GYN Tumor Board, and it was agreed I would not be treated with chemotherapy or radiation. However, I am a definite future candidate for surgical removal of pelvic washings for tumors in other areas of pelvis and omentum.

For someone who had regular gynecologic examinations and a total vaginal hysterectomy in 1993, this could not happen to me!!

My husband had died suddenly six years prior, and so I had moved from the Bay Area to the Eugene area in 2017. I wanted to be closer to family Just In Case I ever needed help. I have always been very independent, working as an RN for 40 years. My support systems were spread out literally up and down the west coast and to points east! Soooo… my support system of family and nurses from years of working together were there!! Pre- and post-operatively, it just happened. They came and cooked, walked the dog, drove me around, and cleaned the house for me!

So my post-operative state now consists of trying to figure out what went wrong and when. I ate healthily before surgery. I was going to Pilates 3 – 4 times weekly, yoga once a week, and walking my dog 3 – 4 miles daily, 7 days a week. With all of this, plus keeping up with all the activities involved in moving and building a house, I guess I was running myself ragged.

What now? Slowing down and trying to take time to adjust and take those vacations I always dreamed of. But at this point in my life I don’t have a firm course ahead of me. Some days it’s awful to try to force myself to go forward, and other days it’s okay. Naps are good.

My commitment is to communicate to all the women I know: the importance of having yearly examinations! I’ve spoken to about 50 women at this time and I will continue to do so.

* Ovarian borderline tumor:
Borderline ovarian epithelial neoplasms (or low malignant ovarian tumors) are noninvasive neoplasms that occasionally have intraperitoneal spread. Borderline neoplasm is currently the most widely used designation by pathologists, gynecologists, and oncologists, and has been adopted into the World Health Organization classification. These tumors exhibit behavior that is intermediate between benign cystadenomas and invasive carcinomas. Most importantly, because they are not true carcinomas (there is no invasion into tissues), the main treatment is surgery, and no chemotherapy is needed after surgery.

These tumors may recur after many years, and even then they are treated surgically. Malignant transformation of borderline ovarian tumors is exceedingly rare.