Grand Forks woman discusses her battle with fallopian tube cancerIn May 2007, Pati Bubach was getting dressed for a special family occasion. The dress she’d chosen to wear for the event was too tight.
By: Pamela Knudson, Grand Forks Herald
GRAND FORKS, N.D. -- In May 2007, Pati Bubach was getting dressed for a special family occasion. The dress she’d chosen to wear for the event was too tight.
“I felt bloated all over,” she said. “My breasts were swollen, and I had some spotting. I felt like I was pregnant. I hurt all over.”
She wasn’t too concerned; she thought the symptoms may be due to fibromyalgia, an ailment she’d been dealing with for some time.
Those symptoms were early signs of fallopian tube cancer — a very rare form, which accounts for about 1 percent of all cancer in a woman’s reproductive system.
“Maybe 200 people a year get it,” Bubach said. “It’s even harder to find than ovarian cancer.”
Symptoms may be so subtle that they aren’t taken seriously. Or, by the time symptoms do prompt a woman to seek care, the disease has advanced.
“They call ovarian cancer a ‘silent killer,’ ” she said. “I call this an ‘unknown killer.’ ”
Her doctor ordered a blood test similar to the PSA test used to identify prostate cancer in men, she said. “It’s almost specific for cervical or ovarian cancer.”
Results indicated the presence of cancer cells.
Her doctor recommended immediate exploratory surgery, which resulted in a hysterectomy, the removal of the uterus, ovaries and fallopian tubes.
“Nobody had seen fallopian tube cancer here before,” she said. “I think Dr. Brown was surprised by what he found.” Michael Brown is an obstetrician-gynecologist with Altru Health System in Grand Forks.
“To diagnose it, doctors have to see it,” she said. “You couldn’t really see it on ultrasound.”
Yet when she received her diagnosis, she wasn’t fearful, she said.
“I just said, ‘OK, what do we have to do?’ ”
She also asked her doctors at Altru, “Will you be with me on this journey?” she said, and they assured her they would.
“Without them, I don’t know what I would have done ... I really trusted them and their judgment.”
After discussing options, Bubach sought a second opinion at an out-of-state facility, where a specialist told her she needed a particularly harsh form of chemotherapy that she would not finish — “because nobody ever did,” Bubach said.
“(The doctor) said that, even if I did happen to complete it, I could expect one year to live,” she said. “My guys (here) never said anything like that. They just focused on recovery.”
Because she was confident in her doctors here and didn’t want to relocate to another city, she started chemotherapy in August 2007 at Altru Cancer Center, where, she said, the staff and nurses “are always so kind, they go out of their way to help.”
The treatment required her to go to the cancer center three times a week for five to six hours each time, three weeks each month for six months.
“I never did get sick,” she said, “just bone tired and bone cold.”
As difficult as it was, she persevered through the regimen. But the treatment left her with neuropathy, a feeling of numbness and pain — “like electrical shocks” — from her elbows to hands and her knees to toes.
Neuropathy is a complex, chronic pain state that results when nerve fibers are damaged. Certain chemotherapy drugs may cause nerve damage.
“It felt like I was dragging around big blocks of ice.”
The neuropathy “was so bad, I couldn’t hold a pen,” she said.
About a year and half after completing chemo, the cancer returned. It meant another six months of chemotherapy, although this type was not as grueling as the first.
“I’m kind of angry,” she said. “You’re told you have to adapt; you have to accept it.”
The neuropathy causes pain that stays with her “24/7,” she said. “It gets so bad sometimes you want to go down to the (basement) and cry.”
Soft surfaces, such as suede upholstery, feel like gravel, she said. “It really hurts.”
The pain has forced her to abandon hobbies such as pottery and sewing. Tasks that require fine motor skills — buttoning clothing or putting on earrings — now require her husband’s help, she said. “You have to relearn a lot of things.”
Because it’s difficult to flex her feet, she has a hard time maintaining balance, she said. “When I walk, I look like I’m drunk.”
She’s unsure how much pressure she’s using to hold a sandwich, so it may fall apart and contents may be squeezed out, she said. “It’s all such silly, simple things.
“That’s where it turns sad, but it’s not sad. It’s just life. You do what you can, and if you can’t, you find something else that you can do.”
Her husband, Rodney, who retired four years ago, said his wife has handled the challenges well.
“Mentally, she’s handled it very well. She’s very determined to not let it get her down.”
He admires her attitude, he said. “She will not give up; she will not quit, even though she’s in pain all the time.”
Pati’s health troubles have “definitely changed our lives,” he said. “It’s slowed us down and limited our ability to go and do things she’d like to do.”
The challenges have influenced their relationship, too.
“We get along better now. We depend on each other more than we ever have. I gotta do things she can’t do for herself,” he said. “She can’t drive; she can’t cook; she can’t see well enough to set up her pills.”
He depends on her, too, he said. “She does give me strength. I’ve calmed down since this developed.”
He enjoys what he’s doing, he said. “I enjoy taking care of Pati.”
Rodney has taken on household tasks — cooking, cleaning, laundry, grocery shopping — that used to be his wife’s domain.
“I’m the housekeeper. It keeps me busy,” he said. “Some might say I do too much, but I don’t think so.”
Bubach had routinely done what women are encouraged to do: get regular physical exams and cancer screenings.
She had no family medical history related to her cancer. The disease was undetected despite CAT or MRI scans.
The CA 125 blood test alerted her doctor to cancer and — followed by surgery — brought her condition to light, she said. “Without the exploratory surgery, I don’t think they would’ve found it.”
Everyone knows his or her own body, she said. “If your body is doing something weird, go to the doctor. And don’t let them tell you it’s all in your head.” She urges women to ask about tests that could shed more light on their condition.
Cancer has changed her perspective, she said. She’s no longer “a Pollyanna; I’m a realist.”
People ought to reach out to cancer patients, she said. “Even if they think they can’t handle it, they could at least offer to come up and read or talk while the person is getting chemo. … Be kind to people, that’s the main thing.”
In her battle with cancer, Pati said, “I really tried to keep a level mind, and tried to see possibilities instead of mountains.”
She doesn’t dwell on death, but if she dies, she doesn’t want an obituary.
“I want my picture … and that phrase from Cheers (TV show), ‘Sometimes you wanna go where everybody knows your name,’ ” she said with a laugh.
Having a sense of humor is “very important” in dealing with difficult circumstances, Rodney said. “You can’t take life too seriously. You’ve got to take the ups and the downs. You’ve got to make a joke of a lot of things.”
His penchant for making light of the heavy stuff may get him in trouble at times. “You can’t be serious all the time,” he said.
When chemotherapy caused her hair to fall out, “not all over, just on top, I looked like Friar Tuck,” she said, chuckling. “You have to think of things like that.”
Pati, whose cancer is termed “inactive,” receives frequent medical checkups. She also participates in Livestrong, a YMCA program aimed at restoring health and well-being to those who’ve been diagnosed with cancer.
Pati calls the program a godsend.
“I know there’s a reason for everybody to be here. We each have a special purpose,” she said. “I’ve been looking for that reason. I think I can make a difference.”
What is fallopian tube cancer?
Fallopian tube cancer begins in a woman’s fallopian tubes, the two small ducts that link the ovaries to the uterus. The cancer begins when normal cells in one or both fallopian tubes change and grow uncontrollably.
It is more common for cancer to spread to the fallopian tubes than for cancer to begin there, according to Cancer.net., which presents oncologist-approved information from the American Society of Clinical Oncology.
Similar to ovarian cancer, fallopian tube cancer is difficult to detect because, sometimes, symptoms are too subtle to raise concern or are attributed to digestive problems.
Several factors that may raise a woman’s risk of developing fallopian tube cancer are: age (this type of cancer occurs mostly in postmenopausal women in their 50s and 60s); family history; and genetic mutations (recent studies suggest that a mutation in the BRCA1 gene, which is linked to breast and ovarian cancer, may also increase the risk of developing fallopian tube cancer).
If detected early, fallopian tube cancer often can be successfully treated.
Possible warning signs
Women with fallopian tube cancer may experience the following symptoms. Sometimes, women with this type of cancer do not show any of these symptoms. Or, these symptoms may be caused by a medical condition that is not cancer.
• Irregular or heavy vaginal bleeding, especially after menopause.
• Occasional abdominal or pelvic pain or feeling of pressure.
• Vaginal discharge, which may be clear, white or tinged with blood.
• A pelvic mass or lump.
If you are concerned about a symptom on this list, talk with your doctor.