Ovarian Cancer Survivor
- Diagnosed with ovarian cancer at age 54
- Treated with surgery and a very strong chemotherapy regimen
- After repeated infections, Jane has been in remission since 2007
In 2006, Jane Van Voorst was 54 years old and feeling healthy and in good shape. She was a runner and took good care of herself. But later in the year, before going on vacation, Jane wasn’t feeling quite right. She couldn’t really put her finger on what was wrong. She had a little bit of intestinal distress and some bloating. Her doctor thought she might have irritable bowel syndrome, but that didn’t sound right to Jane. She took the medications he recommended and initially felt better, but that feeling was short-lived.
“I’ve had the same general practitioner since my kids were born,” Jane says, “so when I went back to him and said I still wasn’t feeling quite right, he listened and knew it wasn’t like me to feel this way. So he sent me for an ultrasound.” The ultrasound revealed fluid build-up in Jane’s gut. Something was going on there. A day or so after the ultrasound, Jane was struck with a “raging fever and pain,” she says. Her doctor suspected an infection and prescribed an antibiotic and a repeat ultrasound in a couple of weeks.
Finally, about a month after her initial complaints, her doctor sent Jane to see a gynecologist. In early October, Jane presented her symptoms in a typed sheet to the gynecologist, which now included pain in her waist. “The doctor read my list and did an exam. She knew what I had, she said, and she drew me a picture,” Jane says. “She said I had ovarian cancer.”
The most difficult part of this diagnosis was telling her husband and sons, Jane says. “When I left the doctor’s office after hearing the diagnosis, I was already focused on ‘let’s attack this,’” Jane says. “I drove straight to my husband’s job and as soon as I had to tell him ‘they think I have ovarian cancer,’ I broke down. Although I was able to keep it together when I called our sons, I found myself getting emotional as we talked. There is something about telling people whom you love and who love you that is difficult. I did not want them to worry about me; I was used to being the caregiver and telling them everything was going to be okay. Now, they were doing that for me."
From her gynecologist, Jane knew she would have to have surgery to treat her cancer and that Seattle Cancer Care Alliance’s Barbara Goff, MD, a specialist in treating gynecologic cancers, should be the one to do that surgery.
“My doctor called me the next day and said Dr. Goff could see me in two weeks. Was I okay with waiting two weeks? And I said, ‘Will I be okay waiting?’ And she said ‘Dr. Goff is worth the wait.’” Jane got a large packet in the mail prior to her appointment with Dr. Goff with information about her disease and what Jane could expect once she got to SCCA.
“My mother had died of breast cancer when I was young, and my father died of pancreatic cancer,” Jane says. She was very motivated to do whatever it was going to take to keep from dying of ovarian cancer.
“Dr. Goff was direct and to the point,” Jane says. “She did her exam and was able to tell me that yes, I did have ovarian cancer throughout my abdomen." The rectal exam revealed blood, which Dr. Goff didn’t expect based on Jane’s earlier exams.
“She told me that she was going to get as much of the cancer out as she could surgically,” Jane says. “She thought I had stage IIIC ovarian cancer, which meant I had about a 10 percent chance of being alive in five years!”
Surgery – Going for a cure
The day after her exam with Dr. Goff, Jane was in the operating room at University of Washington Medical Center. After surgery, while Jane was recovering, her husband, sons, and brother were there to support her. They told her that Dr. Goff had reported that she got all of the cancer out that she could see. “She told my husband Gerrit: ‘We’re going for a cure.’”
Gerrit stayed with Jane while she was in the hospital. Normally she would have been able to go home within the week, but the cancer had perforated Jane’s colon, so Dr. Goff had had to remove and resect part of her colon. Jane couldn’t go home until she had a bowel movement, and her body didn’t cooperate for about 14 days.
Next up in Jane’s treatment was chemotherapy, which she started before Thanksgiving. She got a Hickman line (port) in her chest for systemic chemotherapy and a gut port for additional chemotherapy she would receive directly to her gut.
“Dr. Goff told me that only 35 percent of women finish this treatment,” Jane says. “It’s very toxic, with significant side effects, and she let me know that I’m in the driver’s seat.” Jane was to receive eight systemic chemotherapy treatments. Two as an outpatient at UW Medical Center and in conjunction with the last six systemic treatments, she would receive six in-patient treatments at UW Medical Center for the gut chemo.
“I decided that I could do this! I would be one of the 35 percent,” Jane says.
Jane’s nurses told her that the goal during her treatment was to stay ahead of the nausea and the pain. “I hate to throw up, so I was good with staying ahead of that,” Jane says, “but initially I wasn’t as good at staying ahead of the pain. I wasn’t sure when to take the pain medications and ended up taking them a little late, and not enough of them."
As soon as the pain started, Jane was supposed to take the medications, otherwise the pain would travel throughout her body and be harder to address. After that first battle with the pain, Jane made sure she stayed ahead of the pain.
“I lost my hair after that first chemotherapy,” Jane says. “For fun, I shaved my head in stages.”
She also got tinnitus, ringing in her ears. And at Christmas time, Jane got a C. Diff. (clostridium difficile) infection and she ended up in the emergency room and being admitted for a couple of days for treatment. In late December, Jane required a transfusion, which she got on New Year’s Eve, due to a low red blood cell count.
Jane began six inpatient chemotherapy sessions President’s Day weekend on Sunday. For the next four months, every three weeks on Sunday, Jane would arrive at UWMC at 8 a.m. and be hooked up to Taxol for a 24-hour slow drip and cisplatin, which she received through her gut port to wash her abdomen. Washing her gut was a little like lying on a rocking boat. She’d raise feet first for 15 minutes, then her head for 15 minutes, followed by rolling to one side for 15 minutes and then the other side for another 15 minutes. This process was repeated twice over two hours.
With each infusion, Jane felt worse and worse. But she got into a routine. As the sessions went on, the protocol for the nurses and doctors changed and they had to take more precautions to protect themselves from the toxic therapy Jane was receiving. Jane finished her treatment on April 30. She had become one of the 35 percent to complete a very difficult therapy to rid her body of ovarian cancer.
On the first Friday following the completion of treatment, Jane noticed red dots around her chest port. “It was after hours, of course,” she says, so she called the after hours support line at UWMC. The gynecological oncology resident on call prescribed Keflex to treat the infection with orders to contact Dr. Goff on Monday if she was not better. By Monday, the infection was larger and she had a fever. She emailed a picture to Dr. Goff’s office, and they called with instructions to come to SCCA. Dr. Goff saw her and admitted her to UWMC.
“They drew a six-inch long by four-inch wide circle around the infection,” Jane says, to see if it would progress past the line. She had developed blisters around the area as well. The infectious disease doctors came to see her next and changed her medication to intravenous antibiotics and finally the infection began to shrink. “The bacteria formed a huge ridge around the port,” Jane says. She spent the next week in the hospital as the infection appeared to decrease. But after a week she noticed the infection was running up her chest. “The doctors could not figure out what the infection was!” Jane says. They gave her a new drug then and she spent another week in the hospital.
After four or five weeks, Jane complained to her doctors about her peripheral neuropathy. The Flagyl she was taking to fend off C. Diff. was causing this difficult side effect, initially caused by the chemo, to get significantly worse. She changed to another antibiotic, oral vancomycin, which does not affect neuropathy. But after eight weeks of treatment, her infection was still there.
“My infectious disease doctor called Dr. Goff and he said that Dr. Goff wanted to cut the infection out. Dr. Goff’s nurse said she doesn’t usually do that, but wanted to for me,” Jane says. Jane had an outpatient procedure that left a large scar, which has since been covered with a tattoo!
“The next day I was the keynote speaker at the Relay for Life in Bellingham,” Jane says. After yet another two weeks of antibiotics, Jane finally began to feel better, and stronger.
Life after cancer
“You don’t have control over getting a disease,” Jane says. “But you do have control over how you face the disease. Attitude has a lot to do with weathering the treatment, at least it did for me.”
Finally in remission, Jane looked into going back to work. She’d taken family medical leave during her treatment time. She returned to work to a different job with the bank she’d worked at for several years. “I didn’t want my old job anymore. It was too stressful. So they gave me a project manager job, even with my chemo brain,” Jane says. “But I got better over time.”
Jane now volunteers in Bellingham when she can. She’s the sponsorship chair for the Relay for Life and is the volunteer chair for the American Cancer Society’s Cancer Prevention Studies - 3. “I need to give back,” Jane says. “I’m a firm believer in that.”
She and Gerrit work out together; they are very protective of their time together. They also hike, go mushroom hunting, travel, and participate in close-quarter combat training. “And, we ride Harleys,” she says. “I used to drive, but now I ride with Gerrit as a passenger. It’s much more fun for me–and Gerrit doesn’t worry, so he can enjoy the ride more. We love it, don’t do enough of it, and can’t wait until good weather and retirement so we can do more of it.”
Just this year, Jane and Gerrit have a new favorite thing to do and that is spend time with their grandson. “Being a grandparent is indescribably joyous!” Jane says, “without the treatment I received from Dr. Goff and Seattle Cancer Care Alliance, I know I would not be alive today to be with him. I am, and forever will be, grateful for the gift of life Dr. Goff gave me.”