WEBVTT

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[music]

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I think it\'s one

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of the most important health issues facing women
because of the mortality rate and the very

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unfortunate outcomes for very many women.
I think most women now think about breast

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cancer as being a number one, but the
reality is that breast cancer is now, um,

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80 percent curable. Survival
rates are going up all the time,

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uh, whereas for ovarian cancer, because of
the difficulty of diagnosis and treatment,

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uh, it\'s very sad to say that
survival rates are still below

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50 percent after five years. That\'s a
huge concern for women\'s health. [music]

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Well, the first thing that happened to me is
that I had a strange sort of tiredness, but

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with the life that I lead, which is usually
pretty busy, um, the doctor, the GP

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that I went to, said, \"Well, no wonder you\'re tired. You\'re
never home.\" But, I found that after two early nights

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, the tiredness didn\'t go. That was really
the only symptom that I had. And I was

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just fortunate, I suppose, that I
persisted, uh, when I was first told

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that I had glandular fever. And then I was
subsequently told that I had chronic fatigue.

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And I just didn\'t accept that. So, I went
to the hospital, uh, reported to casualty,

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and demanded a CAT scan. And when the
doctor on duty told me that CAT scans

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were expensive, I told him that I believed
that I was valuable, and I wasn\'t

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leaving until I got one. Now, um, a
guardian angel must have been sitting on my

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shoulder, because of course, within two hours
of having the CAT scan, uh, I\'d been hit

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by the speeding train of diagnosis
of ovarian cancer. [music]

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Well, I\'m very careful about my health.

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I\'ve never been a smoker. I\'m a very, very
light drinker, and I\'m careful about my food.

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I don\'t, um, I\'m careful about my, um, cholesterol
readings and so on. So, I\'m very tuned

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into my body. And when I felt
unwell, I knew it was something

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more than simply what I\'d been told.
And my inclination was to persevere.

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And when I had, um, the tumor
removed it was, I understand, the

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size of a small grapefruit. But, I couldn\'t
see it. I couldn\'t feel it. Um, the doctors

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could feel it, but obviously they\'re more
accustomed to palpating these things than I am.

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But, it was impossible to either see
it or feel it with, uh, an untrained

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examination. And again,
when I explained to people

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what my diagnosis was, they said to me, \"But
haven\'t you been having pap smears?\", which just

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reinforces to me, uh, the lack of
understanding about the diagnosis and

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treatment of ovarian cancer and the need
for women to be aware if they do have

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symptoms which seem unexplainable
and unconnected. [music]

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It is a very difficult pathway. As I
said, my diagnosis was a little bit like

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being hit by a speeding train. And then I
had to go through a process of finding out

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what\'s next, what\'s next. What, what will
I expect. What can I expect? What about

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when I lose my hair? What sort of
residual effect will chemotherapy have?

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How will I cope with the loss of appetite? What sort
of food should I eat? Um, all of these things required

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me to go searching for them at a time
when I was probably less equipped

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to be able to do so than at any other time
in my life. So, I think anything that

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can be given as a package to women, covering these
sorts of issues would be wonderful. [music]

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I came to know Jeannie initially

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as a patient. Um, but subsequently
she did become a friend,

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uh, because she was a very warm person, uh,

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a woman of great charm, uh,
and of great humility. Uh,

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I think as she went down this journey of

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ovarian cancer, um, it was
amazing to me the, the courage

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that she displayed, particularly
throughout the senate inquiry

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that she helped to initiate. I know how
hard it was for her to sit through

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a lot of that evidence. She often
confided in me how, how difficult

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it was to confront, uh, the
reality of her own disease.

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But she did this with, with great courage
and dignity, and I think she did,

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did a lot in a very short time to
help raise the awareness of ovaria

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n cancer among Australian women.

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I would say to women, if you feel unwell,
if your symptoms are odd, if you have

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bloating, if you have an indigestion,
if you have a loss of appetite,

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if you have unusual bowel
motions, don\'t take no for an

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answer. Take your life into your
hand and be assertive. [music]

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It\'s ten year ago since I
was diagnosed with ovarian

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cancer. I had a diary full of
my activities for the year

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1998, and all of a sudden,
all my plans were

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out, blew out the window.
I\'ll never forget, I was told

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to get my parents here from the UK as
quickly as possible, because, uh, the

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deterioration would be rapid. That if I
hadn\'t prepared a will, it would be a

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very good idea to get my affairs in order, which
completely freaked me out. But, you know,

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that\'s where I was, what I was dealing with.
And, um, that they would do everything possible

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to save my life. And, um, you know,
that that\'s the path that I was on.

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My sister, who was with me, was sort of sent off for
grief counseling. It became very evident that I was

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in a, in a, in a very,
very, um, life threatening

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situation. And this all came out of
nowhere. All came of nowhere. I was

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horrified to tell you the honest truth.
Um, I was scared, um, and

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immediate reaction is why me? Um,

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I, I was just in a truly upset
and devastated. I think I

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just put it in a \"I can\'t look at that\" box

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and pretended it was all fine.
Um, we don\'t have any cancer

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in our family at all. No one\'s had it.
I\'m the first one. Um, and for me,

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I\'ve never been really sick at all.
Um, I\'ve just had a normal life,

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you know. Determination. Just wasn\'t
going to let it get the better

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of me. And, um, for roughly
six months to twelve months,

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it did. It takes a lot out of you.
You can\'t do certain things,

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and, um, you do change your life somewhat.
And then you just get back to

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doing what you can. Initially,
you know, the shock,

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the shock of it was just horrible. Um, we

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more or less just went
into panic, panic mode,

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thinking, you know, there wasn\'t long
to go by what we were getting told.

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Um, the family was just
in disarray, and, uh,

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it was just horrific, a
horrific feeling. I think

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women, and I was one of those women in the
beginning, is just so scared. You look

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on the internet, you read
about ovarian cancer and you,

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you\'re almost paralyzed with fear because
you think, \"I\'m just going to die.\"

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But it doesn\'t have to be that way. Some
women, you know, 25 percent of women with

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late stage ovarian cancer do survive.
That could be you. I\'d heard of it only,

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and I remember lying there just

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in and out of shock and disbelief. I couldn\'t
believe it. And I\'ll never forget it.

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And, my main thought went to my mum, um,

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and what were we gonna do now? I couldn\'t,
it was disbelief, just disbelief.

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I felt those things didn\'t happen
to younger, younger women.

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It was, it was hard. It was hard, and I
think it took maybe a week to two weeks

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until it clearly sink in. But by
then I didn\'t also think about

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this, the statistic, I just concentrate
on the immediate action, what could I do.

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Um, start doing something to, to,

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at least to have some chance. And also
I\'m a math teacher and I also tell my,

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always told my students what are the chances
of winning the lotto. And I thought

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my chance of beating this cancer is certainly
much greater that winning the lotto.

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So many people play Lotto every week, you
know, and they believe then at some stage

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they win. So, I thought I\'d give
it my best shot as well. Women are

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fantastic patients. The way they
deal with this disease is amazing.

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And, we see people who we wouldn\'t
expect to survive and do well,

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that five years and seven years and nine
years later, are still coming back.

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And that is just so encouraging

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that we should push on and,
uh, treat this, this disease

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aggressively, because there are people
who you would never expect to cure,

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where we do cure. But I think one of the, the main
things and one of the things that I\'ve, uh, gained

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from working with these women is there
are one of the most positive optimistic

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group of women that you could look after.
And it\'s actually great privilege to be

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involved with them, that despite all the challenges
their disease brings them, they still find positive

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in the situation. Um, and you actually
learn a lot from working with them

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and how they cope with, with what they have to
deal with. From a survival point of view, and I\'m

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so grateful that I had survived, and
anything I can find that I can pass on

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to help anybody else out there, I really
want to find that, because why does one

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person survive and one not? It\'s a question that, you know,
it\'s an answer that I really would, would love to try

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and, and throw in whatever I can, because I\'ve
been one of the lucky ones. And I think for me

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when, when I came back from all of that, and
I lost it. I really, you know, I had to ring

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my parents and tell them. And, I tried
to be so strong for so long, and I can

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remember just going into my bathroom to have a
bath, and just falling to the floor, hysterical

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sobbing. And, and while that was happening, I just,
I haven\'t got time for this. There is no time

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for this nonsense. Gather yourself, girl. And I
got into the bath, and by the time I got out

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of that bath, I was in warrior mode. It
was like, you know, this, this is war

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. This is absolute war. And the only way I\'m going
to survive this is, is to do everything I can

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and to be intelligent, to be strong, and to, to,
I mean, obviously there were, there were tears.

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There were a thousand tears, but the tears were
released. There was always, there was always hope.

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There was always in my mind the
chance that I would survive. [music]

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Ovarian cancer is the

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sixth most common cancer in the world
affecting women. Approximately

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one in every one hundred women will develop
this disease, mostly women over the age of

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45, although it can also occur
in younger women. While

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there is screening tests for breast cancer
and cervical cancer, there is as yet

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no early detection test for ovarian
cancer, although research is underway

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to find one. The problem with ovarian
cancer is that the vast majority of women

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present with advanced disease. So,
you\'re already behind the eight ball

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in trying to manage it. Usually
affects women, uh, who are

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post-menopausal, average age about 52,
although one in five will be pre-menopausal.

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A lot of these women are actually surviving
for four or five years because the

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cancer itself does respond to well
to chemotherapy. So, we\'re very

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fortunate in the sense that we can get women into
remission, even with very advanced disease. It has

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enormous, um, emotional impact
as well as physical impact,

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because it does have a bad reputation.
So, part of the, uh,

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problem with dealing with ovarian cancer is
dealing with also the enormous emotional and

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psychological issues that occur along with
this diagnosis. It sneaks up upon you.

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Within twelve months, one lady I\'m
thinking of, had a fifteen centimeter

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ovarian cancer, having had normal scans
twelve months before it. It\'s a very silent

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and, uh, and insidious
disease, and unfortunately,

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it does spread without giving
much in the way of symptoms

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until quite late in the place(ph). There
are three types of ovarian cancer,

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but by far the most common is epithelial,
which is the focus of this program.

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The name refers to the cells on the
outer surface of the ovary, where

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the tumor grows. It may start
in one or both ovaries and can

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also spread to other parts of the body,
causing secondary cancers called

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metastases. So the stages
of ovarian cancer are,

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um, are based the extent of spread
of the tumor. And so, if the tumor

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is confined completely to the ovary with no evidence
of spread elsewhere, then it is regarded as a

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Stage 1 tumor, despite the size that it might
be. So, you can have Stage I tumors that are 20

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centimeters, 30 centimeters, but as long as
the tumor is confined to the ovary it\'s Stage

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1 and it has a pretty good prognosis.
Um, Stage 2 tumors are tumors in which

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the, uh, tumor has spread outside the ovary
to the pelvic organs, so that might be the

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fallopian tubes or the surface of the uterus or
various other sites in the pelvis. And again,

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the size of the tumor or the size of the, or the
amount of spread really doesn\'t matter. It\'s just

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the fact that it has spread to the pelvis.
Stage 3 is the stage at which

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most patients are diagnosed. Uh, 70 percent of ovarian
cancer patients will be diagnosed with Stage 3

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disease, and that\'s the stage at which the
disease has spread outside the pelvis

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and into the, um, abdomen. And that\'s,
um, means that anyplace in the abdomen

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can be involved. It\'s the peritoneal surfaces, so it\'s
not meaning the inside of the liver or the inside

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of the stomach or the inside of the spleen or
the bowel, but on the surface of the liver,

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um, diaphragm, um, stomach or
any of the peritoneal surfaces.

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And that would make it Stage 3. And Stage
4 is distance spread outside the abdomen.

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I had a tumor on my, uh, large bowel.

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I had, um, a tumor on my,
um, omentum, my diaphragm.

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I had a plum sized tumor
on my left hand side.

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Um, I had tumors scattered,
like scattered nodules all over

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my peritoneum. And, by the
time I actually got a

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diagnosis, my C-section
scar was a row of tumor,

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ulcerating through the skin. Being in her
thirties, Julie wasn\'t considered to be

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at high risk, so the cancer came
as even more of shock. [music]

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Well, when a woman\'s diagnosed
with ovarian cancer,

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one of her concerns might be, um, now that
I\'ve been diagnosed with ovarian cancer, does

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this change the risk to my daughters
or my sisters? And the answer

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to that question is generally no, because most
ovarian cancer does not run in the family.

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And, having one person with ovarian
cancer does not intent to change

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the risk for other women in the family.
The only exception to that is

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some rare families where there is a very
strong family history, and that family

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history can involve breast and ovarian
cancer in different generations

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of the family or sometimes a different
pattern with bowel, cancer of the

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uterus and ovarian cancer. And it\'s
those rare families where there is

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a genetic predisposition. And your
doctor will take that family history

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and possibly refer you to a family cancer
service, it that\'s the case. [music]

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I did take the pill. I did have babies.

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Um, it\'s like being run over by a bus.
It\'s just one of those things.

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Um, yeah, it\'s rough, but my kids are big.
I mean they\'re 19 and they\'re 21,

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and yes I want to be around as
long as I can be around, and,

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and the other thing is that long term survival,
although it\'s, it\'s low, it\'s not zero

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. So, I\'m not actually giving up yet.
[music]

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It all

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sort of started with me, with, with
being tired, feeling unusually tired,

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and constantly tired. And, um, I put
it down to that I was working hard,

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and then I started to get bloated. I started to
feel that I was getting quite bloated around

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my abdomen area. And it just was a progression
of just feeling tired, not feeling well.

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Um, I couldn\'t get out of bed in the mornings.
Um, and started to not want to go out.

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Just, I was just constantly feeling tired. So, I\'ve
got a lot of energy, and I\'m, I\'m used to, you know,

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running around and going to the gym. I worked. When I
was coming home from work, and having to go to bed.

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And that was not normal for me.
Um, and that\'s what made me

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go to the doctor in the first place.
Yeah, the first symptoms that I had, um,

00:19:40.000 --> 00:19:44.999
were abdominal pain, um, just crampy,

00:19:45.000 --> 00:19:49.999
dull, achy, abdominal pain, which was
persistent. And as time went by,

00:19:50.000 --> 00:19:54.999
uh, you know, I was getting other
symptoms as well. Fatigue.

00:19:55.000 --> 00:19:59.999
The nausea started. Um, I
was very tired after work

00:20:00.000 --> 00:20:04.999
every day. I\'d come home and I\'d just
crash out on the lounge, and just try

00:20:05.000 --> 00:20:09.999
and get over the pain. The vast majority of women
with ovarian cancer have symptoms for a long

00:20:10.000 --> 00:20:14.999
period of time, but they\'re very vague. They\'re very non
specific. They\'re symptoms that everybody has. A bit

00:20:15.000 --> 00:20:19.999
of bloating, a bit of abdominal discomfort.
Maybe a frequency of going to the toilet.

00:20:20.000 --> 00:20:24.999
Some change in their bowel habit. Lots of very,
very normal symptoms that both men and women

00:20:25.000 --> 00:20:29.999
have. Uh, I\'d gone to my local doctor
on a Friday. I had some, um, abdo pain.

00:20:30.000 --> 00:20:34.999
Um, he informed me that he thought
I was constipated. Did an x-ray,

00:20:35.000 --> 00:20:39.999
um, and said to go home. And we did some
cleaning out of the bowel. There are a whole

00:20:40.000 --> 00:20:44.999
variety of symptoms, often bowel type
symptoms. Gastro-intestinal things

00:20:45.000 --> 00:20:49.999
like indigestion, nausea,
and it\'s not uncommon

00:20:50.000 --> 00:20:54.999
for women with ovarian
cancer to end up with a, a

00:20:55.000 --> 00:20:59.999
gastro-enterologist and some
colonoscopies, endoscopies,

00:21:00.000 --> 00:21:04.999
to see if there\'s not something wrong with the
bowel. Uh, menstrual disorders can sometimes

00:21:05.000 --> 00:21:09.999
be prominent, uh, pressure
symptoms, pressure

00:21:10.000 --> 00:21:14.999
on the bowel, pressure on the bladder.
Um, all of these things,

00:21:15.000 --> 00:21:19.999
um, if they persist need to
be investigated and ovarian

00:21:20.000 --> 00:21:24.999
cancer needs to be thought of as one of
the differential diagnoses. After I\'d

00:21:25.000 --> 00:21:29.999
been diagnosed, I realized I
did have other symptoms of

00:21:30.000 --> 00:21:34.999
ovarian cancer. I did have bloating,
bloating in my stomach. Um, there was,

00:21:35.000 --> 00:21:39.999
uh, one moment where I had,
um, painful period. I didn\'t

00:21:40.000 --> 00:21:44.999
really have any specific sign other
than this pain that I got, um, in the

00:21:45.000 --> 00:21:49.999
lower abdomen. I had, when I had think
back of it now, I did have one episode

00:21:50.000 --> 00:21:54.999
of, um, painful intercourse.
It was only one,

00:21:55.000 --> 00:21:59.999
and I had a, maybe a month earlier, I had
said to my partner one day getting out

00:22:00.000 --> 00:22:04.999
of the shower, \"Oh, look at this. My
tummy\'s a bit, you know, a bit big.\"

00:22:05.000 --> 00:22:09.999
But not anything that would make me go to the doctor\'s
and say, \"Hey, listen. Something\'s going on.\"

00:22:10.000 --> 00:22:14.999
I had some time to times
unusual stomach pain. Um

00:22:15.000 --> 00:22:19.999
, but, it came and then, then,
then it\'s gone away. It came back

00:22:20.000 --> 00:22:24.999
maybe a few weeks later. Just one day,
I had a lot of wanting to pass water,

00:22:25.000 --> 00:22:29.999
and going to the bathroom for about 12
hours, very, very frequently. If someone

00:22:30.000 --> 00:22:34.999
has a tumor in their pelvis or their
ovaries are very enlarged, it may cause

00:22:35.000 --> 00:22:39.999
pressure on the bladder, so women have
frequency. You need to go to the toilet more

00:22:40.000 --> 00:22:44.999
frequently. Or, can sometimes
complain of what they call a dragging

00:22:45.000 --> 00:22:49.999
sensation in the pelvis. If the tumor\'s
pressing on the rectum, it may mean

00:22:50.000 --> 00:22:54.999
that people feel the need to go to the toilet
more frequently to pass stool. All of a

00:22:55.000 --> 00:22:59.999
sudden, I found that I was having to get
up at night to go to the toilet more

00:23:00.000 --> 00:23:04.999
frequently than I had in the past.
And on one occasion when I got

00:23:05.000 --> 00:23:09.999
back into bed, my left hand
accidentally fell on my left side,

00:23:10.000 --> 00:23:14.999
and I felt a hard mass. The irritable bowel

00:23:15.000 --> 00:23:19.999
that I\'ve had since I was
fifteen was maybe a bit worse.

00:23:20.000 --> 00:23:24.999
And it probably had been a bit worse
for a couple of months before I really

00:23:25.000 --> 00:23:29.999
noticed it. And, just

00:23:30.000 --> 00:23:34.999
one day I thought, \"It\'s really
not going away. This is really

00:23:35.000 --> 00:23:39.999
neurotic, but I think I\'ll
examine my abdomen.\" So,

00:23:40.000 --> 00:23:44.999
I laid out on the bed, and formally examined
my abdomen and found a rock melon in it.

00:23:45.000 --> 00:23:49.999
Frequently we find very large
lumps in the ovary, which are

00:23:50.000 --> 00:23:54.999
only palpable when they finally rise out of the
pelvis and can be seen in the abdomen. Uh, and

00:23:55.000 --> 00:23:59.999
so, unlike a lump that you might have in your
forearm, which you\'ll feel and will stretch the

00:24:00.000 --> 00:24:04.999
surrounding muscle sheath or the like and give you a pain
and something you can feel easily. The ovary can achieve

00:24:05.000 --> 00:24:10.000
a, a dramatic size before you can even
be aware of its presence. [music]

00:24:35.000 --> 00:24:39.999
They\'re the sort of symptoms that you
generally will see with lots of other more

00:24:40.000 --> 00:24:44.999
common conditions. I guess the advice to
women is that if their symptoms are new

00:24:45.000 --> 00:24:49.999
and persistent, you should
at least see someone about

00:24:50.000 --> 00:24:54.999
them. And, try and get a diagnosis.
And if the symptoms persist despite

00:24:55.000 --> 00:24:59.999
some treatment, then look again.
Um, so it doesn\'t mean that

00:25:00.000 --> 00:25:04.999
anyone with these symptoms has ovarian cancer, but
it just means that if they\'re persistent, and the

00:25:05.000 --> 00:25:09.999
symptoms aren\'t managed and got better,
you\'ve got to consider that as a possible

00:25:10.000 --> 00:25:14.999
diagnosis. So, if this
happens to you, and it\'s

00:25:15.000 --> 00:25:19.999
out of the ordinary from your previous
experience, it\'s not the same

00:25:20.000 --> 00:25:24.999
as the bloating and constipation
you\'ve already, you\'ve always had. Or

00:25:25.000 --> 00:25:29.999
alternatively it\'s bloating and
constipation that you\'ve never had, then

00:25:30.000 --> 00:25:34.999
you need to have an ultrasound.

00:25:35.000 --> 00:25:39.999
You need to push if it\'s
not being offered. Um,

00:25:40.000 --> 00:25:44.999
because it\'s actually the first thing you do, not
the, not the thing that you do at the end of all the

00:25:45.000 --> 00:25:49.999
gastro workups. Um, by all
means you could do the

00:25:50.000 --> 00:25:54.999
gastro workup if the, if
the ovarian imaging is

00:25:55.000 --> 00:25:59.999
OK, but you don\'t do it first.
You do the ultrasound

00:26:00.000 --> 00:26:05.000
first. [music]

00:26:10.000 --> 00:26:14.999
Look, there is no doubt that ovarian
cancer is difficult to diagnose

00:26:15.000 --> 00:26:19.999
in some cases. Sometimes the ovaries look normal and
yet there\'s massive disease in the upper abdomen.

00:26:20.000 --> 00:26:24.999
So, I, I guess, um, there\'s
always gonna be cases where

00:26:25.000 --> 00:26:29.999
the patients have been reassured that there\'s nothing
wrong and then three months down the track, um, they

00:26:30.000 --> 00:26:34.999
find they\'ve got advanced disease. Oh, I had
gone to a doctor previously three months before,

00:26:35.000 --> 00:26:39.999
cause I\'d been really tired now. After
being diagnosed, I realized that, um,

00:26:40.000 --> 00:26:44.999
tiredness is one of those vague
symptoms you get with ovarian cancer.

00:26:45.000 --> 00:26:49.999
Um, and she didn\'t pick it up.
I also had a thyroid problem,

00:26:50.000 --> 00:26:54.999
so the doctor actually went along the
thyroid line, testing my thyroid levels.

00:26:55.000 --> 00:26:59.999
And she felt that they were all OK, it was just
a matter that I lived a busy lifestyle, and I

00:27:00.000 --> 00:27:04.999
needed some vitamins. Three months later, I, I
had this terrible pain when I was at the gym.

00:27:05.000 --> 00:27:09.999
I went to another GP, who felt my

00:27:10.000 --> 00:27:14.999
stomach area and could feel a mass. She
thought it may have been related to

00:27:15.000 --> 00:27:19.999
constipation. She did some thorough
questioning and sent me for a stomach x-ray.

00:27:20.000 --> 00:27:24.999
I went back to her that very afternoon because
she obviously had some, um, concerns.

00:27:25.000 --> 00:27:29.999
And, she then organized
me to see a gynecologist

00:27:30.000 --> 00:27:34.999
for trans-vaginal, um, ultrasound.
And it was there

00:27:35.000 --> 00:27:39.999
that I was told that I had, you know,
serious problem, that there was, um,

00:27:40.000 --> 00:27:44.999
what looked like tumors on both my ovaries
that needed to be removed. [music]

00:27:45.000 --> 00:27:53.000
I saw my GP probably

00:27:55.000 --> 00:27:59.999
on three occasions, and then that\'s when
she referred me to have a trans-vaginal

00:28:00.000 --> 00:28:04.999
ultrasound. And, I called up Doctor
Sandra(ph) to see if there was a hernia

00:28:05.000 --> 00:28:09.999
there. Um, when I saw her again,
um, I had a pap smear, and

00:28:10.000 --> 00:28:14.999
then I was, got a referral
back to my obstetrician.

00:28:15.000 --> 00:28:19.999
I saw him once in his rooms. Uh, then I saw
him when he did keyhole(ph) surgery on me

00:28:20.000 --> 00:28:24.999
in the hospital. I saw him again with the
results, that I just had scar tissue. And, I saw

00:28:25.000 --> 00:28:29.999
the second, uh, gynecologist
over a period of

00:28:30.000 --> 00:28:34.999
every month for six months. Um, and then

00:28:35.000 --> 00:28:39.999
he referred me to a plastic surgeon who

00:28:40.000 --> 00:28:44.999
ordered a CT. Then I saw
another, I had another surgery

00:28:45.000 --> 00:28:49.999
with another gynecologist before
I actually got a diagnosis.

00:28:50.000 --> 00:28:54.999
So, you\'re looking at
five doctors, and I saw

00:28:55.000 --> 00:28:59.999
six doctors before, over a period
of ten months. I put the, um,

00:29:00.000 --> 00:29:04.999
pain down to back problems. And started
taking some medication which I\'d taken prior

00:29:05.000 --> 00:29:09.999
to that for back pain. And that
seemed to take care of it and control

00:29:10.000 --> 00:29:14.999
the pain, but it never
really went away. And, uh,

00:29:15.000 --> 00:29:19.999
that triggered off, um, a series of, uh,

00:29:20.000 --> 00:29:25.000
trips, trips to the doctors where I was
getting treated for urine infections. [music]

00:29:30.000 --> 00:29:34.999
They had a cannula in me.
They took bloods. Um,

00:29:35.000 --> 00:29:39.999
and they did a urine test. Um, and
then when the pain started to get

00:29:40.000 --> 00:29:44.999
really bad, they gave me medications
to relieve the pain. And as a

00:29:45.000 --> 00:29:49.999
result of them examining me, I
was sent for a CT scan. And when

00:29:50.000 --> 00:29:54.999
the CT scan came back, that showed
a nine centimeter mass, which was

00:29:55.000 --> 00:29:59.999
not urologically related. It was
gynecologically related. And they said then,

00:30:00.000 --> 00:30:04.999
that, um, the gynecologist would
come and speak to me about it.

00:30:05.000 --> 00:30:09.999
Because I felt that I was sort of putting on a
bit of weight, I started to go to the gym a

00:30:10.000 --> 00:30:14.999
bit more than usual. And I passed out at the
gym, which was really quite, quite scary.

00:30:15.000 --> 00:30:19.999
And it wasn\'t just a faint, it was just quite
unusual. So, from there I went to my doctor

00:30:20.000 --> 00:30:24.999
and told her what had happened.
And she told me that I had low,

00:30:25.000 --> 00:30:29.999
she obviously did some checks, said that I had low
blood pressure, and drinking coffee would be a good

00:30:30.000 --> 00:30:34.999
idea to stimulate me and, uh, whatever.
So, of course, I put that down to,

00:30:35.000 --> 00:30:39.999
it wasn\'t really that serious. And then
from there the tiredness continued,

00:30:40.000 --> 00:30:44.999
the bloatedness continued. But, I was busy at
work. I really didn\'t take that much notice

00:30:45.000 --> 00:30:49.999
of what was going on, because there were other
things happening in my life. So, about three months

00:30:50.000 --> 00:30:54.999
on, I, I remember being at
home one night, and I was in

00:30:55.000 --> 00:30:59.999
excruciating pain, excruciating pain in
my, in my abdominal area. And I thought

00:31:00.000 --> 00:31:04.999
it was like a period pain, it was
just so bad. So, I, uh, I was

00:31:05.000 --> 00:31:09.999
with my boyfriend at the time. We called the
ambulance. The ambulance came. I was examined,

00:31:10.000 --> 00:31:14.999
and a blood test was taken. And they came back and
said that everything was OK. So I just thought

00:31:15.000 --> 00:31:19.999
I was going mad, you know, that, that obviously there\'s
nothing wrong with me. And it went nine months on,

00:31:20.000 --> 00:31:24.999
my belly button popped out, which I thought
was so strange. So, I went again to my

00:31:25.000 --> 00:31:29.999
doctor, and, um, showed it, said \"What on earth
is this?\" And she told me it was an umbilical

00:31:30.000 --> 00:31:34.999
hernia, and it really wasn\'t a big deal. They
happen all the time. Three months on from

00:31:35.000 --> 00:31:39.999
there, crippling pains. I\'m at work,
and I am in agony. I have a half

00:31:40.000 --> 00:31:44.999
a day, a half hour break in my day
as I\'m trying to close this, um,

00:31:45.000 --> 00:31:49.999
big real estate deal. And I go to my
doctor. And that\'s where I started a week

00:31:50.000 --> 00:31:54.999
long of tests. And it became quite
evident to me that whatever was going on

00:31:55.000 --> 00:31:59.999
was very very serious. And I was
taken, I had a, a, a CAT scan and

00:32:00.000 --> 00:32:04.999
an ultrasound. I was sent to a
bowel professor, that dealt with

00:32:05.000 --> 00:32:09.999
the bowel. And he had, he, um, he
then arranged for me to have an

00:32:10.000 --> 00:32:14.999
endoscopy and a colonoscopy, which I
did, I think a day or two days after.

00:32:15.000 --> 00:32:19.999
And that produced no results.
Everything was clear. So, he then

00:32:20.000 --> 00:32:24.999
had several conversations with me and
the suggestion there was that I could

00:32:25.000 --> 00:32:29.999
have cancer. The average
GP will see one woman in

00:32:30.000 --> 00:32:34.999
five to ten years with ovarian cancer,
but during that time, they would

00:32:35.000 --> 00:32:39.999
see countless hundreds of people with the same
sort of symptoms that are due to other non,

00:32:40.000 --> 00:32:44.999
uh, non-malignant conditions.
So it doesn\'t mean that

00:32:45.000 --> 00:32:49.999
the symptoms shouldn\'t be further evaluated
and followed up. They should be.

00:32:50.000 --> 00:32:54.999
And, and I would certainly, sort of,
encourage women if the symptoms

00:32:55.000 --> 00:32:59.999
aren\'t getting better, if
they persist despite some

00:33:00.000 --> 00:33:05.000
treatment or evaluation, go and get
another opinion and look further. [music]

00:33:10.000 --> 00:33:14.999
In broad general categories, I
think there\'s two ways that

00:33:15.000 --> 00:33:19.999
patients can present. One is that they
can, um, have multiple vague symptoms

00:33:20.000 --> 00:33:24.999
over the course of quite a long time,
uh, prior to their actual diagnosis.

00:33:25.000 --> 00:33:29.999
And they\'ve had umpteen investigations
and seen many doctors and

00:33:30.000 --> 00:33:34.999
a diagnosis has never been found until, um,
eventually someone said they\'ve got advanced

00:33:35.000 --> 00:33:39.999
ovarian cancer. And that\'s obviously devastating
to the patient, uh, because they feel that if only

00:33:40.000 --> 00:33:44.999
this had been found out twelve months earlier that
they, uh, their survival and their chances would be

00:33:45.000 --> 00:33:49.999
much better. And the second presentation is often
patients who\'ve been well until just a few weeks prior

00:33:50.000 --> 00:33:54.999
to the diagnosis, when they\'ve suddenly noticed
a rapid increases in the size of their

00:33:55.000 --> 00:33:59.999
abdomen or they felt a mass themselves,
or their GP has felt a mass. And they

00:34:00.000 --> 00:34:04.999
in some ways are equally, um, unsettled by all of this
because as far as they are concerned, they\'d been

00:34:05.000 --> 00:34:09.999
completely well until just three weeks prior to the
diagnosis. And now they\'re told they\'ve got advanced

00:34:10.000 --> 00:34:14.999
epithelial ovarian cancer. And again, that\'s
devastating for them as well. I went back on

00:34:15.000 --> 00:34:19.999
the Sunday because I still had the pain.
Um, and, um, he,

00:34:20.000 --> 00:34:24.999
um, had a feel and said, \"You\'ve
got a mass.\" Um, he tried

00:34:25.000 --> 00:34:29.999
to organize a CT scan there and then on
that day. Was unable to. Um, set me up

00:34:30.000 --> 00:34:34.999
on Monday to have a CT scan, which I had.
Um, when I went back to pick up the x-rays

00:34:35.000 --> 00:34:39.999
to take to the specialist, um, the radiologist
came out and told me that he\'d spoken to my GP.

00:34:40.000 --> 00:34:44.999
Um, and they wanted to an ultrasound.
The obvious best

00:34:45.000 --> 00:34:49.999
test are CA125 and trans-vaginal ultrasound,
done by people who are experience at

00:34:50.000 --> 00:34:54.999
gynecological pathology. I think you
cannot undervalue the, the benefit

00:34:55.000 --> 00:34:59.999
of a clinical exam. There\'s certainly been
lots of my patients who\'ve, um, either felt a

00:35:00.000 --> 00:35:04.999
lump themselves or had a lump felt by their
GP. So I think patients should be examined

00:35:05.000 --> 00:35:09.999
properly. But lots of people are not that comfortable
with, um, findings that are on clinical examination

00:35:10.000 --> 00:35:14.999
and therefore invariably patients have gone
through either an ultrasound or a CT scan.

00:35:15.000 --> 00:35:19.999
Um, and invariably the patients have
had a, a blood test called a CA125,

00:35:20.000 --> 00:35:24.999
which is a tumor marker for ovarian cancer.
If it\'s massively high, meaning over

00:35:25.000 --> 00:35:29.999
5,000, that\'s a pretty good indication that
there\'s a ovarian malignancy or some sort of

00:35:30.000 --> 00:35:34.999
malignancy. But low levels of
CA125, say up to, uh, less than 50

00:35:35.000 --> 00:35:39.999
or less than 100, especially in a
pre-menopausal woman can mean lots of

00:35:40.000 --> 00:35:44.999
other things that are not related to
cancer, such as uterine fibroids,

00:35:45.000 --> 00:35:49.999
endometriosis, even just taking it during the time of your
period can sometimes give you a mild elevation in your

00:35:50.000 --> 00:35:54.999
CA125. So, it\'s never just one test
that\'s gonna tell you what\'s wrong.

00:35:55.000 --> 00:35:59.999
It\'s gonna be a constellation of tests,
including, uh, clinical acumen as well.

00:36:00.000 --> 00:36:04.999
Because I\'m in general practice, I know about
ovarian cancer. I know how it presents.

00:36:05.000 --> 00:36:09.999
I\'m actually very careful
at checking people

00:36:10.000 --> 00:36:14.999
out with this kind of story.
Um, so I really felt

00:36:15.000 --> 00:36:19.999
absolutely neurotic even doing it.
But it was, um,

00:36:20.000 --> 00:36:24.999
but it\'s what, you know, you examine
people and then you do a scan,

00:36:25.000 --> 00:36:29.999
assuming that you don\'t find anything when
you examine them, which mostly you don\'t.

00:36:30.000 --> 00:36:35.000
But I did. [music]

00:36:40.000 --> 00:36:44.999
When I was first diagnosed
with ovarian cancer,

00:36:45.000 --> 00:36:49.999
what angered me most was not the
fact that I had ovarian cancer, but

00:36:50.000 --> 00:36:54.999
rather I knew nothing about it. And
so, of course, one of the questions I

00:36:55.000 --> 00:36:59.999
asked was, what is the prognosis?
And when I was told 40

00:37:00.000 --> 00:37:04.999
percent at five years, I
had to make certain that I

00:37:05.000 --> 00:37:09.999
was in the 40th percent at
five years, still going.

00:37:10.000 --> 00:37:14.999
Uh, and of course, I\'ve been
very fortunate, uh, and it\'s now

00:37:15.000 --> 00:37:19.999
nearly ten years going, since I
was first diagnosed. One of the

00:37:20.000 --> 00:37:24.999
questions that patients ask is, \"well what are my chances,
Doctor?\" And they often ask that on the first visit,

00:37:25.000 --> 00:37:29.999
which is a very reasonable question to ask. Unfortunately
we find it very difficult to talk about that

00:37:30.000 --> 00:37:34.999
because it\'s dependent on so many factors. The first is
that we need to be absolutely certain that it\'s ovarian

00:37:35.000 --> 00:37:39.999
cancer and then the extent of the surgery
and how successful we are in, in

00:37:40.000 --> 00:37:44.999
removing all of the tumor. And again, after
that the response the patients have to, um,

00:37:45.000 --> 00:37:49.999
the chemotherapy. It\'s, it\'s a
difficult thing to address with

00:37:50.000 --> 00:37:54.999
patients sometimes. Some patients are very up
front and say, you know, \"Tell me like it is.\"

00:37:55.000 --> 00:37:59.999
And others say, \"Look, I\'ve read a lot.
I think I understand what it is.

00:38:00.000 --> 00:38:04.999
I don\'t necessarily want you to spell it
out in black and white, exactly what\'s

00:38:05.000 --> 00:38:09.999
gonna happen to me in the next little while.\" Yes,
I preferred that my doctors tell me the truth

00:38:10.000 --> 00:38:14.999
and what they believe, not that they think
something to make me feel better, because

00:38:15.000 --> 00:38:19.999
I have son who is thirteen years old.
He was twelve when I was diagnosed with

00:38:20.000 --> 00:38:24.999
cancer, and he just start high school.
And it was first month

00:38:25.000 --> 00:38:29.999
he went on his own on bus to the
next suburb and came on bus back,

00:38:30.000 --> 00:38:34.999
and started being independent.
And, my long term

00:38:35.000 --> 00:38:39.999
is to be around when he will finish
high school, which is from now

00:38:40.000 --> 00:38:44.999
five and a half years. Every day after
this will be a bonus. And I know

00:38:45.000 --> 00:38:49.999
that I\'ll be very lucky if I will
last so long, but some people do so,

00:38:50.000 --> 00:38:54.999
you know, I believe that I will be
one of them. But, I want to prepare

00:38:55.000 --> 00:38:59.999
also in case I\'m not around.
So, we talk about it,

00:39:00.000 --> 00:39:04.999
but my son family believes that
I will be teach, and he is

00:39:05.000 --> 00:39:09.999
very optimistic. And that\'s good. I want him
to be this way, and I want him to be a normal

00:39:10.000 --> 00:39:14.999
kid, not a kid who just
is worrying about his

00:39:15.000 --> 00:39:19.999
mom being sick. So, the prognosis
of ovarian cancer is highly

00:39:20.000 --> 00:39:24.999
dependent on, first of all, the stage of disease,
and that just makes sense, uh, in terms of,

00:39:25.000 --> 00:39:29.999
um, less disease and less spread of disease
means a better outlook. So, Stage 1

00:39:30.000 --> 00:39:34.999
disease, depending on various
other factors, has a very good

00:39:35.000 --> 00:39:39.999
prognosis, and anywhere from 85 to 90 percent
of patients will survive, um, Stage 1

00:39:40.000 --> 00:39:44.999
ovarian cancer. Then as you increase the
stage, your prognosis gets worse, so that

00:39:45.000 --> 00:39:49.999
by the time you get to Stage 3 disease, you\'re looking
at 20 to 30 percent five year survival. And obviously

00:39:50.000 --> 00:39:54.999
Stage 4 is even worse after that. When
I asked the doctor about statistic, he

00:39:55.000 --> 00:39:59.999
said the odd one survives ten years.
So, I hope to be the odd one.

00:40:00.000 --> 00:40:04.999
Well, all of us who\'ve been
treating ovarian cancer for many

00:40:05.000 --> 00:40:09.999
years know it\'s really hard to predict how an individual
patient will go. There are statistics that you

00:40:10.000 --> 00:40:14.999
can look up for different stages, but
really, if the statistics say the chance is

00:40:15.000 --> 00:40:19.999
say 50/50, what you don\'t know is whether
someone\'s gonna be in the good 50 or the bad 50.

00:40:20.000 --> 00:40:24.999
So, we encourage people to have what we call
realistic optimism, hoping for the best, but

00:40:25.000 --> 00:40:29.999
realizing that sometimes the cancer does come back. But I
can say that we have a number of patients who\'ve been cured

00:40:30.000 --> 00:40:34.999
who had very advanced disease, even at presentation. So
it\'s really wrong to think that there\'s no chance of

00:40:35.000 --> 00:40:39.999
having long term survival with good quality
life. The diagnosis was late third

00:40:40.000 --> 00:40:44.999
stage ovarian cancer. And I was
flabbergasted. I, I didn\'t even know

00:40:45.000 --> 00:40:49.999
what ovarian cancer was. I just don\'t let
things get to me if I can\'t do something

00:40:50.000 --> 00:40:54.999
about it, I try and find a way to, but with
this I just decided it wasn\'t my time, and

00:40:55.000 --> 00:40:59.999
I wasn\'t giving in. It was a shock,
and I hadn\'t had children, so

00:41:00.000 --> 00:41:04.999
it was all those sort of things start racing through your mind. And
then I instantly went into a, \"I\'ve got to live. It\'s more important

00:41:05.000 --> 00:41:09.999
for me to, I\'ve got to fight
this.\" I\'m not about to give

00:41:10.000 --> 00:41:14.999
up and throw the towel in. There are lots of chemos(ph) out
there to try, and I know there\'s lots of other options.

00:41:15.000 --> 00:41:19.999
And I\'ll be there for every one of them.
I\'ve got kids to raise.

00:41:20.000 --> 00:41:25.000
That\'s it. [music]

00:41:30.000 --> 00:41:34.999
Well, all women with ovarian
cancer need to know that the most

00:41:35.000 --> 00:41:39.999
appropriate place to be
managed is by a gynecological

00:41:40.000 --> 00:41:44.999
oncologist and by a gynecological oncology unit. It
doesn\'t necessarily mean that they can\'t have, uh,

00:41:45.000 --> 00:41:49.999
chemotherapy elsewhere, or
close to home, but they

00:41:50.000 --> 00:41:54.999
need to be under the, the umbrella
and the guide and support network

00:41:55.000 --> 00:41:59.999
of a gynecological oncology unit. And
I, there is a plethora of evidence to

00:42:00.000 --> 00:42:04.999
suggest that women who are managed by a
unit or individual gynecologists, in a

00:42:05.000 --> 00:42:09.999
group setting, they\'re provided with more
multi-disciplinary care, and a more global

00:42:10.000 --> 00:42:14.999
approach and overall survival and quality of
life issues are improved in that situation.

00:42:15.000 --> 00:42:19.999
The multi-disciplinary team at these units
include a number of doctors and other health

00:42:20.000 --> 00:42:24.999
professionals who\'ll be working together on
your case and meet regularly, often each week

00:42:25.000 --> 00:42:29.999
to discuss their patients progress
and treatment. You\'re first contact

00:42:30.000 --> 00:42:34.999
is usually the gynecological oncologist
or gyne/onc, who specializes

00:42:35.000 --> 00:42:39.999
in treating cancers which affect
women\'s reproductive organs. So, I\'m a

00:42:40.000 --> 00:42:44.999
gynecological oncologist, which means I
operate on patients with a, uh gynecologic

00:42:45.000 --> 00:42:49.999
cancer, including ovarian cancer, um, as well
as looking after them in the post-operative

00:42:50.000 --> 00:42:54.999
period and following them up for as
long as, uh, they need follow up. The

00:42:55.000 --> 00:42:59.999
majority of women would be offered primary surgery,
and that allows us to confirm the diagnosis, allows

00:43:00.000 --> 00:43:04.999
us to remove as much cancer as we can, and
then would allow the chemotherapy to work

00:43:05.000 --> 00:43:09.999
on smaller volumes of cancer. And that\'s,
that would be the gold standard, the standard

00:43:10.000 --> 00:43:14.999
of treatment practiced throughout this country and
throughout most of the world. Although surgery

00:43:15.000 --> 00:43:19.999
is the first treatment for most
women, in some cases, chemotherapy is

00:43:20.000 --> 00:43:24.999
recommended first. Uh, gynecological
oncologists can approach, um,

00:43:25.000 --> 00:43:29.999
surgical treatment of these tumors in
two ways. You can either go straight in

00:43:30.000 --> 00:43:34.999
and do an operation. And where we look at
scans, and we think we can remove a tumor

00:43:35.000 --> 00:43:39.999
completely, we\'ll do that. But when you look at
a scan and you think there\'s a lot of disease

00:43:40.000 --> 00:43:44.999
spread around, and it\'s probably find disease
over surfaces, we\'re now looking at giving

00:43:45.000 --> 00:43:49.999
the patients chemotherapy first,
for three courses, to then,

00:43:50.000 --> 00:43:54.999
and then have the surgery after that.
What this does is decrease the bulk of

00:43:55.000 --> 00:43:59.999
the cancer that\'s there. That means
we can get more out more easily

00:44:00.000 --> 00:44:04.999
with less complications for the patient.
Chemo before surgery

00:44:05.000 --> 00:44:09.999
may also be advised for women who
have a large buildup of ascites

00:44:10.000 --> 00:44:14.999
or excessive fluid in the abdomen, caused
by the tumors. There are many mechanisms

00:44:15.000 --> 00:44:19.999
to explain the ascites, but essentially what it is
is a build up of fluid, an excessive amount of fluid

00:44:20.000 --> 00:44:24.999
in the abdomen. It causes abdominal
swelling, discomfort, distention.

00:44:25.000 --> 00:44:29.999
It\'s a common presenting symptom in
women with advanced ovarian cancer,

00:44:30.000 --> 00:44:34.999
and can build up very, very quickly.
Sometimes when women present with a very

00:44:35.000 --> 00:44:39.999
swollen abdomen due to ascites, we will
consider draining it before surgery.

00:44:40.000 --> 00:44:44.999
There\'ll be two reasons to do this. One is to
make a diagnosis, so you can send the fluid off

00:44:45.000 --> 00:44:49.999
and they can often get an opinion on what is
likely to have caused that fluid, because

00:44:50.000 --> 00:44:54.999
it may not be an ovarian cancer that\'s causing that
fluid buildup. The second reason is just to make

00:44:55.000 --> 00:44:59.999
someone more comfortable. The only problem
with removing that fluid and not following up

00:45:00.000 --> 00:45:04.999
with surgery in the short term is that that fluid
will tend to recollect fairly quickly, even

00:45:05.000 --> 00:45:09.999
within a few days. [music]

00:45:10.000 --> 00:45:14.999
When my oncologist gave me diagnosis

00:45:15.000 --> 00:45:19.999
that it\'s ovarian cancer, I was there with
my two grown up children. And he recommended

00:45:20.000 --> 00:45:24.999
chemotherapy. Um, my son asked

00:45:25.000 --> 00:45:29.999
if I can have a surgery because
he read on the internet about

00:45:30.000 --> 00:45:34.999
the bulking, remove, remove them.
Um, primary cancer

00:45:35.000 --> 00:45:39.999
of the major bulk of the tumor. And, um,

00:45:40.000 --> 00:45:44.999
doctor said that it would not be in my
interest because it could affect my

00:45:45.000 --> 00:45:49.999
chemotherapy, um, because, um, it

00:45:50.000 --> 00:45:54.999
was a very, very diagnosis. We asked
the doctor if he wouldn\'t mind

00:45:55.000 --> 00:45:59.999
if we get second or third opinion,
and he was very sympathetic. So,

00:46:00.000 --> 00:46:04.999
um, we left and my son did
research on the internet

00:46:05.000 --> 00:46:10.000
and found two leading, um, gynecological
oncologists in Sidney. [music]

00:46:15.000 --> 00:46:19.999
He\'s been to every appointment
with me, and supported me

00:46:20.000 --> 00:46:24.999
right through everything, and I, I don\'t know what
I would have, would have done without him. Um,

00:46:25.000 --> 00:46:29.999
when you\'re talking to doctors and you, they\'re getting
very technical, and whatever, and it\'s something so

00:46:30.000 --> 00:46:34.999
personal, and has such an impact on your
life, then having somebody else there

00:46:35.000 --> 00:46:39.999
listening along, he, he would pick up
things that I didn\'t hear at all, and

00:46:40.000 --> 00:46:44.999
we\'d be talking about something later on, and he\'d be
saying, \"Oh, the doctor said so-and-so.\" And so, when,

00:46:45.000 --> 00:46:49.999
when did he say that, cause I didn\'t hear
it? So, it\'s really good to have some

00:46:50.000 --> 00:46:54.999
support person, um, with you when
you\'re at these appointments.

00:46:55.000 --> 00:47:00.000
You know, I think it\'s necessary, and
he\'s been a great support to me. [music]

00:47:10.000 --> 00:47:14.999
Surgery is designed to do a couple of
things. One is it, it\'s designed to make

00:47:15.000 --> 00:47:19.999
the diagnosis, because sometimes patients
who present with what seems to be

00:47:20.000 --> 00:47:24.999
an ovarian mass turns out to be something
different. So, it could be a uterine or a, um,

00:47:25.000 --> 00:47:29.999
a bowel cancer and not an ovarian cancer. It
also, an important thing is to make the initial

00:47:30.000 --> 00:47:34.999
diagnosis. Um, and the, uh,
second thing is to, um,

00:47:35.000 --> 00:47:39.999
then remove as much of the tumor as
possible. And that\'s what we call debulking

00:47:40.000 --> 00:47:44.999
surgery, which really means, uh,
removing the uterus, tubes and ovaries

00:47:45.000 --> 00:47:49.999
in most patients, removing the omentum or the fat
pad that hangs down from the stomach, and removing

00:47:50.000 --> 00:47:54.999
any, uh, implants of tumor, wherever
they may lie in the abdominal cavity.

00:47:55.000 --> 00:47:59.999
Uh, and that can range anywhere from just
a few spots on, uh, the bowel surface

00:48:00.000 --> 00:48:04.999
to massive disease all through the bowel
on the liver and the diaphragm and spleen.

00:48:05.000 --> 00:48:09.999
Most women who undergo a hysterectomy
for a non-cancer operation,

00:48:10.000 --> 00:48:14.999
that history for me would take somewhere between 45 minutes
and an hour. So, it\'s a very straightforward procedure.

00:48:15.000 --> 00:48:19.999
A hysterectomy and cancer surgery
for ovarian cancer takes somewhere

00:48:20.000 --> 00:48:24.999
between two to four hours. It\'s a much
more labor intensive, and a much more

00:48:25.000 --> 00:48:29.999
aggressive surgery. And hence, patients who
are in hospital a little bit longer. Most

00:48:30.000 --> 00:48:34.999
patients would spend somewhere between
3 to 5 to 7 days in hospital after

00:48:35.000 --> 00:48:39.999
major abdominal surgery for
ovarian cancer. Once, uh,

00:48:40.000 --> 00:48:44.999
surgery is undertaken, it\'s usually
undertaken through what we call a

00:48:45.000 --> 00:48:49.999
vertical midline incision, where an incision is made from
the belly button downwards. And sometimes that cut is taken

00:48:50.000 --> 00:48:54.999
above the belly button as well. When we
operate on ovarian cancer, we find that

00:48:55.000 --> 00:48:59.999
there are many different ways in which
it appears when you actually go

00:49:00.000 --> 00:49:04.999
into the abdomen. There are some women where
the tumor almost falls out, and it\'s the

00:49:05.000 --> 00:49:09.999
only sign of tumor there is, and it\'s very easy
to remove. There are other situations where

00:49:10.000 --> 00:49:14.999
everything is so scarred and stuck down,
that it\'s almost impossible to get the

00:49:15.000 --> 00:49:19.999
tumor out. And sometimes it is impossible to
remove the tumor safely. And if we can get our

00:49:20.000 --> 00:49:24.999
cancer lumps down to about a centimeter in
size, or the size of sugar cube, we would

00:49:25.000 --> 00:49:29.999
call that successful, successful
surgery, because then the chemotherapy

00:49:30.000 --> 00:49:34.999
has less cancer to work on, and those patients will
have a much better survival than if we have to leave

00:49:35.000 --> 00:49:39.999
cancer lumps behind that is greater
than the size of the sugar cube.

00:49:40.000 --> 00:49:44.999
Essentially after this sort of major surgery,
you expect them to have, uh, urinary catheter

00:49:45.000 --> 00:49:49.999
in for a few days. They\'re going to be sore. We
sometimes use epidurals for pain relief, but we

00:49:50.000 --> 00:49:54.999
certainly would normally have a, an intravenous
drip in. And that often gives pain relief and also

00:49:55.000 --> 00:49:59.999
fluids until they\'re drinking and eating
normally afterwards. Sometimes the bowels

00:50:00.000 --> 00:50:04.999
go on strike, and that means that the patients
may become a bit nauseated and vomit afterwards.

00:50:05.000 --> 00:50:09.999
But, um, most of the time that doesn\'t happen, and
most people do get back to eating and drinking

00:50:10.000 --> 00:50:14.999
normally, within a few days. Basically we move
things along fairly quickly after the surgery.

00:50:15.000 --> 00:50:19.999
We\'ll get women out of bed, uh, straight, the
day after their operation to have a shower.

00:50:20.000 --> 00:50:24.999
Sit out of bed. Um, the drains and catheters
start coming out sort of the next day.

00:50:25.000 --> 00:50:29.999
Uh, and the drip, as soon as they start eating and
drinking, which we like to start fairly quickly,

00:50:30.000 --> 00:50:34.999
as long as they haven\'t had their bowels sort
of involved in the operation. Uh, we take,

00:50:35.000 --> 00:50:39.999
we take out on about day two. And then they\'re
back on a normal diet. We like to encourage

00:50:40.000 --> 00:50:44.999
people to get up as soon as they can, and
little walks even to the bathroom and

00:50:45.000 --> 00:50:49.999
round the corridor as the days go on. Um,
they\'ll find it much easy to do that.

00:50:50.000 --> 00:50:54.999
And it\'s just really good to help circulation,
keep their lungs open, prevent lung

00:50:55.000 --> 00:50:59.999
or chest infections, um, prevent blood
clots. I usually tell women that

00:51:00.000 --> 00:51:04.999
it takes about six weeks for their, for
them to feel better and heal after their

00:51:05.000 --> 00:51:09.999
surgery. We don\'t like them to do any
heavy lifting, um, any heavy exercise

00:51:10.000 --> 00:51:14.999
or have sexual intercourse until they come back
for their check, which is about four to six weeks

00:51:15.000 --> 00:51:19.999
after their operation. You know, moving
around and going for a walk, keeping fit,

00:51:20.000 --> 00:51:24.999
I believe that helps my body to
fight this disease. So, when

00:51:25.000 --> 00:51:29.999
I was in the hospital, not the second
day, the next day after the surgery,

00:51:30.000 --> 00:51:34.999
but the day after, I was walking
and along the corridor and,

00:51:35.000 --> 00:51:39.999
and moving quite probably after
maybe three, three or four

00:51:40.000 --> 00:51:44.999
days after this surgery. When my daughter and son
were visiting, we went out and walked around

00:51:45.000 --> 00:51:49.999
the hospital. And left hospital
six days after my surgery,

00:51:50.000 --> 00:51:54.999
and even when I came home and had
maybe twenty to thirty staples in my

00:51:55.000 --> 00:51:59.999
stomach, I was walking around the house.
Post operation,

00:52:00.000 --> 00:52:04.999
I obviously lost an enormous amount
of blood, and I was spent five days,

00:52:05.000 --> 00:52:09.999
I think it was five or six days, in acute care,
where I was given a full blood transfusion.

00:52:10.000 --> 00:52:14.999
And, I couldn\'t move. I could not move.
It was really quite

00:52:15.000 --> 00:52:19.999
a terrifying experience, but then as each
day went by, I got stronger and stronger.

00:52:20.000 --> 00:52:24.999
And I\'ve got to say the most beautiful
angels were surrounding me. The, the staff

00:52:25.000 --> 00:52:29.999
at the, uh, at the hospital there in
that acute care section were just so

00:52:30.000 --> 00:52:34.999
magical and really played a big part in me finding
the strength to get to the next stage and get out

00:52:35.000 --> 00:52:39.999
of there and eventually get out of
the hospital. The team who will look

00:52:40.000 --> 00:52:44.999
after you in a multi-disciplinary unit
usually includes a nurse who specializes in

00:52:45.000 --> 00:52:49.999
gynecological cancers, whose job is to
provide information, counseling and support,

00:52:50.000 --> 00:52:54.999
as well as referrals to other health
practitioners. The role very much is being

00:52:55.000 --> 00:52:59.999
there for the women all the way through their cancer
journey, such that I will see them from diagnosis,

00:53:00.000 --> 00:53:04.999
see them, um, while they\'re in hospital having
their surgery, and see them when they\'re having

00:53:05.000 --> 00:53:09.999
any form of treatment. I will have phone
contact, dependent on what they need.

00:53:10.000 --> 00:53:14.999
Now, for some women that might be women who
phone me two or three times a week, sometimes

00:53:15.000 --> 00:53:19.999
two or three times a day, depending
on what their dealing with. Um,

00:53:20.000 --> 00:53:24.999
for others they just need to know that there\'s someone
around, but it\'s very much sort of keeping up that, that

00:53:25.000 --> 00:53:29.999
constant contact with them so that when they
feel a need, um, to be able to talk about

00:53:30.000 --> 00:53:34.999
things, that, that we\'ve built that
relationship up. OK, my role in the

00:53:35.000 --> 00:53:39.999
care of women with ovarian cancer is very much
helping them to manage the symptoms of the disease.

00:53:40.000 --> 00:53:44.999
Um, women with ovarian cancer can be highly
symptomatic, and are often diagnosed

00:53:45.000 --> 00:53:49.999
with, um, more advanced disease,
can suffer pain and discomfort

00:53:50.000 --> 00:53:54.999
at the time of diagnosis, in which case I might be asked
to consult to see if there\'s something I can simply

00:53:55.000 --> 00:53:59.999
do to help with the pain at diagnosis.
I may not see women again, um,

00:54:00.000 --> 00:54:04.999
until they become unwell for another reason, where
I might be asked to come back in and try and

00:54:05.000 --> 00:54:09.999
sort out the symptoms again. Um, and then
I may not see, see someone again for

00:54:10.000 --> 00:54:14.999
sometimes another couple of years. Um, I\'m
a social worker in gynecological cancer.

00:54:15.000 --> 00:54:19.999
I\'m part of the, uh, big team that sees
all of the women in our unit who are

00:54:20.000 --> 00:54:24.999
diagnosed with ovarian cancer. And then I work with
them and with their families throughout the course

00:54:25.000 --> 00:54:29.999
of their illness, uh, beyond treatment, uh,
dealing with the particular issues that arrive,

00:54:30.000 --> 00:54:34.999
arise for each individual woman as she
confronts this, uh, very difficult diagnosis.

00:54:35.000 --> 00:54:39.999
Usually, the first meeting I\'ll have with
each woman is when they come into hospital,

00:54:40.000 --> 00:54:44.999
usually for their initial surgery. So,
I\'ll meet them at the bedside, and have

00:54:45.000 --> 00:54:49.999
a bit of a chat at that time. Then often I\'ll
follow up by phone or if they\'re coming back for

00:54:50.000 --> 00:54:54.999
follow-up appointments with their doctors here
at the hospital. Um, I can also arrange to

00:54:55.000 --> 00:54:59.999
meet people on an outpatient basis, and sometimes
we do that just here and there on an as needs basis

00:55:00.000 --> 00:55:04.999
or sometimes more regularly if there\'s a particular issue
that they want to work on. Well, initially, as you

00:55:05.000 --> 00:55:09.999
can imagine, um, they\'re filled with anxiety.
Some of them are depressed that this happened

00:55:10.000 --> 00:55:14.999
to them. Um, their families are anxious. They\'re
worrying about their families\' responses

00:55:15.000 --> 00:55:19.999
to what\'s, what the diagnosis has been.
And, and they, they\'re hanging out

00:55:20.000 --> 00:55:24.999
for the… the… um… the diagnosis in terms
of the pathology that\'s going to come

00:55:25.000 --> 00:55:29.999
back. And so they, their first
week being in hospital is,

00:55:30.000 --> 00:55:34.999
is a really difficult period for them, so I
try and help them in that area, just with

00:55:35.000 --> 00:55:39.999
reduction in anxiety, talking to their
family members, uh, answering any

00:55:40.000 --> 00:55:44.999
questions that they may have. But, generally,
they\'re busy trying to get over this

00:55:45.000 --> 00:55:49.999
rather large surgery. [music]

00:55:50.000 --> 00:55:58.000
I\'m a medical oncologist.

00:56:00.000 --> 00:56:04.999
And we\'re in charge of the chemotherapy part of the treatment
program that our ladies with ovarian cancer receive.

00:56:05.000 --> 00:56:09.999
We would normally meet these ladies after their
surgery in hospital, after the diagnosis has

00:56:10.000 --> 00:56:14.999
been confirmed by the pathologist. And from there
we\'re very heavily involved over the next three

00:56:15.000 --> 00:56:19.999
to four months as we supervise the
doses of chemotherapy. Although chemo

00:56:20.000 --> 00:56:24.999
is usually administered intravenously,
it can also be given in tablet form

00:56:25.000 --> 00:56:29.999
or through a tube, directly into the abdominal
cavity. Recently there\'s been some research

00:56:30.000 --> 00:56:34.999
suggesting that maybe if you put the drugs actually into
the tummy, so called, intra-peritoneal chemotherapy,

00:56:35.000 --> 00:56:39.999
that the results may be even better.
That\'s not completely proven yet,

00:56:40.000 --> 00:56:44.999
but for some patients who are very fit and strong, and we think might
be suitable for that treatment, we may even give them chemotherapy

00:56:45.000 --> 00:56:49.999
into the tummy rather than into the vein. But that
will vary a lot depending on the patient\'s individual

00:56:50.000 --> 00:56:54.999
circumstances. For most ladies,
the chemotherapy\'s actually

00:56:55.000 --> 00:56:59.999
done as an outpatient. And they come to the hospital
usually once every three weeks. And usually

00:57:00.000 --> 00:57:04.999
if they\'re having treatment into the vein they have an injection
through a drip that keeps them at hospital over several hours.

00:57:05.000 --> 00:57:09.999
Then they go home. It\'s quite interesting in
that there\'s quite a strong dynamic that builds

00:57:10.000 --> 00:57:14.999
up in the chemotherapy room, particularly
in, uh, the hospital that I work,

00:57:15.000 --> 00:57:19.999
where all the people having treatment are
all women with gynecological malignancies

00:57:20.000 --> 00:57:24.999
and largely ovarian cancer. There\'s a lot of
bonding. There\'s a lot of, uh, support and

00:57:25.000 --> 00:57:29.999
strong networks are built in, in the room. And, and you
know, there\'s all sorts of things that can happen.

00:57:30.000 --> 00:57:34.999
Some people enjoy discussing and talking
and sharing. And other people prefer,

00:57:35.000 --> 00:57:39.999
prefer to be more private, and they\'ll
bring, um, an ipod or a laptop or a book

00:57:40.000 --> 00:57:44.999
and not necessarily participate
in those discussions. But, never

00:57:45.000 --> 00:57:49.999
the less, there is, uh, quite a lot
of interaction between patients,

00:57:50.000 --> 00:57:54.999
in discussion and support in the chemotherapy
room. The chemo ward\'s a really social place.

00:57:55.000 --> 00:57:59.999
We see the same people often every time we come.
Some people are great cooks and bring all their

00:58:00.000 --> 00:58:04.999
lovely cakes and biscuits, which fatten us up. And
so, I eat salad at lunchtime to make up for the

00:58:05.000 --> 00:58:09.999
junk food that we eat while we\'re being social. And
we\'re very supportive \'cause women are supportive.

00:58:10.000 --> 00:58:14.999
And I\'ve had some of my best tips here. Like,
did you know if you go through menopause,

00:58:15.000 --> 00:58:19.999
shave your hair, take your hair off when you get
hot flash. That\'s why mine\'s off at the moment.

00:58:20.000 --> 00:58:24.999
What the chemotherapy does is really very interesting.
We used to think it was kind of like a poison,

00:58:25.000 --> 00:58:29.999
like a bottle with a skull and crossbones on it. But, it\'s
actually much more subtle than that. The chemotherapy

00:58:30.000 --> 00:58:34.999
actually triggers the cancer cells to die off
in the same way as happens when the tadpole

00:58:35.000 --> 00:58:39.999
reabsorbs its tail or when say, a big fern, and
the leaves are starting to wither on the fern.

00:58:40.000 --> 00:58:44.999
That\'s exactly what the chemotherapy does to the cancer. And
then the cancer gets smaller and smaller and shrinks away

00:58:45.000 --> 00:58:49.999
until you can\'t see it. Now, sometimes the
cancer\'s so sensitive to the drugs that it\'s just

00:58:50.000 --> 00:58:54.999
gone, dies off and can never recur. But
sometimes there\'s just a little residual root

00:58:55.000 --> 00:58:59.999
left behind that\'s not sensitive to the drugs, isn\'t
killed off. And then sometime down the track on its own

00:59:00.000 --> 00:59:04.999
schedule, it starts to grow again. And those patients
will need more treatment then. There are quite

00:59:05.000 --> 00:59:09.999
a number of drugs that are used to
treat ovarian cancer. The backbone

00:59:10.000 --> 00:59:14.999
of all treatment is platinum, usually carboplatin.
In the past we used to use a drug called cisplatin,

00:59:15.000 --> 00:59:19.999
but nowadays, most women get
carboplatin because it has

00:59:20.000 --> 00:59:24.999
less side effects. And carboplatin is
either used alone or more commonly in

00:59:25.000 --> 00:59:29.999
combination with other drugs, specifically
a drug called baclitaxel. It\'s

00:59:30.000 --> 00:59:34.999
important to understand that there isn\'t one absolutely
standard regiment that\'s, that all patients get.

00:59:35.000 --> 00:59:39.999
We do have to individualize the treatment for the
patients own particular case and particular needs.

00:59:40.000 --> 00:59:44.999
This is the closest I\'ve had to get to blond.
And what\'s great about it is, I just go,

00:59:45.000 --> 00:59:49.999
boom, boom, and I can look great, but I
even answer the front door now without

00:59:50.000 --> 00:59:54.999
hair on, because I\'m quite cool without my hair on. Most
of the time the ladies will actually lose their hair

00:59:55.000 --> 00:59:59.999
from the chemotherapy, because mostly the
chemotherapy needs to have two drugs in

01:00:00.000 --> 01:00:04.999
it. And one of the drugs causing the patients to
lose their hair. But the hair always comes back

01:00:05.000 --> 01:00:09.999
after the treatment stops, although it takes two to three
months before it comes back. Interestingly enough,

01:00:10.000 --> 01:00:14.999
it often comes back a bit curlier than it was before, and we\'re not
quite sure why that is, but it\'s just one of those things that happens.

01:00:15.000 --> 01:00:19.999
But it always does come back the same as
it was before. They told us that, um,

01:00:20.000 --> 01:00:24.999
the, the, having the taxel,
um, that within, you know,

01:00:25.000 --> 01:00:29.999
a week or two of having the first treatment,
your hair would start to fall out, which was

01:00:30.000 --> 01:00:34.999
correct. It was spot on. Um, when I went
for my three week review meeting, it was

01:00:35.000 --> 01:00:39.999
starting to come out then. And I had
baldy patches on my head in various

01:00:40.000 --> 01:00:44.999
spots. During treatment, women
are seen every three weeks or

01:00:45.000 --> 01:00:49.999
prior to each dose of treatment, and,
uh, we find out how they tolerate

01:00:50.000 --> 01:00:54.999
the previous treatment. We look at their
blood count. We examine them. And we modify

01:00:55.000 --> 01:00:59.999
the dose if we required. And we also, importantly,
just answer questions that have popped up

01:01:00.000 --> 01:01:04.999
over the preceding three weeks. And
we just discuss how, um, it went

01:01:05.000 --> 01:01:09.999
since the last chemo. Um, you
know, was the medication

01:01:10.000 --> 01:01:14.999
that they\'re giving you to bring
home for your nausea and etcetera

01:01:15.000 --> 01:01:19.999
working? Are you coping with it? Do
we need to change anything? Um, and

01:01:20.000 --> 01:01:24.999
just generally review the position. If
anything needs to be changed, then it will get

01:01:25.000 --> 01:01:29.999
changed. And so, then when I go for my chemo
on Monday, the changes will be implemented.

01:01:30.000 --> 01:01:34.999
While the chemo kills the cancer cells,
it can also damage normal cells,

01:01:35.000 --> 01:01:39.999
which is what causes the side effects. Those
most affected are the rapidly growing

01:01:40.000 --> 01:01:45.000
cells in your mouth, stomach, bowel,
skin, hair and bone marrow. [music]

01:02:05.000 --> 01:02:09.999
After the second session of chemotherapy, I
developed, um, what felt like numbness and

01:02:10.000 --> 01:02:14.999
tingling, or pins and needles in both
my hands and both my feet. Um, so

01:02:15.000 --> 01:02:19.999
at the next review meeting that I had,
um, I mentioned that I was having this

01:02:20.000 --> 01:02:24.999
symptom, and it was decided then to, uh, for
me not to continue on the taxel, because

01:02:25.000 --> 01:02:29.999
we didn\'t want to have long term nerve end
damage, you know, which would make it

01:02:30.000 --> 01:02:34.999
very hard for me to do up buttons
and little things with my fingers.

01:02:35.000 --> 01:02:39.999
So, um, after coming off it,
and having been off it now

01:02:40.000 --> 01:02:44.999
for the last two sessions, the pins and needles have gone
from my left hand. I\'ve got a little bit in my right,

01:02:45.000 --> 01:02:49.999
and still in my feet. But, it may take,
you know, a, a long time, six months

01:02:50.000 --> 01:02:54.999
to a year probably for, for that,
that to go away. Chemo wasn\'t

01:02:55.000 --> 01:02:59.999
actually nearly as bad as I thought
it was gonna be. Um, I did feel sick.

01:03:00.000 --> 01:03:04.999
Um, but after the first cycle,
they fixed the drugs and I didn\'t

01:03:05.000 --> 01:03:09.999
vomit, and I could get out
and about and do stuff.

01:03:10.000 --> 01:03:14.999
And it was unpleasant for, for about
ten days, but not disabling at all.

01:03:15.000 --> 01:03:19.999
Didn\'t really stop me doing anything. In
retrospect, I probably could have worked,

01:03:20.000 --> 01:03:24.999
and I chose not to. And I\'ve, and
in some ways this six months

01:03:25.000 --> 01:03:29.999
out has been a really precious time.
My young adult

01:03:30.000 --> 01:03:34.999
kids have been at home. It\'s been fun.
I get the aches on day three and four,

01:03:35.000 --> 01:03:39.999
and my solution to that is go for a
long walk and jump in my spa bath. And

01:03:40.000 --> 01:03:44.999
my spa bath is big enough for company, so
sometimes my daughter comes and gives me company

01:03:45.000 --> 01:03:49.999
. And she\'s good at massaging, so she\'ll
massage my feet, and she also massages my head

01:03:50.000 --> 01:03:54.999
for me. The first day was not too bad.
You were quite well and could do

01:03:55.000 --> 01:03:59.999
a few things around the house. The next day you
would get sick. You would spend, um, or I spent,

01:04:00.000 --> 01:04:04.999
I should say, a lot of the
time, um, feeling nauseated.

01:04:05.000 --> 01:04:09.999
Um, they give you medication to take and
that\'s important to, to keep up. Um,

01:04:10.000 --> 01:04:14.999
you go to the toilet away. You pass a lot
of water, which is the chemo coming out of

01:04:15.000 --> 01:04:19.999
you. Um, I was quite, um, nauseated and dry

01:04:20.000 --> 01:04:24.999
retching was probably more of my problem. Um, I
had a lot of problems with dry retching at, at

01:04:25.000 --> 01:04:29.999
any stage during the day. Um, you
lose a lot of weight. I lost quite

01:04:30.000 --> 01:04:34.999
a few kilos in that first few
days following the chemotherapy.

01:04:35.000 --> 01:04:39.999
Um, I never got any mouth ulcers.
Um, I just, um,

01:04:40.000 --> 01:04:44.999
had a bit of a sore mouth.
No mouth ulcers. And as the

01:04:45.000 --> 01:04:49.999
days went on for the second and third day
post the chemotherapy, um, became very

01:04:50.000 --> 01:04:54.999
tired, very lethargic. Couldn\'t get around.
Couldn\'t walk, even to,

01:04:55.000 --> 01:04:59.999
you know, the toilet would be quite hard
to get to, just because your body is, um,

01:05:00.000 --> 01:05:04.999
you know, so run down I suppose
from the chemotherapy. I have

01:05:05.000 --> 01:05:09.999
breezed through chemo. I didn\'t know whether I
would or wouldn\'t, but yes. I mean, I\'ve become

01:05:10.000 --> 01:05:14.999
diabetic for the first two weeks because of the
steroids they give to help me with the chemo.

01:05:15.000 --> 01:05:19.999
I\'ve lost my hair. I have not lost weight,
should have. And I\'m finding it easy.

01:05:20.000 --> 01:05:24.999
Well, most people go through
chemo, and they just have sickness

01:05:25.000 --> 01:05:29.999
for a few days, two or three days, fell off color.
With me, every time I had the chemo, I basically

01:05:30.000 --> 01:05:34.999
was down for almost two weeks. Finally,
would get back on my feet only to

01:05:35.000 --> 01:05:39.999
have another session of chemo. And for
quite a few times I ended up back in

01:05:40.000 --> 01:05:44.999
Westmead dehydrated. And
ending at the, just before the

01:05:45.000 --> 01:05:49.999
final chemo with a virus that hospitalized
me for two weeks. And with each session,

01:05:50.000 --> 01:05:54.999
it got worse. Um, the first session was
fine. I sort of said to myself, I didn\'t

01:05:55.000 --> 01:05:59.999
know what people were sort of saying about it. Or I\'m going to
get through this really well. The second session wasn\'t too

01:06:00.000 --> 01:06:04.999
bad, a little bit worse. But the third session, yep.
The fourth session was my, probably, one of my worst,

01:06:05.000 --> 01:06:09.999
and I thought, oh god, and um, my
support team said, you know, two more.

01:06:10.000 --> 01:06:14.999
That\'s all, you\'ll be finished. My fifth one,
after my fifth one, and I believe everybody says

01:06:15.000 --> 01:06:19.999
the same thing, I\'m not going back for it. But, we do
have to go back for it, um, because that\'s the only

01:06:20.000 --> 01:06:24.999
way we get better. So, the fifth one is
the hardest, and you think the sixth one,

01:06:25.000 --> 01:06:29.999
I\'m just not gonna do it. But, you do do it, and
you will get through it. Fortunately, I wasn\'t

01:06:30.000 --> 01:06:34.999
affected by the chemotherapy,
and so I could keep working,

01:06:35.000 --> 01:06:39.999
although I felt pleasantly tired. So,
between the computer and the bed,

01:06:40.000 --> 01:06:44.999
there was only a short distance to travel.
And so I was able

01:06:45.000 --> 01:06:49.999
to keep working and in fact, in many respects,
I did some of my most productive work,

01:06:50.000 --> 01:06:54.999
because instead of running everywhere
all the time, I was in one

01:06:55.000 --> 01:06:59.999
position. During the chemotherapies, I would
come, actually come back to work, and work,

01:07:00.000 --> 01:07:04.999
um, about a week, um, in between.

01:07:05.000 --> 01:07:09.999
I was allowed to, um, you know, do what
I could do, which was really good. Um,

01:07:10.000 --> 01:07:14.999
and then I returned following my last,
a lot of chemotherapy in March, um,

01:07:15.000 --> 01:07:19.999
to full time work, and I\'ve been working ever
since. I\'ve had about a week off. Um, they keep

01:07:20.000 --> 01:07:24.999
asking me to take some time off and to
relax, but, I sort of am a workaholic, so,

01:07:25.000 --> 01:07:29.999
I need it. You\'d have the chemo, and
then there would be ten days of sheer

01:07:30.000 --> 01:07:34.999
horror. And to deal with those ten days of sheer horror,
I would take it into, I\'d take the day into segments,

01:07:35.000 --> 01:07:39.999
so that I could deal with it. So it didn\'t feel
like I has 24 hours of horror. I\'d have an hour.

01:07:40.000 --> 01:07:44.999
And I\'d sort of stay home. I\'d watch
all the daytime television programs,

01:07:45.000 --> 01:07:49.999
and, um, so I\'d go from one program to the
other, and just knowing if I could get

01:07:50.000 --> 01:07:54.999
closer and closer to the end of these ten days
that I would be able to feel, you know, a lot,

01:07:55.000 --> 01:07:59.999
a lot better. So, that\'s sort of how I,
how I dealt with it as best I could.

01:08:00.000 --> 01:08:04.999
After my, my first chemo, probably two days

01:08:05.000 --> 01:08:09.999
after this, I was in a lot of pain.
When I walked, I, I

01:08:10.000 --> 01:08:14.999
actually, I was hanging onto
furniture, falling into walls. Um, I

01:08:15.000 --> 01:08:19.999
had some pain killers at home, but I didn\'t
remember which pain killers I could take.

01:08:20.000 --> 01:08:24.999
And I also feel nausea,
but not as much. And, um,

01:08:25.000 --> 01:08:29.999
I, I was very proud that I
didn\'t throw up once, uh, during

01:08:30.000 --> 01:08:34.999
my whole chemotherapy treatment.
And I learned from that thing,

01:08:35.000 --> 01:08:39.999
after each chemotherapy session
for few days I experienced

01:08:40.000 --> 01:08:44.999
the side effects, so, uh, I had
someone, either my daughter

01:08:45.000 --> 01:08:49.999
or my sister-in-law or my son come over
here, being at home, or bringing me

01:08:50.000 --> 01:08:54.999
something to drink, or, or looking
after my youngest son so I could

01:08:55.000 --> 01:08:59.999
just survive the few days. And
then for about two weeks I was

01:09:00.000 --> 01:09:04.999
more or less, could go for walks again.
And could, was

01:09:05.000 --> 01:09:09.999
able to do my shopping or even lawn mowing.
So, I learned little thing,

01:09:10.000 --> 01:09:14.999
a little thing that first
week after the chemotherapy

01:09:15.000 --> 01:09:19.999
treatment, I should take things
extremely easy, and always,

01:09:20.000 --> 01:09:25.000
always make sure that I had
pain killers at home. [music]

01:09:30.000 --> 01:09:34.999
My hair has always been

01:09:35.000 --> 01:09:39.999
very important to me. Uh, and
perhaps, you know, some in my early

01:09:40.000 --> 01:09:44.999
years, I used to be at the hairdresser
three and four times a week. And,

01:09:45.000 --> 01:09:49.999
so the thought of losing my
hair was not very palatable.

01:09:50.000 --> 01:09:54.999
However, uh, it\'s important
if you get ovarian cancer

01:09:55.000 --> 01:09:59.999
that you have your hair
cut short so that when it

01:10:00.000 --> 01:10:04.999
starts to fall out, it\'s not too much
of a shock. Uh, now I used to wear

01:10:05.000 --> 01:10:09.999
factory hygiene caps to bed, so
that in the morning I would just

01:10:10.000 --> 01:10:14.999
remove the cap, straight into the
kitchen tidy, and, uh, I wasn\'t

01:10:15.000 --> 01:10:19.999
conscious of it. But, the first thing is
if you allow the hair to fall out on your

01:10:20.000 --> 01:10:24.999
pillow, and that\'s very distressing
for a lot of women. Oh, god.

01:10:25.000 --> 01:10:29.999
I mean, this is all, this is all mine now, and
if anybody out there\'s bald, look. It\'ll come

01:10:30.000 --> 01:10:34.999
back. I lost my eyelashes, my
eyebrows, all my hair. And

01:10:35.000 --> 01:10:39.999
it was horrific, but again, I, I then thought, well
we might as well have some fun with this. And,

01:10:40.000 --> 01:10:44.999
uh, got my wig organized at this
magnificent Hollywood wig, that

01:10:45.000 --> 01:10:49.999
looked fine for when I was going out, but not
real good when I was just going for a walk

01:10:50.000 --> 01:10:54.999
up the road. But, it was, you know, again
you just gotta try and make the most

01:10:55.000 --> 01:10:59.999
of what\'s going, which is hard to do at the
time. But, you know, it\'s not, it doesn\'t need

01:11:00.000 --> 01:11:04.999
to be a permanent, it\'s not a permanent thing.
It\'s a temporary thing, and you just deal

01:11:05.000 --> 01:11:09.999
with it day by day. A day, the next day
is a day closer to you being better.

01:11:10.000 --> 01:11:14.999
And, and for me, I\'d look in the mirror and see the
little hairs coming up on my head, and that was

01:11:15.000 --> 01:11:19.999
fantastic. My eyelashes, my eyebrows
came back, and you know, these are such

01:11:20.000 --> 01:11:24.999
gifts, the we take such advantage of.
I, I don\'t know.

01:11:25.000 --> 01:11:29.999
I\'m not a vain person, but I think
if you are losing your hair, it\'s

01:11:30.000 --> 01:11:34.999
sort of, I found miserable.
So, I put it on in

01:11:35.000 --> 01:11:39.999
a shop, and I left the shop wearing my wig,
and was looking around and feeling great.

01:11:40.000 --> 01:11:44.999
So, maybe two weeks later, I
bought another wig, exactly

01:11:45.000 --> 01:11:49.999
the same one, so even if I go outside
and do some lawn mowing, whatever, I

01:11:50.000 --> 01:11:54.999
always put the wig on. I mean, why,
why wear, I thought, why should I

01:11:55.000 --> 01:11:59.999
bother and put a hat on or scarf? Putting
a wig is also something else which I

01:12:00.000 --> 01:12:04.999
put on my head, and I feel good.
And I never ever got so

01:12:05.000 --> 01:12:09.999
many compliments about my
hair like now. The hair

01:12:10.000 --> 01:12:14.999
loss actually didn\'t bother me as much
as I thought it would. I got used

01:12:15.000 --> 01:12:19.999
to it remarkably quickly. But, I mean,
at home I never have it on. Um,

01:12:20.000 --> 01:12:24.999
I figure my friends can deal with it. Anybody
who comes to the house can deal with it.

01:12:25.000 --> 01:12:29.999
I just don\'t necessarily need to walk
around the streets wearing a sign

01:12:30.000 --> 01:12:34.999
saying, look I have cancer. Um,
it\'s much easier to live a normal

01:12:35.000 --> 01:12:39.999
life if you wear a wig. And nobody knows
unless you feel that you want to tell them.

01:12:40.000 --> 01:12:44.999
And there are days when you want to tell
everybody. And there are days when you

01:12:45.000 --> 01:12:49.999
don\'t. But, you know, I need
to have control over that,

01:12:50.000 --> 01:12:54.999
and the wig gives it to me, I guess.
But, I\'m actually very

01:12:55.000 --> 01:12:59.999
perfectly happy to look like a tortoise.
We toddled off to

01:13:00.000 --> 01:13:04.999
the wig library, and I got a wig that was very
much like my own hair, so I was quite happy

01:13:05.000 --> 01:13:09.999
about that. I\'ll show
you my beautiful hair.

01:13:10.000 --> 01:13:14.999
Just absolutely, very much
like my own hair. I don\'t know

01:13:15.000 --> 01:13:19.999
how it looks. It looks a bit yucky, doesn\'t it?
But when it\'s all brushed up and nice and puffy,

01:13:20.000 --> 01:13:24.999
it looks good. It looks great. So, that\'s that
one. And when I\'m not wearing that, I just wear

01:13:25.000 --> 01:13:29.999
my hats or my, um, beanies.

01:13:30.000 --> 01:13:34.999
Yes, so, or a little sun hat.
Keep a bit of sun off

01:13:35.000 --> 01:13:39.999
me. Quite cute. Yup

01:13:40.000 --> 01:13:44.999
. Oh, the beanie, which keeps
my head warm at night.

01:13:45.000 --> 01:13:49.999
Got to have a warm beanie.

01:13:50.000 --> 01:13:54.999
I had planned to get married
in April, and um, I

01:13:55.000 --> 01:13:59.999
canceled the wedding for the simple
reason that I wanted to get married

01:14:00.000 --> 01:14:04.999
having hair and not in a wig. Yeah, now
that it\'s ten months down the, the

01:14:05.000 --> 01:14:09.999
track from the chemotherapy, um, it\'s time for
the wig to come off. And I thought I\'d show

01:14:10.000 --> 01:14:14.999
you how much hair you would have
when you get there. So, take it

01:14:15.000 --> 01:14:19.999
off. This, it has been colored. Um, and um,

01:14:20.000 --> 01:14:24.999
but it\'s quite long now. And, it flips

01:14:25.000 --> 01:14:29.999
back, and puffs up. So,

01:14:30.000 --> 01:14:34.999
so this about six months from the
chemotherapy. Since I finished in March.

01:14:35.000 --> 01:14:39.999
I finished the chemotherapy in March,
and this is what I\'ve grown now

01:14:40.000 --> 01:14:44.999
in September, so. Um, there are a
number of things you can do to actually

01:14:45.000 --> 01:14:49.999
women as they go through the treatment. Um, for example
there is a fantastic program that I thoroughly recommend,

01:14:50.000 --> 01:14:54.999
called \"Look Good, Feel Better\" program,
which is actually sponsored by the cosmetics

01:14:55.000 --> 01:14:59.999
industry. And, I\'ve never yet had a patient who didn\'t
go to the program come out thinking that was a really

01:15:00.000 --> 01:15:04.999
worthwhile thing to do, so I would strongly
recommend that. Now, what I\'m gonna do

01:15:05.000 --> 01:15:09.999
, I want to see a nice natural eyebrow. So,

01:15:10.000 --> 01:15:14.999
I\'m feathering. I\'m not drawing a line.
I\'m just feathering,

01:15:15.000 --> 01:15:19.999
very light, aren\'t I? I\'m doing it very lightly,
because this pencil really is fantastic. It\'s kind

01:15:20.000 --> 01:15:24.999
of secret women\'s business. I\'ve never actually
been, but the patients go there and they get advice

01:15:25.000 --> 01:15:29.999
from consultants who are specially trained in how to
actually make the most of their appearance, because

01:15:30.000 --> 01:15:34.999
people are often pretty upset when they\'ve lost their hair and don\'t
feel the same. They\'ve had surgery which they might regard as

01:15:35.000 --> 01:15:39.999
being mutilating or pretty upsetting. And
they give them advice about cosmetics and

01:15:40.000 --> 01:15:44.999
wigs and turbans and those sorts of things. But,
when you see people when they come out of the room,

01:15:45.000 --> 01:15:49.999
they always come out of the room with a smile on their face, with
their life on again. And it makes a remarkable difference. Oh, yeah.

01:15:50.000 --> 01:15:54.999
Bald head. I think,

01:15:55.000 --> 01:15:59.999
um, in the oncology world now, it seems
to be that people are understanding that

01:16:00.000 --> 01:16:04.999
it\'s not just giving them the chemo or the
radio therapy. It\'s treating the whole person,

01:16:05.000 --> 01:16:09.999
understanding what is going on in their
life, emotionally, physically, spiritually

01:16:10.000 --> 01:16:14.999
as well. And, I suppose \"Look Good... Feel Better\"
falls into that holistic approach, whereas

01:16:15.000 --> 01:16:19.999
we\'re dealing with, um, the physical
aspects, but that in turn, those changes

01:16:20.000 --> 01:16:24.999
can affect someone quite dramatically in an
emotional way. Um, if they don\'t feel good about

01:16:25.000 --> 01:16:29.999
themselves, if they lose their confidence, maybe their
self esteem takes a battering. So, it\'s an aspect

01:16:30.000 --> 01:16:34.999
of their life whilst they\'re going through treatment that they can
have control over, and that is their appearance. We give them

01:16:35.000 --> 01:16:39.999
the basic tools and techniques so
they can create some sort of, um,

01:16:40.000 --> 01:16:44.999
normality, where they\'ve maybe lost their hairs,
their brows, their lashes. So, it helps them cope

01:16:45.000 --> 01:16:49.999
with their treatment in a more positive way. It
helps them go about their day to day life as

01:16:50.000 --> 01:16:54.999
they normally would have to a certain degree. So, we,
we believe it\'s a very important part of the cancer

01:16:55.000 --> 01:16:59.999
treatment journey. [music]

01:17:00.000 --> 01:17:08.000
So, after,

01:17:10.000 --> 01:17:14.999
after completion of chemotherapy, then usually
the patients are followed, um, pretty regularly,

01:17:15.000 --> 01:17:19.999
uh, every three months or so with
either their, um, medical oncologist

01:17:20.000 --> 01:17:24.999
or their gynecologic oncologist, or in
our case, we alternate visits. Um, and

01:17:25.000 --> 01:17:29.999
that\'s just to check and see, A, how the
patients are going, B, uh, whether or not

01:17:30.000 --> 01:17:34.999
there\'s any signs of recurrence, and C,
checking on any complications from the

01:17:35.000 --> 01:17:39.999
treatment, whether it be surgical or, uh, as a
result of the chemotherapy. The most likely

01:17:40.000 --> 01:17:44.999
time for patients to experience a recurrence is in
the first couple of years, and so in that time,

01:17:45.000 --> 01:17:49.999
the visits are, are quite frequent.
And the further you get out, the more

01:17:50.000 --> 01:17:54.999
happy we become and the less frequent you need to come and
see us. I have been back to see my medical oncologist,

01:17:55.000 --> 01:17:59.999
and um, surgeon, and they\'re both happy,
happy with my progress at the moment. Um,

01:18:00.000 --> 01:18:04.999
alternate every three months with them.
Um, so, my next appointment is with,

01:18:05.000 --> 01:18:09.999
um, the oncologist in November.
So, they\'re all really happy with

01:18:10.000 --> 01:18:14.999
the way I\'m going. Um, you still worry,

01:18:15.000 --> 01:18:19.999
you know, what\'s gonna happen in the next few months.
There\'s no way you can get away with that. Um, but it\'s

01:18:20.000 --> 01:18:24.999
just, you\'ve got to move forward and
look forward and say, it\'s, it\'s

01:18:25.000 --> 01:18:29.999
not gonna get me. Yeah. I say, going, going
to the oncologist every three months.

01:18:30.000 --> 01:18:34.999
He has a full pelvic examination. Um, doesn\'t,
checks that he can\'t feel anything. You\'re also

01:18:35.000 --> 01:18:39.999
very moffy(ph), so everything you feel. Oh, is that
a tumor? You have a headache, you think, oh no,

01:18:40.000 --> 01:18:44.999
it\'s gone to the brain. You have a backache.
Oh, it\'s gone, I\'ve got bone bits now.

01:18:45.000 --> 01:18:49.999
It never ever stops. If ovarian
cancer does recur, the first sign is

01:18:50.000 --> 01:18:54.999
usually an elevation in a
tumor marker such as CA125,

01:18:55.000 --> 01:18:59.999
which is the commonest tumor marker
that\'s positive in ovarian cancers.

01:19:00.000 --> 01:19:04.999
And you\'ll often see the tumor marker rise long
before they get any symptoms of any disease

01:19:05.000 --> 01:19:09.999
recurrence. And if these tumor markers do
start to rise, then we would look to see

01:19:10.000 --> 01:19:14.999
if there was any sign of disease anywhere.
And that usually means in the forms of scans

01:19:15.000 --> 01:19:19.999
and these may be CT scans,
which are the most common.

01:19:20.000 --> 01:19:24.999
Occasionally we\'ll use MRI or PET
scans to give us more information.

01:19:25.000 --> 01:19:29.999
Uh, PET scans are usually done when
we\'re looking for looking for disease,

01:19:30.000 --> 01:19:34.999
particularly if you\'ve had a CT scan that
has not shown anything, but we have a

01:19:35.000 --> 01:19:39.999
rising marker. It is much more
sensitive to find disease than a CT

01:19:40.000 --> 01:19:44.999
alone, but it can be combined
with CT to give very good images

01:19:45.000 --> 01:19:49.999
of the, uh, the intra-abdominal
structure to localize disease.

01:19:50.000 --> 01:19:54.999
And you take, uh, you drink the
radio, radioisotope labeled,

01:19:55.000 --> 01:19:59.999
uh, glucose, and you run through the
scanner, and by then. In a computer

01:20:00.000 --> 01:20:04.999
it\'s all put together to give you your
images. And if a recurrence is found, then

01:20:05.000 --> 01:20:09.999
for the most part, patients are
retreated with chemotherapy. It\'s

01:20:10.000 --> 01:20:14.999
unusual that surgery is
mentioned or recommended for,

01:20:15.000 --> 01:20:19.999
um, recurrent disease. There are
some specific cases, such as cases

01:20:20.000 --> 01:20:24.999
in which the patient has a bowel obstruction, and
that\'s, that\'s needed to prevent, to control symptoms.

01:20:25.000 --> 01:20:29.999
And in rare cases where there\'s an isolated
recurrence, that it\'s felt that the surgery would

01:20:30.000 --> 01:20:34.999
get rid of that recurrence, um, then
it\'s, that\'s suggested. But, most

01:20:35.000 --> 01:20:39.999
patients who have a recurrence will have a recurrence
within the abdomen. There\'s often lots of sites of disease,

01:20:40.000 --> 01:20:44.999
and for that reason chemotherapy is
better placed to treat that than surgery.

01:20:45.000 --> 01:20:49.999
So three and a half years after my
initial diagnosis, I had a recurrence

01:20:50.000 --> 01:20:54.999
of ovarian cancer. That was with pain again

01:20:55.000 --> 01:20:59.999
in my lower area and in my back, so
it was in my stomach and my back,

01:21:00.000 --> 01:21:04.999
that proved to, um, show that I had,
the ovarian cancer was in my bladder

01:21:05.000 --> 01:21:09.999
and my spleen and parts of my stomach.

01:21:10.000 --> 01:21:14.999
Um, so we were back into,

01:21:15.000 --> 01:21:19.999
to the chemotherapy again,
and, um, I responded

01:21:20.000 --> 01:21:24.999
well again. I had four months
and then I found that I had

01:21:25.000 --> 01:21:29.999
another pain, and that was in my stomach.
That was cancer

01:21:30.000 --> 01:21:34.999
again. So, I\'ve just
completed another six cycles

01:21:35.000 --> 01:21:39.999
of chemotherapy, and that finished
two months ago. When I finished

01:21:40.000 --> 01:21:44.999
chemotherapy treatment, my cancer markers
were back to normal, and I went to

01:21:45.000 --> 01:21:49.999
see the doctor now, who was
taking care of me. Um,

01:21:50.000 --> 01:21:54.999
he advised me to have radiation
treatment, it\'s for my lymph

01:21:55.000 --> 01:21:59.999
nodes, which were affected by cancer.
Radio therapy is used in a

01:22:00.000 --> 01:22:04.999
relatively small number of women with ovarian
cancer. I think it has a, an important role,

01:22:05.000 --> 01:22:09.999
and it can make a big difference particularly
in women with local recurrence that are

01:22:10.000 --> 01:22:14.999
amenable to radio therapy. The
example, if someone developed a

01:22:15.000 --> 01:22:19.999
recurrence at the top of the vagina, and that was
causing bleeding. Radio therapy\'s very effective

01:22:20.000 --> 01:22:24.999
in stopping and improving that. If
there\'s a lump in the neck, and

01:22:25.000 --> 01:22:29.999
that\'s causing localized discomfort, then radio therapy
is very effective for that as well. So, radio therapy is

01:22:30.000 --> 01:22:34.999
very good for localized recurrences.
One of the things in, uh,

01:22:35.000 --> 01:22:39.999
ovarian cancer though is that localized recurrences
are not that common. It\'s usually more diffuse,

01:22:40.000 --> 01:22:44.999
and that\'s why we don\'t use radio therapy all
the time. For early stage ovarian cancer,

01:22:45.000 --> 01:22:49.999
the majority of people of cured of disease in
perhaps only five to fifteen percent of people will

01:22:50.000 --> 01:22:54.999
recur. For advanced stage
disease, some 60 to

01:22:55.000 --> 01:22:59.999
70, 75 people will actually go into
remission after primary surgery

01:23:00.000 --> 01:23:04.999
and chemotherapy, which is really extraordinary, um,
for patients presenting with an advanced cancer.

01:23:05.000 --> 01:23:09.999
Unfortunately, approximately half those patients
will come out of remission at some time,

01:23:10.000 --> 01:23:14.999
and those patients who come out of remission
earlier tend not to do as well as those

01:23:15.000 --> 01:23:19.999
patients who come out of remission some time later.
So, we talk about a treatment free interval,

01:23:20.000 --> 01:23:24.999
and the longer the patient is from primary
treatment to when the cancer returns,

01:23:25.000 --> 01:23:29.999
the more likely they are going to respond to
second line treatment and the more likely then

01:23:30.000 --> 01:23:34.999
we\'re able to put them into
secondary remission. Um, well,

01:23:35.000 --> 01:23:39.999
trying to work towards getting me into another remission.
It is possible that she can have several remissions

01:23:40.000 --> 01:23:44.999
. Um, ovarian cancer doesn\'t mean a

01:23:45.000 --> 01:23:49.999
death sentence, you\'re gonna be
dead by the end of the year.

01:23:50.000 --> 01:23:54.999
It depends on how your body responds to
the chemo. My body has responded to this

01:23:55.000 --> 01:23:59.999
chemo before, so there\'s no reason why
that, it shouldn\'t respond again.

01:24:00.000 --> 01:24:04.999
If it doesn\'t, then I\'ll try other drugs.
It doesn\'t get easier.

01:24:05.000 --> 01:24:09.999
Um, but after I got my first
recurrence, I realized

01:24:10.000 --> 01:24:14.999
that I was stuck with this
disease, and this, um, this is how

01:24:15.000 --> 01:24:19.999
my life is going to be. I live with the hope that
there\'ll always be new drugs so that I can keep,

01:24:20.000 --> 01:24:24.999
um, getting positive results to the
chemotherapy. And if that\'s the

01:24:25.000 --> 01:24:29.999
way my life is gonna be, that\'s the way it\'ll
be. Um, as long as I can keep living, that\'s

01:24:30.000 --> 01:24:35.000
what I\'ll do. [music]

01:24:40.000 --> 01:24:44.999
The support of everyone was
very important. And one

01:24:45.000 --> 01:24:49.999
thing that I did do, I told everyone.
I didn\'t want anyone to be

01:24:50.000 --> 01:24:54.999
embarrassed, not knowing what to say.
I told

01:24:55.000 --> 01:24:59.999
everyone that I had ovarian
cancer, and their support was

01:25:00.000 --> 01:25:04.999
invaluable to me. It didn\'t matter if they
were in New York or London or, or Melbourne

01:25:05.000 --> 01:25:09.999
or Sydney. It was just, uh, they supported
me all along the track. When I was,

01:25:10.000 --> 01:25:14.999
when I was diagnosed, and, uh, I
went into my lock down period,

01:25:15.000 --> 01:25:19.999
I, I\'ll never forget the kindness that
I was shown. The simplest things.

01:25:20.000 --> 01:25:24.999
People that, um, would, would ring and leave
a very kind message. People would send

01:25:25.000 --> 01:25:29.999
cards. They would just let me know that they were thinking
of me. And, you know, if I\'d see them in the street,

01:25:30.000 --> 01:25:34.999
they\'d touch me. They\'d come up and they\'d
very gently touch me. That was so beautiful.

01:25:35.000 --> 01:25:39.999
It was such a, it meant so much, and such a lovely
thing to know that there are people that care.

01:25:40.000 --> 01:25:44.999
You don\'t have to tell them what\'s going on. They know.
Uh, it was just a really beautiful thing. And I think for

01:25:45.000 --> 01:25:49.999
anyone hears that someone\'s got cancer,
and what do you do? Just a phone call,

01:25:50.000 --> 01:25:54.999
just a very quick hi, I\'m thinking of you,
wishing you all the best. It really can mean

01:25:55.000 --> 01:25:59.999
the world. You want them to treat you normal,
but you also want them to, to show you

01:26:00.000 --> 01:26:04.999
some, a bit of empathy. If they say, let
me know if I can do anything, then,

01:26:05.000 --> 01:26:09.999
I mean, we\'re not, we\'re not, we don\'t like to
ask for people\'s help, or would prefer that

01:26:10.000 --> 01:26:14.999
friends just come up and say, um, I was, you
know, I just come to get all you ironing.

01:26:15.000 --> 01:26:19.999
I\'m going to take your ironing home and
do it. Or, here, here\'s seven nights

01:26:20.000 --> 01:26:24.999
dinners, and even write their names on the
tupperware container so we know who, who owns

01:26:25.000 --> 01:26:29.999
what. Just be more, um,
instead of saying, if there\'s

01:26:30.000 --> 01:26:34.999
anything I can do, let me know.
Actually get in there and

01:26:35.000 --> 01:26:39.999
say, this is what I\'m doing. Come round
and mow the lawn. You know, like,

01:26:40.000 --> 01:26:44.999
um, ring up and say, I\'ll take the
children for a, for a day. Um,

01:26:45.000 --> 01:26:49.999
but it\'s all, we\'re all
new at this game, and

01:26:50.000 --> 01:26:54.999
it\'s I guess as, as time
goes on, a lot of friends

01:26:55.000 --> 01:26:59.999
actually fall by the wayside too.
Um, I\'ve lost many friends,

01:27:00.000 --> 01:27:04.999
because they just don\'t know what to say.
This really critical stages in life, you have

01:27:05.000 --> 01:27:09.999
to look at who you have in your life, and,
and what they bring. And, and are they

01:27:10.000 --> 01:27:14.999
helping you or are they not helping you.
And, I had to make some very, very hard

01:27:15.000 --> 01:27:19.999
decision about who was sort of
gonna be part of my survival

01:27:20.000 --> 01:27:24.999
and who wasn\'t. And that, I honestly
believe, was a big part of me getting to the

01:27:25.000 --> 01:27:29.999
other side. I basically shut down the person.
I kept a small inner circle of friends,

01:27:30.000 --> 01:27:34.999
and they were my support. But, I didn\'t,

01:27:35.000 --> 01:27:39.999
you know, Pete field, uh, fielded all the calls from
everybody. But I didn\'t want to keep in contact with a

01:27:40.000 --> 01:27:44.999
, um, a very few people. Um, I guess,

01:27:45.000 --> 01:27:49.999
when you\'re in this situation, you don\'t know what to
do. Would you have a party, or would you want a bit of

01:27:50.000 --> 01:27:54.999
privacy? Um, I\'m quite a, quite
a private person. And, um,

01:27:55.000 --> 01:27:59.999
I just felt like I needed to be left
alone, and just, um, get the support,

01:28:00.000 --> 01:28:04.999
the support I, um, needed to have
from the few friends that I chose.

01:28:05.000 --> 01:28:09.999
It comes back to what I say about how you
have to pick the right people to be on

01:28:10.000 --> 01:28:14.999
your team to help you get over it. I had people
around me that made me want to live, that gave me

01:28:15.000 --> 01:28:19.999
so many reasons to get beyond, beyond this

01:28:20.000 --> 01:28:24.999
experience and live and have fun, and,
you know, put it in its box and bury

01:28:25.000 --> 01:28:29.999
it. And that\'s what\'s been done. And I\'m so
blessed. My sister, for example, I mean,

01:28:30.000 --> 01:28:34.999
she, and it was, we tried to make it
fun, which probably sounds ridiculous.

01:28:35.000 --> 01:28:39.999
I mean, we had the, she\'d come with me every
blood test, every chemotherapy treatment,

01:28:40.000 --> 01:28:44.999
she\'d come with me. And, like, I couldn\'t eat for
ten days thereafter, because I just felt so sick.

01:28:45.000 --> 01:28:49.999
So, she\'d make these huge,
um, these huge, um, lunches

01:28:50.000 --> 01:28:54.999
and these huge little hampers with all these
treats and what have you, and we\'d laugh

01:28:55.000 --> 01:28:59.999
and giggle and talk about all the fun things that had happened
in our lives. It was great for us to actually spend so

01:29:00.000 --> 01:29:04.999
much time together, because the chemo treatments for
me were like, they took six or seven hours for it all

01:29:05.000 --> 01:29:09.999
to go through, and the nurses were. So we had
fun. We, sort of as best we could, had fun. Um,

01:29:10.000 --> 01:29:14.999
my partner, Rob, um, it\'s been very hard on
him. I think it\'s hard on all partners, um,

01:29:15.000 --> 01:29:19.999
to deal with it. He\'s been very supportive.
Um, I\'ve had a great

01:29:20.000 --> 01:29:24.999
network of friends who have supported me as
well, and supported him, which has been good.

01:29:25.000 --> 01:29:29.999
Um, he has helped me through all of
the chemo, was, you know. You need a

01:29:30.000 --> 01:29:34.999
carer to, to help you through it, whether
it be your partner or, um, my mum

01:29:35.000 --> 01:29:39.999
also did a lot of my, um,
carer\'s work, because, um, Rob

01:29:40.000 --> 01:29:44.999
did night duty, night shift. So,
he would be away all night, and

01:29:45.000 --> 01:29:49.999
sleeping during the day. I initially
kept working, although it

01:29:50.000 --> 01:29:54.999
was hard. I just, I just wanted to, I felt
horrible just getting up and going to

01:29:55.000 --> 01:29:59.999
work as, as normal. Um, you
know, while Julie was here with

01:30:00.000 --> 01:30:04.999
the kids, and, and coping with
what she was just told. Um,

01:30:05.000 --> 01:30:09.999
I done it for a few months, and then, uh,

01:30:10.000 --> 01:30:14.999
when the first line came, I didn\'t seem
to be doing anything, and we\'re getting

01:30:15.000 --> 01:30:19.999
more bad news. And Julie just said to
me, you\'re just gonna have to stop

01:30:20.000 --> 01:30:24.999
work. And I literally stopped
work overnight. And I said, yeah,

01:30:25.000 --> 01:30:29.999
um, whatever time there is, well,

01:30:30.000 --> 01:30:34.999
I don\'t want to be working. Oh, having
my daughter around. She took some

01:30:35.000 --> 01:30:39.999
time off work to make sure that my needs
were met, and also if she couldn\'t be

01:30:40.000 --> 01:30:44.999
around, she made sure there was
something in place that I could have

01:30:45.000 --> 01:30:49.999
a backup. And then I finally had
nursing assistance come in,

01:30:50.000 --> 01:30:54.999
which made it a lot easier.
I, uh, well I just, some days

01:30:55.000 --> 01:30:59.999
I just basically do everything, you know.
The children, I attend to the children.

01:31:00.000 --> 01:31:04.999
I, um, you know, meals, washing, um,

01:31:05.000 --> 01:31:09.999
a bit of cleaning. Not too much, but
I just do what I can do. He\'s been

01:31:10.000 --> 01:31:14.999
just absolutely wonderful. He
knows the exact routine now.

01:31:15.000 --> 01:31:19.999
Um, we used to, you know, when,

01:31:20.000 --> 01:31:24.999
you know, talk about when he used to work and I was
always the housewife. You know, we joke, what a

01:31:25.000 --> 01:31:29.999
cushy life housewives got.
Um, what do you do all day?

01:31:30.000 --> 01:31:34.999
And now, he certainly knows, um, that it\'s

01:31:35.000 --> 01:31:39.999
not like that at all. Um, he just
done everything, everything he\'s had

01:31:40.000 --> 01:31:44.999
to do without complaining. Looked
after the boys. Looked after me.

01:31:45.000 --> 01:31:49.999
Tried to keep the family on track.
And, um, I don\'t know, if anything

01:31:50.000 --> 01:31:54.999
ever happens to me, I have,
you know, I don\'t, I know

01:31:55.000 --> 01:31:59.999
that he would keep the family going. So he\'s
been really wonderful. It\'s a diagnosis

01:32:00.000 --> 01:32:04.999
that has a huge impact on families,
particularly partners and children. Um, so

01:32:05.000 --> 01:32:09.999
often a partner themselves will be going through
similar kinds of emotional turmoil. But on

01:32:10.000 --> 01:32:14.999
top of that, they will have a feeling of helplessness.
There\'s not much I can do to help at all. What should I do?

01:32:15.000 --> 01:32:19.999
So when I met with partners, often it\'s, it\'s talking
to them a bit about their own coping as a carer,

01:32:20.000 --> 01:32:24.999
as a partner. What they can do to help. And
also I often talk to women and their partners

01:32:25.000 --> 01:32:29.999
as well about children. How are the children are coping,
what the children\'s understanding is. And, and that

01:32:30.000 --> 01:32:34.999
sort of difficult conversation, how to talk to children
about cancer. Explain what it is. Explain treatments and

01:32:35.000 --> 01:32:39.999
be able to answer questions that they might have or,
or look after the children\'s emotional well being

01:32:40.000 --> 01:32:44.999
as well. I\'ve got a three year old.
Um, he was one

01:32:45.000 --> 01:32:49.999
at the time when I was diagnosed.
Um, Daniel is now six,

01:32:50.000 --> 01:32:54.999
and he was four when I was diagnosed. And
they know lots about cancer. They and I just,

01:32:55.000 --> 01:32:59.999
and they ask a lot of questions, especially
the six year old. He will ask, \"Mummy,

01:33:00.000 --> 01:33:04.999
um, some people get better from
cancer, right?\" Yes, I do,

01:33:05.000 --> 01:33:09.999
Daniel. \"So you could get better, get
better again?\" And I\'ll say, \"I hope so.\"

01:33:10.000 --> 01:33:14.999
And that makes him happy. And sometimes
when we get, I\'ll get a good blood result,

01:33:15.000 --> 01:33:19.999
that the, my numbers are going down, we\'ll all
dance around the house. The rocks are going away.

01:33:20.000 --> 01:33:24.999
The rocks are going away. And that gives him
that little bit of, um, hope that his mummy\'s

01:33:25.000 --> 01:33:29.999
going to be OK. Apart from
family and friends, other

01:33:30.000 --> 01:33:34.999
avenues of support, both during and after treatment
may include your specialist gyneoncology

01:33:35.000 --> 01:33:39.999
nurse, palliative care specialist,
hospital social worker

01:33:40.000 --> 01:33:44.999
or psychologist, and of course your GP.
Uh, there is a lot of, uh,

01:33:45.000 --> 01:33:49.999
a lot of liaison with GP\'s to,
uh, to keep these patients

01:33:50.000 --> 01:33:54.999
well. Because of course, it\'s the GP that the patient\'s
going to ring in the middle of the, uh, in the middle

01:33:55.000 --> 01:33:59.999
of the night. And the GP must
know who to call, be that me

01:34:00.000 --> 01:34:04.999
or be that the palliative care specialist,
depending on the, uh, the circumstances.

01:34:05.000 --> 01:34:09.999
There are also many opportunities for networking
with other women w ho are dealing with cancer,

01:34:10.000 --> 01:34:14.999
including support groups and retreats.

01:34:15.000 --> 01:34:19.999
What we know is that if
women have access to

01:34:20.000 --> 01:34:24.999
support in the form of, uh, of services
and counseling and support groups,

01:34:25.000 --> 01:34:29.999
then mostly they will make the adjustment,
and in fact, gain strength and

01:34:30.000 --> 01:34:34.999
find that they, they develop new coping
strategies, uh, to help them through

01:34:35.000 --> 01:34:39.999
what almost always is the worst thing that\'s
happened to them in their lives. We have discussions

01:34:40.000 --> 01:34:44.999
on nutrition or ways of coping
with cancer for those who need it.

01:34:45.000 --> 01:34:49.999
And we do craft classes, which are
very good, and we get a lot of,

01:34:50.000 --> 01:34:54.999
um, comradeship out of it. And you
meet very nice people and you can see

01:34:55.000 --> 01:34:59.999
how you can help each other with the support
we give each other. Some people have only

01:35:00.000 --> 01:35:04.999
just been diagnosed, and they\'re looking for
someone to give them some positive attitudes.

01:35:05.000 --> 01:35:09.999
Some are coming to the end of their chemo,
so they feel that\'s when they need it.

01:35:10.000 --> 01:35:14.999
And then people like myself, who\'ve been
there, we just like to go, so we can help

01:35:15.000 --> 01:35:19.999
the others see that there is light at the
end of the tunnel and treatment for them.

01:35:20.000 --> 01:35:24.999
So, our advice centers around taking on
board the fact that we have this difficult

01:35:25.000 --> 01:35:29.999
problem that needs to be addressed, and
helping them to think through what strategies

01:35:30.000 --> 01:35:34.999
have helped in the past. Most women have had
other crises. They\'ve had, uh, problems

01:35:35.000 --> 01:35:39.999
in relationships or death of parents,
or they\'ve moved from, uh, another

01:35:40.000 --> 01:35:44.999
country or they\'ve had the death of a child or,
you know. It, it\'s not usually the first life

01:35:45.000 --> 01:35:49.999
crisis that the women have had. So, to help
them to see how their coping strategies have

01:35:50.000 --> 01:35:54.999
worked in the past and how we might need
to, uh, engage them again in that sort of

01:35:55.000 --> 01:35:59.999
process is important. Uh, and then to, to
tell them about what services are there are

01:36:00.000 --> 01:36:04.999
that will help them through the survivor-ship phase
of this illness, because it\'s not just about

01:36:05.000 --> 01:36:09.999
the week of the operation and the four or
five or six months of chemotherapy. It\'s

01:36:10.000 --> 01:36:14.999
about the new life that will stretch out
ahead of them once the treatment\'s finished.

01:36:15.000 --> 01:36:19.999
I didn\'t realize, no one
had prepared me for

01:36:20.000 --> 01:36:24.999
that post traumatic stage, and what happens

01:36:25.000 --> 01:36:29.999
after somebody has been through a life
threatening experience like I\'d had.

01:36:30.000 --> 01:36:34.999
I mean, I\'d spent the best part of twelve
months fighting for my life. And, I

01:36:35.000 --> 01:36:39.999
went back into my work, and I was
not the person that had left

01:36:40.000 --> 01:36:44.999
my work. And I was incredibly fragile.
I was incredibly vulnerable. And

01:36:45.000 --> 01:36:49.999
I had all these, I mean I only had to
have a pain in my head, and it would be

01:36:50.000 --> 01:36:54.999
cancer. I only had to have a pain
somewhere, and I was now really

01:36:55.000 --> 01:36:59.999
sort of so consumed with the whole fear
of this thing, that it was, it was a very

01:37:00.000 --> 01:37:04.999
difficult period for me. I never leave
them, so to speak. I\'m one of the sort

01:37:05.000 --> 01:37:09.999
of continuity people for them,
so when treatment is finished,

01:37:10.000 --> 01:37:14.999
they will often be in contact because they may have questions
about some of the effects of what treatments cause,

01:37:15.000 --> 01:37:19.999
whether they\'ve got something like peripheral neuropathy
or impacts of body image fertility and sexuality or these

01:37:20.000 --> 01:37:24.999
sort of things, or relationships. Um,
so dealing with the outcome of cancer.

01:37:25.000 --> 01:37:29.999
And often that, we, they don\'t have those questions til
everything\'s finished. They\'ve sort of got time to think about it.

01:37:30.000 --> 01:37:34.999
Sex is a very complex topic.
It\'s a very complex area.

01:37:35.000 --> 01:37:39.999
It\'s complicated by many factors,
um, including the treatment

01:37:40.000 --> 01:37:44.999
that they have, so, the extent
of the surgery for example, um,

01:37:45.000 --> 01:37:49.999
the sort of chemotherapy that they,
they have, how sick that makes them.

01:37:50.000 --> 01:37:54.999
Um, and if they have radio therapy,
they may have other sorts of problems.

01:37:55.000 --> 01:37:59.999
Um, but by and large, um, you know,
the treatment has enormous problems

01:38:00.000 --> 01:38:04.999
for the patient sexually, because most
often they have their ovaries removed.

01:38:05.000 --> 01:38:09.999
Um, and they will go through
menopause, an early menopause, uh,

01:38:10.000 --> 01:38:14.999
which causes different
problems with the vagina.

01:38:15.000 --> 01:38:19.999
Um, they have painful penetration of the
vagina, because there\'s no estrogen

01:38:20.000 --> 01:38:24.999
any longer. I think sometimes
the emotional, um, impact

01:38:25.000 --> 01:38:29.999
of a cancer diagnosis can hit you later on,
rather than while you\'re going through the,

01:38:30.000 --> 01:38:34.999
the battle, because what you want to
do is survive. It\'s afterwards that

01:38:35.000 --> 01:38:39.999
you, you can feel the strain of
what you\'ve been under. Um, so

01:38:40.000 --> 01:38:44.999
I went about doing things. I
guess I felt a, quite, um,

01:38:45.000 --> 01:38:49.999
vulnerable in lots of ways, and I
found it difficult to make plans

01:38:50.000 --> 01:38:54.999
for things. As time went on,
my confidence grew. And I

01:38:55.000 --> 01:38:59.999
decided too, that if it ever came back, I\'d
just have to do what I did before. And that is

01:39:00.000 --> 01:39:04.999
to get treatment and fight, fight the
disease. And that\'s basically been my

01:39:05.000 --> 01:39:09.999
attitude about it. We have the privilege
of meeting some wonderful women

01:39:10.000 --> 01:39:14.999
and some wonderful families who find courage that they
didn\'t know they had. And so to be able to walk with

01:39:15.000 --> 01:39:19.999
women through that journey, and with
their families, and to see them adjust

01:39:20.000 --> 01:39:24.999
and make incredible gains in
what is otherwise a disaster

01:39:25.000 --> 01:39:29.999
in their lives, is an absolute privilege. We
can\'t change the fact that they have ovarian

01:39:30.000 --> 01:39:34.999
cancer, and no amount of, um, me feeling
depressed or sad on their behalf will change

01:39:35.000 --> 01:39:39.999
what they\'re going through. But, to have the opportunity
to help someone and to make a difference in their

01:39:40.000 --> 01:39:44.999
lives, is, is, uh fantastic. [music]

01:39:45.000 --> 01:39:53.000
I never thought of

01:40:10.000 --> 01:40:14.999
myself as a cancer victim. I was always, even in
the depth of it, I was always a cancer survivor.

01:40:15.000 --> 01:40:19.999
So, for, for me at that time, it was, it was to
be positive. I\'ve always been a very positive

01:40:20.000 --> 01:40:24.999
person. I, I would deal with what was going on
in a day to day basis. And mentally, I would

01:40:25.000 --> 01:40:29.999
try and find the right way of
communicating with this thing.

01:40:30.000 --> 01:40:34.999
Um, it was war. It was absolute war,
and, and one of us was gonna win,

01:40:35.000 --> 01:40:39.999
and I was determined that it wasn\'t gonna be
the cancer. I didn\'t give it a great deal of

01:40:40.000 --> 01:40:44.999
thought. Every day I got
up, I opened the blinds,

01:40:45.000 --> 01:40:49.999
and it was a new day to be lived.
I always tried to do things,

01:40:50.000 --> 01:40:54.999
uh, so that at the end of the, each
day, I could look back and say,

01:40:55.000 --> 01:40:59.999
I\'ve achieved this or that. And
it\'s very important for women, that

01:41:00.000 --> 01:41:04.999
even if I only walked down through
the garden, uh, to actually plan

01:41:05.000 --> 01:41:09.999
to do something each day rather
than to sit at home and just

01:41:10.000 --> 01:41:14.999
feel very sad for themselves.
For all that cancer is

01:41:15.000 --> 01:41:19.999
, I think my, the way it\'s affected my life, I\'ve,
I\'ve wanted it to have, be a positive thing,

01:41:20.000 --> 01:41:24.999
because it\'s taken enough, and I won\'t let
it, um, destroy the way I live my life

01:41:25.000 --> 01:41:29.999
or to live in fear. I\'ve,
um, embraced that good

01:41:30.000 --> 01:41:34.999
that cancer does teach you, and I think that
is that you live your life well. You love

01:41:35.000 --> 01:41:39.999
until the people you love. It\'s very

01:41:40.000 --> 01:41:44.999
hard to be positive all the time.
Um, one can,

01:41:45.000 --> 01:41:49.999
you know, I find I can be positive

01:41:50.000 --> 01:41:54.999
most, almost all of the time really,
but, by putting it in a box and

01:41:55.000 --> 01:41:59.999
not going near it and really pretending
that it isn\'t happening. But I don\'t need

01:42:00.000 --> 01:42:04.999
to look at it all the time. And I also
don\'t need to be positive about it all the

01:42:05.000 --> 01:42:09.999
time. And I don\'t need to believe
that I\'m going to win a battle,

01:42:10.000 --> 01:42:14.999
because maybe I won\'t. Maybe it will get me
in the end. Probably it will get me in the

01:42:15.000 --> 01:42:19.999
end. But, it doesn\'t mean that I can\'t
enjoy myself now. Every day counts.

01:42:20.000 --> 01:42:24.999
Every day is precious, that it\'s no use
to worry what will happen in five,

01:42:25.000 --> 01:42:29.999
ten, twenty years. Many of
my friends, because I\'m 55

01:42:30.000 --> 01:42:34.999
now, so they are slowly approaching retirement
and worrying about the super-annuation.

01:42:35.000 --> 01:42:39.999
Do they have enough, will they have
enough money to travel, to do things.

01:42:40.000 --> 01:42:44.999
And I\'m not worrying about it. If I be

01:42:45.000 --> 01:42:49.999
just alive, even with very little
money, that would be the greatest gift.

01:42:50.000 --> 01:42:54.999
You\'ve been challenged, and you\'ve learned a
hard lesson, I think. To move on and live

01:42:55.000 --> 01:42:59.999
a full and prosperous life, you\'ve got to look for what else
is out there for you, so that you can immerse yourself.

01:43:00.000 --> 01:43:04.999
And get the cancer away from you. Get the
cancer and the whole experience away from you.

01:43:05.000 --> 01:43:09.999
So, I go back and forth to Bali,
which is wonderful. And each time

01:43:10.000 --> 01:43:14.999
I get back there, I feel like I\'ve put the
flag back in the soil, and I\'ve made it back.

01:43:15.000 --> 01:43:19.999
I\'ve got some lovely friends over there.
I meet people all the time, um,

01:43:20.000 --> 01:43:24.999
who are just great for my spirit and, um,

01:43:25.000 --> 01:43:29.999
I buy and sell a bit of jewelry.
I do a lot of fundraising. I\'m

01:43:30.000 --> 01:43:34.999
passionate about the work I do for the cancer
council. I spend a lot of time with my

01:43:35.000 --> 01:43:39.999
mum. I go to the beach a lot. I
just, I enjoy my new little niece

01:43:40.000 --> 01:43:44.999
immensely. Um, yea, my sister, um, and

01:43:45.000 --> 01:43:49.999
doing the things that I, I love.
I\'m going to go and see, um,

01:43:50.000 --> 01:43:54.999
a naturopath after I\'ve finished. You can\'t
have anything while you\'re on chemo,

01:43:55.000 --> 01:43:59.999
because it may interfere with it. So
that, um, on the agenda. Um, all the

01:44:00.000 --> 01:44:04.999
way through now, um, I\'ve just
been concentrating on having a

01:44:05.000 --> 01:44:09.999
healthy diet, and eating, uh,
good, uh, meals with lots

01:44:10.000 --> 01:44:14.999
of vitamins and minerals and nutrition,
covering, you know, all the,

01:44:15.000 --> 01:44:19.999
uh, dietary requirements.
And, drinking lots of fluid

01:44:20.000 --> 01:44:24.999
to flush out the toxins from the
chemotherapy. Just making sure

01:44:25.000 --> 01:44:29.999
the fluid level, levels are up. Drinking fruit
juices and, yeah, just being very health conscious.

01:44:30.000 --> 01:44:34.999
Be well, I\'m making carrot and apple juice.
It\'s my favorite one. I try

01:44:35.000 --> 01:44:39.999
so many other juices. Spinach juice,
definitely I cannot drink, because when I

01:44:40.000 --> 01:44:44.999
drink it once, I threw up, because it was just too
much of the good thing. So, I think moderation

01:44:45.000 --> 01:44:49.999
is the key. Yes. So, and this
one is really, really nice.

01:44:50.000 --> 01:44:54.999
And because they are not organic
ones, I wash them in warm water.

01:44:55.000 --> 01:44:59.999
And I scrub them for sure there\'s
some pesticides will be still in.

01:45:00.000 --> 01:45:04.999
And I try to make it fresh each time.
This makes quite a lot of noise.

01:45:05.000 --> 01:45:09.999
My full time job is to look
after myself and get better.

01:45:10.000 --> 01:45:15.000
And this is very important job.
The most important job. [sil.]

01:45:20.000 --> 01:45:24.999
It\'s good. Really good. Yeah.

01:45:25.000 --> 01:45:29.999
I started to walk, and when I went for walk,
I check at the stand, so I could walk five

01:45:30.000 --> 01:45:34.999
kilometers. So then after walking
all week, five kilometers each day,

01:45:35.000 --> 01:45:39.999
on Sunday I walked ten kilometers.
And then only I asked my oncologist

01:45:40.000 --> 01:45:44.999
if he thinks I will do any damage to
my body if I walk city to self(ph).

01:45:45.000 --> 01:45:49.999
And he smiled, and he said, \"If you like,
you can run.\" And when city to self

01:45:50.000 --> 01:45:54.999
came, I walk all fourteen
kilometers, and it, it was not,

01:45:55.000 --> 01:45:59.999
it was easy. And it was,
I enjoyed every moment.

01:46:00.000 --> 01:46:04.999
And I was so happy when I came to the finish
line. I ran in the past four times, and I

01:46:05.000 --> 01:46:09.999
run all the way. So this time, I

01:46:10.000 --> 01:46:14.999
was probably one of the last ones to
arrive to the finishing line, but I think

01:46:15.000 --> 01:46:19.999
it was very special. It was my
most important city to self.

01:46:20.000 --> 01:46:24.999
It\'s been over, almost a year now
since I was diagnosed. Um, I\'ve put

01:46:25.000 --> 01:46:29.999
on a lot of weight, of which I didn\'t have
prior to, to being sick, almost 12 kilos.

01:46:30.000 --> 01:46:34.999
Um, I feel healthy. You know, from
what they tell me I look healthy.

01:46:35.000 --> 01:46:39.999
Um, and, um, I have changed my diet.
My diet\'s definitely, um,

01:46:40.000 --> 01:46:44.999
much improved. Um, a lot of natural type

01:46:45.000 --> 01:46:49.999
ingredients. Stay away from the
processed food where I can. Um,

01:46:50.000 --> 01:46:54.999
take a lot of natural, um,
products as well. Um, but

01:46:55.000 --> 01:46:59.999
yeah, I think I\'m doing really well.
So many people ask

01:47:00.000 --> 01:47:04.999
me, you know, how, how did you deal
with it? How do you feel you survived?

01:47:05.000 --> 01:47:09.999
What was it that, that helped you to
survive? And, I, I look back on it now,

01:47:10.000 --> 01:47:14.999
and having read Lance Armstrong\'s book,
and being exposed to what I was, for me,

01:47:15.000 --> 01:47:19.999
cancer was never about death. It
was about life. So, when I hear

01:47:20.000 --> 01:47:24.999
people say, \"Oh, I\'ve got cancer.\" And I, and I,
and they say it, but you have too, because I\'d be

01:47:25.000 --> 01:47:29.999
in the chemo ward. I\'d say, \"No, I haven\'t. I\'m
getting rid of cancer.\" I\'m not a, a cancer

01:47:30.000 --> 01:47:34.999
patient. I hated that, that word, patient.
I was a chemo customer. You know,

01:47:35.000 --> 01:47:39.999
I was there as a customer to have my chemo.
So, I would empower myself

01:47:40.000 --> 01:47:44.999
as best I could, and the cancer was there
doing what it could. But, every day

01:47:45.000 --> 01:47:49.999
that force against it, I felt, was so powerful
that it had to go. There was no place

01:47:50.000 --> 01:47:54.999
for cancer in my life. There was no place for
it in my world. And even now, as I\'ve gone on

01:47:55.000 --> 01:47:59.999
and I\'ve got back to my life, I, I don\'t
even think about cancer now. It, it

01:48:00.000 --> 01:48:04.999
never leaves you. It\'s there, but
I, I deal with it now in, in a very

01:48:05.000 --> 01:48:09.999
different way, where it has no
significance to my life, whereas,

01:48:10.000 --> 01:48:14.999
in the early stages, obviously, it was all I
thought about. Now it\'s an experience that I had.

01:48:15.000 --> 01:48:19.999
It\'s an experience that is gone. And
I\'ve been left with amazing gifts.

01:48:20.000 --> 01:48:24.999
Um, you know, my, my whole perspective
on life now is so different to

01:48:25.000 --> 01:48:29.999
what it was before. And what the cancer has given
me, and I respect it for that, has been magical.

01:48:30.000 --> 01:48:34.999
But, it doesn\'t need to come back. I\'m definitely not
interested in it coming back. It\'s an acquaintance

01:48:35.000 --> 01:48:39.999
I do not need to make again. Thank you
very much. And for anybody else out there

01:48:40.000 --> 01:48:44.999
that, that has that experience of cancer, you need
to develop a relationship with it, that empowers

01:48:45.000 --> 01:48:49.999
you, and takes the power away from the cancer.
Because, that, that\'s really in my mind,

01:48:50.000 --> 01:48:55.000
what, what helped me survive
and get on with it. [music]