Before I share my story, I must say I had the wonderful honor of knowing Louisa. She was one of the most bravest women I knew. She loved her family and life in general. She fought hard and with grace every step of the way. We met through our oncologist. I am forever grateful to have met her. She taught me so much, and because of her and the difference she made in making a difference, I push twice as hard to fight for me and every other amazing woman out there. RIP Louisa, you are dearly missed, and forever loved.

My name is Nanci Cacossa. I have cancer. Ovarian cancer. Stage 3C ovarian cancer. I lost my ovaries, uterus and fallopian tubes to this disease, but I’m not about to lose my life. No, I’m fighting with all I’ve got. And what I’ve got is great! My family, friends and doctors joined hands and hearts with me, and we built a circle of strength. Together, we are fighting. We have in our arsenal weapons that will help me silence this cancer known as the silent killer. Ovarian cancer symptoms are quiet. But if you listen carefully, as I did, you can hear the whispers. Please, read my story. Please, listen to your body. Please join us in The Circle of Strength and use your voice and donations to fund ovarian cancer research to silence the silent killer.

It was October 2008 when I felt a pulling sensation in my pelvic area after I emptied my bladder. As a diabetic, I don’t ignore when my body is trying to tell me something, and it was telling me to go to a doctor. I went to my internist, who ruled out the urinary tract infection diagnosis I anticipated. The next day I was at my gynecologist’s office, where I’d been seven months earlier for my annual visit. At that time, I received a full exam, including an internal sonogram, and was given a clean bill of health. This time, the internal sonogram shocked both my doctor and me. In a little over half a year, it seemed a four-centimeter tumor had grown on my right ovary. A transverse vaginal sonogram and CAT (Computerized Axial Tomography) scan confirmed it. I had a tumor on my right ovary. Whether it was benign or malignant could only be determined through surgery.

The next four weeks were chaotic, to say the least. Emotionally, I couldn’t wrap my brain around the idea that I might have cancer. Intellectually, I told myself I would have a relatively simple laparoscopic surgery to remove the tumor and all would be fine. My dad and step mom, both cancer survivors, encouraged me to find the best gynecological oncologist surgeon available, just in case. I’ll never be able to thank them enough for their advice.

On November 25, 2008, the best gynecological oncologist surgeon began a laparoscopic procedure that turned into an eight-hour full hysterectomy. When the scope showed the condition of not only my right ovary, but my left one as well, she asked for a scalpel. My right and left ovaries, fallopian tubes and uterus were cut out. While exploring my abdominal cavity, where ovarian cancer cells are known to float, she removed anything suspicious to send for pathology evaluation. The quick pathology assessment done during surgery confirmed her suspicion and my worst fear. I had cancer.

Oh, that pulling sensation I felt after emptying my bladder? It had absolutely nothing to do with my ovarian cancer, and everything to do with discovering it. When my surgeon began removing my uterus, she found my bladder was attached to it by the scar tissue my body developed after the C-section that delivered my son 14 years earlier. God bless that scar tissue. It spoke to me and I listened.

Two weeks later, I sat in my surgeon’s office with my wonderful, supportive husband, Frank, and my parents waiting for the pathology results. The diagnosis was brief. Ovarian cancer, stage 3C. Words and images collided in my head and mind’s eye. Cancer. Chemotherapy. Death. Husband. Children. Friends. Life. My father already buried one daughter, would he have to bury me?

It took me several days to come to terms with this new part of my identity. Cancer Patient. Fortunately, I quickly realized that while I couldn’t choose my diagnosis, I still had a choice; I could fight or I could surrender. I chose to fight.

Based on tumor size, pathology reports and blood test levels, my doctors determined the best course of medical treatment for my cancer. Six rounds of Taxol and Carboplatinum chemotherapies. It was up to me to determine the best course of personal treatment. Based on who I am, my needs and wants, I decided not to go it alone. I opened my heart and story to my family and friends for support and encouragement. As I went through my treatments, I used Facebook status updates to update people on my status. I vented emotions, happy and sad, and posted pictures of myself in wigs, hats and simply bald. People replied with a constant stream of hearts, smiles, love and never-ending words of moral support to maintain my morale. My openness about my illness and honesty about what I was enduring was a huge learning experience for us all. The exchange and flow of information and emotion kept us strong so I could fight. Together we became a circle; The Circle of Strength.

Chemotherapy was very tough, but my cancer responded to it well and immediately. Ovarian cancer is monitored through different means. One is a blood test called CA 125. A woman’s level should be 35 or below. Before surgery, mine was 129. After surgery, it came down to 54. After just one treatment, my level was 15. The CAT scan after my third treatment confirmed my body was responding positively to the chemotherapies. The medical and personal strategies were working!

On April 22, 2009, five months after surgery, I was told I was N.E.D. (No Evidence of Disease.) I fought the good fight and won. The cancer was gone!

What followed was bliss. We celebrated my daughter’s Sweet 16 in May. The summer was what summer should be- busy and fun. Fall brought a Halloween filled with treats, and Thanksgiving was thankful, to say the least. The holiday season was imbued with a renewed feeling of comfort and joy.

In January 2010, my body whispered to me again. I was feeling pain in my lower left abdomen. Maybe I pulled a muscle? After 10 days of discomfort, I called my oncologist and saw him the following day. After examining me, running blood work and scheduling a CAT scan for the next day, he said he’d call when the results were available. On January 21 he called. I think he was as upset to say as I was to hear what needed to be said. It’s back.

It’s rare that I’m in my office alone, but I’m glad I was. I cried. I cried hysterically. I cried so hard that it was difficult to breathe. I was angry. I was sad. I was petrified. They’d told me it was gone. What happened? I played by the rules of cancer. I endured surgery and chemo. How could it be back? In what sick world does a sick woman get well only to be told she’s sick again? My dear friend LCS calls cancer -the beast. How cruel can the beast be? Apparently, very cruel. During my short-lived remission, while I was being monitored, the beast was hiding under the radar of blood tests and CAT scans.

When I finally caught my breath, I knew I had to call my husband. It broke my heart to tell him, but I needed him. We agreed to meet at home and drive to the doctor together. The bad news was that a recurrence  is different from an original diagnosis. The good news was the CAT scan only showed small nodules and my CA 125 was at 42. However (a word that should be banished from the dictionary), because it was a recurrence, this round of chemo would be stronger and longer.

Facebook Status Update: Calling out to The Circle of Strength. My cancer has returned. Need support. Who’s in? Everybody! All my family and friends were there for me. Once again, I was blessed with an outpouring of support, encouragement and love.

The following Tuesday, it was back to chemo. Taxol, Carboplatinum and now Avastin, which isn’t a chemotherapy, but works with chemo to fight cancer. The following week, I lost my newly grown hair and generally felt like crud. Just as I felt better, it was time for another treatment. I didn’t think it was time to develop an allergic reaction to Carbo, but apparently someone did. Now what? I need Carbo. Turns out it’s common for an allergic reaction to develop after seven or eight treatments. Bingo, this was my eighth. Carbo would now be given over six hours on a separate day from other meds. On the bumpy road of cancer, I chose to think I merely hit a pebble.

In September 2010 (Ovarian Cancer Awareness Month), I was told I was, once again, N.E.D. A clean bill of health. It’s a bill I gladly would have paid, if only I felt clean. Something in my gut told me the beast was lurking under the radar. I demanded periodic CA 125 monitoring. By December, the results showed the numbers creeping from 15 to 22 to 27. By January 2011, the level climbed to 72 and I was experiencing sharp pains in my upper right abdomen. The beast was back and it was time for a new chemo.

The Taxol/Carbos are platinum-based, this time we went with plant-based Doxil. I hated it. I absolutely, positively hated it. Since patients on Doxil are prone to blistering, we are advised to keep our hands, feet and mouth cold for three days after treatment to avoid it. Also, chemotherapy lowers the white blood cell count, which the body needs to fight infection. At all cost, I had to avoid blisters that might get infected. I guess it’s lucky we had a cold, snowy winter. While the rest of the East Coast bundled up, I walked into the snow in flip-flops and tossed snowballs to my golden retriever with my bare hands.

It didn’t really matter what I did; Doxil didn’t work. My CA 125 surged to 385. Considering my level was 129 before surgery, this was a very scary number. Worse yet, a CAT scan showed the cancer was progressing. It hadn’t spread, but new nodules (small tumors) appeared. Time for yet another medication change.

Topotecan. (Toe-poe-tee-can.) It is also plant-based. You sort of have to love a chemotherapy that sounds like an exotic bird. I think I do love it. After the first treatment, my number came down to 289. After the second, 163. It’s a good trend.

As of now, I am receiving treatments every three weeks, four days in a row and fighting the fight. I’m not going anywhere anytime soon. Not if I can help it. My husband and I plan to spend many more years living and loving together. There are still lessons to teach my children and milestones in their lives I intend to celebrate. There is love and joy to share with friends and family. I will not surrender.

I am hopeful. For now, for today, my body is again responding well to the treatments. I am hopeful I will not only tame the beast, but kick its butt once and for all. I am hopeful that my story and the efforts of The Circle of Strength will arm women with information and raise money for ovarian cancer research that will make a difference. I am especially hopeful that after you’ve read my story, you will join hands and hearts with The Circle of Strength. Together, we can silence the silent killer.

~Nanci, NY