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| Melinda Cosman |
Ovarian cancer is often known to affect women, but what happens where an eight-year old girl, whose reproductive organs are yet to become mature for procreation suddenly becomes a victim?
Read the sad story of Melinda Cosman below:
Melinda
Cosman, of Manchester, Conn., thought the hard part was over when she welcomed
her husband home from a yearlong deployment to Iraq.
She never imagined
the family would have to endure a more difficult challenge. In June 2011,
shortly after her husband returned, their 7-year-old daughter Natalie was
diagnosed with ovarian cancer.
"Your life is put on a test," said Cosman.
"It has made us stronger."
Throughout the previous year, Natalie
complained of stomach pains, sometimes so excruciating, she would have to miss
school. Her doctors chalked it up to constipation, maybe a stomach bug. But when
the pain became unbearable, Cosman took Natalie to the emergency
room.
"[The doctors] were shooting for appendicitis and they brought her
in for an ultrasound in the morning to confirm that," said
Cosman.
Instead of a ruptured appendix, the ultrasound detected a
7-centimeter cyst on Natalie's ovary.
Nearly 22,000 women are diagnosed
with ovarian cancer each year, according to the National Cancer Institute.
Experts estimate that 500 to 1,000 cases occur in females under age
20.
While cysts are common among women of childbearing age, they are
considered rare in young girls who have not undergone
puberty.
"Especially girls who haven't had their period yet, nothing
should grow on their ovary," said Dr. Judith Wolf, division chief of surgery at
MD Anderson Cancer in Houston.
Young girls develop a different type of
the disease than adult women, according to Dr. Cynthia Herzog, professor of
pediatrics at MD Anderson Cancer Center.
Women more commonly have a form
called an epithelial carcinoma, where the cancer begins in the cell on the
surface of the ovary. For girls with the disease, the cancer begins in egg
cells, and develops into a so-called germ cell tumor.
Germ cell tumors
make up about 3 percent of all childhood cancers, according to the National
Cancer Institute. Ninety percent of germ cell tumors are found in the ovaries or
testicles and are more common in children and adolescents.
A biopsy
confirmed a cancerous germ cell tumor in Natalie.
"I kept thinking,
'ovarian cancer in a 7-year-old?'" said Cosman.
It can be difficult for
many women to come to terms with an ovarian cancer diagnosis. The process of
understanding and accepting the diagnosis is often more difficult for young
girls.
"She knows she had cancer and that it was ovarian cancer," said
Cosman. "To this day I don't think she gets the extent of it."
For
Natalie, undergoing treatment meant missing a year of school and having to sit
out on her favorite activity: dance.
"I felt disappointed because I like
to dance," said Natalie. "I like to perform in front of people. I also had a lot
of friends at school."
Two decades ago, treatment for the disease was
devastating to young girls. As a precaution, surgeons removed both ovaries,
regardless of where the tumor was found. The method eliminated any chance of
childbearing.
In recent years, pediatric oncologists have suggested that
perhaps a total removal is unnecessary, preserving these young girls'
reproductive health.
While the cause of ovarian cancer in young girls in
unclear -- studies have not pointed to a genetic or environmental trigger --
treatment for the disease is effective, said Wolf.
"The good news is that
even if they're found when they're advanced, they respond really well to
chemotherapy," said Wolf, who has treated nearly two dozen
cases.
Chemotherapy is over 90 percent effective at treating germ cell
tumors, even if it has spread to lymph nodes, according to Wolf.
"The one
ovary is removed that's affected and doesn't necessarily mean infertility," said
Wolf. In July 2011, Natalie's surgeons removed her right ovary and right
fallopian tube.
"There wasn't a doubt in my mind [to do the surgery]
because when you're told that your daughter has cancer and that's what's going
to treat it, you do it," said Cosman. "I put her in the palm of the
doctors."
Natalie also had her gall bladder removed as part of her
treatment. Six rounds of chemotherapy followed, and by January 2012, Natalie
completed treatment for the disease.
"I feel a lot better besides all
that stuff," said Natalie.
"To this day she jokes that her right side is
lighter than her left," said Cosman.
While the disease is rare in young
girls, Cosman warned parents not to ignore pain symptoms in their
children.
Potential signs of the disease in young girls include a lump
that can be felt in the abdominal area, severe abdominal or lower back pain, and
prolonged bloating or constipation, Wolf said.
In many cases, the disease
goes undetected until either the parent or child notices a protruding mass on
the child's abdomen, said Herzog, who sees about three young ovarian cancer
patients a year, most of whom are teenagers.
"The mass gets to a critical
size where it doesn't fit in the pelvis anymore and protrudes," said Herzog.
"That's the thing that triggers most girls to get seen."
The U.S.
Preventative Task Force recommends against ovarian cancer screening for women
who are not at high risk.
Since it's unclear what type of young girl
would be at risk for the disease, Herzog said, "It's too rare to make screening
for young girls a reasonable thing."
But if symptoms persist, Herzog
recommended that parents take their children to a pediatrician for
evaluation.
ABC News.
