‘I had pain in my groin when I went to the bathroom. I thought it was a muscle strain, but it was ovarian cancer at age 27’ | Health

Thalita Nedochetko, 30, uses TikTok to warn other young women about ovarian cancer, the second most common gynecological malignancy, behind only cervical cancer. She was 27 years old when a nodule appeared on her left ovary and later became a malignant mass. The attendant had to undergo three surgeries, which led her to remove both ovaries and her uterus. She is currently in remission from the disease.

Nedochetko decided to look for a gynecologist at the beginning of 2021, confused about why she couldn’t get pregnant despite having unprotected sex and without using contraceptives.

The specialist said that her case was polycystic ovaries and that, as a result, she was unable to get pregnant easily. “She said I could solve this with exercise and dietary changes,” she recalls. At the same appointment, Nedochetko received a referral to undergo a transvaginal pelvic ultrasound.

“In these first tests, a 48 millimeter cyst appeared on my left ovary. The doctor gave me an antibiotic to take and said that I would expel the cyst in the next cycle,” she reports. Because she wanted to get pregnant and signaled this to the specialist, the doctor prescribed medication for the ovulation attendant.

With her menstrual cycle unregulated, Nedochetko had to wait longer than usual before she could return to the doctor and redo the exam that would show whether the cyst had been expelled. When she returned to the office, she was negatively surprised.

“The cyst had already grown a little, there was a mass outside the ovary and I was diagnosed with an ectopic pregnancy”, she recalls. The condition consists of gestation outside the uterus, when the embryo implants outside the uterine cavity. As the embryo is not able to survive outside the uterus, it is usually necessary to remove it to avoid damaging neighboring organs.

Nedochetko was taken to the emergency room, as the ectopic pregnancy is risky. However, when undergoing treatment, she took the beta HCG test and did not confirm that she was pregnant. The attendant was sent home.

“While I was trying to schedule a return appointment with my gynecologist, without much concern because I didn’t know the real situation, I ended up in the emergency room because I had a lot of pain in my groin, on the right side, when I had to go to the bathroom”, reports.

In a conversation with her mother-in-law, who is a physiotherapist, she said that her case could be a groin strain. The mother-in-law advised her daughter-in-law to take a muscle relaxant and monitor the symptoms. But it got to the point where the attendant cried in pain and didn’t want to go to the bathroom anymore, postponing the moment to evacuate as long as possible. It was at that moment that Nedochetko went to the emergency room.

The attendant underwent an ultrasound which found that the 48 millimeter cyst was already 6 centimeters in size, and was referred to a surgical oncologist.

The discovery of ovarian cancer

“At the first consultation, he explained to me about ovarian cancer and that it could be due to the size and shape of the cyst. I was a little scared, but I wanted to go after it to find out what it really was,” he recalls.

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Nedochetko took the CA 125 blood test, a protein produced by the body that can serve as a tumor marker for ovarian and endometrial cancer, in addition to the imaging test.

The CA 125 must be less than 35 to be considered within normal limits. The attendant’s reading was 106. It was then decided that the patient would undergo videolaparoscopy surgery to remove the 6-centimeter tumor and analyze whether the mass was malignant or not.

When Nedochetko went into surgery, there was no longer any doubt: she had stage four ovarian cancer, which had metastasized. “I discovered that they had several points of the disease on the peritoneum [membrana presente na cavidade abdominal, que envolve os órgãos internos] and I would have to undergo another surgery to remove everything”, he says.

The discovery of ovarian cancer was a grieving process for the attendant, especially about the possibility of getting pregnant.

“The doctor told me to rethink the decision to have children, because I wouldn’t have time for that. I could try to get pregnant and wait for the birth to have the next surgery. Or I could treat myself, get better and adopt a child. This really affects me, because I really wanted to have a baby”, he says, his voice choked with tears.

What is ovarian cancer?

Ovarian cancer is usually a silent disease at first, which means that women discover the condition in more advanced stages. At first, what raises suspicion of the condition is the presence of a cyst, as happened with Nedochetko.

“The ovaries are the female reproductive glands. Cancer can arise from one of the three layers present in the organ: epithelial, germinal and stromal cells. 85 to 90% of tumors are of the epithelial type”, explains the oncologist Renata Arakelianfrom Hospital Santa Paula – DASA Oncologia.

“When the tumor starts to grow or is very aggressive, the person has an increase in abdominal volume and the formation of fluid in the belly. Cancer can compress the bladder, causing urinary symptoms, and the intestine, leading to difficulty in evacuating”, reports the gynecologist Adriana Campanerfrom Alta Diagnósticos and president of the National Commission Specialized in Pathology of the Lower Genital Tract at Febrasgo.

Sudden weight loss is also among the symptoms of ovarian cancer.

Nedochetko reports that, in addition to pain in the groin, he presented other symptoms that he did not associate with the disease: “I had abdominal swelling, pain in the lower part of the belly and during sexual intercourse, excessive tiredness, and nausea.”

The harsh treatment of ovarian cancer

According to Arakelian, ovarian cancer treatment consists of chemotherapy, surgery and may include molecular targeted therapy, such as olaparib and niraparib and anti-angiogenic drugs such as bevacizumab.

After the first surgery, Nedochetko was referred to an oncology gynecologist to undergo the second procedure also via laparoscopy. Nedochetko would need to say goodbye to all of his reproductive system organs as a way to prevent the cancer from returning.

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“It was very difficult for me to accept, but I accepted it. When I came out of surgery, the doctor said it was a success and that we could be parents. I was very happy. She said that it was not necessary to remove the uterus or the right ovary because she did a biopsy right away and found that they were not malignant. She removed the lymph nodes, which were enlarged, and 120 spots of cancer from the peritoneum, gallbladder and appendix,” she recalls.

The biopsy in this case, however, is not 100% reliable, due to the speed with which it is performed. Therefore, the collected material was sent for analysis anyway. When the report came out, the attendant collapsed. She would need the third surgery.

“There was still cancer in the bottom of the Douglas sac, which is under the uterus, and in the right ovary”, he explains. Nedochetko decided to return to the first doctor who was monitoring her and he clarified that the organs would need to be removed and that this should have already been done in the second surgery because there was a risk of the disease spreading to other locations when kept.

The attendant underwent three chemotherapies, then underwent a third surgery and then underwent three more treatment sessions, until the disease went into remission.

Nedochetko reflects that losing her hair during chemotherapy was one of the most difficult moments of the treatment. She thought she would be abandoned by her partner, but that didn’t happen.

The attendant’s thoughts are not unrealistic. A survey by the Brazilian Society of Mastology (SBM), released in April 2023, revealed that seven in ten women with cancer in Brazil are abandoned by their partners. This means that around 70% of cancer patients face the disease alone.

Currently, Nedochetko wants to lose the 20 kilos she gained during treatment for ovarian cancer. He also wants to reverse the fat in his liver, which appeared due to chemotherapy, to later operate on an umbilical hernia. She remains grateful to be able to “live one day at a time, trying to overcome everything, and helping other women discover the disease as soon as possible”.

She hasn’t given up on motherhood: “We have plans to adopt. Not one, but two sons or daughters. The important thing is that we give a home to a child in need. We have a lot of love to give her.”