‘The tears welled up and I started to ask questions’

Maire Dundon was surprised when the doctor conducting a routine medical check-up at work asked was she pregnant, although she had been conscious of having a bloated stomach, along with “horrendous” period pains.

When she told him she wasn’t, he advised her to go to her GP, which she did that same evening in Tallaght, Dublin. But the doctor she saw at the clinic told her it was nothing more than irritable bowel syndrome and advised her not to eat white bread.

A year and a half passed, during which she was watching what she was eating but it seemed to make little difference to the bloating and discomfort. And people were no longer asking her was she pregnant, they were enquiring when the baby was due.

“I knew I was eating properly and there was no reason I should be [overweight] and I was fairly active as well.” Her boyfriend of just a few months, Finbarr Brady, was also concerned and encouraged her to go back to the doctor.

In December 2008 she returned to the GP clinic and got a different doctor. He remarked that it was the worst case of irritable bowel syndrome, as diagnosed by his colleague, that he had ever seen, and started to discuss a possible course of action.

“I sat there and listened and said I was prepared to go with whatever he was proposing but that I was not leaving without a [referral] note to go for a scan, because I felt that there was something else going on. He possibly would have given that to me anyway but I was very determined.”

However, she still wasn’t unduly worried as she went into Mount Carmel one Saturday for the scan – just expecting it to show some minor problem.

“I was so relaxed about it I went by myself and I was going to go straight down to Wexford [where her mother is from] afterwards.”

She had to drink lots of water before the scan and she remembers lying down and feeling a great sense of pressure. “I actually felt the water was up in my throat.”

As soon as the scanner operator finished the scan, his demeanour completely changed. He told her to go to the toilet and then come straight back into him.

“I sat down. He said that normally he would just give the patient a letter to give to their doctor or forward a report but, he continued, ‘I’m conscious of what I found here today and I don’t feel I can let you go without giving you some idea of what I’ve seen.’

“That’s when the hairs on the back of your neck stand up,” says Dundon. “I said ‘okay . . .’ and he said basically he had found a large growth, which he believed to be ‘ovarian in origin’ but he couldn’t confirm that.

“The tears started to well up and I started to ask him questions and he just kept saying ‘it’s not my area of expertise’ over and over again. But he was very good and his assistant was fantastic and took me into a different room [because] I was so upset.”

A friend came to collect her, she cancelled the trip to Wexford and on the Monday she returned to the GP who had given her the letter for the scan.

“You could see he was very affected by it,” remarks Dundon, who this time had brought her mother, a nurse, in with her.

“He started to talk more to her than to me – probably because I was a blubbering idiot in the corner.” The doctor told her mother that he was very concerned and that he had never seen something like this in somebody of her daughter’s age.

“He was saying all these things and this was is the first time that cancer came into my mind. I said ‘are you saying that you think I might have cancer?’” She knew she had a growth and would probably require surgery but she hadn’t consciously made the link with cancer.

“He turned around and said ‘I think that could be a possibility that you will have to prepare for’. I just went to pieces.”

Nearly 400 new cases of ovarian cancer are diagnosed every year in Ireland, which has the highest mortality rate for this disease in Europe. Some 70 per cent of women diagnosed with ovarian cancer die within five years.

Often referred to as “the silent killer”, the symptoms (see panel) tend to be confused with less serious conditions. As a result, the majority of cases are not diagnosed until the cancer is in the advanced stages and more difficult to treat.

The first annual World Ovarian Cancer Day is being staged tomorrow to help raise awareness of the disease, which is responsible for an estimated 140,000 deaths worldwide each year. It is being promoted in Ireland by three ovarian cancer charities: OvaCare, which focuses on support and advocacy; Supporting Ovarian Cancer Knowledge, which promotes awareness. and the Emer Casey Foundation, which is dedicated to funding research. Campaigners hope that increased knowledge of symptoms will mean more cases will be caught earlier.

Dundon was angry that time was lost for her, due to initial misdiagnosis. The second GP acknowledged as much but promised to have her in with one of the two doctors in the country who he believed were “brilliant” in dealing with this condition.

Within two weeks she was in the hands of one of those – Dr Tom D'Arcy at the Coombe Women and Infants University Hospital in Dublin. He said she had a complex cyst, with several types of material, but that he would not know exactly what he was dealing with until he removed it.

“He went on to say what he would be taking out and drew it up on a board: ‘We will have to take the ovary, then we will have to take the Fallopian tube . . .’ and then the apron of fat that covers these organs and he might have mentioned the appendix.”

Dundon recalls sitting there thinking, “don’t all these organs do something?” She also remembers her mother grabbing her hand, which underlined the seriousness of what lay ahead. “Being a daughter of a nurse, you could have an axe in your head and it would be nothing,” she laughs.

After surgery, D’Arcy confirmed that he had found a borderline tumour – a potentially invasive cancer. But he was confident he had got everything; the whole ovary had been removed and the tumour had been encapsulated in that and had not leaked out anywhere and no further treatment was required. “I remember coming out of the hospital after he told me the news and a friend was saying isn’t this great and you can get on with things now. And I was like, ‘I don’t think this ends here . . .’ ”

As the initial, all-consuming fear about cancer abated, concern about the impact it might have on her fertility started to take its place. She wondered if, when the time came, would she be able to have a baby?

It was a subject she raised with D’Arcy who said he couldn’t tell her (or indeed any young woman) whether or not she was going to have children but that all the signs were in her favour – she had regular periods, which meant the other ovary had taken over the function of the missing one and there was nothing wrong with her womb.

“One of the conversations I had to have with Finbarr, which was very awkward, was to tell him that I didn’t know what my future was. I had to say, ‘If this is an issue for you, we need to know now because there is no point going further down the line.’ You love someone so much at that stage but at the same time you have to be fair to them.”

Her boyfriend who, she says, had been fantastic and carried her through it all, replied that they would cross that bridge if and when they got to it.

Both aged 31 now, they moved into an apartment in Stepaside, Co Dublin, together a year ago and, very shortly afterwards, she was shocked to find herself pregnant. In different circumstances she might have fretted that it was too soon, that they weren’t married, but having been what she had been through, she was delighted.

And of course, since baby Tomás – named after Dr D’Arcy – arrived last February, they can’t imagine life without him.

For more information see: ovacare.com; sock.ie and emercaseyfoundation.com

swayman@irishtimes.com