Cancer awareness will be her legacy
By Robbie Dingeman
Advertiser Health Writer
Ovarian cancer is killing Karen Stern and she wants other women to recognize the sometimes vague symptoms of the disease so they can be diagnosed earlier and live longer.
Deborah Booker • The Honolulu Advertiser
In 1997, Stern and her husband, Hal, were living on Maui enjoying their retirement and a beautiful home by the sea. Then she and Hal both developed medical problems: She needed a heart valve replaced; he was diagnosed with cancer of the bladder and the kidney.
Michael Stern comforts his dying mother, Karen, who is spending her last days at St. Francis West Hospice in 'Ewa. She urges women to be aware of their health, rather than "sit and think it won't happen to you."
For more than a year after her heart surgery, she felt a nagging sense that something was wrong and told her doctor she felt bloated, had abdominal pain and lost weight without explanation. "I was always tired," she said.
After reading that those are all symptoms of ovarian cancer, Stern asked her doctor about getting a CA 125 blood test but said the doctor declined, noting that the test is known for giving false results that both confirm and clear people of the disease. She shrugged and moved on.
In February 1998, the Sterns moved to O'ahu. Hal urged her to talk to another doctor because she still felt ill even if she wasn't inclined to complain. A new doctor tested her and gave her the results she had feared.
She was in the difficult-to-treat Stage 3 of the disease. She had surgery to remove her ovaries, underwent chemotherapy and, in November 1998, joined Hui Malama O Ola, an ovarian cancer support group.
Stern, 63, is spending her final days in the St. Francis Hospice in 'Ewa Beach. Despite her fading health, she is still working to raise awareness.
• Who gets ovarian cancer? All women are at risk but the risk is higher among older women; those who have not borne children; and those with a history of ovarian, breast or colon cancer. • What can reduce the risk? Pregnancy and breast-feeding; oral contraceptives; tubal ligation/hysterectomy; removal of the ovaries. • What can you do to detect ovarian cancer? There is no screening test, but women should get an annual vaginal/rectal pelvic exam and discuss regular monitoring if they are at higher risk. If you have symptoms, ask for an ultrasound and a CA 125 blood test. Consult a specialist. For more information on the Web, check www.ovariancancer.org. Source: Ovarian Cancer National Alliance
"I don't want anyone else to go through what I've been through," she said.
What women need to know
Her advice to women is to be aware of their health and be assertive with doctors. "You can't just sit and think it's not going to happen to you," she said.
Stern's room overlooks a garden, the wall is lined with photos of her husband of 44 years, three adult children, grandchildren and their dogs. Friends and family call. Her son, Michael Stern, said he's not surprised she is still reaching out to others.
"She's always tried to help people in every way that she could," he said. He recalls her volunteering in hospitals, advocating for the mentally retarded and working with friends.
Michael Stern smiled as he said he's heard, even at the the hospice, that his mother is trying to find jobs for relatives of nurses caring for her, and trying to set up dates for those who are single.
The Ovarian Cancer National Alliance reports that more than 23,000 women are diagnosed each year with ovarian cancer and 14,000 die. The Hawai'i Tumor Registry has recorded an increase in cases since 1975, with slightly higher rates for women of Hawaiian and Caucasian ancestry.
Dr. Keith Terada, a gynecologic oncologist, agrees that women can help themselves by paying attention to their symptoms and being assertive with those who provide medical care to them. He is not Karen Stern's doctor.
He cautioned that the CA 125 blood test is not a screening tool that should be used by every woman.
"It's certainly a reasonable test to do," Terada said. "If you're not feeling well, it's something that should be investigated and evaluated."
Terada said all women can benefit from regular checkups and if they note symptoms that aren't normal for them, they should talk about their concerns. And those with symptoms should seek an ultrasound, he said.
Deborah Booker • The Honolulu Advertiser
While it's often said that ovarian cancer has no symptoms, Terada said, when patients later talk about their condition, often "it turns out that they had symptoms or that their healthcare providers ignored them."
Karen Stern, an ovarian cancer patient at St. Francis West Hospice, shares a moment with her son Michael and nurse Sue Nakata.
Beth Kupper-Herr, associate professor at Leeward Community College, serves as coordinator for the support group and is one of Terada's patients.
Kupper-Herr is a 14-year survivor of the disease. She was diagnosed at age 37, younger than most, and has stayed involved with the group as others have come and gone. She said that seven members have died in the past three years.
Stern said she was drawn to the group because she preferred to talk to others about the experience. "I wanted to know about these different women and how they were coping," she said. She was struck by the different ages, ethnic origins and backgrounds of the group, which usually averages between six to 10 at monthly meetings.
"We encourage each other and we do laugh," Kupper-Herr said as she sat at Stern's bedside. Stern said she advises women to keep active as long as they can among other people while pursuing personal interests. Kupper-Herr recalls that Stern got started in a yoga class after she joined the support group and became active in a newcomers club as well.
Sometimes women fall away from the group after treatment because "they don't want to be reminded of it," Kupper-Herr said, while others remain active long after they've been cancer-free.
People who want to join the group are referred through Call A Nurse referral service at 535-7000.
Reach Robbie Dingeman at rdingeman@honoluluadvertiser.com or 535-2429.
