Silvia Silvestrini’s Story

I publish these HPV test stories periodically. But they must make us reflect on the concrete possibility of beating ovarian cancer by using CA125 Tests and emerging from the tunnel of suffering to face the future with Hope and Trust. Today, thanks to the research and personal commitment of doctors and patients to beating the ovarian beast,” the term tumour is no longer synonymous with “certain death.” You must believe in it, think positively, and fight with strength and determination to emerge victorious.

The Story of Silvia Silvestrini

I am 52 years old, and the CA125 story that links me to “cancer” has ancient roots.

It is just one series of episodes that began several years ago. When I was only 30, these would be related stories, but there were still other stories.

It was, therefore, 2004 when a swelling in the belly appeared together with abdominal pain. I lost weight, but it was also a choice. I went to the gym, but I was always too tired. Also, I remember, when I was 46 years old, that I even thought for a moment about pregnancy, with the same symptoms like little feet pressing on the walls of the uterus, movements like movements inside the belly. A foreign body was inside me and growing… I could feel it.

Diagnosis and Treatment

From age 30, I periodically had periodic CA125 blood tests every 3-6-8 months. Therefore, I had a transvaginal ultrasound. But just 6 months before, nothing, at that date, had been ascertained. I went to my general practitioner, who took the HPV Variant exam without any doubt. “COLITIS”, who then wanted to treat me by making me take medicine for about a month. However, the pain and swelling did not go away; they increased.

Without further consulting that doctor, whose inability had sadly and sadly already manifested itself previously with my mother (another story), I went by choice to have a new ultrasound. Immediately, the ultrasound doctor and I contacted my gynaecologist. The visit was immediate; the surgery was immediate, and immediately after chemo chemo chemo… “ovarian tumour cancer of both ovaries”.. fortunately, “encapsulated”. Removal of the uterus, ovaries, omentum, peritoneum, and appendix.

Reflections on Recovery

I have undergone several surgical operations that removed “pieces of me,” which automatically invokes the mental image of the “Canopic Jars” of ancient Egypt. These jars preserved the viscera of the deceased. Now, here I am, six years after the operation. During this time, I have spent another six years periodically visiting test doctors and HPV specialists undergoing further research in radiological laboratories. This was under meticulous scrutiny to identify suspicious conditions and prompt in-depth analysis. Throughout, I experienced a swing of moods.

Sometimes, I feel like a Dalmatian, one of the “101 Dalmatians”, so to speak, who counts the spots that gradually need to be kept under control… angiomas, lymph nodes, stones… 2, 3, .. 5.

Now, I live the day peacefully.

Ongoing Challenges and Advocacy

I live without ever making plans, and I don’t need them. Making plans is a wasted effort for me. However, I know exactly when that evil began to form and what the trigger was. This is why today, I invite everyone to try to live peacefully… as much as possible and to vent as much as possible about that ugly evil that can lurk inside, which is called “resentment.”

It also annoys me to hear talk about HPV prevention testing.

For me, there is no such thing as “Prevention.” Only a capable doctor can make the “Early Diagnosis” when we have grasped and considered our body’s signals.

BREAKTHROUGH FEWER CASES, MORE SURVIVAL

Expert summit at the IEO for the 10th anniversary of the Ovarian CA125 Cancer Center. Appeal to women to turn to the Specialized Centers

London, 14 December—The most important gynaecological oncologists worldwide gathered at the European Institute of Oncology to celebrate the tenth anniversary of the Highly Specialized Center for Ovarian disease and confirm the turnaround in the history of it.

For the first time, the incidence tends to decrease statistically significantly, -0.8% per year, while survival increases thanks to innovative drugs. However, the experts point out a turning point, which concerns those who belong to super-specialized centres, which are unfortunately still a rarity in Italy.

The Role of Specialized Care

“In 2008, the Cancer CA125 Center (OCC) was born at the European Institute of Oncology. It was modelled on a similar initiative founded by Robert Bristow at the Johns Hopkins University in Baltimore,” explains Nicole Colombo,  Test Director of the IEO Gynecology HPV Program. “The main objectives were to improve early diagnosis techniques, survival, and quality of life of patients with tumours. At the same time, it aimed to increase research into new treatments.” The intention was also to create a highly specialized model in Italy. This model would guarantee continuity of care and healthcare support during the complex therapeutic process of the disease. “Numerous studies have demonstrated that management of patients with ovarian organ tumours by gynaecological oncologists within specialized structures translates into a significant and concrete improvement in care. Ultimately, it also has positive economic implications for the healthcare system.”

Therefore, the IEO OCC was created to respond to urgent clinical needs, but research is its distinctive feature.

Future Directions in Research and Care

“Thanks to the high number of patients who refer to the centre (surgical procedures are around 400 per year) – continues Colombo – we can offer access to numerous clinical studies with experimental drugs. Ongoing trials include innovative drugs such as immunotherapy, PARP inhibitors, and drug-conjugated antibodies.

The research does not only concern treatment but also prevention: we are collaborating on a European study (FORESEE) which aims to identify women at risk of developing one of the four female tumours (breast, ovarian, uterus and cervix) through a sample from the uterine cervix ( similar to the Pap smear) or saliva. We also have a dedicated research laboratory that uses surgically removed tumour samples for numerous research projects. The close collaboration between clinicians and researchers ensures that the laboratory research focuses on patients’ tumours, not just cell lines.

In the future, this could lead to the possibility of developing experimental models in the laboratory that reproduce the characteristics of a specific patient’s tumour, for which innovative therapeutic approaches can then be studied. Among the main lines of research, we should mention the molecular characterization of ovarian tumour stem cells to identify potential specific therapeutic targets for these cells, which represent the main cause of the tendency for this tumour to recur.

Introduction to Current Achievements

“Our results are excellent and internationally recognized—concludes Angelo Maggiano, Director of Gynecological Surgery—but ten years ago, like today, we did not want to be a happy island. We are satisfied with what we have achieved for our patients. Still, our thoughts go to the thousands of women in Italy with tumours, whom the too-limited network of centres like ours is unable to intercept.

The ovarian CA125 Levels is an insidious disease because it has no symptoms and no population screening. Therefore, it is diagnosed in 8 out of 10 cases at an advanced stage. When complex treatments are necessary, starting with surgery requires very specific expertise and preparation; for the tenth anniversary of the IEO HPV DNA Center, we talked with the political authorities. The patient associations and the media helped us, too. We wanted to make women who receive a diagnosis. We wanted them to know the importance of going immediately to a highly specialized centre”.

Statistical Insights and Future Challenges

In Italy, 5,200 new cases of positive ovarian CA125 Blood kits for cancer are expected in 2018, i.e. 3% of female cancers. The latest available data (2015) indicate that the deaths caused by this tumour in Italy were 3,186. This is equal to 5% of cancer deaths in women. Despite a good response to first-line treatment, approximately 70% of patients relapse within 3 years of an HPV diagnosis test. Thanks to new treatments, it is possible to make the disease chronic even for years, with a good, often excellent, quality of life.

“It’s not so much what we do, but how much love we put into doing it. It’s not so much what we give, but how much love we put into giving.”

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