Thursday 29 September 2016

Uncommon cancer: early detection led to successful treatment of malignant tumour

As World Cancer Day approaches, Marcella Kavanagh advises anyone who detects a suspicious lump to have it investigated. She tells our reporter how she owes her life to the early diagnosis of a rare form of cancer

Joy Orpen

Published 01/02/2016 | 02:30

Marcella Corcoran was lucky her GP detected the problem so quickly. Photo: Mark Condren.
Marcella Corcoran was lucky her GP detected the problem so quickly. Photo: Mark Condren.

Marcella Kavanagh must be one of the luckiest women around, because her doctor was able to diagnose a rare, potentially fatal disease, at a relatively early stage. If that hadn't happened, she might well have lost her leg, and maybe even her life.

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Marcella, who is in her 60s, grew up in Loughrea in Co Galway. She played the cello in the school orchestra, developed an interest in historical matters, and read a lot. After her Leaving, she spent several happy and productive years in Germany, and particularly in the UK. "I really, really loved everything about London," she says. "But a time came when people were moving on, and so I decided to return to Ireland. There were more jobs opening up then."

Marcella got a position with a merchant bank, and remained in the financial sector for most of her working life. "There were some very nice people in banking, and we had lots of fun," she says. Her last job, before she retired at the age of 55, was with the Bank of Ireland. Currently, she lives in Killester, on the north side of Dublin.

Throughout her life, Marcella has been fascinated by historical matters, especially those that relate to the social aspects of times past.

"When I was growing up, I was always pestering my grandmother and other old people about 1916, and the War of Independence. But they weren't very forthcoming; I think they wanted to put those things behind them," she says. Currently, ancestry holds a special interest for Marcella, so she spends a good deal of her spare time looking into the lives of those who have gone before us. She also plays the piano.

However, in recent years, she has had to move her focus from the past to the present, especially when it comes to her health. About five years ago, Marcella began to experience some discomfort in her leg (just above her knee), when she moved her foot from the accelerator to the brake, while driving her car. "It was an occasional thing, so as soon as I completed my journey, I'd forget about it," she explains. But as time went on, she began to take more notice of the pain, and to question its origin. "I thought it might be due to stretching my leg muscles, when I exercised at the gym," she says.

At the beginning of 2011, Marcella made a list of New Year's resolutions: among them was an intention to buy an ironing board, another was to have her leg seen to. In January, she bought the ironing board, but ironically she only spoke to her GP about the leg problem in April of that year. "Little did I know what I was facing when I made that list," she muses. "When I went to see Dr Helena Butterfield, she examined my knee, and then said she would send me for an MRI scan. I was taken aback, and asked why I would need a scan for what I took to be a strained muscle. And she said there was a possibility I might have a tumour. I was stunned; it was so unexpected; it was completely disarming."

"I detected a problem straight away," says Dr Butterfield. "My main concern then was how long she would have to wait until she got that scan." Fortunately, Marcella had good health insurance, so she was able to have the test quite quickly. "I had it done at 5.40pm about a week later," she says. "At 8.30am the next day, I got a call from Dr Butterfield, asking me to come in to see her straight away." Marcella soon learned there was a growth above her right knee, and it needed further investigation.

So she was referred to surgeon Gary O'Toole at Cappagh Hospital. She saw him the following morning. "Having examined the scans, he said a mass could look quite dreadful and still amount to very little. But on the other hand, he said it could be a tumour. I knew in my heart this was serious," Marcella says. "A kind neighbour came with me, and she took notes. Which is just as well, because I don't remember a single, solitary thing that Mr O'Toole said to me. The shock had definitely sunk in by then."

A biopsy was done, and a week later Marcella learned that she had a soft-tissue sarcoma. This is a type of malignant cancer that can affect muscle, fat and blood vessels in any part of the body. Other kinds may affect the bone. Marcella knew absolutely nothing about sarcomas, so a friend researched it on the internet for her, with some very alarming results. "So she told me not to do the same, not to go on the internet. And I didn't. I decided to put all my trust in my doctors," she says.

Nine days later, Marcella was operated on at St Vincent's University Hospital in Dublin. When she woke after the three-hour operation, she had a wound running from her hip to her knee and "all sorts of drips and drains". She soon learned the surgeon had removed the tumour, the surrounding tissue (as a precaution), muscles and lymph nodes.

"I had extensive physiotherapy and had to learn to use different muscles when I moved my leg, as the other ones were gone," says Marcella. "It was a very, very slow, painful process, but, with much help from the physiotherapist, it worked." She also learned that if she hadn't got such an early diagnosis, she might well have lost her leg.

Following a period of convalescence, Marcella began radiation therapy at St Luke's Hospital under the supervision of Dr Charles Gillham. "He was very reassuring and sympathetic, as was his team. I went every day for seven weeks, as a precaution, and to clean up any rogue cells," she explains. That was over four years ago, and she has been well ever since.

Last December, Marcella attended a meeting of the recently formed Irish Sarcoma Group and told her story. "People couldn't believe my GP had picked up on it so quickly," she says.

Dr Gillham says the group was formed to raise awareness about the various "uncommon" cancers that fall under the umbrella term of sarcoma, and to encourage centralisation of services. He says 200 to 250 new cases are diagnosed each year, and while sarcomas are most commonly found in the legs, they can appear anywhere in the body, and at any age. He says they are best treated by a highly specialised, multi-disciplinary team. Anyone who detects a lump bigger than 5cm under the skin, (whether it is tender or not) and which appears to be growing, should have it investigated. "Many people have lumps and bumps, and most are not malignant," he says, "but the earlier a sarcoma is treated, the greater the chance of a cure."

For more information about the Irish Sarcoma Group, contact Margaret Cavanagh, tel: (01) 834-1211, or email margaret.cavanagh@cappagh.ie

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