As I've mentioned before, at times I work with hospice organizations  in the course of my job.  Given that "end care" is something of my specialty, I know several bereavement couselors.   If you  hope to truly get anywhere with further consideration of a lawsuit, and do so using a good attorney, then you must have bereavement counseling.   As your potential lawsuit appears to involve multiple doctors or clinics, and at least one hospital, you will need a good attorney.   Malpractice is difficult to prove, especially with advanced cancer cases, and making a case is much more difficult when trying to prove that more than one doctor at more than one facility or clinic was in the wrong.

Next, the most common procedure is not to give chemotherapy first, and then operate later.   Most commonly, cancer is confirmed by surgery/biopsy, and then chemical treatment begins.  Giving chemotherapy first is indeed a practice of some cancer specialists, but  as results can be mixed, most specialists do not treat in this manner.  As more chemotherapeutic agents are developed, and surgical procedure become more advanced, this process might change in the future.

The sad fact is that every day women die of ovarian cancers. Some women's cancers are not found until they have an advanced stage, and thus treatment begins when the patient is already at a disadvantage.  Other women's cancers are aggressive to the point that no amount of existing treatment methods can stop or even slow the spread of the disease.   It is up to us, the family and friends of those who have died of the disease, to keep pressure on the world to make progress in detecting and treating this disease.  Just look at what has changed in the past thirty years with regards to breast cancer, and those accomplishments have been made due to the attention given to the disease.   Whatever you do - be it talking with friends, a counselor, or a legal advisor - know that you are restoring a voice to your mother, and she will not be forgotten.

Hi Christine, sorry to hear about your precious loss.  I'm an OVCA patient as well with diagnosis at Stage III.  The irony of being diagnosed with cancer is that my cousin and I were both diagnosed at the same time.  We both go to the same cancer clinic.  Yet the Gyno Onc used different treatment plans for both of us.  In my case, he performed immediate surgery to remove the ovarian cancer even though the surgery ended up being suboptimally debulked.  Chemo treatments were after my surgery.  In my cousin's case, he wasn't exactly sure that the primary was OVCA, so he treated her with chemo first to bring her tumour markers down.  After the six chemo treatments, he then performed surgery on her.  Best wishes..

hi christine, im so sorry for your loss and all the pain your poor mum went through. i just lost my wonderful mum to this terrible disease. mum was diagnosed in january but could only be dx with results from a ct scan, before this was done they said they werent sure what was going on, so this needed to be done first she had stage 3c, they started her on chemo straight away (that day infact), then the tumours shrunk and were able to operated in may, but all grew back very fast even after the op. are you in the uk? i was told by onc that it is normal practice in the uk (with stage 3), that chemo first then op if they can, but dont take my word as gospel as im no doctor. i can understand how distressing this is for you and your family, as when my dad passed away last year i dont feel he was attended to properly or that they did all they could for him, and it does haunt you, i hope you manage to sort this all out. my thoughts are with you xx

Dear Christine.. First of all I want to say how sorry I am to read your post, and to note what you and your family have gone through. I'm so sorry you've lost your Mum. I'm from another country, so our laws could differ from yours, but over here, it would be very hard to prove negligence against the medical profession. They 'close ranks' and will not help a patient to prove a case against one of their colleagues. The only chance that you may have, is if you can gather up your Mum's medical records, right from 'Day 1'.. and get a top Lawyer onto the case.
Secondly, I was also dx with Stage 3-4 after going back and forth to my Docs for almost 9 months. I was told by an attending Doctor at my debalking operation, that one of the Surgeons thought I was too far gone too, and he was keen to sew me up, and send me home to die, however the other Surgeon said no... they needed to give me a chance, so they proceeded with the operation... and it's almost 3 years, and I'm still here. I have problems in that I'm still on chemo, and have been for a couple of years, but life is sweet, and I'm thankful that I had one Surgeon who was willing to give me that chance for more life.
Thirdly... They don't need to give chemo before an operation. They didn't with me... and I was covered in cancer. It got to my bowel, so I also have a colostomy. Not the most pleasant outcome, but not as bad as people think. I'd rather that, than the alternative that I was obviously facing. Sometimes, if the cancer is well advanced, as it was in my case...and your Mum's too, by the sound of it, they like to get in and operate and get rid of as much cancer as they can, so that the chemo doesn't have so much to contend with. Over here sometimes, they do chemo first, then the operation, and then chemo again. I started my chemo 2 weeks after the operation, and I had a combo of Taxotere/Carbo which worked well for me. It's just a terrible thing that your Mum wasn't given the chance. I think, from what you've described, the Doctors she had was like the weakling Surgeon that I had, who wanted to quit.
Christine.. I'm just so sorry for your loss. I also have a daughter, and I know how she would be, had it been me.
Gather up your Mum's records, if you are lucky enough to get them all intact... and see a good Lawyer.Take the Lawyer's advice, but be prepared for the Doctors to close ranks, and fight the case tenaciously.
Best of luck.... Helmar...

Hi there, I can certainly understand that you are upset.  It is one of the hardest things we go through as humans to lose a loved one.  I agree with Becky, I don't understand how they can diagnose her with ovarian cancer without having done surgery or a biopsy, and I doubt they would have done a biospy because if they suspect cancer at all, they don't like to do biopsys in fear that it could release cells to spread. From what I have heard and seen, surgery is usually done first before chemo, unless like Becky said they KNOW before hand that it is inoperable.  The fact that there were so many doctors involved in your moms care should make you feel better, sort of like a second opinion.  Cancer is sometimes unpredictable, and sometimes takes unexpected turns, which is why even the best doctors in the world can't cure it and save everyone.  It is very hard for cancer patients to sue because of this.  I agree with Becky, you would have to get a lot more information, find out how they even diagnosed your mom before surgery, get CT scans xrays etc.  I don't know much about the chemo and her having to wait, but I know that the chemo can make your WBCs low, maybe they were giving her a heavy dose since her cancer was so advanced?  You would have to prove that they all the doctors didn't follow standard protocol, that their peers would have followed.  I am sorry you are going through all this turmoil, it would be easier for you if you knew that the doctors did the best they could ( if that is the case )  Have you tried talking to a grief counselor?  I know what you are feeling is very common too.  At the hospital I work at, many families are mad at the staff for each and every little thing that they perceive as being less then perfect when in actuality they are really angry because their family member is sick. Maybe you should gather all the info you can and try to figure it out for yourself so you will be able to come to terms with it.  Good luck, and god bless you.  Merytre

No, you didn't upset me.  I'm pretty sure they didn't do a CT scan.  But I'm not positive.  That's one reason I'm going to get all her medical records before we even see a lawyer. I'm angriest about the fact he gave her the wrong chemo drug, and too much of another kind later on.  The second gyn/onc delayed her chemo, too.  It's just one big mess.  

I don't know if we'll actually go through with a lawsuit or not.  Right now, I'm more worried about my father and his colon cancer, but he's been talking about suing the surgeons, and I thought I'd ask other people's opinions.  This just haunts me every day.

I'm sorry, I just saw the second half of your post - wow! She had quite the run around it seems. I know I just asked my gyne/onc about why they were delaying me having more surgery (they just found two new tumors on Sept 25th, and are still deciding what to do) and he said that a few weeks, even 5 or 6 wouldn't make a difference with regards to it spreading. The chemo thing is tricky. As far as I know, the only way to know if a chemo will work is to try it for a few cycles - if the CA125 numbers drop, then they can assume it's working. If they rise, then they usually try something else. Epithelial cancer is just a type of Ovarian Cancer - it's actually the most common, I believe. It's the part of the ovary where the cancer starts to grow. I don't know why they wouldn't have inserted a shunt to relieve her of the pain of acitites - I would be asking about that one. I understand why you can't put this behind you, but please arm yourself with knowledge about this disease before you make any decisions. Get her pathology reports and test results - send them away for a second opinion if you need to. I'll be honest, I wasn't going to reply to this because I was afraid to say anything that might upset you - I hope I haven't.
Becky

I'm not sure about many things and I'm sure your still digging for information, but I'll give you my two cents worth. Your mom could not have been diagnosed with Ovarian cancer prior to surgery - they may have had an idea that it was cancer, but unless she had surgery, no Dr I know would have said she had cancer for sure without pathological evidence. Did she have a biopsy done? She had to have had a CT scan or ultrasounds before they operated - otherwise, what were they operating for? I hope you can find them. If they suspected cancer, they would have done surgery first and tried to debulk all visable tumor before starting chemotherapy. They would have only done chemo first if the tumors were inoperable (ie: attached to major organs etc...) I don't understand why a gyne/onc would open someone up to discover they had cancer, then close them up without doing anything. They are the specialists in this feild - I'm not sure why he wouldn't have gone ahead and started debulking her. I can't imagine what it must have been like to see your mom suffering and in pain from an infected incision. Ovarian cancer is a horrible disease that can throw even the best gyn/onc's for a curve. Mine told me, based on biopsy's I had done, that I didn't have cancer - when I woke up from my surgery, I found out that I had stage 3c. I was 26yrs old and  had a hysterectomy, bladder and bowel ressections and am still suffering with complications a year later. I have no idea how no one could have known prior to surgery how bad this was - I will probably never know. I really don't know what else to say except I'm sorry for your loss. Hopefully more women will come and share their expierences with you....
Becky

Possibly seeking a lawsuit--Part 2

Sorry this is so long!

When my mom saw her PCP, she showed him the infection.  His eyes almost popped out.  He gave her an antibiotic, but even with that, it took her MONTHS to heal!!  My father cleaned her abdomen several times a day.  

As it that weren't bad enough, my mom was receiving two kinds of chemo, and only ONE of them was the right kind!!  So he had to switch one of the chemos.  But it didn't work for long.  The surgeon retired, and then my mom got new gyn/onc...who promised to take care of my mom, and kept delaying her chemo!  So that gave the cancer time to grow!  It was delayed because the wrong chemo she had received all those months made her blood counts drop drastically.  While my mom was in the hospital in February getting blood transfusions, she was introduced to ANOTHER oncologist (not a surgeon) who promised to that there was still time, and that she would most likely get better under his care.  Well, he cared for her all right!  He switched her chemo again--and gave her too much of one kind, and it dropped her white blood count SO LOW, he said it was possible her bone marrow was almost completely destroyed!  Well, it wasn't.  She ate a lot of protein, and her white blood count went back up.  

But her chemo was delayed again for like the third time (March of this year).  The oncologist finally got her a CT scan, and said she developed more tumors!  Of course she did--she hadn't had chemo in a few weeks!

My mom received one more treatment before she went back to the hospital--to die!  Because of the constant delays, the cancer went into her liver, her CA125 numbers shot back up again, and she couldn't keep any food down.  

Finally, one day I went outside her room, where her PCP was writing in her chart.  It really got me angry he was so tight-lipped.  I asked her, "What's my mom's CA number?" and he said, "Not good.  It's 277.  The cancer's in her liver, and it looks like she has three months left!"  My mom's oncologist and the other brain trust gyn/onc. confirmed this.    

THe only real prompt attention my mom had was when she fell in the hospital room.  (Her legs were very swollen from the ascites).  They did a brain scan, but she was okay--or so they say.  One night when I was in ICU where they eventually moved her, it was then the nurse on duty showed me her chart and told me she had epithelial ovca.  I don't know why the doctors left out these details!  

The gyn/onc who was supposed to treat my mom before the third oncologist took over her case, PROMISED my family and I that she would insert a shunt that was supposed to drain the ascites and make her more comfortable.  It never happened.  She came up with all kinds of excuses not to do it.  My mom passed 4/14/06

Do you think it's worth trying to seek a lawsuit with the first oncologist who retired?  Don't most surgeons chose to give CHEMOTHERAPY before surgery?  My father was diagnosed with colon cancer in July.  The doctors didn't say, "Let's operate right away!"  (true, it's only confined in the colon).  But the surgeon said my mom's cancer wasn't that bad.  He wanted to perform the operation.  If her cancer wasn't so bad, then why on earth didn't he start her on chemo FIRST and THEN do surgery??  Everyone who I talk says he screwed up.  I just want your opinions!

I can't put this to rest.  Everyday, I think about how my mom suffered.  I know she's in a much better place, but I can't stop thinking about what she went through.  It haunts me, my father, and my aunt.  It's impossible to put it out of my mind!  I think a lot of her suffering could have been prevented!  I've become obsessed with reading about ovca, and coming to these boards, hoping to find answers I know I'll never find.  I'm going out of my mind.  Talking to a bereavement counselor won't help.  I talk to my friends about how I feel, and that's better than talking to a counselor.  

I"m sorry if I sound like a broken record.  If you go through the archives on this site, you'll see that I posted a lot about my mom, and what she went through.  I come to this board several times a day, and resist posting more questions most of the time.  I can't put this behind me!

Thank you for listening to me vent for the millionth time.  That's all I ask for--your ears!