Debbie Bunten has always been slim and active. She hikes, bikes, does technical rock climbing and she taught dance for 25 years.
In February, just before the COVID-19 pandemic changed the world, Bunten’s abdomen became so bloated, she said, “I looked like I was ready to deliver.’’
Signs and symptoms of ovarian cancer
She went to doctors in Canon City who suggested that the weight gain was a result of stress from her new job. Then, over the course of a few weeks, Bunten developed another concerning problem: She couldn’t eat. Bunten’s ribs and shoulder bones protruded as if she was malnourished. At times, she felt like she did when she was pregnant with her two girls, with so much pressure in her abdomen she couldn’t catch a deep breath. The weight loss, though, became an urgent concern.
“I looked like a skeleton,’’ said Bunten, who lives with her husband, Gary. “My shoulder bones were sticking out and I called someone who I had seen at a local clinic, and I said, ‘We have got to do something.’’’
The caregivers in the local clinic sent her to Parkview Hospital in Pueblo, where she had an ultrasound on her abdomen. She and Gary had nearly made the hour’s drive back to their home in Canon City when the phone rang. The voice on the other end said Bunten needed more tests.
“She said, ‘You’ll need to pack a bag and come back here. Plan on spending the night in the hospital,’’ Bunten recalled.
Back at the hospital, Bunten learned that the ultrasound showed lesions on her liver, colon, and throughout her abdomen. She had ascites, or fluid buildup in the abdomen. When she saw an oncologist at Parkview the next day, she got more bad news. She had stage 4 ovarian cancer.
“I was in total denial because I thought I was healthy,’’ Bunten said. “I said, ‘Well, I guess I’m out of here, because it was so widespread, I thought, ‘I’m done.’’’
New ovarian cancer treatments
Angry that no one caught the cancer sooner, and in a state of disbelief, Bunten thought she’d get her affairs in order. Still, the Pueblo oncologist reassured her that she should not give up. There was a strong chance she would survive and live a long life. There had been many improvements in treatment in the last year. He sent her to Dr. Dirk Pikaart, a gynecological oncologist at UCHealth Cancer Center – Memorial Hospital Central in Colorado Springs.
“Several therapies have been added to our options that are focused on keeping the cancer away once a patient is finished with chemotherapy and surgery,’’ Dr. Pikaart said. “There are also some new treatment medicines for recurrent therapy. She has not had any of these as of yet.’’
Bunten began to have a ray of hope, and she gained strength.
“I have two children, one lives in Georgia and one lives in Oregon. I’ve got grandkids. It was very difficult for them too. It was tough, and it was just disbelief, but I’m a fighter. I just kept going. They say there’s a chance so, by golly, I’m going to keep fighting.’’
An ovarian cancer fighter
Pikaart said attitude is important for patients battling disease.
“I believe when patients have an ‘in the fight’ mental attitude it can have an effect on how patients tolerate disease and treatment. I have noticed that patients who don’t feel like they have much to live for don’t do as well,’’ Pikaart said.
About the time she began seeing Dr. Pikaart, a worldwide pandemic began to unfold. Bunten knew that some hospitals around the country were cutting back on services and she worried. On her first visit with Pikaart, he assured her that nothing would delay her care. No lifesaving treatments or surgeries had been canceled, and he proceeded with a plan to help.
“He said, ‘There’s two ways we can go. We can go with four rounds of chemo and then surgery and then more chemo. Or we can start with surgery and finish out with chemo.’ ‘’ Bunten recalled. “So, we decided on the first one – four rounds of chemo.’’
Stage 4 ovarian cancer treatment
Bunten began having regular appointments for paracentesis, abdominal taps to draw fluid off her abdomen. The type of cancer cells she had produced fluid, and each week, she had nearly three liters of fluid removed. After paracentesis, Bunten literally felt the load off. She could eat and take a deep breath, though it wouldn’t last long. A few days later, fluid would again fill her abdomen.
“This was ovarian cancer and in the more advanced stages, it often produces fluid in the abdominal cavity. We drain it off to provide relief, but the real problem is the cancer its self. Draining fluid is symptom management, not treatment,’’ Dr. Pikaart said.
During another visit, caregivers placed a port under the skin in her upper chest so medications, including intravenous chemotherapy, could be delivered through the port, eliminating the need for multiple needle sticks.
“That infusion center is amazing. I had never been to an infusion center, so I didn’t know what that was like. They treat patients like they’re royalty, all accommodations are met with a smile,’’ she said.
Chemotherapy for ovarian cancer
Before chemo started, Bunten wanted to know how long it would take for the medicine to start working. How soon would the fluid stop building up in her abdomen? When would she feel normal again?
“Dr. Pikaart and his staff, they are the best I’ve ever seen,’’ she said. “They are absolutely great; nothing falls through the cracks, they are always available and they always answer my questions. They treat patients like they are royalty and every accommodation is met with a smile.’’
Pikaart told her it would be two to three treatments in the UCHealth Outpatient Infusion Clinic – Memorial Hospital Central before she would start seeing a difference.
“So I started measuring my abdomen five days after my first infusion, it went down half an inch a day, every day, by the second round of chemo, my abdomen was flat. I am one of those very fortunate people who was actually better on chemo than I was before.
“Chemo is no joke, though. I don’t need to tell anybody that. I was very fortunate I didn’t have any vomiting or anything like that. But each treatment, my blood numbers just improved dramatically. The way I looked and felt improved dramatically, so I figured out that I had about seven days that I felt kind of crappy, and then I could do whatever my body was capable of at that point.’’
During the four infusion treatments, she was able to ride her bicycle a little between treatments. When it came time for the surgery, a CT scan was performed.
“Dr. Pikaart said, ‘If I didn’t know that you had cancer, I would say this is a normal CT scan.’ I cannot tell you how that felt, Bunten said.
Clinically, she said, “my blood numbers were just perfection. ‘’
That meant that the hysterectomy surgery could be done laparoscopically, and she would not have to have a large incision.
Ovarian cancer surgery
“She had an excellent response to the chemotherapy and the amount of disease left was small enough to be removed with a minimally-invasive approach,’’ Pikaart said. “Small incisions hurt less and recovery is much easier. If there is a large amount of disease it cannot adequately be removed through laparoscopic ports.’
“Post-operatively I was very anxious to return to exercising full tilt but had to be careful not to hurt anything inside,’’ she said.
She had two more rounds of chemo. A blood test showed she was cancer free, and Dr. Pikaart said she could return every three months for a pelvic exam and blood tests that monitor for recurrence of cancer.
“To go from not even knowing if I was going to see Memorial Day back in February when I got diagnosed, to seeing the leaves turn in the fall and now the winter, it’s been quite the journey. I just had my 3-month checkup. My blood numbers look perfect and I just had my port removed.
“I’ve come to grips with the fact that I will always be at risk, but am determined to live life to its fullest without looking back at that dark cloud,’’ she said.
Her ovarian cancer story
Bunten’s treatment and surgery all occurred during the time of the pandemic, and she is grateful for the men and women who showed up every day to help her. When she had to return to the hospital to have her port removed, she wondered how she would feel going back into the hospital.
“Is it going to feel like, ‘oh my gosh, bad memory?’ It did not feel like that. These people gave me my life. They saved my life. They pump your body full of some crazy chemicals, but then I was healing. So I’m living with a very grateful heart right now.’’
Bunten said that if it wasn’t for the pandemic, she’d be traveling with Gary and living her fullest life. Until the pandemic eases, she’s laying low and spending days, hiking and biking, grateful to be alive.