After her doctor told her that her post-menopausal bleeding wasn’t a sign of anything abnormal, Amy Weirick sought a second opinion. That's when she learned she had a type of rare ovarian cancer.
“It was very very lucky, not just luck but pluck, that I stayed on it and I didn’t just say, ‘Oh well, we’ll just keep an eye on it,’” Weirick, 60, a public relations profession in Columbus, Ohio, told TODAY. “I don’t think ovarian cancer is a good thing to keep an eye on — because you can’t.”
It seemed like a period but after menopause
For about a week starting in June 2021, Weirick experienced bleeding and clotting as if she had a period. It stopped. Then started again. After being in menopause for a decade, she knew this wasn’t right.
“It felt like pelvic congestion feeling, it just felt weird,” she said. “I would come home and crash afterwards where like nine months before I would stay up until 1 in the morning doing home improvement projects.”She visited her OB-GYN, who tested her for cervical cancer. When those results returned as being negative for cancer, her doctor told her that she was fine.
“I felt like they were blowing me off and shrugging their shoulders,” she said. “(I asked) ‘So, why am I bleeding?’ and they were like, ‘Well, I don’t know.’ And it was just a laissez-faire attitude toward it.’”
She knew that breakthrough bleeding in menopause was a problem because she had a friend who had ovarian cancer and one who worked with an oncologist. She asked that friend to refer her to a new gynecologist.
“She called somebody and then said, “OK you’ve got an appointment on Monday morning to see this gynecologist oncologist,’” Weirick said. “I’m like, ‘Well don’t you think that’s nuts?’”
She worried that she didn’t need to go directly to an oncologist but her friend insisted Weirick needed a second opinion. She met with Dr. Larry Copeland, a gynecologist oncologist at the Ohio State Comprehensive Cancer Center – The James.
“I said, ‘Well, I feel like I’m wasting your time if it isn’t cancer,’ and he said, ‘Look my job when a women is bleeding after menopause is to assume it’s cancer until I prove to myself otherwise. Your job is to just not worry about it and live your life and let me take care of the rest,’” Weirick recalled.
After testing and observation, Copeland recommended a hysterectomy and oophorectomy (surgical removal of the ovaries). Doctors also found a cyst the size of a “peanut M&M.” It was stage 1 ovarian cancer, which was “encapsulated” in the tumor.
“They found what’s called a granulosa tumor, which is a very slow growing cancer but tends to come back,” she said. “It’s only 1 or 2% of all ovarian cancers.”
Symptoms of ovarian cancer
Symptoms of ovarian cancer can be “quite varied and can be quite subtle,” Copeland said. Signs include:
- Urinary frequency.
- Change in bowel movements.
- Abdominal bloating.
- Feeling full quickly.
- Abdominal discomfort.
- Back pain.
But these symptoms are so ordinary that it can be hard for people to understand what's normal and when to seek help. Lots of people might experience diarrhea and constipation that could be related to food poisoning or something else.
“The difference is the if the symptoms persist longer than usual,” Copeland, a gynecological oncologist at the James, told TODAY. “When the symptoms persist for a week or two, that’s not normal.”
Bleeding after menopause is never normal, though, and Copeland stresses that people call their doctors when that occurs. Once someone started menopause, they are always in it.
“I see patients who say, ‘Well, I re-started my period when I was 55 or 60.’ I’m like, ‘Well, what do you mean re-started?’” Copeland said. “There’s a poor understanding of the significance of it.”
Oftentimes bleeding after menopause is associated with endometrial cancer, which is a cancer of the lining of the uterus. Still, Copeland urges people in menopause who start bleeding to make an appointment with their doctors as soon as they can.
“Every cancer, the sooner it’s diagnosed the better probability you’re going to have a better outcome,” he said.
Copeland added that people who have a higher risk of ovarian cancer include:
- People with a family history of ovarian or breast cancer.
- People who have the BRCA 1 or 2 mutation.
- People who have not had children or been on the birth control pill.
While surgery to remove the uterus and ovaries is the first line of treating ovarian cancer in many cases, some people also need chemotherapy.
“For ovarian cancer, the cornerstone treatment is probably surgery,” Copeland said. “Then many, if not most, patients require adjuvant or additional therapy and that is usually in the form of chemotherapy.”
Life after surgery
When Weirick first started bleeding and Googled it, everything indicated that postmenopausal bleeding was a sign of cancer.
“I was really mad at my gynecologist and disappointed, like ‘How could you not know this?’” she said. “There’s no reason that a woman would bleed after menopause.”
While surgery in September 2021 went well, her wound became infected and it took her a little longer to recover. She’s now cancer-free but goes every three months for follow up to make sure she stays that way. Since then she’s felt great and started traveling and home improvement projects again. She feels grateful that she pushed for a second opinion.
“If you feel like something’s wrong listen to your body. If you feel like a doctor is not listening to you or is not taking things seriously enough, find somebody else,” she said. “If you’re bleeding after menopause, you need to get to the bottom of it.”