Practice nurse Ruth Payne was diagnosed with ovarian cancer when she was 42.
"I went to my GP because I had a number of minor symptoms," says Ruth. "I had irritable bowel-type symptoms and went through a period of being very depressed, which I now think may have been related to the cancer. But I also had bloating, which is why I went to see the doctor. I looked seven months pregnant."
Ruth's GP thought she was pregnant. "She put me on the couch, held a sonicaid to my stomach and said, 'There's a very rapid heartbeat'. But then she realised it was my heartbeat."
Ruth was sent to her local hospital for a scan. "The radiographer took a long time. She'd obviously seen something that wasn't right." The results indicated a "suspicious lump". The next morning, the GP referred Ruth to the hospital.
At her first appointment with her consultant, he seemed fairly convinced that it was ovarian cancer. Various tests were organised to help them find out what the problem was. These included blood tests, a CT scan and a kidney function X-ray.
"As a nurse, I knew quite a lot about women's health issues, but I didn't know much about ovarian cancer," says Ruth. "It wasn't talked about much in the study days on women's cancers I attended. I just knew it as the 'silent killer'.
"By the time I was admitted for surgery, I was so large I could hardly walk. Whatever it was obviously needed removing. The day before surgery, one of the scans suggested that there could be a problem with my liver, which meant having a liver scan done just before my operation. Fortunately, the scan revealed no problem."
During the surgery, doctors performed a frozen section biopsy to give them some idea of whether Ruth had cancer. This type of biopsy isn't always possible and it isn't 100% reliable. In Ruth's case, however, results showed that it was cancer. The ovaries were removed and a hysterectomy was carried out, and other tissues were sampled to check that the cancer hadn't spread to other parts of her body.
Ruth says, "The oncologist came to see me several days later. He said that although the cancer was at an early stage, I needed chemotherapy as well, because it was an aggressive tumour. He gave me the option of having standard chemotherapy, or participating in a trial of another kind of chemotherapy as well. I decided to go for the standard treatment."
The doctor told Ruth the worst side effect she would feel from the chemotherapy was tiredness. "I don't think 'tired' is quite the word!" she says. "I know it varies from person to person, but some days I felt like I'd been poleaxed. I even found it difficult to walk."
Ruth also cut her hours as a practice nurse, as she was concerned about picking up an infection. She had six cycles of chemotherapy, one every three weeks. Her chemotherapy treatment lasted for 18 weeks.
After the chemotherapy, Ruth didn't need any more treatment. She's still cancer-free, although she has only just been discharged. It took Ruth a long time to recover fully from the chemotherapy. "I got tired very easily and I was infected by any bug going around. For a long time it was easy to think that any ache or pain was the cancer returning, but this gradually lessened as time went on."
She advises women diagnosed with ovarian cancer to take things one day at a time. "It's natural to want to know what's going to happen in a year's time. But if you think about all the things that might happen, you can't cope. Make the most of your friends. If they offer help, give them specific things to do, like taking you to hospital, cooking meals when you might be feeling sick, collecting the children from school, and just being there if you need to talk.
"Don't be surprised if you don't feel on top of the world when you get to the end of treatment: it can often feel like an anti-climax. After all the medical attention you have received, you might feel very vulnerable without all the checks you've had at the hospital. It's sometimes at this stage that the enormity of all that's happened suddenly hits you.
"You might find it helpful to speak to others who've been in a similar position. Ask if there are any support groups, but this might not be for everyone. Be careful about searching on the internet, as there can be a lot of information, which can be quite overwhelming and a bit scary. It sometimes helps if you can get a friend to look for you. Some information may be out-of-date and it won't all apply to you."