About Me

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Ovarian cancer will be diagnosed in 1 of 72 women; 14,000 will die. Please know the symptoms and risk factors: read Outshine: An Ovarian Cancer Memoir. Books at www.amazon.com. ALL PROCEEDS GO TO GYNECOLOGIC CANCER RESEARCH. I am a member of Rave Reviews Book Club and Rave Writers International Society of Authors, and Patient Leadership Council. I WILL NOT USE YOUR EMAIL ADDRESS FOR ANY OTHER PURPOSE THAN CONTACTING YOU DIRECTLY. ALL ORIGINAL CONTENT COPYRIGHT 2011 THROUGH 2018.

Thursday, October 25, 2018


Four ovarian cancer survivors


In continuing to give information about maintenance drugs and those of us facing recurrent ovarian cancer, I am introducing a special new movement called Not On My Watch.Visit NotonMyWatch.com to view the PSA. Every share of the PSA will trigger a donation of $5 towards patient education and support programs. Follow the movement on Facebook, Twitter (@TwitterHandle), and Instagram (@InstaHandle and share the PSA from those channels as well.

This is a new movement developed to inspire and inform women who have ovarian cancer at any stage. The four women presented are of various ages, stages of ovarian cancer, history of various treatments and/or surgeries, and diagnosed at different ages.

I was honored to be asked to be a part of the creation of this remarkable movement. 

      "Disclosure: TESARO paid for my travel expenses to participate in the Not on My Watch PSA. All comments made by me about the campaign or PSA, TESARO, and/or the Not on My Watch program are at my own discretion and based on my own opinion." 

                     As a note, PSA stands for Public Service Announcement.

To give you a little background about me and my journey with ovarian cancer. I am a retired RN who had received no education about any gynecologic cancer in my training. In my 35 years of nursing, I had one patient who was in hospice for ovarian cancer. As her hospice nurse, my intention was to help her make a painless and peaceful transition during the few days she was my patient. Therefore, I did not do any research on her cancer.

In 2008, at the age of 67 years, I started having bloating in my abdomen, which I quickly attributed to my age and being post-menopausal. Unfortunately, I had a malignant tumor that was the size of a honeydew melon on my left ovary. I had a hysterectomy and six rounds of chemotherapy.

Six years later in 2014, the cancer returned which required more chemotherapy shrinking the tumor to the point that the PET scan showed "No Evidence of Disease." But cancer was not done with me. In 2016, a malignant tumor was found and I was treated with chemotherapy again until the tumor shrunk enough to surgically remove it.

In June of 2017, I started maintenance therapy with a PARP inhibitor which I have tolerated quite well.  As of this writing I am glad to say I am NED (No Evidence of Disease).

By reading my biography, I am sure you will understand why I am so supportive of the endeavors of TESARO by presenting the Not on My Watch movement.                                             


It is my hope that the information provided through the various links will be helpful. Please help spread the word about ovarian cancer and promote Not on My Watch by sharing this blog with other survivors.

Friday, October 19, 2018


Recurrence is a cloud of fear that hangs over many cancer survivors. Will the cancer come back? Am I cured? If it comes back, what are my treatment options? 

Refractory or recurrent ovarian cancer can occur after surgery and front-line chemotherapy. Persistent cancer refers to those patients whose cancer cells persist despite treatment. There is second-line treatment options available now more than ever. It is best for the patient's physician to discuss her choices for further treatment and the side-effects and risks involved. 

Here is a brief overview of drugs and treatments now available:

   Doxil, Hycamtin, and Gemzar are showing to be effective in prolonging survival. https://www.texasoncology.com/types...cancer/ovarian-cancer/recurrent-ovarian-cance..

   PARP inhibitors have proven great efficacy. According to Dennis R. Scribner, Jr. MD 

"We now have oral PARP inhibitors for patients in the recurrent setting who are on third- and fourth-line therapies. Now, we’re looking at them as maintenance therapy. There are a lot of checkpoint inhibitors [being explored]. It’s amazing that we now have drugs that allow our immune system to recognize cancer cells when, in the past, they were hidden by these receptors. Now, we can block them. I’m hopeful that this will take us to the next category of drugs that we can use to help these women." https://www.onclive.com/.../treatment-approaches-evolving-in-recurrent-ovarian-canc...

 "There’s a lot of interest in maintenance therapy” — given after treatment to help prevent disease progression or recurrence — “either with a PARP inhibitor or with Avastin,” said Sarah Adams, M.D., assistant professor of obstetrics and gynecology at the University of New Mexico Comprehensive Cancer Center. "Avastin works by limiting the oxygen supply to cancer cells, eventually causing them to die, while PARP inhibition blocks the PARP protein, which helps to repair breaks in the DNA strand. If these breaks are not repaired, the cancer cell will die."

   Gene therapy "delivers a protein that suppresses the development of female reproductive organs may improve survival rates in patients with ovarian cancer that has recurred after chemotherapy. Recurrence happens 70 percent of the time and is often fatal." https://news.harvard.edu/gazette/story/2015/07/recurrent-ovarian-cancer-patients-may-have-hope/

   Immunotherapy is being investigated in clinical trials. According to Sarah Adams, MD "There are also clinical trials underway exploring the use of immunotherapy with checkpoint inhibitors and CAR-T cells in ovarian cancer. Checkpoint inhibitors block the activity of proteins that keep the immune system from going into overdrive; this frees up T cells to recognize and attack cancer. CAR-T cells are immune cells that are removed from a patient, engineered in a lab to target and kill specific types of cancer cells, and then returned to the body."

I believe it is through information that we can make decisions that are best for us and provides some control over our treatment. I hope the information is beneficial to you. This helps to reduce anxiety.

On the previous blog, I discussed the role of anxiety in our lives and how to best overcome it. Anxiety is detrimental to our health. It is best to live each day to its fullest, filling it with love and joy. 

Tuesday, October 2, 2018


A common issue for those of us with a serious or life-threatening disease is handling our anxiety. This is true at the time of the diagnosis, during treatment, and also during remission, or we are told that we are cured. 

It is important to not let anxiety rule your life. It deters the growth of the immune system, creates poor eating and sleep habits, and can have negative affects on our relationships.

Here are some things you can do to help handle your anxiety.

   Try to do normal day to day activities: continue exercise program, spend time with family and friends, engage in favorite hobbies.

   Share your feelings and fears with your loved ones. Be comfortable to show your emotions as you tell them about what you are feeling. Crying, wringing of hands, palpitations, sweaty hands, and word-finding difficulty is typical.

   Knowledge and awareness gives us power and a sense of control and better decision-making. Ask questions and share your concerns with your physician, the nurse, or social worker. Seek out information on the Internet only at recognized institutions: Mayo Clinic, Johns Hopkins University, M.D. Anderson, and such. Do not rely on individual comments, theories, or experiences. The information may well be inaccurate, misleading, and individual.

   Do things that bring a smile to your face. It might be a hobby; playing games; watch funny movies or television programs; go to a zoo or a favorite place in nature; go to a concert; listen to your favorite music and dance; or go to a favorite restaurant. Smiling and laughter can put life in a positive light which automatically releases anxiety.

    Taking quiet time to relax and communicate with your god or higher power and provide peace. Being in touch with your spiritual side is as important as any physical or emotional/mental aspect. Many believe that we are holistic (wholistic) and it is imperative that we address all three parts of ourselves.

   Our bodies are meant to move whether it is walking, running, yoga, or isometrics. Along with exercise nutritious eating is vital to keeping our body healthy and strong. Endorphins are released during exercise which improves our psyche and emotional state. It is tempting to eat sweets and junk food when we are anxious, but that is the very antithesis of what is best for us. Choose those foods you enjoy from the fruit and vegetable category.

By following these steps you can be at peace and at acceptance, more prepared to face whatever might be in your future.

Did you know that 1-72 women will be diagnosed with ovarian cancer each year?
Know and monitor the warning signs: bloating, pelvic pain, back pain, indigestion, painful intercourse, changes in bowel or urinary habits, fatigue. If any one or more of these last more than two weeks, go to your ob-gyn physician. Early detection is imperative.

Saturday, September 1, 2018


Understanding the process of clinical research can be confusing. There may be misinformation or misinterpretation, which might keep someone from being a part of a clinical trial. Several of the photos below have been provided by Tesaro, "an oncology-focused biopharmaceutical company." My thanks to them for permitting me to use these photos.
The FDA website provided valuable information as well. https://www.fda.gov/ForPatients/Approvals/Drugs/ucm405579.htm

                                      To find new drugs is a long and expensive process:

     Step 1: Development
Once researchers identify a promising compound for development, they conduct experiments to gather information on such things as molecular make-up, absorption, interactions, side effects, dosages, etc.

     Step 2: Preclinical Research
Before testing a drug in people, researchers must find out whether it has the potential to cause serious harm, also called toxicity. 
     Step 3: Clinical Research
The drug is now tested on people. As the developers design the clinical study, they will consider what they want to accomplish for each of the different Clinical Research Phases and begin the Investigational New Drug Process (IND), a process they must go through before clinical research begins.

     Step 4: FDA Review

If a drug developer has evidence from its early tests and preclinical and clinical research that a drug is safe and effective for its intended use, the company can file an application to market the drug. The FDA review team thoroughly examines all submitted data on the drug and makes a decision to approve or not to approve it.

 FDA Post-Market Drug Safety Monitoring
   Step 5:

Even though clinical trials provide important information on a drug’s efficacy and safety, it is impossible to have complete information about the safety of a drug at the time of approval. Therefore, the true picture of a product’s safety actually evolves over the months and even years that make up a product’s lifetime in the marketplace. FDA reviews reports of problems with prescription and over-the-counter drugs, and can decide to add cautions to the dosage or usage information, as well as other measures for more serious issues.

I recently attended the Ovarian Cancer Research Fund Alliance annual conference. Here are some new treatments that were presented. Please note that these new drugs would not be available without people volunteering for clinical trials.  Think of them as being a part of a study, not as a "guinea pig."


PARP Inhibitors

Great strides in treating women with or without the BRCA mutation for recurrent ovarian cancer. There are three drugs that affect the DNA of the cancer cells by inhibiting the PARP enzyme. Learn more about them at: https://scholar.google.com/scholar?hl=en&as_sdt=0,10&as_vis=1&qsp=6&q=parp+inhibitors+in+ovarian+cancer

Immune Therapy

Another area showing great promise by building a woman's own immune system through a vaccine. This research is in its early stages. https://ocrfa.org/2018/04/vaccine-for-ovarian-cancer-shows-promising-results-in-pilot-trial/

Gene Therapy

A gene therapy that delivers a protein that suppresses the development of female reproductive organs may improve survival rate in women who have recurred after initial chemotherapy. Unfortunately recurrence happens 70% of the time.https://news.harvard.edu/gazette/story/2015/07/recurrent-ovarian-cancer-patients-may-have-hope/

 There are dedicated physicians, scientists, researchers, and people working hard to find cures or improved treatments and medications. I am grateful to each of them.

Thursday, July 26, 2018


I believe that life is a series of roads that we take. As we reach a fork in the road, we must decide which direction we choose to follow. Sometimes we stop along a road to refresh or reflect. Other times we walk the path as quickly as possible to get to the next fork in the road. Whichever road we walk, it is important to learn from the experiences and adventures.

My first blog was published on October 12, 2011 titled, Facing Ovarian Cancer. Since then I have written about ovarian cancer, relationship issues, travels, newest research, spirituality, and various people. 

Several guest bloggers and I have blogged about such health issues as nutrition, breast cancer, Lynch Syndrome, mesothelioma, lymphedema, neuropathy, melanoma, sleep, and various medicines, treatments, surgeries, and chemotherapy. 

I thank such people as Joan Noeldechen, D.G. Kaye, Ron Yates, Charles Porter, Sally Cronin, Nonnie Jules, Joanne Guidoccio, Bonnie Donihi, and Rachel Lozano for their contributions as authors.

Topics about adoptive mothers, the roles of animals, the military, caregivers, survivors, aging, paying it forward, touch, abuse, chains of life, grief, and regrets are just some of the topics that were posted.

The key words of Outshining Ovarian Cancer blog were:

       God, serendipity, prayer, wisdom, serenity, courage, humility, miracles, coping, hope
       joy, reverence, laughter, healing, military, gratitude, lessons, friendship, people, family,
       peace, and health.

I have had people from all over the world read my blog. I was blessed to meet one such person in Barcelona, Spain. We had a beautiful short time together and I will never forget her. Unfortunately, she passed away from ovarian cancer a few months later. At a recent ovarian cancer conference, I met many women who follow my blog. It was a very special time to hug and talk to one another.

I did not choose the ovarian cancer road with its many curves of treatments, surgeries, and recurrences, but it is one I have walked for the past ten years. I became a blogger and an award-winning author because of the cancer. However, the path as a blogger has come to a fork in the road. So, I am changing this site to a monthly newsletter and write only about ovarian cancer and other gynecologic cancers and disorders. There are still too many women and medical professionals who do not know about this most deadly form of gynecologic cancer.

I cannot see where this road might lead me, but I am willing to travel it and experience what is around the corner. I am now in a position to do more presentations, write more articles, continue to attend support groups, advocate more, and finish the several books I have started. I know in the deepest part of my soul that this is the road God wants me to take. I believe I will be able to reach more people. 

I am very grateful to each of you, who have faithfully followed me. Of my 300+ followers you have left comments, written to me through email, or personally thanked me. I have appreciated every word of encouragement. If you would like to be an official follower, I ask that you click on the blue box "follow" in the upper right side, then click on "follow by email."

This is not "good-bye." It is "bon-voyage" as I take my first steps on this new path. I can always be reached by email at kareningalls1941@gmail.com, and my two websites: outshineovariancancer.com and kareningallsbooks.com. My first newsletter will be posted in early September.

Karen Ingalls

Sunday, July 8, 2018


It breaks my heart when I read about anyone who has cancer, however when it affects our young people it is the saddest. My first response is one of shock and I think or say, "Oh no," which is the first stage of grief. I try to understand why, but I have never come up with a satisfactory answer.

According to the Dana Farber Institute at Boston Children's Cancer and Blood Disorders Center, "Ovarian tumors account for one percent of all malignant tumors found in children between birth and age 17."

The cure rate is much higher than those diagnosed as adults. At Dana Farber 100% of the ovaries are saved so these young girls can be fertile someday. 


Perhaps many of you are familiar with the following two cases of Natalie Cosman and Paige LaRoas. Natalie was 7 years old when she was diagnosed with ovarian cancer. The young girl was having severe stomach pains. The doctors first treated her for constipation, and then in the ER she was sent for a CT scan believing the pain was from her appendix. That is when a 7cm cyst on one of her ovaries was discovered. 

Paige LaRosa was diagnosed with ovariian cancer when 11 years old. Her symptoms were extreme fatigue and loss of appetite. Unfortunatley her ovaries were not saved nor were any eggs harvested. https://www.findatopdoc.com/Women-s-Health/Two-Brave-Young-Girls-Overcome-Ovarian-Cancer

Newsweek  Bradley Lowery

The most common cancers in our youth are:

      Brain and spinal cord tumors
      Wilms tumor
      Bone cancer

Our youth with cancer face different challenges than we adults. Fertility and hormones is a major one. Their sense of self-esteem due to hair loss, fatigue, and other chemotherapy side effects might be compromised. The days in the hospital and frequent doctor appointments can well interfere with their social life. Normal activities may be too much due to fatigue, nausea, and diarrhea. Some suffer from lower self-esteem due to their body image and if their illness is causing major financial concerns, they might feel guilty or responsible.

Ethan Jostad Foundation

Yet, it is amazing how resilient our youth can be. They are often courageous and can smile or laugh. Certainly they have their times of sorrow and fear. 
Once they have finished treatment, many of them develop a greater sensitivity tothe needs of others, have improved relationships, and a greater world view.

Here are some resources and groups available for our young:
     https://www.lls.org/  (Leukemia and lymphoma society)
     www.dana-farber.org › ... › Support Services & 
              Amenities › Young Adult Program

Friday, June 22, 2018


Are you as fascinated with clouds as I am? I find them mysterious, ever-changing, frightening, and beautiful. Ovarian cancer is also mysterious, changing our lives, can be quite frightening, and is far from beautiful...it is ugly.

There are ten types of clouds: stratus, cirrus, cumulus, stratocumulus, altocumulus, nimbostratus, altostratus, cirrocumulus, cirrostratus, and cumulonimbus. Ovarian cancer has several forms each with its own genetic code.

Yes, I looked up the information. https://www.thoughtco.com/types-of-clouds-recognize-in-the-sky-4025569  I wanted to learn about them and see how they may or may not be similar to us humans, you and me. I will include just a few photos from this site, but I encourage you to go to the link above and see photos of all the cloud types. How do we react, cope, and change when diagnosed with cancer?

Cumulus clouds are usually the first clouds we see in the morning. Their tops are round and puffy but the bottom portion is often dark and flatter. They are nick-named fair weather clouds because they develop on bright sunny mornings.

      There are those people who may appear to be happy, positive and have a sunny 
       disposition, but in reality they are not always that way. Many of us try to keep a
       happy face on, yet fear and/or anger might be hidden away.

Stratus clouds hang low near the ground; are grey and gloomy; often confused with fog. There is often a light mist or drizzle with them.

     We all have our gloomy moods from time to time, but be wary if you always have a 
      grey cloud hanging over your head. To always be sad or fearful is NOT healthy nor
      help our bodies try to heal.

The low, puffy clouds that are gray and white with blue patches of sky in between are the stratocumulus clouds having an almost honeycomb look.

      Happy people like to be around happy people. Misery sometimes loves company of
      like-minded people. It is best to be with positive, wise, and responsible people when
      facing a serious illness of cancer.

Nicknamed "sheep backs" or "mackeral skies" are officially called altocumulus clouds. They remind me of a lot of cotton balls scattered across the sky. Thunderstorms are quite likely to develop when these clouds appear in the morning sky.

     There are people who just seem to bring on trouble. Perhaps they might actually enjoy
     stirring up problems, the thunderstorms. It is usually best to avoid such people. If you
     are one looking for the magical cure ignoring advice and treatment from your medical team,  
     then a dangerous health might well be on the horizon.

Nimbostratus are rain clouds we are all familiar with. Their thick dark layer blocks out any sunshine.

     People with a darkness about them are often depressed, ill, or have a mental problem. 
     Problems often surround them and they do not know how or are incapable of 
     bringing sunlight into their lives. There are physicians, nurses, therapists, social
     workers, family and friends always available to help you.

Altostratus are low-lying gray clouds that cover the whole sky. However, one can see the sun thinly veiled behind them.

     Those individuals that are struggling with depression or sadness know there is a light
     which will help lift them up. No matter how bleaklife might seem, always search 
     for the light so a storm does not develop.

Buttermilk skies are officially called cirrocumulus clouds. They can look like grains of sand to some. They are formed in the higher atmosphere from ice crystals and are not as commonly seen.

      Individuals that are scattered with their thoughts and endeavors, have trouble staying at  
      task are not always someone we can depend on. Hopefully such scatterness is short-lived 
      and is not a frequent part of one's behavior. It is important to stay focused on those
      treatments, people, and events that can help us.

White and almost transparent are the cirrostratus clouds. Often a ring will show around the moon or the sun.

      Spirituality may be the strong part of these people. They tend to glow, smile, and 
      give people around them a sense of peace. Keeping your faith in the forefront of each
      day will help you have the strength to get through each day.

One of my favorite cloud formation is what I call "mare's tails" are actually cirrus clouds. They are high in the sky formed by ice crystals.

      Playfulness is a major part of these people. Yet for that very reason they may not see or   
        hear the storm coming.  Humor, laughter release powerful endorphins, yet one must not 
        be childlike and ignore the important and more serious parts of life.

Cumulonimbus clouds are commonly referred to thunder clouds. To some they look like cauliflower as they enlarge. A thunderstorm is to be sure coming.

      There are people who are larger than life. They can be domineering, loud, and even
      threatening. Be gentle, soft, and kind to yourself and others.

We each have our personality traits, moods, strengths, and weaknesses. Next time you look up and see a cloud formation, see if you can identify it and how it does or does not fit with you.
                                                What kind of a cloud(s) are you?

I am cirrostratus and a stratocumulus: I am spiritual and like to be around people who are like me. I have a little cirrus in me who loves to play and bring out the child in me.

Ovarian cancer's most common symptom is bloating. If it occurs for more than two weeks, seek out medical advice.

Sunday, June 10, 2018


There are those of us who struggle with fear, doubts, and the unknown. This is especially true for those dealing with a serious or life-threatening illness. Yet, I believe that if we seek love in the world around us, our gratefulness will help us to be healthier and more contented with life. 

We can find such love in the people around us, in nature, music, meditation or relaxation. 



 "Your thoughts, words, and deeds are painting the world around you."

    This quote by Jewel Diamond Taylor poignantly explains  not what life does to us, but how we react and interact in our world. Ms. Taylor well knows how the power of love and gratitude can help rise above any challenge when she lost her first-born son to cancer.

     From that experience she learned to turn her life around through her Christian beliefs. Her books and seminars teach about how we can each readh inner strength, overcome depression, and shift our thinking. She is considered the souldier of good. https://jeweldiamondtaylor.com/2016/04/28/meet-jewel-diamond-taylor-2/

When we are content, grateful, positive, smiling, and trusting then our bodies, minds, and spirits are relaxed and healthier. 

All the body's systems are in an environment to work more harmoniously and efficiently; our minds are free of cluttering thoughts and needless worries; and our relationship to God or a Higher Power is more profound.

I usually arise at 5:00 in the morning. I go into my office, open the blinds, and watch the sun rise. That is my time of surrounding myself with love and peace. I take slow, deep breaths, send prayers and say positive affirmations.

                This always prepares me for whatever the day might have in store for me.

      A good friend recently shared how she looks at three different photographs of family and nature each morning to start her day and each evening as she prepares for sleep. One photo makes her laugh; another one reinforces her appreciation for the beauty of nature; and the third photo reminds her of God's unconditional love.

                 "It is easier to breathe," my friend said. "I still have challenges 
                                        and problems to face, but life is smoother.

             Might I suggest that each morning and at each bedtime:
   1. Sit or lie down in a comfortable position.
   2. Breathe in and out three long slow breathes.
   3. Look at 3 photographs that lift your spirit, make you smile, and grow your gratitude.
   4. After a few minutes, arise and enjoy your day; or have a peaceful sleep.

As difficult and challenging life might be at times, we can learn from them and become 
                                       better and healthier people.

Ovarian cancer news: Immunotherpay is showing promise in many cancers. Here is a link with the very latest information: https://www.youtube.com/watch?v=OkaS6ZkPml0

Monday, June 4, 2018


I am honored and pleased to introduce you to Joan Noeldechen, an inspirational and gifted poet. 

She has poetry published in June Cotner's anthologies from 1995 through 2017/. She is sharing three of her poems that I hope you will find comforting, uplifting, and moving. I know she will welcome your comments below.

                               A SELECTION OF POEMS FOR HEALING
                                  BY JOAN NOELDECHEN


My womb rose
to the surgeon’s knife.
Before being cut,
it bled one last time
as if to play one last joke.
Childbearing time is
over for me.
There has never been a man who
had found me for more
than a quick encounter.
Never did they want
babies at my breast.
I was free of proving
myself worthy and
from passing on
my mother’s insanity.
I fell asleep
in the hands
of God
wondering if
he was taking
me out for good.
He was the only
man I could trust
to love me


Reflective Pool

But not forgotten
I have my faith
To keep myself
Bound together.
I am still a woman
And whole
In spite of the cancer beast.
Silently I pray
For strength
As they cut into my
I release my life
As I fall into darkness.


You were my safe haven
until cancer took away
your drive and energy.
I couldn't care for you
any longer.
We were torn apart
before you left this earth.
I miss your shining light,
like a ball of fire
over a peaceful calm.

Joan Noeldechen is an accomplished poet; listed in Who's Who; graduate of Flagler College; and has many of her works published in June Cotner's anthologies. She is the author of several books.


Lulu: http://www.lulu.com/spotlight/jnoeldechen

Linked In: www.linkedin.com/in/joan-noeldechen=242224141

Twitter: @etowahdoma1