The Silent Killer among the most Innocent Victims
The following article contains information that may be disturbing to some readers.
By Shima Rostami, Ed.D., Executive Director, AND Erika Hatfield, Advisory Council, Gateway Human Trafficking
This month, wearing teal has an even deeper purpose other than its beauty as September is Ovarian Cancer Awareness Month. What if you know a number of physician organizations have issued policy statements calling for the education and involvement of physicians in combating child trafficking as they have discovered many child trafficking victims have developed Ovarian Cancer as the result of their exploitation?
Here is a Survivor Story Retrieved from “Ovarian Cystadenoma in a Trafficked Patient” by Titchen, MD et al.
"An 88.6-kg, 18-year-old patient was referred by her pediatrician to an adolescent medicine specialist for severe left abdominal pain recurring over 1.5 years. The patient experienced recurrent debilitating pain for which she had been seen at a local emergency department and by her pediatrician. Physical examination revealed an obese teenager (BMI, 35.72; 98th percentile) with multiple tattoos, some of which included expletives and nonspecific symbols. Her abdomen was soft, tender to palpation, nondistended, and with a firm mass palpated in the left lower abdominal quadrant. During this initial adolescent medicine visit, the patient disclosed, sexarche at 13 years of age, and an “estimated 150” sexual partners. She had a history of runaway status and homelessness, multiple sexually transmitted diseases (STDs), and heroin abuse after receiving a prescription for Percocet (Endo Pharmaceuticals, Newark, DE) for a tonsillectomy at age 12 years; she also reported multiple heroin overdoses. She had quit heroin “cold turkey” upon regaining consciousness from her last overdose in a motel room. The patient reported a suicide attempt, as well as physical abuse by her father and “being sexually exploited while on drugs and exchanging sex for money.” Although she had reconciled with her mother and had been seen regularly by health care workers when she was 12 years old, she had not disclosed the extent of her sexual or drug history to medical providers before this visit. Results of the STD testing at this time revealed infection with Neisseria gonorrhea, Trichomonas vaginalis, and bacterial vaginosis, and these infections were treated. An MRI determined a cystic mass on the patient’s left ovary. After treatment of the patient’s STDs, and after a brief period during which she was lost to follow-up due to estrangement from her mother and homelessness, the patient was relocated. She returned to the children’s hospital for laparoscopic reduction of torsion of the para-ovarian mass with laparoscopic resection."
Ovarian cancer is difficult to detect, especially in the early stages. Some women with ovarian cancer turn toward the whole-body approach of complementary therapy to enhance their fight against the disease. Radiation therapy uses high-energy X-rays to kill cancer cells and shrink tumors and Chemotherapy, and using chemicals designed to destroy cancer cells or stop them from growing are common methods of fighting this cancer. Additionally, surgery to remove the cancerous growth is the most common method of diagnosis and therapy for ovarian cancer. Most women with ovarian cancer will have surgery at some point during the course of their disease, and each surgery has different goals (National Ovarian Cancer Coalition).
According to Titchen, MD et al, ovarian masses are highly uncommon in minors. The risk of developing ovarian cancer is not directly linked to factors that the child trafficking survivor faced; however, her inability to seek treatment for the mass likely caused it to grow over time. Human trafficking patients may breed necessity for greater dedication of services by medical professionals. “[The] adolescent medicine health care provider asked the study patient if she had ever traded anything for sex, and it was the patient’s positive response to this question that alerted providers to the possibility that this patient was a victim of human sex trafficking” (Titchen, MD et al.) Medical professionals have the opportunity to recognize the warning signs of sex trafficking which can lead to effective intervention (Titchen, MD et al).
National Ovarian Cancer Coalition, http://ovarian.org/about-ovarian-cancer/what-is-ovarian-cancer
Ovarian Cystadenoma in a Trafficked Patient, Case Report, Kanani E. Titchen, Douglas Katz, Kidian Martinez and Krishna White Pediatrics April 2016, e20152201; DOI: https://doi.org/10.1542/peds.2015-2201