MTV Star Diem Brown Facing Third Cancer Battle

As a contestant on MTV”s Real World/Road Rules Challenge in 2006, Diem Brown thought she had learned all she needed to know about difficult journeys. She and her partner, Derrick, underwent their challenge only one month after having surgery for ovarian cancer. Brown had one ovary, several lymph nodes and part of her fallopian tube removed, but still flew off to Australia to participate in the show, and managed to finish in fourth place in the competition.

In May 2012, Brown received the bad news that her cancer had returned, when tests done because of abdominal pain revealed a large ovarian cyst. The doctor was able to keep 30% of her remaining ovary when the cyst was removed.  Brown made the decision to postpone treatment temporarily so that eggs could be harvested before the remainder was removed as part of her treatment for cancer. She found Dr. Jamie Grifo at NYU who was able to harvest five eggs. Diem, who was only 30 at the time, still hoped she would be able to have children after her cancer was in remission, which she achieved in 2013. She chronicled her cancer journey in a blog for People magazine.

While taping in Europe for a new reality show, about a week ago,  Diem collapsed and was airlifted to NYC, where she underwent emergency surgery. According to her sister Megan:

“Doctors found one tumor blocking her colon completely so they had to do emergency surgery that evening to remove the blockage. They were able to remove the mass, but once they were inside they found out there were multiple tumors.”

Diem had to undergo a hysterectomy (removal of the uterus/womb). A tumor was found in the lining of stomach, and she has a colostomy bag. An infection in her abdomen caused Brown to undergo a second emergency surgery three days later.

The hysterectomy was probably the hardest thing to take. As she told People magazine:

“When I came to, they told me that they couldn’t save my uterus. That was a blow. We’d fought so hard to keep it. Might sound silly to most, but it’s what made me still feel like a woman and gave me hope for a future. I felt empty … gutted.”

But in typical upbeat Diem Brown fashion she still has hope:  “I might not have the ability to ever carry a child and I have this damn bag for the time being – but I’m alive.”

One of Celebrity Diagnosis’s goals is to point out possible misinformation that media outlets may be spreading (see our Steve Jobs story). The Diem Brown story may be another such case. Here are quotes from other websites:

“Diem Brown Diagnosed with Colon Cancer”: People 

“MTV Star Diem Brown Diagnosed With Colon Cancer After Collapsing Overseas”: Wetpaint

“The reality star is now battling cancer for a third time after being diagnosed with colon cancer while filming a new reality show.”: Hollywood Life

“She was recently diagnosed with colon cancer.”: E-Online

Does Diem Brown really have colon cancer? This would be a second type of primary cancer, one which is most common in people over 50.

Although not unheard of for a patient with one kind of cancer to later have another kind, it is probably more likely that Brown actually has a recurrence, and metastasis of her ovarian cancer. The tumor has spread around the abdomen and affected her stomach and colon. Her sister said- “one tumor was blocking her colon. ” She didn’t say that the tumor originated there.

What is metastatic cancer?

Metastatic cancer is cancer that has spread from the place where it first started to another place in the body. A tumor formed by metastatic cancer cells is called a metastatic tumor or a metastasis. The process by which cancer cells spread to other parts of the body is also called metastasis.

Metastatic cancer has the same name and the same type of cancer cells as the original, or primary, cancer. For example, breast cancer that spreads to the lung and forms a metastatic tumor is metastatic breast cancer, not lung cancer. If Diem Brown has ovarian cancer in her colon, it is still referred to as ovarian cancer!

Under a microscope, metastatic cancer cells generally look the same as cells of the original cancer. Moreover, metastatic cancer cells and cells of the original cancer usually have some molecular features in common, such as the expression of certain proteins or the presence of specific chromosome changes.

Although some types of metastatic cancer can be cured with current treatments, most cannot. Nevertheless, treatments are available for all patients with metastatic cancer. In general, the primary goal of these treatments is to control the growth of the cancer or to relieve symptoms caused by it. In some cases, metastatic cancer treatments may help prolong life. However, most people who die of cancer die of metastatic disease.

There are three ways that cancer spreads in the body.

Cancer can spread through tissue, the lymph system, and the blood:

  • Tissue. The cancer spreads from where it began by growing into nearby areas.
  • Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
  • Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.

The metastatic tumor is the same type of cancer as the primary tumor. For example, if ovarian epithelial cancer spreads to the lung, the cancer cells in the lung are actually ovarian epithelial cancer cells. The disease is metastatic ovarian epithelial cancer, not lung cancer.

Where does cancer spread?

The most common sites of cancer metastasis are, in alphabetical order, the bone, liver, and lung. Although most cancers have the ability to spread to many different parts of the body, they usually spread to one site more often than others. The following table shows the most common sites of metastasis, excluding the lymph nodes, for several types of cancer:

Cancer type Main sites of metastasis*
Bladder Bone, liver, lung
Breast Bone, brain, liver, lung
Colorectal Liver, lung, peritoneum
Kidney Adrenal gland, bone, brain, liver, lung
Lung Adrenal gland, bone, brain, liver, other lung
Melanoma Bone, brain, liver, lung, skin/muscle
Ovary Liver, lung, peritoneum
Pancreas Liver, lung, peritoneum
Prostate Adrenal gland, bone, liver, lung
Stomach Liver, lung, peritoneum
Thyroid Bone, liver, lung
Uterus Bone, liver, lung, peritoneum, vagina
For ovarian cancer, there are four stages:
In stage I, cancer is found inside a single or both ovaries.  In stage IC, cancer is found in one or both ovaries and may be on the surface of the ovary or there may be cancer cells floating in the fluid that lines the pelvis.
In stage II, cancer is found in one or both ovaries and has spread into other areas of the pelvis, such as the uterus or fallopian tubes.
In stage III, cancer is found in one or both ovaries and has spread outside the pelvis to other parts of the abdomen and/or nearby lymph nodes.
In Stage IV, cancer has spread beyond the abdomen to other parts of the body, such as the lungs or tissue inside the liver. Cancer cells in the fluid around the lungs is also considered stage IV ovarian cancer.Whether Diem has ovarian or colon cancer, we wish her well. She has a difficult road ahead of her.

 

 

 

 

 

Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.

3 Comments

  1. Sarah Hooper

    September 27, 2014 at 3:57 pm

    Who is the Public Physician?
    There’s no doubt that a ton of misinformation is produced and spread through media, much of which relates to the medical field. In television, this medical misinformation may take the form of false portrayals of doctors or incorrect symptoms/treatments concerning a disease; in magazines it can appear as the false diagnosis of a celebrity; on the internet, misinformation may be hidden quizzes that produce a medical conditions based on symptoms that the user inputs. An issue many modern doctors are facing is deciding their role in this public domain. As doctors, should they bear the responsibility of correcting information they know is wrong? Or should their role as doctors be fulfilled only in physical practice? Many are beginning to lean towards the former. Since doctors have an extensive knowledge of medicine, they may be the only ones capable of recognizing and disputing misinformation. A consumer is often likely to place more value on the opinion of a doctor—even if it is found on the internet—than a random magazine headline or the opinion of an anonymous Yahoo Answers user.
    Celebrity Diagnosis appears to have partly taken on this role as the public physician. As is written in their article, “MTV Star Diem Brown Facing Third Cancer Battle,” “One of Celebrity Diagnosis’s goals is to point out possible misinformation that media outlets may be spreading (see our Steve Jobs story).” The article then goes on to address what exactly is metastatic cancer, how and where cancer spreads, and variations in different forms of cancer. Written by a doctor, this article both teaches the reader about cancer and dispels much of the misinformation already out there relating to Diem Brown’s cancer case, all while providing interesting celebrity news. The public realm of celebrity gossip intersects the far more reliable field of physician knowledge of medical information.
    This intersection is what makes the article special. There are plenty of sources on the internet delving deep into the details of colon, ovarian, and metastatic cancer, and any consumer with internet has the potential to access these sources. However, seeking them out can be both boring and tedious work. Oppositely, the consumption of celebrity gossip is entertaining and often sought after—the main reason I was drawn to this article wasn’t because I wanted to learn about cancer, but because I was concerned about Diem, whom I had watched on MTV many years ago. By compiling correct medical information with the source of celebrity gossip, the consumer automatically comes away without misinformation.
    Maybe it is sites like Celebrity Diagnosis that will slowly become the public physician. Instead of having individual doctors simply post accurate medical information online, or having them leave angry comments whenever they see misinformation in media, the public physician could be interwoven into public media. Correct medical information in articles, TV shows, and magazines would result in more knowledgeable consumers who learn simply by consuming media.

  2. Sara Dew

    October 8, 2014 at 7:27 pm

    When a celebrity’s health is discussed in the media, it is not simply a clinical problem but a story to be told. Diem Brown is described in the headline here as an ‘MTV star’ in a ‘battle’ with her cancer, rather than clinically as a metastatic cancer patient as Dr Berman goes on to outline. These contrasting depictions point to a difference that Patel et al. have highlighted in how patients and doctors perceive health. Disease in the doctor’s eyes, they argue, is ‘the dysfunction of the body’ in a biomedical sense, whilst illness from the patient and public perspective is ‘the social and moral meaning attached to this dysfunction that involves the disruption of the patient’s normal life’.
    Diem Brown’s experience with cancer has an extensive social story, one that she has chronicled in her blog for People magazine as referenced in this post. On this blog she shares her experience of living with cancer. These are not clinical experiences, but emotional ones. In one post, for example, she writes “As I “patiently” wait for my results to come in, I’m feeling good! I’m visualising the scan being clear and imagining by doc saying I am at the finish line to my second bout with cancer” (see http://www.people.com/people/article/0,,20669474,00.html). In a vlog for the same magazine she shares the experience of losing her hair as she undergoes treatment for cancer http://www.youtube.com/watch?v=F8P_vCkOHPs. These accounts are highly personal, locating her cancer experience in the broader context of her day to day life and feelings.
    The psychological and social sides of living with cancer that Diem Brown discusses here are distinctly different from Dr Berman’s description of what metastatic cancer is bio-medically. Berman discusses molecular features of cancer, the expression of proteins and chromosome changes. Whilst Dr Berman and Sarah Hooper in her response focus on the perceived role of the ‘public physician’ to educate the public on clinical ‘truths’, to focus only on these ‘facts’ ignores a hugely important part of health. Both patients and doctor understand health through storytelling. Rita Charon argues that ‘storytelling is one avenue through which we become ourselves’. For a doctor to understand a patient’s experience of illness, therefore, and the problems which the patient wants them to address the doctor must listen not only to the symptoms of disease they present but also the way in which they present them.
    Understanding the role of stories in talking about health is particularly relevant to the work of Celebrity Diagnosis. The doctors that blog for this website aim to provide the clinical information that explains the stories of health that celebrities discuss in the public eye. It is important, however, not to divorce ‘the social and moral meaning’ of celebrity discussions from biomedical explanations. When a doctor understands the contextual narratives that shape a patient’s understanding of their own health, they are empowered to make the best engagements with their patients.

  3. John

    June 7, 2018 at 3:13 am

    Cancer is one of the most serious diseases the world is facing now.I am basically from Australia and I think colorectal cancer is one of the most common cancers people faces.Colorectal surgeons in Sydney are very famous for there effective treatment.

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