It all started in 2019.

My niece Emily Eckman had an ovarian cyst burst and required immediate surgery. No routine testing was done on the cyst.

Shortly thereafter, she had another ovarian cyst and scheduled surgery for removal. Testing was done, and the results came back as Stage 3 clear cell ovarian cancer.

She became a champion for everything cancer, while fighting her own battle with all she had, and formed a huge network of fellow cancer patients in various stages and types of cancer.

She created videos for her friends and family detailing her chemotherapy treatments and stages of this disease.

Even though she was in pain, she was there for her husband, children, family members and friends if they needed anything. She attended her son’s sporting events and her daughter’s dance recitals while receiving treatment.

She supported women who were recently diagnosed. She encouraged friends and strangers to get tested for ovarian cancer when they knew something wasn’t quite right. And she worked nonstop to raise money for various organizations that are working to find a way to detect ovarian cancer and those organizations working toward a cure.

She endured multiple surgeries, ovarian cancer trials and many procedures to ease her pain.

Emily lost her battle tragically and unexpectedly June 14 at age 40 when she called for an ambulance and died from a pulmonary embolism which resulted in cardiac arrest in the hospital.

There was no opportunity to say goodbye to her 7-year-old twins, her husband, parents, sisters, grandparents and extended family.

September is Ovarian Cancer Awareness Month.

Here is what is known about ovarian cancer.

Ovarian cancer often has no symptoms in the early stages. In the later stages, symptoms may include abdominal bloating or swelling, quickly feeling full when eating, weight loss, discomfort in the pelvic area, fatigue, back pain, changes in bowel habits, such as constipation, or a frequent need to urinate.

According to the Ovarian Cancer Research Alliance, “The American Cancer Society estimates in 2022, about 19,880 new cases of ovarian cancer will be diagnosed and 12,810 women will die of ovarian cancer in the United States.

“Mortality rates for ovarian cancer have declined only slightly in the 40 years since the ‘War on Cancer’ was declared. Ovarian cancer accounts for 2.5% of cancers in women.

“While the 11th most common cancer among women, ovarian cancer is the fifth leading cause of cancer-related death among women.

“Ovarian cancer is the deadliest of gynecologic cancers, and mortality rates are slightly higher for African-American women than for Caucasian women.

“Ovarian cancer survival rates are much lower than other cancers that affect women, and the relative five-year survival rate for ovarian cancer is 49.1%. It is much lower if the cancer is clear cell ovarian cancer.”

There are many misconceptions about tests for ovarian cancer. Pap smears only detect cervical cancer and related issues and don’t screen for ovarian cancer. There is no routine test for ovarian cancer.

“There are two tests used most often (in addition to a complete pelvic exam) to screen for ovarian cancer - a transvaginal ultrasound and the CA-125 blood test. TVUS (transvaginal ultrasound) is a test that uses sound waves to look at the uterus, fallopian tubes and ovaries,” according to the American Cancer Society. However, the CA-125 tests have to be requested and will only be given if people have a history of breast or ovarian cancer in their families. Emily’s cancer wasn’t related to the BRCA gene but stemmed from endometriosis.

The American Cancer Society says being able to find ovarian cancer early could have a great impact on the cure rate. “Researchers are testing new ways to screen women for ovarian cancer. One method being tested is looking at the pattern of proteins in the blood (called proteomics) to find ovarian cancer early.

“The use of new imaging techniques such as Functional MRI are being evaluated in ovarian cancers. PET/CT scans are also being studied to see where they may be best used for ovarian cancer.”

In a proclamation issued Aug. 31, President Joe Biden said, “As we observe National Ovarian Cancer month, we will never forget those we have lost. We honor our health care experts who work tirelessly to save lives. And we offer strength to women and families across this country fighting ovarian cancer today and in the future.”

Emily was the first to make me an aunt and my go-to source for anything I was writing about children.

I wrote an editorial about the effects of school shootings on children - most recently at Robb Elementary School in Uvalde, Texas, May 24. I asked my niece if she was planning to talk to the kids about the shooting and wrote about how the kids got off the bus and told her a distorted version of what happened.

We had lunch June 1 and I showed her the article. She read it, looked at me and said, “I’m famous! I was quoted in the paper!”

Thirteen days later, she was gone.

If you are reading this editorial and have any of these symptoms, please contact your doctor and ask for a CA-125 blood test. It could save your life.

As my family continues to grieve this precious soul, we have pledged to continue to support the fight to cure ovarian cancer and find a test for early detection. We owe that to Emily and her 7-year-old daughter and son.

As Emily’s cancer metastasized, the family began to realize she might be losing the fight.

I was in some sort of fantasy world, I suppose, thinking there would be a new trial that would cure her type of cancer. I always had hope. Apparently, I was mistaken.

We never thought it would happen this quickly. We thought we had more time.

Debbie Galbraith is editor of the East Penn Press and Salisbury Press.