Teri Woodhull: Keeping Ovarian Cancer at Bay Thanks to Clinical Trials
Since I was diagnosed with advanced ovarian cancer in November 2010, I have opted to be treated through clinical trials because they give me something beyond the standard of care. Most recently, I have been receiving a targeted therapy called niraparib (Zejula). Although this treatment is not a cure, it has kept the cancer at bay for more than 2 years. It is also giving me a quality of life that was not possible with chemotherapy. With chemotherapy, I could barely get out of bed. With niraparib, I’ve traveled the world with my family; I’ve been on safari in South Africa and hang gliding over the Swiss Alps.
Cancer has been part of my life for almost as long as I can remember. My mom died of breast cancer in 1990, at the age of 46. Her mother had breast cancer and my mother’s cousin had breast cancer in her 40s. In 1990, even before there were any known breast cancer susceptibility genes, the doctors told me that they were sure there was a hereditary aspect to the disease in my family.
I was fortunate to be living near the Mayo Clinic in Minnesota where they were investigating whether young women from families with a strong history of breast cancer, like me, would be prevented from developing breast cancer by having a bilateral mastectomy. I had the procedure in 1993, at the age of 30.
About a year later, the first breast cancer susceptibility gene, BRCA1, was identified. I was aware of this but chose not to be tested because I thought I had done everything I could to protect myself and there was no law at the time to protect people from genetic discrimination in health insurance and employment. Fortunately, now there is the Genetic Information Nondiscrimination Act.
What I didn’t know was that BRCA gene mutations also increase risk for other cancers. It was only after my advanced ovarian cancer diagnosis that I was tested and found to have inherited a BRCA1 mutation.
I really didn’t have many symptoms before my diagnosis apart from constipation. It wasn’t until I could feel something in my abdomen that I went to the doctor. MRI and CT scans and a CA125 blood test showed that I had ovarian cancer that had spread beyond my abdominal cavity. I had advanced disease.
I was working in the health care field at the time and I knew that the survival statistics for women with my diagnosis were not good. After surgery, during which they removed all visible disease, I thought enrolling in a clinical trial would improve my chances of beating the statistics. The trial I participated in was testing whether giving chemotherapy directly into the abdomen, rather than into the blood, would reduce disease recurrence. It was also testing whether maintenance therapy with bevacizumab (Avastin) after the chemotherapy would help. Tolerating the chemotherapy was tough but I made it through and by the middle of 2011, just as I started the maintenance bevacizumab, there was no evidence of disease.
Unfortunately, a CT scan in the fall of 2014 showed that the cancer was back. I had surgery again and then standard chemotherapy. It was brutal. I was barely functioning; it was hard to get up, get dressed, eat, anything.
Even worse, when I met the gynecological oncologist to get the results of the routine CT scan after finishing the chemotherapy, I learned that the cancer had progressed. It was a sobering moment, but I’m a positive person, and I was determined to keep living.
After a lot of research, I managed to get a spot on a clinical trial testing the targeted therapy niraparib. It was in San Francisco, so I’ve had to travel back and forth a lot over the past 2 1/2 years. The day I started the trial, I took the red eye home and then flew the next day to my daughter’s graduation. It was pretty crazy. But cancer has taught me that my family and friends are the most important things in my life and I take every opportunity to spend time with them and be there for the important life events.
At this point, I have CT scans every 12 weeks. Every scan that shows niraparib is still keeping the cancer stable reminds me how fortunate I am. I also know that the path I chose, participating in clinical trials, is helping make a difference to the future of ovarian cancer care.