Patty Klein: Keeping Ovarian Cancer at Bay Thanks to a Clinical Trial
Coral Gables, Florida
In 2013, when my ovarian cancer recurred for the third time, I had the option of receiving more chemotherapy or trying to find a clinical trial. My husband and I did a lot of research and I was fortunate to get into a clinical trial at the Dana-Farber Cancer Institute in Boston under the direction of Dr. Suzanne Berlin. The drugs I’ve been receiving through the trial, olaparib [Lynparza] and BKM120, have kept the cancer at bay for 16 months. I recently passed five years since my original diagnosis, which I am very thankful about because 60 percent of women who receive a stage 3C ovarian cancer diagnosis die before reaching this milestone.
In many ways, my journey with cancer began when my mother was diagnosed with breast cancer at age 40. As a result, I was always extremely concerned about breast cancer and had annual mammograms. I even had a biopsy along the way, but everything always came back negative.
Then, just over five years ago, I gained 10 pounds or so. I thought it was just natural, middle-age weight gain. But one day, while I was traveling on business, I suddenly felt pain in my side that was so bad I immediately went to a local doctor. He mentioned that it could possibly be hepatitis C virus, shingles, or gallbladder issues and did an ultrasound. I sent a copy of the ultrasound to my brother-in-law, who is a cardiologist in Detroit, and he told me to come to Detroit right away. On Saturday I had a CT scan, and on Monday I was diagnosed with ovarian cancer; the pain in my side was caused by ascites [a buildup of fluid in the abdomen] pressing against my liver.
After my diagnosis I learned that I have a BRCA1 mutation. I also learned that being of Jewish Russian heritage increases a person’s chances of carrying a BRCA mutation and that these mutations act as a link between breast and ovarian cancers. I wish I had known all this earlier because I would have been proactive about monitoring other aspects of my health in addition to my breast health and maybe I would have been diagnosed at an earlier stage, when ovarian cancer is more likely to be treated successfully. On the other hand, learning this opened doors to clinical trials available only to patients with BRCA mutations.
About a week after my diagnosis, I had extensive surgery—a complete hysterectomy [surgical removal of the whole uterus and cervix], omenectomy [surgical removal of the tissue that surrounds the stomach and other organs in the abdomen], a bilateral salpingo-oophorectomy [surgical removal of both ovaries and fallopian tubes], and tumor debulking [surgical removal of all tumors larger than 1 cm]. This was followed by 18 rounds of chemotherapy, including several rounds of chemotherapy delivered directly into my abdomen. There were weeks when I would travel to Ann Arbor for chemotherapy on Monday then fly to Las Vegas or Orlando to work a full schedule the rest of the week.
By January 2011, I was told there was no evidence of cancer in my body. Unfortunately, about six months later, my blood CA-125 levels, which are used to monitor for potential relapse, were rising and a PET scan showed that the cancer had reoccurred. After another six rounds of chemotherapy with taxol and carboplatin, I was again told there was no evidence of disease, but again the cancer recurred about six months later. Another six rounds of chemotherapy with taxol proved very challenging, but I worked through it all.
When my cancer recurred yet again, in December 2013, I was offered more chemotherapy. However, my doctor had previously mentioned that there were clinical trials testing drugs called PARP inhibitors, which were showing promise for BRCA-mutant cancers like mine. When I asked him about these he said they were all full, but I decided to do my own research because it sounded a much better option for me than more chemotherapy.
I learned very quickly that you need to meet a lot of eligibility requirements before you even qualify for a trial and that understanding all of these is not easy. Then you have to get into the trial. The two trials that I found that I qualified for had long waiting lists and only enrolled a small number of patients each month. Somehow I was fortunate enough to get a slot in the trial at Dana-Farber and I have received the most outstanding cancer treatment and care from the staff there.
For the first eight weeks I had to go to Dana-Farber each week, but now I only go every four weeks. During my visits, they alternate between testing my blood and performing a CT scan. I can stay in the trial as long as my tumor does not grow more than 10 percent above baseline. The fact that I can take pills every day, which have very limited side effects, is phenomenal because it allows me to be completely focused on work, like I’ve always been.
Unfortunately, there is no cure for ovarian cancer and our only hope of finding a cure is by supporting research and the great scientists out there who are working toward this goal.
[The trial in which Patty is participating was partially funded by the Stand Up To Cancer Targeting PI3K in Women's Cancers Dream Team.]
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