Coping With an Ovarian Cancer Diagnosis
- An Indiana news anchor shared her ovarian cancer diagnosis after experiencing stomach pains and bloating she initially planned to ignore. However, at the insistence of her family, she went to the doctor and was diagnosed.
- Ovarian cancer is often harder to catch in its early stages because of its subtle symptoms, such as bloating, weight gain, and abdominal pain, that can mimic regular menstrual cycle fluctuations.
- After ovarian cancer patients complete initial treatment, maintenance therapy may be recommended to try and delay possible recurrence.
- Maintenance therapy for ovarian cancer can involve taking an oral pill called a PARP inhibitor every day after chemotherapy and can keep cancer in remission longer. PARP inhibitors prevent cancer cells from repairing their DNA.
- Elahere (molecular name mirvetuximab) is an FDA-approved targeted therapy also providing hope for patients with platinum-resistant ovarian cancer (cancer that returns within six months of treatment with platinum-based chemotherapies, like carboplatin and cisplatin.)
Jennifer Copeland is sharing her abrupt cancer journey to caution people if they start feeling “new and different” in any way to go see a doctor.
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However, her symptoms were signs of something more serious. Tests revealed she had a cancerous tumor growing on her ovary.
“I’ve been diagnosed with stage 1 ovarian cancer,” she said bluntly.
Ovarian cancer is often harder to catch in its early stages because of its subtle symptoms, such as bloating, weight gain, and abdominal pain that can mimic regular menstrual cycle fluctuations.
Copeland said she’s begun chemotherapy, which is the standard of care for ovarian cancer patients.
“I’m doing well and feeling stronger every day. I’m determined to get through this with as much grace, beauty, and normalcy as I can,” Copeland said.
After the reality of Copeland’s cancer diagnosis set in, she admitted her perspective on life shifted.
Concerned news viewers learning of Copeland’s diagnosis showered her with prayers and support.
“So glad you listened to your body! You are so strong and have such a positive spirit! You’ve got this! I’m thinking about you and your girls!” Facebook user Kristin Bien commented.
“God Bless you, Jennifer Copeland. I will be praying for you. I admire your courage and hope your story inspires others to listen to their bodies,” Facebook user Terry McFadden wrote.
The beloved news anchor hopes that people learning about her cancer journey will heed her takeaway message.
“I don’t care how trivial, embarrassing, or expensive it is — if something feels off — Go! See your doctor,” Copeland said emphatically.
Helping Patients Understand Treatment Options for Ovarian Cancer
Battling Ovarian Cancer
Ovarian cancer has been called the “cancer that whispers” because women often don’t experience symptoms until their cancer has already reached its late stages. The symptoms that do appear at first are hard to identify as cancer.
“Ovarian cancer does not have any specific symptoms,” Dr. Beth Karlan, a gynecologic oncologist at UCLA Medical Center, told SurvivorNet.
Many ovarian cancers begin in the fallopian tubes. A few cancerous cells first grow on the fallopian tubes. Then, as the fallopian tubes brush over the ovary, these cells stick to the ovaries and eventually form a tumor.
“The symptoms include things like feeling full earlier than you usually would when your appetite is strong and feeling bloated. Some changes in your bowel habits. Some pain in the pelvis. These are symptoms women may have every month. These are not very specific. But we’ve found this constellation of symptoms from multiple studies,” Dr. Karlan added.
The symptoms of ovarian cancer may include the following:
- A feeling of bloating or fullness
- Pain in the pelvis or abdomen
- Nausea
- Vomiting
- Changes in bowel habits
How Ovarian Cancer is Treated
The standard of care for ovarian cancer patients is chemotherapy, which helps many patients reach remission.
Ovarian cancer recurrence happens in “almost 25 percent of cases with early-stage diseases and in more than 80 percent with more advanced stages,” according to research published in Gland Surgery medical journal. With recurrence a strong possibility for this disease, especially in the later stages of ovarian cancer, certain drug treatments to deal with it are giving many women hope.
RELATED: Dealing with recurrence.
WATCH: Treating ovarian cancer.
Ovarian cancer is sub-categorized into two groups.
- Platinum-Sensitive Ovarian Cancer: Cancer does not return for more than six months after treatment with platinum-based chemotherapies, like carboplatin and cisplatin.
- Platinum-Resistant Ovarian Cancer: Cancer returns within six months of treatment with platinum-based chemotherapies, like carboplatin and cisplatin.
“The mechanism that causes platinum resistance will cause someone to be resistant to other chemotherapies, as well. That’s why we’re looking for what we call targeted therapies — precision medicine,” Dr. Noelle Cloven from Texas Oncology-Fort Worth Cancer Center explained.
RELATED: Recurrent Ovarian Cancer Treatment Is Your Disease “Platinum-Sensitive”?
Targeted therapies or precision medicine specifically target the proteins controlling cancer cells’ growth, division, and spread.
Maintenance Therapy for Ovarian Cancer
Maintenance therapy is continued treatment after the patient finishes their initial treatment. After an ovarian cancer patient completes a round of treatments — such as surgery and chemotherapy — her doctor may recommend some form of maintenance therapy to try and delay possible recurrence. Maintenance therapy can involve taking an oral pill called a PARP inhibitor every day after chemotherapy and can keep cancer in remission longer.
Genetic testing helps doctors determine the best maintenance therapy.
“The biggest question is: How do you choose between bevacizumab (brand name, Avastin) or a PARP inhibitor for maintenance therapy?” Dr. Alpa Nick, a gynecological oncologist with Tennessee Oncology in Nashville, explained to SurvivorNet. Genetic testing can help doctors narrow down which treatments are better options.
The drugs combat cancer cells in very different ways. PARP inhibitors prevent cancer cells from repairing their DNA, while Avastin blocks the formation of new blood vessels, starving tumors of nutrients.
The Food and Drug Administration approved bevacizumab (Avastin) to be used in conjunction with olaparib (brand name LYNPARZA) in HRD (Homologous Recombination Deficiency) positive women who show a response to platinum-based chemotherapy. During clinical trials, the drug combination increased progression-free survival from an average of 17 months to 37 months.
“A patient really has to make a decision upfront, or near the beginning of their treatment, that they want bevacizumab maintenance treatment because they’ll have it with their primary chemotherapy,” Dr. Nick explained.
The drug is administered intravenously and can be given in combination with other chemotherapy drugs. Avastin affects the growth of blood vessels, starving tumors of the blood they need as nourishment.
The American Society of Clinical Oncology (ASCO) guidelines recommend PARP inhibitors be offered to women, with or without genetic mutations, who are newly diagnosed with stage III or IV ovarian cancer and have improved with chemotherapy.
Surgery offers another important decision point. “When patients have their surgery, we can test their tumor to decide if their tumor has a homologous recombination deficiency,” known as HRD. If it does, that also suggests they would benefit from PARP inhibitor maintenance therapy,” said Dr. Nick.
Elahere (molecular name mirvetuximab) is an FDA-approved targeted therapy that provides much-needed hope for patients with platinum-resistant ovarian cancer. This drug treatment is for women who test positive for a molecular factor called folate receptor alpha (FRα). While many ovarian cancers test positive for the folate receptor, to be eligible for Elahere, you must have very high levels (>75%) of the folate receptor-alpha (FRα).
It is an antibody-drug conjugate. This kind of new anti-cancer drugs, known as “biological missiles,” is leading a new era of targeted cancer therapy.
The antibody part of the drug conjugates binds to the folate receptor on the tumor cells, and then that gets taken up into the tumor cell. The drug that it conjugates with kills the tumor cells by affecting the tumor cell’s ability to divide.
Questions to Ask Your Doctor
If you have been diagnosed with ovarian cancer and need guidance to further educate yourself on the disease and treatment, consider these questions for your doctor.
- What type of ovarian cancer do I have?
- What stage is my cancer in?
- Do you recommend I get genetic testing for any gene mutations, such as the BRCA gene mutation?
- What initial treatment options do you recommend?
- What are the possible side effects of the recommended treatment, and how can they be coped with?
- Will insurance help cover my recommended treatment?
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