Ovarian Cancer Caught Early with Genetic Testing

Lisa Baxter and her grandson on day 1 of her second time in chemotherapy. Photo Credit: Lisa Baxter.

Lisa Baxter of Stafford Springs was 51 when she started having issues that were attributed to pre-menopause.  When her niece who was seven years younger than her was diagnosed with a genetic form of ovarian cancer she decided that she should undergo genetic testing.

Some ovarian cancers cluster in families. These cancers are described as hereditary and are associated with inherited gene mutations. Hereditary ovarian cancers tend to develop earlier in life than non-inherited (sporadic) cases.

Lisa and other female members of her family all underwent genetic testing at UConn Health to determine if they were at risk for ovarian cancer.  She, her mother, who is 91, and her 29-year-old daughter were all found to carry mutation of the RAD51D gene.

Everyone has two copies of the RAD51D gene, which we randomly inherit from each of our parents. Mutations in one copy of the RAD51D gene can increase the chance for you to develop certain types of cancer in your lifetime including ovarian cancer.  Those with the mutation of this gene have a 10-12% increased chance of developing ovarian cancer compared to 1-2% in the average woman.

Lisa was referred to Dr. Bradford Whitcomb, Division Chief, Gynecologic Oncology at the Carole and Ray Neag Comprehensive Cancer Center at UConn Health and she decided she wanted a hysterectomy with removal of her tubes and ovaries as a preventative surgery.

Risk management decisions are very personal, and the best option depends on many factors. It is important to discuss these options with your doctor.

At the end of January 2018, Baxter had surgery. On inspection during the operation, her ovaries were benign, however, it was later examined more extensively by pathology and microscopic amounts of cancer were discovered.

Dr. Whitcomb reports the biggest challenge in gynecologic oncology is preventing and catching ovarian cancer early when it hasn’t yet spread to other organs. Ovarian cancer is the most lethal gynecologic cancer in the United States because it is usually discovered at more advanced stages. Whitcomb is currently working with Dr. Pramod Srivastava, director of the Carole and Ray Neag Comprehensive Cancer Center, to recruit newly diagnosed ovarian cancer patients to the world’s first clinical trial testing a unique genomics-driven immunotherapy vaccine aimed at preventing the disease’s recurrence.

In addition, Dr. Whitcomb and his team of gynecologic cancer providers deliver the most up to date, evidence-based treatment of ovarian cancer from the time of diagnosis through surgery, postoperative chemotherapy, and survivorship. Their goal is to provide the highest quality, compassionate, individualized care leading to long term survival in a setting that offers all services to cancer survivors and their families.

Baxter underwent eighteen weeks of chemotherapy and was able to attend her daughter’s wedding.

However, after coming in for her regular follow-ups, Whitcomb informed her that the CT scan had shown nodules in her abdomen that were malignant.  The cancer had returned (recurred), which is unfortunately common in this type of ovarian cancer.

In some cases, cancerous tumors can invade surrounding tissue and spread to other parts of the body. If ovarian cancer spreads, cancerous tumors most often appear in the abdominal cavity or on the surfaces of nearby organs such as the bladder or colon.

Whitcomb advised Baxter that her cancer was inoperable and the suggested course of treatment would be another six rounds of chemotherapy.

“I wanted this cancer out of me and Whitcomb encouraged me when I told him I wanted a second opinion,” says Baxter.

She made appointments at the Dana-Farber Cancer Institute in Boston and Memorial Sloan Kettering Cancer Center in New York. Her first appointment was at Dana-Farber and the gynecologic oncologist there concurred with Whitcomb’s decision on the treatment regimen.

After hearing that, she canceled her appointment at Memorial Sloan Kettering and started the first of six more cycles of chemotherapy at the Neag Comprehensive Cancer Center.

In its early stages, ovarian cancer usually does not cause noticeable symptoms. Baxter indicates she never really had any symptoms and she felt fine; had it not been for the genetic testing that found the gene mutation, she would have not have known she had cancer.

Because it is often diagnosed at a late stage, ovarian cancer can be difficult to treat; it leads to the deaths of about 14,000 women annually in the United States, more than any other gynecological cancer. However, when it is diagnosed and treated early, the 5-year survival rate is much higher.

Baxter is grateful that she did the genetic testing and was able to catch her ovarian cancer as early as possible.

“No one should go through this alone,” says Baxter who credits her daughter who is a nurse and her significant other as well as friends and co-workers as her support system.

“UConn Health is my one-stop shop,” she says. “I cannot say enough good things about Dr. Whitcomb and his team. He’s so compassionate.”

Baxter is now on a regimen of oral chemotherapy and is feeling well.  She works, cares for her 91-year-old mother, and gardens. She says that physical exercise was the key to feeling well, using an elliptical at home. She and her caregiver were set to participate in the Live Strong Program at the Ellington YMCA when COVID-19 altered those plans.

Visit the UConn Health, Carole and Ray Neag Comprehensive Cancer Center, and the Division of Medical Genetics, for more information.