Ovarian Cancer Diagnosis Discovered During Visit to Emergency Department for a Cough

As we round out Ovarian Cancer Awareness Month, we spoke with our experts in this area about the difficulty in diagnosing ovarian cancer early and Sharon Johnson about her diagnosis and treatment of ovarian cancer at UConn Health.

Views of the Carole and Ray Neag Comprehensive Cancer Center sign at the Outpatient Pavilion on June 9, 2022. (Tina Encarnacion/UConn Health photo)

In December 2021, Sharon Johnson, 54 of Bristol, CT had what she thought was a cold. Suffering from bronchitis since birth, she always had at least one bad cold that turned into a cough each winter. Unable to catch her breath, she had her husband take her to the Emergency Department.

A CT Scan indicated that there was fluid in the pleural cavity of the right lung. A biopsy concluded it was a malignant pleural effusion which is the build-up of fluid and cancer cells that collects between the chest wall and the lung. This can cause you to feel short of breath and/or have chest discomfort. It is a fairly common complication in a number of different cancers.

Stage 4 ovarian cancer in both of her ovaries was found on the CT Scan, the cancer had spread to other body organs as well.

Johnson was referred to Dr. Jennifer Jorgensen, assistant professor of Obstetrics and Gynecology at the Carole and Ray Neag Comprehensive Cancer Center at UConn Health. Jorgensen is part of the gynecologic oncology team at the Cancer Center including Dr. Molly Brewer, Dr. Bradford Whitcomb, and a team of nurses to provide complete cancer care from diagnosis through treatment, whether a patient needs surgery, chemotherapy, radiation, or palliative care.

Sharon Johnson, photo provided by Sharon Johnson

Ovarian cancer is the second most common gynecologic cancer in the United States and causes more deaths than any other cancer of the female reproductive system. Ovarian cancer is the abnormal growth of cells that form in the ovaries. The cells multiply quickly and can invade and destroy healthy body tissue.

Often with no symptoms in the early stages and late-stage symptoms that tend to be non-specific, ovarian cancer goes undetected until it has spread to the pelvis and stomach area.

At this late stage, ovarian cancer is more difficult to treat and can be fatal.

Dr. Bradford Whitcomb, chief of Gynecologic Oncology at the Carole & Ray Neag Comprehensive Cancer Center at UConn Health reports one of the greatest challenges in gynecologic oncology is preventing and detecting ovarian cancer early when it hasn’t yet spread to other organs. While there is not a good screening test for ovarian cancer, it remains important to have regular gynecologic exams and discuss persistent symptoms with your doctors. On a more positive note, the survival of patients with ovarian cancer has improved over the past 3 decades and there has been much headway in treatment.

The symptoms of ovarian cancer replicate many other issues- which is why it is often found late.

Ovarian cancer may cause the following signs and symptoms:

• Vaginal bleeding (particularly if you are past menopause), or discharge from your vagina that is not normal for you.
• Pain or pressure in the pelvic area.
• Abdominal or back pain.
• Bloating.
• Feeling full too quickly, or having difficulty eating.
• A change in your bathroom habits, such as more frequent or urgent need to urinate and/or constipation.

“There is not a screening test available at the time for ovarian cancer, so it is important to pay attention to your body, and know what is normal for you. If you have unusual vaginal bleeding, see a doctor right away. If you have any of the other signs for two weeks or longer and they are not normal for you, see a doctor,” says Jorgensen.

In 2013 Johnson had a hysterectomy for fibroids but chose to keep her ovaries rather than have to take hormones. She did not have any symptoms at the time of her diagnosis of cancer, however, in hindsight, she remembers years ago complaining to her primary care physician of bowel issues and pain in her abdomen, which she now wonders if those were cancer symptoms.

“Dr. Jorgensen is fantastic, she takes her time during appointments and cares about the whole person, asking about my family and my cat,” says Johnson. “She got me right in and did not waste any time, she scheduled my surgery right away.”

“We provide individualized personalized medicine for each patient, so while surgery and chemotherapy are often the treatment for ovarian cancer, it can be a different sequence or plan for each patient,” says Jorgensen.

Johnson had her first surgery shortly after meeting Jorgensen, during the surgery, the cancer was found to have spread more extensively than originally thought. The cancer was in the ovaries, fallopian tubes, appendix, spleen, omentum, stomach, and intestines.

During the first surgery, Jorgensen removed the fallopian tubes, ovaries, and appendix and decided the best option was a course of chemotherapy to shrink the cancer tumors that had spread to the other organs and a second surgery would take place.

After four rounds of chemotherapy, Johnson was ready for another surgery that removed her spleen and omentum. Three more rounds of chemotherapy were administered after that surgery.

“Here at the UConn Health Cancer Center, the treating doctor also manages each patient’s chemotherapy so they have inclusive and precision care with one doctor,” says Whitcomb.

Johnson admitted she held a lot inside and finally realized that she needed help emotionally. As part of her treatment, she utilizes the services of Judith Cooney PhD, health psychologist and associate professor of Psychiatry at the Cancer Center at UConn Health. Cooney works with cancer patients at all phases of treatment to help cope with cancer, evaluation and diagnosis, treatment, and post-acute treatment during survivorship to return to life and thrive following cancer.

“While I used humor to deal with my diagnosis, I didn’t know how to express myself without upsetting the people around me,” says Johnson. “Dr. Cooney, really helped both me and my husband, who had just lost his father, was caregiving for his mother and now told his wife had cancer.”

“My mom taught me to be a strong, independent woman, but when you get socked with cancer you lose your independence and I had a hard time with that,” admits Johnson. “Your whole world is turned upside down, but I have learned to not be afraid to ask for help.”

Johnson is now on maintenance medication and has an infusion every three weeks, she has 9 more to complete, and then she will move to the monitoring phase of her recovery.

At her last scan, she was cancer free! She has gained back her independence  and returned to work as a retail manager with the help of a walker since the chemotherapy has caused painful neuropathy.

Her hair is growing back, she has started driving again, and is bowling once a week with her bowling league.

“While the cancer is gone, there is an 80 percent chance it will reoccur so I am more aware of what is happening with my body,” says Johnson.

“Everyone at UConn Health was fantastic, some of the most caring people I have ever met in my life,” says Johnson.

If you are concerned about ovarian cancer or other gynecologic issues, please contact the UConn Health Women’s Center at (866) 328-8086.