Confronting Ovarian Cancer
After undergoing specialized treatment for ovarian cancer, Allison Sharpe became an energetic advocate for awareness of the disease and a mentor to other patients
Everyday life was hectic and stressful for Allison Sharpe. The working mother from Valparaiso, Ind., felt exhausted most of the time.
"Sometimes, I wanted to close my eyes while driving home from my office," said Sharpe, who has two children and is director of medical staff services for a hospital on Chicago’s South Side. "I was concerned about my extreme tiredness, but I didn’t realize it could be related to an illness."
In spring 2011, Sharpe, then 48, saw University of Chicago Medicine obstetrician/gynecologist, Iris Romero, MD, MS, for evaluation of prolonged periods. The visit led to a diagnosis of ovarian cancer.
"Heavy periods are not a symptom of ovarian cancer," Romero said, "but Allison’s exam revealed enlarged organs in her pelvic area, which raised concern and warranted evaluation with a transvaginal ultrasound." The scan showed a suspicious mass in the right ovary. Romero recommended Sharpe be seen by a gynecologist oncologist, a physician who specializes in the diagnosis and treatment of cancers of the female reproductive system.
The Right Type of Care
An estimated 22,240 women were diagnosed with ovarian cancer in 2013 in the U.S. and 14,030 died of the disease. Symptoms of the cancer are subtle: fatigue, bloating, abdominal pain, feeling full. Many patients are not alarmed by the discomforts, or, like Sharpe, attribute them to other causes. As of now, there is no reliable screening test for ovarian cancer. The disease typically goes undiagnosed until it is at an advanced stage and has already spread.
Romero referred Sharpe to her colleague, Ernst Lengyel, MD, PhD, an expert in gynecologic malignancies.
"A patient who has ovarian cancer should be treated only by a specialist in gynecology oncology," Romero stressed. "Here, our gynecologic teams are closely integrated and this greatly benefits the patients. Right from the get go, Allison got the right type of care."
Lengyel performed exploratory surgery on Sharpe in May 2011. Before the procedure, he informed her that, if cancer was identified, he would also complete a hysterectomy. In addition to a baseball-sized mass in Sharpe’s ovary, Lengyel found evidence of tumors in nearby lymph nodes and in the tissue that lines the bladder and the abdominal wall.
Working nearby in the same surgical area, gynecological pathologist Anthony Montag, MD, examined biopsied tissue through a high-resolution microscope. His immediate analysis confirmed the tissue was malignant (cancerous).
The surgical team then proceeded with the standard "debulking" procedure for ovarian cancer: a complete hysterectomy and removal of lymph nodes, appendix and the omentum (the fat pad that covers the bowel). This surgery has two primary goals: to stage the cancer and to remove as much disease as possible.
"We strive to leave behind no residual tumor," Lengyel said, explaining that successful debulking (also referred to as optimal debulking) has proven to increase survival rates for patients.
After Sharpe recovered from surgery, Lengyel told her that, although the cancer had spread, his team removed the entire ovarian mass and all visible evidence of tumor. Chemotherapy was the next step in comprehensive care for the disease. But before recommending a specific treatment course, Lengyel would discuss her case at the UChicago Medicine Multidisciplinary Gynecologic Oncology Tumor Board.
"This weekly meeting brings together specialists in gynecologic oncology, medical oncology, pathology and radiology," Lengyel said. "The team evaluates cases and jointly plans the most effective treatment course for each patient by drawing on one another’s specific expertise."
Clinical Trial Offers Latest Therapy
When Sharpe returned to clinic, Lengyel discussed the available therapies for her disease, which had been determined to be an advanced stage. He recommended she enroll in an ongoing national clinical trial testing a refinement to the standard treatment strategy. As members of the Gynecologic Oncology Group (a National Cancer Institute-supported cooperative cancer research group), the gynecologic oncology team -- under the leadership of Diane Yamada, MD -- regularly helps develop and run clinical trials of emerging therapies for ovarian and other gynecologic cancers.
Because Sharpe wasn’t familiar with clinical trials, she took time to learn about the study. "I asked many questions and did lots of research," she said. "I wanted to make an informed decision." She opted to participate in the trial.
Sharpe received outpatient intravenous chemotherapy over a five-month period. This was followed by 15 months of maintenance therapy on bevacizumab, a drug that is thought to work by blocking the formation of blood vessels that feed tumors. Results from the trial, which is now closed, are pending.
"I did well while undergoing treatment," she said. "I rested, ate healthy and took care of myself." She decided not to work full time during chemotherapy, but returned to her job during the maintenance phase of her treatment.
Today, Sharpe is an active advocate, mentor and volunteer for the National Ovarian Cancer Coalition (NOCC). She says she is healthier and happier than ever. "I thank God everyday and I tell everyone I love them so they will always know how I feel," she said. "I don’t think about when or if the cancer will come back. I think about tomorrow and spending it with my children, family and friends."
From Patient to Advocate: In Allison Sharpe’s Words
"Since my diagnosis, I have become an advocate for ovarian cancer awareness. My family members, friends, co-workers, medical staff, business contacts, doctor, and the hospital staff, have all been so supportive and encouraging to me. Many of these special people participated in the National Ovarian Cancer Coalition (NOCC) "Run/Walk to Break the Silence on Ovarian Cancer" events in Chicago. We were the top fundraising team and I was the top fundraiser for the last two years. I became a volunteer with NOCC and was instrumental in bringing their Teal Totes educational packets program to the University of Chicago Medicine. I attend seminars and conferences so that I can learn everything I can about ovarian cancer, recurrence, treatment options, clinical trials and survival. Having cancer makes one very brave. I’ve done things like raise money and talk to strangers about ovarian cancer – things I would never have done before. Someday, I would like to be a motivational speaker and continue to encourage women diagnosed with ovarian cancer not to give up and to continue to have hope, just as my doctor encouraged me."