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Back in the Saddle

After being treated for ovarian cancer, Christine Gabriel -- who also survived breast cancer -- returned to work doing commentary for horse racing clubs in the U.S. and across the world.

Christine Gabriel and her horse, Nabienne Breast and ovarian cancer survivor Christine Gabriel and her horse, Nabienne, at Shamrock Farm in Barrington Hills, Ill.

When asked about her chances of beating ovarian cancer, horse racing handicapper and on-air analyst, Christine Gabriel, 57, says the odds were against her.

Between 1987 and 2000, Gabriel underwent treatment for breast cancer three times. Then in 2008, when she thought she had pneumonia, one physician told her the breast cancer had recurred, she had six months to live and she should "get her affairs in order."

"That was unacceptable," said Gabriel, who at the time lived both at her home in Inverness, Ill., and in Dubai, where she and her husband, Frank, both worked for the Meydan Racecourse.

The Stakes were High

Gabriel was familiar with the University of Chicago Medicine Comprehensive Cancer Center through Riding for a Cure, a charity organization she founded eight years earlier when she was a TV analyst for Arlington International Racecourse in Arlington Heights, Ill. Some of the funds raised through the group’s equestrian events had supported research at the cancer center.

"We learned from them that even $40,000 could get a project off the ground," Gabriel said. "And the cancer center really appreciated what we were doing." Gabriel transferred her care to the University of Chicago Medicine and to S. Diane Yamada, MD, one of the physicians whose research the group had funded.

Imaging exams showed that Gabriel had fluid in her lungs, which can be a complication of cancer. Blood tests revealed highly elevated CA125, a marker indicating cancer activity in the abdominal cavity. Results of a computed tomography (CT) scan pointed to primary peritoneal carcinoma, a type of ovarian cancer.

S. Diane Yamada, MD, and Christine Gabriel S. Diane Yamada, MD, and Christine Gabriel

"As with the majority of patients with ovarian cancer, the disease was at an advanced stage when it was discovered," said Yamada, who leads the gynecologic oncology program at the University of Chicago Medicine. "We needed to take an aggressive approach to her surgical and medical care."

Yamada performed extensive debulking surgery -- a hysterectomy as well as removal of the omentum and a portion of the bowel, and stripping of the diaphragm. The goal of the surgery was to remove all visible evidence of tumor. The debulking procedure has proven to increase survival rates for ovarian cancer patients.

Yamada then recommended a combination of intravenous (IV) and intraperitoneal (IP) chemotherapy for the next phase of Gabriel’s care. IP chemotherapy, given through a catheter inserted directly into the peritoneal cavity, bathes the entire abdominal area with a high concentration of chemotherapy for an extended period of time. National Cancer Institute-supported clinical trials leading to the recommended use of this treatment had been completed just two years before Gabriel was diagnosed. Yamada and her colleagues at the University of Chicago Medicine participated in the groundbreaking trials.

While IP chemotherapy results in longer relapse-free survival for patients, women can experience difficult side effects while undergoing the treatment, including low blood counts, metabolic complications and neurological problems.

"Christine was otherwise healthy, so I felt she could physically handle the IP chemotherapy," Yamada said. "She was also really tough."

As a young girl learning to ride, Gabriel’s father had told her to "brush off and get back on the horse" every time she was bucked off. She took that same approach when experiencing setbacks during the cancer treatment. After each challenge, she said, "I always got back in the saddle."

But she never wanted false hope. "I asked Dr. Yamada to always be a straight shooter," she recalled, saying Yamada understood her personality. "I always wanted to know what I was up against."

In the Winner’s Circle

Gabriel underwent the combined IV/IP chemotherapy cycles during four inpatient stays at the hospital over a five-month period, completing treatment in February 2009. Afterward, Yamada wanted her to take it easy, but Gabriel had other plans.

Christine Gabriel in Dubai at World Cup Gabriel in Dubai at the 2009 World Cup

"I told Dr. Yamada, ‘I am out of here,’" she recalled. "I needed to get to Dubai for the World Cup." Two weeks later, Gabriel donned a red and black fascinator hat accented with foot-long feathers and provided on-air analysis for the international thoroughbred horse race. Her commentary from the Meydan winner’s circle was simulcast to tracks all over the world.

Six years after her diagnosis, Gabriel now lives in the United States again, both in Inverness and Saratoga, NY, where her husband recently took a job at the Belmont Park racetrack. She recently retired from a career as an analyst and spends much of her time riding a Dutch mare named Nabienne. "I ride for pleasure almost every day and take instruction for jumping," Gabriel said. "I look forward to competing in shows again."

Yamada continues to monitor Gabriel once a year for signs of recurrence. But because Gabriel has been disease-free from ovarian cancer for more than five years, Yamada says, she has already beaten the odds.

July 2014