From the Oncology Ward to the Maternity Ward
Jennifer Bishop-Staley had been looking forward to returning to college all summer. Three weeks before classes were to start, she discovered a mass on her left side that had grown so large and painful she could barely stand up straight. During the two months prior, she had visited the doctor three times for stomach pains, a mild ongoing fever and nausea.
Doctors had previously told her the symptoms were nothing serious, but at her next appointment in August 2000, she insisted all of the symptoms, including the mass, were somehow related.
"Then, things started to change," Bishop-Staley recalled.
Bishop-Staley’s primary physician referred her to the University of Chicago Medicine, and after a CT scan and an ultrasound, she was scheduled for surgery the next day. The good news was that Diane Yamada, MD, now chief of the Section of Gynecologic Oncology, successfully removed several malignant lymph nodes, Bishop-Staley’s left ovary and the tumor growing inside it, which was about the size of a softball.
The bad news was Bishop-Staley would not be going back to school that year. At age 19, she was diagnosed with a rare form of ovarian cancer.
"My first question was if I could go back to school," Bishop-Staley recalled, now 27 years old. "I wanted to get my college degree, have a family one day, all those things that a normal 19-year-old wants. I was so upset, because now I was not going where I thought my life was taking me."
The first round of chemotherapy melted almost 15 pounds off of Bishop-Staley’s already petite, 5-foot-3-inch frame. "I weighed 89 pounds," Bishop-Staley said. "My legs looked like little sticks coming out of my shorts. I was already a size zero, and now that was baggy."
By the second round her hair was falling out with each brush stroke. The constant vomiting invited negative thoughts. "I thought this was it," Bishop-Staley remembered. "But my mom would say, ‘You’re not dying,’ and she would put me back in my place."
"Patients have a lot of resolve," said Yamada, who draws on her own experience at age 13, when her mother battled breast cancer. "They have to dig down deep within themselves, and I take stock of that when I’m deciding on a treatment course. It’s not always the patient’s age or medical history, but sometimes you have to look them in the eye and ask, ‘How strong are you?’"
Only about 1.3 percent of ovarian cancer diagnoses occur in women under age 20, and the majority die from it. But Bishop-Staley was strong enough to withstand two surgeries and seven rounds of a five-drug chemotherapy regimen over nearly six months. The chemo agents were so strong they had to be administered to Bishop-Staley as an inpatient. Add to that the 15 medications that were prescribed to control the side effects, including an anti-nausea medication dispensed through a portable catheter.
"We as a team of oncologists, pathologists, radiation therapists and nurses spent a lot of time discussing her treatment; we searched the literature extensively and drew on our own experience with this disease," Yamada said. "We went into it saying, ‘This is a young girl,’ and we were going to be in it for the long run. We did not want to compromise anything or leave any stone unturned." Yamada credits chemotherapy nurse, Juliana Lutz, RN, for encouraging and supporting Bishop-Staley through her treatment.
Yamada followed Bishop-Staley’s blood test and CT scan results to determine how many rounds of chemotherapy were needed. By the fourth round, her blood tumor marker levels were no longer elevated. By the sixth round, Bishop-Staley’s once-enlarged lymph nodes were returning to normal.
In January of 2001, the week before her 20th birthday, Bishop-Staley finished her final round of chemotherapy. As her cancer showed fewer signs of recurring, Yamada reduced the visits from every three months, to every six. Early 2009, was the first year Yamada decided that only an annual visit was necessary, but a few weeks later Bishop-Staley was already making another appointment.
Eight years after surviving ovarian cancer, she was pregnant with her first child.
"I was over the moon," Yamada said, cracking up laughing. "I have known her for so long that she's like part of our family. I was ecstatic." On January 20, 2010, Bishop-Staley gave birth to a 7-pound, 1-ounce baby boy, Lawrence Thomas Staley.
Prior to the birth, Bishop-Staley received pre-natal care at the University of Chicago Medicine from Mahmoud Ismail, MD, co-director of the medical center's perinatal network and an expert in high-risk pregnancies. He was recently designated one of the Chicago's top doctors by both Chicago magazine and North Shore magazine.
At an appointment with Ismail just before the baby was born, a woman walking by doubled back to pop her head in the door. "Hey, I saw you on television," she said to Bishop-Staley and her fiancé, Edward. On Thanksgiving Day, they were featured in a commercial with Yamada to promote the medical center's cancer treatment and research program.
"What makes you so special?" the nurse teased as she removed the blood pressure cuff from Bishop-Staley's arm.
Bishop-Staley put her hand on her protruding belly and smiled. "Eight years ago, I had ovarian cancer."