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Pinehurst Woman Urges Others to Know the Symptoms of Gynecologic Cancer
| Date Posted: 10/6/2022
PINEHURST, NC – Barbara Miller is a spunky, 78-year-old retired entrepreneur who always has a steady stream of friends and family from across the nation visit her in Pinehurst. She dearly loves her “crazy group of friends of all ages” in town. Neither she nor her social life was prepared for a diagnosis of stage 4 endometrial cancer.
Now in her second battle with the disease, she remains optimistic about the future and joins FirstHealth of the Carolinas in observing Gynecologic Cancer Awareness Month. She agrees with FirstHealth’s cancer team that knowing about cancers affecting the female reproductive organs—the ovaries, cervix, uterus, vagina and vulva—is one of the best ways to beat them.
In October 2020, at age 76, Barbara experienced vaginal bleeding, uncommon for her age. She also didn’t feel well, so she contacted her primary care physician. Tests for bladder cancer came back negative, and Barbara’s symptoms had diminished. She was relieved. However, two months later, she woke up to horrible pains in her lower abdomen, and her daughter rushed her to the emergency department at FirstHealth Moore Regional Hospital. After several rounds of testing, she was referred to gynecologic oncologist Michael Sundborg, M.D.
“Dr. Sundborg told me I had stage 4 endometrial cancer,” Barbara said. “He was very candid, and I immediately liked him.”
What is endometrial cancer?
Cancer starts when cells become abnormal and multiply out of control. For endometrial cancer, the abnormal cells originally appear in the endometrium, the inner lining of the uterus. Also called uterine cancer, endometrial cancer is the most common cancer of the female reproductive organs. The American Cancer Society reports 66,000 new endometrial cancer diagnoses and 12,550 deaths due to the disease each year in the United States. Endometrial cancer is one of five gynecologic cancers, including ovarian cancer, cervical cancer, vaginal cancer and vulvar cancer.
What are the signs and symptoms of gynecologic cancer?
Of all gynecologic cancers, only cervical cancer has a screening test (Pap test or Pap smear) that can detect it. Therefore, Dr. Sundborg said that the key to early detection of gynecologic cancer is knowing your body, noticing what’s not right and talking with your doctor. He encourages women to contact their doctor right away if they experience any of these symptoms:
- Abnormal vaginal bleeding or discharge (common for all gynecologic cancers except vulvar cancer)
- Feeling full too quickly or difficulty eating, bloating, and abdominal or back pain (common for ovarian cancer)
- Pelvic pain or pressure (common for ovarian and uterine cancers)
- More frequent or urgent need to urinate and/or constipation (common for ovarian and vaginal cancers)
- Itching, burning, pain, or tenderness of the vulva, and changes in vulva color or skin, such as a rash, sores, or warts (only in vulvar cancer)
“The good news about gynecologic cancer is that when detected, diagnosed and treated in the earliest stages, the five-year survival rate is more than 90%,” said Dr. Sundborg.
Who is at risk for gynecologic cancer?
Dr. Sundborg reports that all women are at risk for gynecologic cancer simply because of their anatomy. Other uncontrollable factors that may put women at risk of gynecologic cancer include:
- Age (the risk for most types increases with age)
- Family history of gynecologic cancer
- Genetic (inherited) conditions, such as mutations in the BRCA1 or BRCA2 genes
- Medications or chemicals exposed to years ago
- Menstrual cycle issues, such as infrequent periods, menstruation before age 12 or menopause after age 50
- No history of pregnancy
Women do have control of some factors linked to gynecologic cancer, including:
- Excessive weight
- Health conditions such as diabetes or high blood pressure
- Human papillomavirus (HPV) infection, linked with most cases of cervical cancer and avoidable for many girls and women with a vaccine
Barbara’s Battle, Part 1
Imaging tests revealed that Barbara’s uterus was full of tumors. Dr. Sundborg presented her with two options. “He told me about Hospice, which I think is a matter of protocol for people with my advanced stage of cancer,” she said. Dr. Sundborg also offered chemotherapy to shrink the tumors so he could perform a hysterectomy (surgical removal of the uterus) and take out the cancer’s source. Neither of them was overly optimistic about her prospects, but she chose chemo. “It was worth a shot,” she said.
After two rounds of chemotherapy, in March 2021, Barbara underwent a positron emission tomography (PET) scan of her uterus so doctors could see if there was any change. “Dr. Sundborg called me into his office and cracked a joke,” Barbara said, recalling her confusion. However, there was no joke: He turned his computer monitor around and showed Barbara an image of the area that once was full of tumors. It was now clear. The therapy worked, so the next stage was a hysterectomy which Dr. Sundborg completed to remove any remaining cancer. Her procedure was minimally invasive, using robot-assisted laparoscopic surgery.
Barbara felt strong and resumed her busy social schedule until March 2022. A follow-up scan then revealed a tiny tumor at the base of where the uterus had been before the hysterectomy. More cancer.
Barbara’s Battle, Part 2
Barbara started radiation therapy with FirstHealth radiation oncologist Sushma Patel, M.D. “Barbara had an optimistic outlook on her desire to move forward with treatment and was hopeful for a positive outcome,” said Dr. Patel. “Throughout her treatments, she was able to maintain her energy and positivity.” Barbara completed a round of radiation therapy—five sessions per week for six weeks. She was hopeful that she was in the clear.
Barbara’s Battle, Part 3 (and Holding)
Another scan on July 29, 2022, showed that Barbara’s cancer had spread to her chest and abdominal area. Again, Dr. Sundborg mentioned Hospice, and again, Barbara figured it was protocol. He also mentioned that since her chemotherapy regimen worked to remove the tumors the first time, she could consider it again.
“Why wouldn’t I give it another shot?” Barbara remembered telling Dr. Sundborg. Barbara said he was pleased with her choice and was “on fire” to get all logistics coordinated for her. She joked to Dr. Sundborg, “You know, if you keep me alive long enough, I’m going to run out of money.” Barbara’s medication was horribly expensive, and the hospital bills seemed to never stop.
Dr. Sundborg reminded her to call FirstHealth’s financial assistance department. She balked, thinking others needed help more than she did. He gently balked back with, “Eligibility is for them to determine.” Through grants for specific cancer types and funds provided by The Foundation of FirstHealth, Barbara received assistance with her bills. “I’m so grateful,” she said.
For Barbara’s second round of chemotherapy, Dr. Sundborg told her she wouldn’t need “Ursula” (the name she gave to her wig) because she won’t lose her hair. The round involved three sessions, with the last one scheduled for late September 2022. A scan in late October will reveal if it worked as well as the last time. Always the optimist, Barbara recently welcomed to her home Charlie Mae, an Aussie-doodle and Berna-doodle mix puppy. “She’s a double doodle,” Barbara laughed.
Barbara remains hopeful, positive and thankful. “The caregivers at FirstHealth are wonderful people,” Barbara said, raving about her entire care team, particularly highlighting the certified nurse assistants (CNAs) who also study at Sandhills Community College to become registered nurses. “And I can’t say enough about Dr. Sundborg. He is my friend, a true doctor and a healer. He cares.”
She continued, “I’m so grateful that I have exceptional care here in Pinehurst. I couldn’t imagine having to go to Duke or Chapel Hill. Not only would that be financially impossible, but it’s also good to be in your own bed.”
World-Class Cancer Care Close to Home
Women in the Sandhills facing a gynecologic cancer diagnosis like Barbara have access to first-rate care at FirstHealth with its full continuum of cancer services, including genetic counseling and testing, diagnosis, surgery, medical management, chemotherapy, radiation therapy, clinical trials, support services and long-term follow-up.
“At FirstHealth, we use a team model to develop a comprehensive, personalized treatment plan for each cancer patient,” said Dr. Patel. Coordinated efforts by physicians, advanced practitioners, patient navigators, nurses and support staff guide patients and their families through the complicated process of diagnosis, treatment, and survivorship.
FirstHealth’s advanced approach to cancer is uncommon for community hospitals. For example, the health care system has a multidisciplinary tumor board where gynecologic oncologists, radiation oncologists, pathologists, radiologists and other providers meet to collaborate on patients’ treatment options—a practice usually reserved for larger medical systems such as Duke or the University of North Carolina at Chapel Hill. FirstHealth also participates in numerous clinical trials, giving patients early access to potentially breakthrough therapies—a rarity for rural hospitals.
Additionally, FirstHealth offers a wealth of oncology support services. “We care for women and their families throughout their cancer journey,” says Laura Kuzma, MSW, FirstHealth Administrative Director, Oncology Services and Clinical Trials. Comprehensive cancer services include patient navigation, nutrition and dietary assistance, stress management, massage therapy, financial assistance and more. In addition, the Clara McLean House on the Moore Regional Hospital campus in Pinehurst provides caring and affordable lodging for out-of-town patients and their families.
Looking Forward to the Future
Barbara looks forward to receiving follow-up care in FirstHealth’s new Comprehensive Cancer Center, set to open in early 2023. The four-story, 120,000-square-foot comprehensive outpatient cancer on the Moore Regional Hospital campus in Pinehurst will allow patients to receive FirstHealth’s full scope of cancer care under one roof.
In addition to medical oncology, gynecologic oncology, infusion and radiation oncology, the Comprehensive Cancer Center will house a wide array of support services, including cancer wellness with meditation, yoga, chaplaincy, exercise, massage, canine and music therapies, teen center and support groups. The center will also be home to more nurse and financial navigators, multidisciplinary clinics, expanded clinical trials, grief counseling and outpatient palliative care.
Barbara also looks forward to more friends and family visiting in the next several months. “Life is such a trip,” she mused.
For more information about FirstHealth Gynecologic Oncology, call (910) 715-8684 or visit our Cancer Services website at www.nccancercare.org.