In the past few years, advances in ovarian cancer - particularly for stage 4 metastatic disease - have given physicians new treatment options and significantly extended the lives of patients. In addition, patients are also reporting that the newest class of drugs is improving their quality of life.
Baptist Health Miami Cancer Institute’s patient Erika Guay is a prime example of someone who has benefitted from the newest treatments. First diagnosed and treated for stage 4 ovarian cancer in 2018 when she was living in New York City, Ms. Guay’s cancer returned in 2020, after she moved to Florida. In the two years between diagnoses, PARP inhibitors, a new class of drugs, had become available.
“We now have immunotherapies and PARP inhibitors,” says John P. Diaz, M.D., chief of gynecologic oncology at Miami Cancer Institute. “And this year we had the first antibody drug conjugate approved for the treatment of recurrent ovarian cancer. It’s an exciting time in the management of the disease. We have a lot more options for patients than we did in the past.”
Like many women with ovarian cancer, Ms. Guay had almost no symptoms. One day, before her first diagnosis, she was in the middle of her routine workout when she felt a popping sensation in her neck as she lifted a weight overhead. Stage 4 ovarian cancer had spread to her lymph nodes. She was only 43. Even with regular monitoring, the first sign of recurrence came when Ms. Guay again felt a small lump in her neck.
“We took a multidisciplinary approach to her care,” Dr. Diaz says. Through a robotic procedure, he removed a lymph node and cancerous tissue in her pelvis and another physician removed the node in her neck. Then Ms. Guay had six rounds of chemotherapy. During her treatment, she completed her MBA at the University of Miami.
At first glance, Ms. Guay does not seem to be a likely candidate for ovarian cancer. She has always watched her weight and exercised, even running marathons, and she had no immediate family history of cancer. Genetic testing, however, showed a BRCA gene mutation, which was found to be linked to her father’s side of the family.
Because of her BRCA status, after chemotherapy and as a maintenance regime, Ms. Guay was placed on a PARP inhibitor to reduce the ability of the cancer cells to repair themselves. Because of possible side effects, most patients take the oral medication daily for 15 months to two years, Dr. Diaz says.
Today, at age 48, Ms. Guay is cancer-free.
Miami Cancer Institute offers a high-risk clinic for those with identified genetic mutations or other factors that put them at greatest risk for ovarian cancer. Those patients are put under active surveillance, which may include frequent ultrasound and mammography, and at a younger age than is typically recommended for women at low risk. In addition, the Institute offers a variety of clinical trials.