Clinical Trial Gives Toni the Best Outcome:
Meeting Her Great Grandbabies
Toni Gallagher dismissed a nagging pain on the left side of her abdomen as muscle strain after paddleboarding with her grandchildren in August 2019. The 77-year-old was shocked when the diagnosis was stage 4 ovarian cancer. I've never been sick in my life before this," she said.
It's common for women to have no noticeable symptoms when ovarian cancer first develops. And when symptoms do appear, such as abdominal bloating or swelling, weight loss, back pain or constipation, they are frequently attributed to other, more common conditions. "Ovarian cancer is a silent killer because it often goes undetected until it is at an advanced stage," said James Barter, MD, gynecologic oncology surgeon and medical director of gynecologic oncology research, Holy Cross Health.
That was the case for Toni. A month later, Toni underwent surgery with Dr. Barter. Initially, he began performing a hysterectomy using robotic surgery but had to change to open surgery to remove a large portion of the bowel because the cancer had spread. That necessitated a colostomy to create an opening for the colon through the abdomen. "Having a colostomy was the best way to save her life," said Dr. Barter.
During her stay at Holy Cross Hospital, Toni praised the stomal therapists, nurses specially trained to care for stomas (openings in the abdomen wall). "They showed all four of my daughters how to care for my colostomy, and patiently went through everything to prepare me to go home," she said. "My care at Holy Cross Hospital was phenomenal. "Holy Cross Hospital is accredited by the American College of Surgeons' Commission on Cancer as a Comprehensive Community Cancer Program. A multidisciplinary team of cancer care specialists, which may include surgeons, medical oncologists, radiation specialists, nurse navigators, and oncology social workers, works together to create an individual care plan for each patient.
Holy Cross Health surgeons specialize in advanced, minimally invasive surgery and perform more gynecologic and gynecologic oncology inpatient surgeries in Maryland than any other hospital or health system.
Holy Cross Hospital is a Center of Excellence in Minimally Invasive Gynecology, designated by the Surgical Review Corporation.
Dr. Barter brought in Frederick Min, MD, medical oncologist, to manage Toni's chemotherapy treatment and evaluate whether she was a candidate for a clinical trial. In November 2019, Toni started a regular regimen of chemo, and a few weeks later, began participating in a clinical trial of a PARP inhibitor. PARP helps repair damaged DNA. In cancer treatment, "blocking PARP may keep cancer cells from repairing their damaged DNA, causing them to die," according to the National Cancer Institute.
The targeted treatment lets a single DNA strand grow and accumulate, tricking cancer cells into replicating too quickly, which kills them.
Toni was willing to do the trial, hoping her participation might help others in the future. But she was surprised that she was eligible considering her age. Dr. Min explained that patients, like Toni, who had previously been in good health with few to no coexisting medical conditions can be excellent candidates. Further, he noted that everyone he has enrolled in the PARP trial has done very well.
Dr. Min added immunotherapy to Toni's personalized treatment regimen. "Immunotherapy is a very powerful medication that is changing our cancer outcomes for lung, ovarian, and breast cancers," he said. "Combining immunotherapy and PARP made a difference for Toni."
Toni remains on maintenance therapy with the same treatment today, having one infusion every six weeks and taking daily medication. "I've never had any severe side effects," she said. Toni credits Dr. Barter's and Dr. Min's teamwork for helping her through her battle, bolstered by incredible support from her family. "I'm able to live my normal life."
"If Toni had not opted for treatment after surgery, she probably would not have lived more than three months," Dr. Min said. "Now, it's been two and a half years for her — an amazing story."
Understanding Clinical Trials and Research
Watch our medical director of gynecologic oncology research, Dr. James Barter, and our medical director of the Holy Cross Health Cancer Institute, Dr. Pablo Gutman, discuss the advances in clinical trials and research that broaden access to cancer care.