While ovarian cancer is relatively rare, it’s the fifth-leading cause of cancer-related deaths among women. Ovarian cancer seldom causes noticeable symptoms until it’s in later stages when it’s harder to treat. And unfortunately, there’s currently no recommended screening to detect the disease.
That’s why Atrium Health Levine Cancer Institute researchers are so passionate about leading clinical trials to find better ways to treat ovarian cancer.
Atrium Health’s ovarian cancer clinical trials
Levine Cancer Institute (LCI) researchers are studying several promising ovarian cancer treatments in clinical trials. Clinical trials have paved the way for many of the cancer treatments we have available today. Three current standout trials at LCI include:
- STRO-002: A phase III international clinical trial led by Dr. Wendel Naumann, director of gynecologic oncology research and associate medical director of clinical trials. The trial evaluates the efficacy and safety of STRO-002, an intravenous drug given every three weeks to patients with advanced epithelial ovarian cancer.
- GOG 3051: A phase II clinical trial led by gynecologic oncologist Dr. Jubilee Brown. The trial evaluates the efficacy and safety of biomarker-driven therapies in patients with persistent or recurrent rare epithelial ovarian tumors (BOUQUET).
- GOG GY019: A phase III national trial led by gynecologic oncologist Dr. Erin Crane. The trial is for patients with stage II to IV low-grade serous carcinoma of the ovary, fallopian tube or peritoneum. The study compares hormonal treatment to chemotherapy followed by hormone treatment. If approved, this anti-hormone, pill-only treatment could eliminate chemotherapy side effects for eligible patients.
“Part of our research strategy is to make sure we have new treatments to offer patients that perhaps they can’t get elsewhere,” says Naumann. “That’s the advantage of going to a large cancer treatment center like Levine Cancer Institute. We can look at relatively rare mutations and match patients to trials that specifically target that mutation.”
Sandi Spratt’s ovarian cancer story
Charlotte resident Sandi Spratt, 63, knows firsthand the power of clinical trials. Sandi was diagnosed with stage IV ovarian cancer in February 2016. She didn’t notice any unusual symptoms, though a seemingly random series of health challenges ultimately led to her diagnosis.
“Nothing seemed amiss at all,” says Sandi. “I had all my annual checkups and everything was fine.”
Then, in January 2016, Sandi developed what she thought was bronchitis. She went to urgent care and got a prescription for antibiotics. Her symptoms got better, but then quickly worsened. Sandi returned to urgent care when she began experiencing pain in her side.
“I thought I cracked a rib,” she says.
The urgent care provider took an X-ray, which showed a significant amount of fluid around Sandi’s lungs. They sent her to the emergency department to have the fluid removed.
“They took out about a liter and a half of fluid and I felt so much better,” she says. “That was on a Wednesday. On Saturday, I started feeling really bad again and everything was hurting. I thought I was having a heart attack, so I went back to the same emergency room.”
The emergency department team ran an EKG to check her heart and all results were normal. The emergency medicine physician who treated her on Wednesday was on call during her second visit.
“He came in and asked if anyone had called me that week,” she said. “I said no. He said, ‘I’m really sorry to tell you this, but you have ovarian cancer.’”
Sandi remembers thinking, “How embarrassing for him—he has the wrong patient.”
He told her that they tested the fluid they removed from her lungs and it showed evidence of cancer cells.
“It was the biggest shock of my life,” says Sandi. “I have no family history. I didn’t have any risk factors. I didn’t even know anyone personally who had ovarian cancer.”
Meeting with Dr. Naumann
Sandi met with Naumann on Monday.
“He was super encouraging and said I had treatment options,” she says.
Sandi immediately began chemotherapy, which lasted six months, then she underwent surgery.
“It was pretty freaky and I felt a lot of emotions,” she says.
After surgery, she started chemotherapy again.
“It got to the point where I had no evidence of disease and life was good,” she says.
However, the cancer eventually recurred and became resistant to platinum-based chemotherapy, which is considered the best chemotherapy for ovarian cancer. Because other chemotherapy agents have a relatively low response rate, Naumann encouraged her to go on the STRO-002 clinical trial.
Sandi spent two years on the trial before she began to have serious side effects and had to discontinue treatment.
“She has been on and off chemotherapy for over six years,” says Naumann. “This can damage the bone marrow in such a way that it cannot recover from chemotherapy. In some cases, this can lead to leukemia. Fortunately, Sandi has had good recovery of her bone marrow.”
He notes that gynecologic oncologists often run out of effective treatments for patients with ovarian cancer, making it crucial for researchers to develop new drugs and new ways to offer chemotherapy.
Sandi was off treatment from January through August 2022 as she recovered. She says the summer was “a blessing.” However, in August, a tumor perforated her small intestine and ruptured, requiring major emergency surgery. Thankfully, the surgery went smoothly and Sandi is recuperating well.
She will restart chemotherapy this month and take it from there. She maintains a positive attitude and relies on her faith and support system to stay strong.
“What I’ve discovered is that keeping a positive attitude is the only way you can do this,” she says. “You really learn to appreciate the gift of life every day. I’ve been able to do some fantastic trips. I feel like I really enjoy things on a deeper level than I did before. My diagnosis has taught me a lot about slowing down and taking things as they come.”
Sandi’s message to others with ovarian cancer
Sandi’s encouragement for other women with ovarian cancer: “Keep going. Try to stay off the internet. Align yourself with other survivors. It’s important to be plugged in so you don’t feel like you’re a lone ranger.”
The future of ovarian cancer treatment
Naumann’s patients, like Sandi, inspire him to develop new, better treatments for ovarian cancer.
“When I started, the average survival for patients with advanced ovarian cancer was only about eight months,” he says. “We have made steady progress in developing better supportive care for chemotherapy, lessening the morbidity of surgery and developing new drugs. We have seen incredible progress in this field, which is being driven by the type of research done here at LCI. Now, patients with advanced ovarian cancer are expected to survive more than five years, and we are probably curing more patients, but we have a long way to go.”
Ovarian cancer risk factors
Understanding ovarian cancer risk factors can help you make informed choices about your health. Women who are at a higher risk:
- Are middle-aged or older. About 90% of women who get ovarian cancer are over 40.
- Have close family members—such as a mother, sister, aunt or grandmother—who have had ovarian cancer.
- Have a genetic abnormality called BRCA1 or BRCA2, or Lynch syndrome, an inherited cancer syndrome that’s associated with a higher cancer risk.
- Have previously had breast, uterine or colon cancer.
- Have endometriosis, a condition where tissue from the lining of the uterus grows elsewhere in the body.
- Have never given birth or have had trouble getting pregnant.
If you have a family history of ovarian cancer, ask your gynecologist about genetic testing.
Ovarian cancer symptoms
There’s currently no screening exam for ovarian cancer, so it’s crucial to listen to your body and talk to your gynecologist or primary care provider if you notice one or more of the following symptoms:
- Abnormal vaginal bleeding or discharge, particularly if you’re post-menopausal.
- Bloating.
- Feeling full very quickly during a meal.
- Trouble eating.
- Pressure or pain in your pelvic area.
- Abdominal pain.
- Back pain.
- Change in bathroom habits, such as urinating more often than usual or chronic constipation.
“Ovarian cancer is often labeled as the ‘hidden cancer,’” says Dr. Crane. “In ovarian cancer’s early stages, symptoms may not be obvious. This is why seeing a gynecologist for an annual physical is so important. A thorough history and physical exam, including a pelvic exam and rectal exam, can detect signs of early ovarian cancer. I encourage all women to see a gynecologist each year for their overall health and well-being.”
How to reduce your risk of ovarian cancer
There are several ways you can reduce your risk of ovarian cancer. Ask your health care provider if any of these options are right for you.
- Taking birth control, such as oral contraceptives.
- Breastfeeding.
- Having your fallopian tubes removed (tubal ligation) if you are finished having children or do not plan to have children.
Learn more about ovarian cancer treatment at Atrium Health Levine Cancer Institute.
