Second opinions led to improved care and a clinical trial
Richmonder Bindu Panapalli’s experience with ovarian cancer has been difficult, but it’s hard to tell due to her cheerful disposition and contagious laugh. She recently finished treatments for ovarian cancer, and is now participating in a clinical trial studying the effects of diet and exercise on ovarian cancer recurrence.
A scientist by trade with a background in biochemistry, Panapalli understands the importance of research in understanding and curing disease.
“I had had issues with uterine fibroids for a while, but last year things had gotten worse. My doctor recommended a hysterectomy, but did not remove my ovaries,” she recounts. “I had a lot of nausea and cramps while recovering, so I was sent to a gastroenterologist who suspected a bowel obstruction. It was when I underwent surgery for the bowel obstruction that the doctor saw that my abdominal cavity was essentially glued together.”
A biopsy confirmed that Panapalli had ovarian cancer, and her community doctor recommended an oophorectomy, a procedure to remove the ovaries, followed by chemotherapy. She sought a second opinion from Weldon Chafe, M.D., gynecologic oncologist at VCU Massey Cancer Center, who agreed with the treatment approach. But after a CT scan prior to surgery revealed additional tumors, it was suggested that she start chemotherapy immediately in an attempt to shrink the tumors prior to surgery.
Panapalli’s insurance company suggested she get one more opinion from the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins. It was there that she met Sarah Temkin, M.D., who is now director of gynecologic oncology at Massey. Temkin also agreed with the treatment plan, so Panapalli underwent six rounds of chemotherapy and then had her third surgery in less than a year at her community hospital.
She went back to see Temkin following the surgery for another opinion on her doctor’s recommendation for additional chemotherapy to help kill any remaining cancer. By that time, Temkin had already moved to Massey, so Panapalli transferred her care to Temkin and Massey.
“I’m glad I came here to Massey,” says Panapalli. “Looking back, a lot of symptoms were missed. Here, I feel that the team makes you more aware of what symptoms to look out for and the potential side effects of treatment.”
It was Temkin who also encouraged Panapalli to consider the clinical trial. Temkin is a physician-researcher who has led clinical trials for gynecologic cancers and recently published a study that showed minorities are underrepresented in clinical trials for gynecologic cancers.
Panapalli and her husband participated in this year’s Massey Challenge, walking the Ukrop’s Monument Avenue 10k in support of cancer research at Massey. In addition to her husband, Panapalli receives support from her two daughters, one a sophomore at Virginia Commonwealth University studying bioinformatics and the other a junior in high school. “They want to learn as much as they can, so they often read about different studies and then come tell me about them,” she says.
Panapalli exercised regularly before her diagnosis, and her husband is an avid runner, so she thought the clinical trial would be a good fit and signed up.
The phase 3 trial studies whether changes in diet and physical activity can increase the length of survival without the return of cancer (progression-free survival) compared to usual care in patients with previously treated stage II, III or IV ovarian, fallopian tube or primary peritoneal cancer. A number of other factors related to participants’ quality of life and physical and emotional well-being are also being studied.
Participants in the study are split into two groups. One follows a specific diet and exercise regimen, meets regularly with a counselor and keeps a nutrition diary. The second group receives information about the study but are not asked to follow a specific diet or exercise plan, although they are free to exercise and eat how they wish.
“I will do whatever it takes to prevent another recurrence. And if I can help future patients by joining the study, then it’s all worth it,” said Panapalli. For other patients in similar situations, she encourages them to take things one day at a time and to always get a second opinion.
To learn more about the clinical trial, contact Patricia Dodson, R.N., clinical research nurse at Massey, at (804) 628-2582 or visit the clinical trials section of Massey’s website and search for ovarian cancer clinical trials. Visit Massey’s website for more information about gynecologic cancer care.