Stephanie Virgin was 29 and hoping to start a family, so ovarian cancer was the last thing on her mind — even when she experienced textbook symptoms.

The Louisville native chalked up her back pain to the high heels she wore to her work in real estate. She thought the need to urinate frequently was from all the water she drank, and she blamed the cramping, bloating and irregular periods on going off birth control. And then there was the heartburn, decreased appetite and fatigue.

When she almost passed out one morning in September 2014, her husband, Greg, insisted she go to the doctor. Her physician pressed on her belly and felt what he thought was a large ovarian cyst. An ultrasound showed something more ominous.

“When you get told you have cancer, you black out. … I literally froze,” Stephanie said.

Stephanie did not fit any of the risk groups. She was young. The average age of diagnosis is 63.

Also, she had no family history of breast or ovarian cancer, didn’t smoke, wasn’t overweight, did not have endometriosis and never had taken fertility medications.

Stephanie’s surgeon found cancer on both ovaries, fallopian tubes, uterus, cervix, bladder, ureter, omentum and colon. Her diagnosis: Stage 3 low-grade serous adenocarcinoma.

Stephanie went to see Lynn P. Parker, M.D., gynecologic oncologist with Norton Cancer Institute Women’s Cancer Center.

“Dr. Parker is big on research,” Stephanie said

The research showed patients who can tolerate an aggressive treatment (IV/IP chemotherapy) survive an additional 18 months on average.

“I felt like this was my best chance,” Stephanie said.

The inpatient chemotherapy was difficult. Stephanie was given Taxol intravenously, and the chemo drug cisplatin was injected directly into her abdomen, a procedure called intraperitoneal (IP) chemotherapy. The treatment caused the number of infection-fighting white blood cells called neutrophils to decrease to the point where Stephanie needed blood transfusions.

“That was tough,” she said. “Dr. Parker was always there to answer any question you had. When you talk to her, it’s like you’re her only patient. She doesn’t need to look at the chart to see who is this and what is this about.”

After 5 years, still under surveillance

After five years, Stephanie is being monitored closely and taking medication because of a high recurrence rate for ovarian cancer.

Stephanie speaks to third-year medical students about her experience and does other outreach to spread the word about ovarian cancer, which strikes 1 in every 88 women.

“I had almost every symptom,” Stephanie said.

Those symptoms, however, are relatively easy to ignore or blame on something else.

“Ovarian cancer is called the silent killer or the cancer that whispers,” Stephanie said.

Stephanie belongs to Ovarian Awareness of Kentucky (OAK) and tries to use social media such as Facebook and Instagram to let women know about ovarian cancer, especially younger women who may not think they are at risk.

She also tries to mentor young survivors through an Ovarian Cancer Young Survivors Facebook page she started, which has more than 500 members.

Stephanie is back at work, running First Saturday Real Estate with her husband.

‘Whatever it takes for you to be a mommy’

Because she had a radical hysterectomy, Stephanie knew she couldn’t have children.

“For me, one of the toughest things was the loss of my fertility. I went through a period of mourning,” Stephanie said. “I cried and told my husband, ‘We would have made such beautiful babies.’ My husband was amazing. He said, ‘We’re going to do whatever it takes for you to be a mommy.’”

Stephanie and Greg have since adopted biological brothers through the foster care system. The boys are now ages 7 and 3.

“We have two beautiful boys,” said Stephanie, who is passionate about her family and her work.

According to Stephanie, her cancer journey has changed her outlook. She now says yes to more experiences and risks.

High chance of recurrence

While Stephanie remained under close surveillance of Dr. Parker for several years while her cancer stayed at bay, she knew that 80% of patients diagnosed with epithelial ovarian cancer have it recur within five years.

In early 2020, after a routine colonoscopy, Stephanie had significant abdominal pain. Dr. Parker “jumped into action” and ordered labs.

After conducting bloodwork and undergoing MRI imaging, Stephanie had her worst fear confirmed — the cancer was back.

“Typically, once ovarian cancer recurs, it does not go away,” Stephanie said. “While we would love for me to be ‘no evidence of disease’ again, I have had to learn to be content with ‘stable’ disease.”

Stephanie credits her ability to gracefully navigate her cancer journey to Dr. Parker, whom she is “100% confident in,” as well as her ongoing work with the Norton Cancer Institute Behavioral Oncology Program.

Currently, Stephanie and Dr. Parker work together to review clinical trials and different treatment options and to explore genetic testing to help guide her treatment plan.

“When I meet with Dr. Parker, I know that I am being fully listened to, that she is up to date on all of the latest treatment options, that I am collaborating with her on my care and that she is going to show me the utmost compassion and respect,” Stephanie said. “Dr. Parker sets the bar for cancer care.”

Stephanie belongs to Ovarian Awareness of Kentucky, a support group, and tries to use social media such as Facebook and Instagram to let women know about ovarian cancer, especially younger women who may not think they are at risk.

She also tries to mentor young survivors through an Ovarian Cancer Young Survivors Facebook page she started, which has more than 500 members.

Signs and symptoms of ovarian cancer

Early-stage ovarian cancer seldom causes symptoms. Advanced-stage ovarian cancer may cause symptoms that often are mistaken for common benign symptoms.

Signs and symptoms of ovarian cancer may include:

• Abdominal bloating or swelling
• Quickly feeling full when eating
• Weight loss
• Discomfort in the pelvis area
• Changes in bowel habits, such as constipation
• A frequent need to urinate

Your doctor can review your family history with you. If you have relatives with ovarian cancer, you may want to meet with a genetic counselor to discuss testing for certain gene mutations that can increase your risk.

The post Living with ovarian cancer, Stephanie Virgin is a focused mom and advocate for awareness appeared first on Norton Healthcare.

The dermatologist biopsied the lump and sent the tissue to the laboratory, and the result came back as non-Hodgkin lymphoma, a blood cancer. Lonnie, then age 31, was floored.

“I never dreamed I would get cancer,” he said. “I was shocked and wondered if I was about to die. I didn’t know where to go from there and was pretty anxious those first few days. But I had my family there to support me.”

Once again, Megan stepped in, helping her husband find specialists to get him the care he needed.

“She said, ‘We’re going to go through this the right way and see the best of the best. Everything is going to be just fine,’” Lonnie said.

Lonnie went to see Norton Cancer Institute oncologist Don A. Stevens, M.D., who ordered a positron emission tomography (PET) scan that revealed his cancer had not spread. Good news there. But the imaging test picked up something else: A suspicious-looking spot in his colon. A gastroenterologist performed an endoscopy and colonoscopy, discovering a large precancerous polyp that would require surgical removal.

This early detection became a lifesaver since the normal age for a colonoscopy is between 45 and 50 years old. Lonnie will have to undergo a colonoscopy annually as a preventive measure.

“I’m very fortunate that the polyp was discovered early,” he said.

For a time, Lonnie’s cancer took a back seat to his colon condition. But after he recovered from surgery in November 2014, the father of three underwent radiation treatments for his lymphoma. Now his condition is monitored but does not require active treatment.

Lonnie gives all of the credit to his wife.

“Megan supported me and directed me to the right specialists,” he said. “Her insistence that I go see the dermatologist saved my life, no doubt about it.”

The post In sickness and in health appeared first on Norton Healthcare.

My concern was how others were going to react to it — my sisters, my mom, my dad and my daughter. I knew I had to fight because, at the time, my daughter was 26, and I’m like, “I can’t leave her.”

I had to decide what I was going to do with this journey. Am I going to go in fighting? Am I going to go in crying?

I’m celebrating life. I’m celebrating each year that I got through. I thought that when I lost my job of 20 years that that was important, but it wasn’t. And I loved my job, but this job that I have now — as a cancer survivor — is what I’m supposed to do: Be a survivor, support the next individual, and push them, push them, push them!

– Wanda Anderson

Breast cancer prevention

Preventing breast cancer begins with living a healthy lifestyle. While some risk factors, including a family history of breast cancer, cannot be changed, the following lifestyle changes can help reduce your risk:

• Limit alcohol intake.
• Don’t smoke.
• Use caution when considering hormone replacement therapy.
• Exercise 30 minutes a day, six days a week.
• Eat a healthy diet.
• Pay attention to changes in your breast, such as lumps, bumps or skin changes.

The post Wanda’s tale of triumph appeared first on Norton Healthcare.

This clinical trial is studying the antiviral and anti-inflammatory properties of selinexor in patients with severe COVID-19. At Norton Healthcare, the study is being led by Don A. Stevens, M.D., a hematologist/oncologist with Norton Cancer Institute.

“We are examining how we can decrease the ability of the virus to replicate or reproduce in our patients’ cells,” Dr. Stevens said. “We also want to see how it can decrease the release of a biochemical responsible for inflammation that in some cases can cause organ damage.”

Norton Healthcare is one of 40 locations internationally to participate in this clinical trial.

Related: What COVID-19 and the vaccines mean for cancer patients and survivors

To be eligible, patients must be hospitalized with a laboratory-confirmed case of SARS-CoV-2 (the virus that causes COVID-19) and consent to participation within 48 hours of hospitalization.

Criteria to take part in selinexor COVID-19 trial

Patients must meet additional criteria:

• Confirmed laboratory diagnosis of SARS-CoV2 by standard approved Reverse transcription polymerase chain reaction (RT-PCR) assay or equivalent approved testing.
• Currently hospitalized and consented within the first 48 hours of hospitalization.
• Informed consent provided as above (participants must be dosed with study drug within 12 hours of consent).
• Has symptoms of severe COVID-19 as demonstrated by:
• At least one of the following: fever, cough, sore throat, malaise, headache, muscle pain, shortness of breath at rest or with exertion, confusion, or symptoms of severe lower respiratory symptoms including dyspnea at rest or respiratory distress.

AND

• Clinical signs indicative of lower respiratory infection with COVID-19, with at least one of the following: respiratory rate ≥ 30 breaths/minute (min), heart rate ≥ 125 /min, Oxygen saturation (SaO2) < 93% on room air or requires > 2 Liter (L)/minute oxygen by NC in order maintain SaO2 ≥ 93%, PaO2/FiO2 < 300 mm/hg.

• Concurrent anti-viral and/or anti-inflammatory agents (e.g., biologics, hydroxychloroquine) are permitted.
• Female patients of childbearing potential must have a negative serum pregnancy test at Screening. Female patients of childbearing potential and fertile male patients who are sexually active with a female of childbearing potential must use highly effective methods of contraception throughout the study and for 3 months following the last dose of study treatment

See full list of eligibility criteria.

More on the selinexor COVID-19 study

Selinexor is an oral selective inhibitor of nuclear export (SINE) compound that blocks the cellular protein XPO1, which may be involved in both the replication of SARS-CoV-2 and in the inflammatory response to the virus.

The randomized, multicenter, placebo-controlled Phase 2 study (XPORT-CoV-1001/NCT04349098) of low-dose selinexor is designed to assess the activity and safety of 20 milligrams of selinexor given orally three times a week for two weeks. Patients tolerating therapy well and experiencing clinical benefit may be eligible to continue treatment for an additional two weeks at the discretion of the treating physician.

Norton Healthcare’s clinical trials program is the most robust program in the region and has been instrumental in the development of many drugs and medical devices. Norton Healthcare clinical trials include emerging treatments for cancer, cardiovascular issues, neurological conditions, orthopedic conditions, maternal-fetal medicine and many more.

The post Norton Healthcare physicians first in world to test cancer drug as COVID-19 treatment appeared first on Norton Healthcare.

In 2017, David developed what he thought was a minor hernia. He had bouts of stomach pain and over a two-month period lost about 40 pounds.

David was familiar with lung cancer’s symptoms — his father died from it — but he wasn’t coughing and had no trouble breathing. He just felt weak and knew something was wrong.

His wife, Valerie, convinced him to visit a Norton Immediate Care Center near their home. From there he was sent to the emergency department at Norton Brownsboro Hospital, where a scan showed a mass in his right lung.

David was admitted, and tests confirmed he had lung cancer. Adam D. Lye, M.D., oncologist with Norton Cancer Institute; and George J. Mikos, M.D., thoracic surgeon with Norton Cardiothoracic Surgery; joined forces to work out David’s best treatment plan.

Comprehensive care approach

Drs. Lye and Mikos collaborate often through Norton Cancer Institute’s Comprehensive Lung Center. This multidisciplinary program brings together state-of-the-art cancer diagnosis, treatment and ongoing support services with a focus on patient-centered care.

Early diagnosis of lung cancer is critical, so screening is a key part of the center’s comprehensive care approach. Low-dose computed tomography (CT) scans, which can detect even the smallest tumors, are used to screen for lung cancer in individuals with high risk factors.

Dr. Lye said the lung center’s “multi-specialist” approach, with fast access to a surgical opinion, is a huge benefit for patients. To save families time, added travel and worry, Dr. Lye often consults with Dr. Mikos to review a case for possible surgery during the patient’s appointment.

“One of my goals is to give patients a clear, precise, leading-edge treatment plan as soon as I can, and this just wouldn’t be possible without someone with the expertise of Dr. Mikos being available.”

Initially the team hoped David’s tumor — estimated to be about the size of an egg — could be surgically removed. It proved to be larger than expected, so removal of David’s right lung was necessary.

David was scheduled for 12 chemotherapy treatments. He responded well and was able to stop after eight sessions, when a positron emission tomography (PET) scan confirmed no obvious signs of cancer. He continues to get regular follow-ups.

“Dr. Lye keeps telling me his goal is to cure, not just treat me,” David said. “I joke with him and say, “I’m holding you to that.’”

Screenings, medical advances improve survival rates

As a former smoker, David recalls the days when “we used to have ashtrays on our desks at work.” He’s glad that is no longer the norm.

According to the Centers for Disease Control and Prevention, lung cancer is our nation’s leading cause of cancer deaths.

The good news is survival rates are improving, thanks largely to reduced smoking rates, earlier detection and better treatment options. Dr. Lye underscores the need for screening and points to three other factors that are giving patients cause for hope:

• Increased understanding of lung cancer genetics
• Advanced targeted therapy and immunotherapy
• Newer treatments with far less toxicity and side effects than past traditional cytotoxic chemotherapy

“Many of our patients even with stage 4 disease are now able to live multiple years with the appropriate treatment,” he said.

David cherishes time with his family, including his two grandchildren.

“I’m so lucky they found my lung cancer when they did,” David said.

For those with a history of smoking, getting a lung cancer screening could be a lifesaver. Take it from David on this when he says, “Get checked. Don’t wait around until you know you have a problem. It could be too late by then.”

The post Lung cancer survivor credits ‘lucky’ outcome to early detection and expertise appeared first on Norton Healthcare.

Renato V. LaRocca, M.D., a neuro-oncologist and cancer medicine specialist with Norton Cancer Institute, is working on new treatments that use immunotherapy to turn the body’s immune system against the cancer. Norton Healthcare is among several institutions in the country offering ongoing clinical trials for glioblastoma.

Glioblastoma cells tend to reproduce quickly and are supported by a large blood vessel network. The cancer also can come back after treatment.

“For many reasons, glioblastoma is nearly impossible to cure. We can never truly remove every single tumor cell from the brain during brain tumor surgery,” said David A. Sun, M.D., Ph.D., neurosurgeon with Norton Neuroscience Institute. “After surgery, we rely on radiation treatments and chemotherapy medicines.”

Why immunotherapy is important to glioblastoma treatment

Most cancer-fighting medicines can’t get into the brain, according to Dr. Sun. The best medicine for glioblastoma can enter the brain but only works on a portion of glioblastoma cells. Following current treatment plans, most patients survive just 15 months after their diagnosis.

Dr. LaRocca and others “are trying to utilize a strategy of having the brain’s own natural immune system fight the tumor cells for us,” Dr. Sun said.

The effort focuses on checkpoints — molecules that suppress the body’s immune response. Cancer cells sometimes use the checkpoints as a way to slip through the immune system unharmed. Immunotherapy drugs often will seek to unblock the checkpoint, unmasking the cancer cell as a target for the immune system.

“Checkpoint inhibitors, such as PDL-1, are showing great promise against lung cancer, melanoma and other cancers. Their role in primary brain tumors is under investigation,” said Dr. LaRocca, who added that Norton Cancer Institute also is conducting a series of experimental vaccine trials for newly diagnosed and recurrent glioblastoma.

“Health care research is critical to producing new and innovative medications, devices and technologies that save lives and improve quality of life,” said Stephen Wyatt, M.D., vice president of Research for Norton Healthcare. “Trials like these ensure the people in our region have access to evolving clinical science.”

The disease has made headlines over the past few years when Sen. John McCain, former Sen. Edward Kennedy and Beau Biden, son of former Vice President Joe Biden, lost their lives to glioblastoma.

Glioblastoma symptoms can include headache, nausea, vomiting and drowsiness, as well as weakness, speech difficulties and memory issues.

The post Glioblastoma clinical trial uses immunotherapy in fight against the deadliest brain cancer appeared first on Norton Healthcare.

For fun, Dr. Lye and his family like to go for hikes around the commonwealth. He also follows Kentucky country musicians Chris Stapleton, Sturgill Simpson and Tyler Childress.

Dr. Lye’s love for his home state extends to helping combat one of its biggest challenges. Kentucky has the highest lung cancer rate in the country.

“I’m committed to the area, and I’m committed to the people,” said Dr. Lye, who recently joined Norton Healthcare and will practice at the new Norton Cancer Institute – Brownsboro opening Nov. 5.

New lung cancer treatments and early detection

Quitting smoking is the best way to lower the risk for lung cancer. Next best is for smokers to undergo screening beginning at age 55. Lung cancer is usually detected late, making treatment much more difficult.

“Early detection makes a huge difference,” said Dr. Lye, who is board certified in internal medical and medical oncology. “If you detect lung nodules early, your chance of curing lung cancer improves dramatically.”

Recent advances in genetics also are improving the outlook for patients with lung cancer, according to Dr. Lye. Certain chemotherapy drugs can be deployed against specific genetic mutations, improving their effectiveness.

Another breakthrough in cancer treatment is immunotherapy. Immunotherapy uses the patient’s own immune system to fight cancer.

“There are all kinds of new and exciting treatments coming on that are helping make a difference in people’s lives,” he said. “These new therapies are providing patients with hope.”

Norton Cancer Institute offers patients personalized medicine with surgical, chemotherapy, radiotherapy, immunotherapy and genetic therapies tailored to combat the unique genetic makeup of their cancers.

A love for taking care of patients

Before attending medical school, Dr. Lye worked in the medical device business for five years.

“That served me well. It gave me a different perspective than someone who goes straight through school,” he said. “It has helped me communicate with patients.”

Dr. Lye said he never wavered from his plan to go into medicine.

“My love really is patients and taking care of patients,” Dr. Lye said. “The patient interaction is really what I wanted and what I focus on.”

He said he wants cancer patients in Kentucky to know they do not need to leave the state to get the best cancer care. Patients at Norton Cancer Institute have access to more than 100 specialists and 180 cancer-related clinical trials, offering the latest therapies.

“Norton Healthcare is a great place to get world-class care,” Dr. Lye said. “We do everything just as well as other major cancer centers, if not better.”

The post Proud Kentuckian providing lung cancer treatment to fight state’s worst cancer challenge appeared first on Norton Healthcare.

Driven by a love for history, aviation and the South Pacific, Dr. LaRocca participated in an expedition to Nikumaroro, an uninhabited island 1,500 miles north of Fiji. The trip marked the 80th anniversary of Earhart’s disappearance. It was led by The International Group for Historic Aircraft Recovery (TIGHAR) and sponsored partly by National Geographic.

In Fiji, Dr. LaRocca joined archaeologists, researchers, climatologists and retired pilots, plus four border collies trained to sniff out human remains. The group traveled five days by boat to Nikumaroro, where TIGHAR theorizes Earhart and her navigator, Fred Noonan, landed and later died.

The 4-mile-long, half-mile-wide island is surrounded by a coral reef. It’s densely vegetated and teeming with crabs, yet Dr. LaRocca found it beautiful.

“I know islands, and this one is truly special,” Dr. LaRocca said. He joked that expedition members voted him “the one most likely to stay.”

The team worked five days scouring the island for bone fragments and aircraft debris. Trained scuba divers checked the coral reef for wreckage, but were unable to find a large metal piece spotted during a former expedition.

Using logic, one day Dr. LaRocca found the previously discovered “Camp Zero,” where the famed aviators may have survived briefly. He looked from the shore to the point on the reef where the plane would have stopped and imagined a straight line to the nearest area of vegetation beyond the beach. There it was — an open area with a rusted oil drum, two piles of rock “seats”, and a stone fire pit. It is unproven, but possible, that Earhart and Noonan camped here.

Earhart’s mystery remains unsolved, but growing evidence supports TIGHAR’s theory. For example, numerous radio transmissions thought to have come from her aircraft were tracked for three days after her disappearance. In 1940, partial skeletal remains were found on the opposite end of the island.

Those remains were sent for testing and subsequently lost, however a modern forensic study of the finder’s notes concluded the bones were most likely a Euro-American female. As the search party worked the site where the lost bones were first found, the forensic dogs lay down several times to signal a “find.”

The group found no concrete answers, but collected material that is undergoing DNA analysis.

Dr. LaRocca sees parallels between practicing medicine and unraveling this mystery.

“Essentially, you’re using critical thinking to meticulously solve a complex puzzle,” he said.

He said he would love to be part of solving this puzzle and is actively working with his TIGHAR colleagues to return to Nikumaroro in 2019.

“Any takers?” he asked.

The post Cancer specialist looks to help solve Amelia Earhart mystery appeared first on Norton Healthcare.

Don A. Stevens, M.D., medical oncologist/hematologist and director of the Hematologic Malignancy Program at Norton Cancer Institute, was one of only two physicians in the country able to enroll patients in a national clinical trial to study the new medication.

The FDA granted accelerated approval of Aliqopa (copanlisib) on Sept. 18, 2017, to Bayer Healthcare Pharmaceuticals. Aliqopa is for patients who have received at least two prior rounds of treatment for follicular lymphoma, a slow growing, non-Hodgkin lymphoma.

According to Dr. Stevens,  follicular lymphoma often comes back even after multiple treatments. When this happens, treatment options are limited since patients tend to develop a resistance to previously used therapies. The new drug gives patients another chance.

“While there is some potential to recycle previously used drugs, most are less effective in subsequent courses of treatment,” Dr. Stevens said. “These patients have no cure at this point, so novel compounds like Aliqopa that offer a safe alternative are obviously good news.”

Norton Cancer Institute maintains a robust research program to give patients access to leading-edge therapies. This clinical trial (known as CHRONOS-1) included 104 patients with follicular B-cell non-Hodgkin lymphoma who had relapsed following at least two prior cycles of treatment.

New hope

Brenda Montgomery, a patient of Dr. Stevens from Carrollton, Kentucky, enrolled in the trial in February 2016. Active and healthy throughout her life, Montgomery never expected a routine checkup to lead to a nine-year battle with follicular lymphoma. She also never guessed she would be left with few treatment options after a relapse following her first- and second-line treatments.

“Aliqopa has given me new hope,” Montgomery said. “After nine years and several relapses, I’m still here, running my own business and enjoying life.”

The trial measured how many patients experienced complete or partial shrinkage of their tumors after treatment with copanlisib injections. Results showed 59 percent of patients had a complete or partial response. On average, the response continued for more than one year.

“The results of this clinical trial were very positive,” Dr. Stevens said. “Nearly 60 percent of patients who participated saw significant shrinkage of their lymphoma as measured by CT scans.”

Montgomery beams when she talks about her results: “My last scan showed I’m cancer-free at this point!”

Aliqopa received accelerated approval from the FDA because it filled an unmet medical need for a serious condition. Further clinical trials are required to confirm Aliqopa’s clinical benefit. As the trial sponsor, Bayer currently is conducting these studies.

Side effects of Aliqopa can include high blood sugar levels, high blood pressure, diarrhea and decreased general strength and energy. Low levels of certain white blood cells (leukopenia, neutropenia), nausea, lower respiratory tract infections and low levels of blood platelets (thrombocytopenia) also are possible.

According to Dr. Stevens, most of these side effects proved to be temporary or manageable.

Other potential serious side effects can include infections, inflammation of the lung tissue (noninfectious pneumonitis) and severe skin reactions. Women who are pregnant or breastfeeding should not take Aliqopa because it may cause harm to a developing fetus or newborn baby.

Follicular lymphoma is the most common indolent, or slow-progressing, form of non-Hodgkin lymphoma, a blood cancer that starts in white blood cells called lymphocytes.  Follicular lymphoma will account for one in five of the nearly 73,000 new cases of non-Hodgkin lymphoma that will be diagnosed this year. Each year, follicular lymphoma claims more than 20,000 lives.

The post Norton cancer specialist’s research paves way for new FDA-approved lymphoma treatment appeared first on Norton Healthcare.