Saturday, June 20, 2026

#ASCO26 The Primary Surgery vs NACT Debate

Today I will share information from the #ASCO26  session Let's Debate: Surgery Versus NACT in Advanced Ovarian Cancer , May 31, 2026 with  Dr Mahner- Surgery  and Dr Olawaiye NACT and Dr Bixel distilling the information. 

I posted this to X the day I viewed the session.   

 

Let me share a few other slides from the debate. 

 Dr Mahner shared information about the TRUST and other trials and then looked at real world data regarding surgery and NACT to reach his conclusion that primary surgery is preferred when certain conditions exist. 






Then Dr Olawaiye spoke about NACT - neoadjuvant chemotherapy in late stage ovarian cancer and reached this conclusion to support his position. 

 



Dr Bixel distilled  the data presented during the debate. She spoke of the use of different scoring methods to predict whether surgery was appropriate or not ( Peritoneal Cancer Index and Fagotti Score / Predictive Index Value) and then drew her conclusions. 

 



(There is an article by Dr Bixel in the ASCO Education Book  - https://ascopubs.org/doi/10.1200/EDBK-26-520652   - give a read for more details. )

The Key take away for me was:  

Shared decision making is key! Patient Factors ( frailty, co-morbidities etc)  and amount and location of disease must be discussed with patients. This way each patient is receiving the best treatment for their circumstances.  


Dee

Every Day is a Blessing! 

Thursday, June 4, 2026

Review of #ASCO26 - Gyn Cancer Oral Abstract Sessions, May 29th sessions

I did not attend ASCO in person this year but rather I watched sessions live.  When not available live I watched session On Demand the next day.  I continued the tradition I started when I attended meetings in person.  I posted on X (Twitter) summarizing and sharing slides from the presentations. 

The Oral Abstract Session for Gynecologic Cancers was held on Friday, May 29th. My focus what on ovarian cancer treatment research. ( Although there is one endometrial trial in this post) 

 Endometrial Cancer: Ruby Trial Dostarlimab + Chemo Abs 5501

 Ovarian Cancer  NRG GY018  Abs 5502

Ovarian Cancer ROSELLA trial  Abs 5503

 Late Breaking Abstract CHIPRO  LBA 5504

 Ovarian Cancer CHRONO Abs 5505

 

Distillation of these studies : 

Ovarian Cancer Phase 2 MIRV trial Abs 5506

 

I'll post over the next few days other ASCO sessions including - Rapid Oral Abstracts, Surgery vs NACT, and the Poster Session. 

Dee

Every Day is a Blessing!  

Friday, May 22, 2026

Looking Forward to #ASCO26

This year's ASCO Annual Meeting runs from May 29 - June 2, 2026 in Chicago. The theme this year is "The Science and Practice of Translation:Improving Cancer Outcomes Worldwide". 

I will be attending virtually, so I know I will experience FOMO when I see the postings by other cancer advocates on social media. I will not miss the long walks to get to sessions in the various buildings at McCormick. But I will miss meeting up with other cancer advocates in the ASCO Advocate Lounge and interacting with gyn cancer researchers who through the years have become friends. 

There are a few new ASCO Voices that I look forward to following this year on X including @DrBarbiOnc, @NazliDizman ,  @Ramila, @YGaritaonaindia  and @DrSAHAddad. I recommend you follow them too, 

I recently planned my attendance to focus on ovarian cancer session. 

Friday May 29  

Gyn Cancer Oral Abstracts 3:45-4:45 (ET)  Livestream 

Sat May 30 

Gyn Cancer Rapid Oral abstract Session 9am (ET)

Opening Session  Livestream 

ctDNA in Clinical Practice 9am Livestream

Rare Gyn Cancers 5:45 

Antibody Drug Conjugates 5:45 Livestream 

Sun May 31 

Let's Debate: Upfront Surgery Versus Neoadjuvant Chemotherapy in Advanced Ovarian Cancer

State of the Art: Therapeutic Strategies on the Horizon for Gynecologic Malignancies

Monday June 1 

New Horizons for Hereditary Cancer Syndromes  

Gyn Cancer Poster session  ( posters available day of session) 

 

I'm ready to listen and learn. 

If you are attending in person please use the #gyncsm hashtag in your social media posts. I'll be posting highlights from the meeting following ASCO. 

 

Dee Sparacio

Every Day is a Blessing! 


 

 

 

Thursday, May 14, 2026

Prompted by a hashtag!

For World Ovarian Cancer Day on May 8th this year, OCRA ran a campaign called #ReachForTheScars. OCRA's goal with this program was to spotlight the stories, experience and the physical visible and invisible scars of women with ovarian cancer .

We who have been diagnosed have scars that are visible - although we may choose to hide those and some scars that are invisible. Your life being on the line can be a stressful and dare I say traumatic experience for those diagnosed with ovarian cancer. So with these scars there are stories. Here is mine once again. 

For World Ovarian Cancer Day, I chose this year to do a quick watercolor painting of my scars as part of the #ReachForTheScars campaign. These scars are hidden under clothes most of the time. You will not see these scars since you won't find me wearing a bikini or crop shirts. 


The first scar was the vertical one, made in 2005. It came after an hours long surgery - hysterectomy, oopherectomy and debulking surgery for stage 3B high grade serous ovarian cancer. This one healed over time as I continued treatment with nine cycles of carboplatin and taxol. In 2006 there was no evidence of disease. 

I recurred in 2008. The lesions that appeared on my liver and spleen were discreet,  so surgery was an option. I had choices : chemo ( carbo / taxol again) first then surgery, chemo first then surgery or a clinical trial which included bevacizumab.  I chose the surgery first which was done by a surgical oncologist along with my gyn onc. That surgery is what led to my second scar, a  horizontal one.  The surgeon removed my spleen on the left side of my abdomen and resectioned the lower lobe of my  liver which was on the right side of my abdomen. Their removal at the same time is why my OC scars now look like a T. 

Along with other cancer survivors, I carry invisible scars too. I continue to fear a recurrence. The fear is not as strong as in the early years of my survivorship but there are times when news of another long term survivor recurring after 15 years brings it back into the forefront.  I deal with some neuropathy in my toes. I have learned to deal with it by buying shoes with larger toe boxes. I admit they are not the most fashionable shoes but they work for me. And let's not forget how I still forget the names of things.  Thanks chemo brain!

I had thought that those two scars would be my last but just this week I have gained a new one. In April, I pointed out a new pink rough spot on the back of my arm to my dermatologist. After a biopsy came back that the spot was basal cell carcinoma, I decided to have incisional surgery this week to have it removed . This scar will be more visible due to its location and may lead to people asking questions about it. That is OK though. Then I can tell them how important it is to check your skin and see a dermatologist if you see anything new or a spot that changes in appearance. As we head into summer -my advice is to wear sunscreen , hats and spf 50 clothing when out in the sun for a period of time. 

 Do you have hidden scars caused by ovarian cancer? Share them in the comments. 

 Dee

Every Day is a Blessing! 

 

 

Tuesday, April 21, 2026

News From the SGO Annual Meeting 2026

I was excited to be attending the marriage of my nephew in North Carolina the weekend of April 11th. At the same time, the SGO Annual Meeting was taking place in Puerto Rico. I have followed news from the SGO meeting for many years and been an active patient advocate member since 2020. I even attended a few annual meetings in person.  I always enjoyed learning about the latest research and making connections with gyn oncs, researchers and other advocate members. 

This year's meeting theme was "Advancing Science. Empowering Teams. Embracing Change". Since I did not attend the annual meeting in person I will share information from a number of different sources regarding ovarian cancer research presented that weekend.

MedPage 

Chemo Combo Wins in Ovarian Cancer, but Single-Agent Therapy Still in the Game-NRG-GY019
 
"chemotherapy plus letrozole as standard of care for low-grade serous ovarian carcinoma (LGSOC), as letrozole monotherapy failed to meet non-inferiority requirements for progression-free survival (PFS). However, a subgroup analysis showed a 50% reduction in recurrence with single-agent letrozole in patients who had no gross residual disease after surgery. Analysis of that subgroup -- comprising almost two-thirds of the patients randomized to letrozole monotherapy -- yielded a hazard ratio (HR) within the non-inferiority range." 
 
Novel Regimen Boosts Survival for Recurrent Platinum-Resistant Ovarian Cancer
 https://www.medpagetoday.com/meetingcoverage/sgo/120748
 
"Adding the glucocorticoid receptor antagonist relacorilant (Lifyorli) to nab-paclitaxel improved median overall survival (OS) by 4 months versus nab-paclitaxel alone. The regimen received FDA approval in March on the basis of an improvement in progression-free survival (PFS)." 
 
  

 

Article from The Gynecologic Oncology Journal  @gynoncjnls

Identifying ovarian cancer with AI analysis of abdominal CT scans
Conclusion:
"Deep Learning using segmented abdominal-pelvic CT scans, particularly convolutional neural networks-based architecture, demonstrate strong potential for distinguishing Epithelial Ovarian Cancer (EOC)   from benign pelvic masses. Further studies are needed to create accurate Deep Learning models for early EOC detection. "

SGO Meeting News https://www.sgomeetingnews.org/ 

Mirvetuximab soravtansine plus carboplatin in folate receptor alpha-expressing recurrent platinum-sensitive ovarian cancer - late breaking abstract 

"The study included 125 patients with measurable, recurrent FRa-expressing PSOC and one prior line of platinum-based chemotherapy. ...MIRV plus carboplatin in recurrent  platinum-resistant ovarian cancer (PSOC) with an FRa greater than or equal to 25% can be safely administered with minor dose modifications and proactive adverse event management. It also achieved favorable objective response rates and progression-free survival rates, showed comparable efficacy to pre-poly (ADP-ribose) polymerase (PARP) inhibitor era benchmarks, and established the safety and efficacy of continuing MIRV after carboplatin for the first time.  The study suggests it can also be safe and effective to combine with carboplatin in the treatment of PROC, and to continue administering MIRV as a maintenance therapy after treatment with carboplatin."

A Clearer Signal in Ovarian Cancer 
https://www.sgomeetingnews.org/home/article/22964575/a-clearer-signal-in-ovarian-cancer 
 
"Emily O'Brien, MD, reported on the clinical performance of a ctDNA whole genome assay in patients with Stage III and IV ovarian cancer undergoing neoadjuvant chemotherapy (NACT), interval debulking surgery (IDS), and adjuvant chemotherapy (ACT).  ...The study followed 15 patients with advanced-stage, high-grade serous ovarian cancer treated between 2022 and 2024. ...Patients with persistent ctDNA positivity were more likely to have platinum-resistant or refractory disease, while one patient with platinum-sensitive recurrence demonstrated transient ctDNA clearance before becoming positive again at recurrence, suggesting ctDNA may capture evolving tumor biology in real time." 
ctDNA is still investigational and more testing needs to be done but there is promise that the clearance of ctDNA could lead to more personalized treatment. 

 If you attended the meeting please share in the comment section which studies you found most impactful to patient treatment. Thanks.

 Dee

Every Day is a Blessing! 

 

Thursday, March 5, 2026

Why Do You Write?

I just read a post Tiny Stories: Why I Write by my friend, Marie Ennis-O'Connor  She wrote her piece because of a prompt suggested by Linda Caroll  https://substack.com/home/post/p-189895052 to write a tiny story no greater than 250 words. 

Here is my response to that same prompt. 

I write because back in 2005 I was diagnosed with stage three ovarian cancer. And I felt alone. I had surgery , chemotherapy, and countless scans and tests. I spoke on the phone to one survivor of  ovarian cancer during my treatment. It was almost a year later until I met in person a survivor of ovarian cancer. 

At first when asked to share my story I said no.  

Then my gynecologic oncologist shared information about the LiveSTRONG Summit with me. I was lucky to be chosen to attend. I came home feeling energized and ready to share my story and advocate for a screening test for ovarian cancer. 

In December of 2007, I started writing this blog. I  shared how it felt to be a survivor of a cancer that I had only a 30% chance of surviving 5 years. I talked about research. When I had a recurrence I shared the good and the bad - the surgery, loosing my hair again,  the severe allergic reaction to carboplatin and the neuropathy.  I wrote to share information about ovarian cancer with women in my state and the world. Through this blog, I  met women  and their caregivers in the US, UK and Canada through this blog. 

By writing , I no longer felt alone. But even better than how I felt,  I knew I was reaching other women and supporting them. 

It is now nineteen years and I am still writing and making connections and feeling a part of a larger community and I am still advocating for research to develop a screening test for OC. 

Dee

Every day is a blessing! 

Friday, January 16, 2026

Beyond Being a Best Friend

It was August of 2010,  a little over a year since finishing treatment for my recurrence.  My husband and I started talking about getting a dog. Our son had taken his hound dog, Murphy back to graduate school with him. 

For us it was a bit risky. Taking on a puppy being just one year out of treatment for my recurrence made me a bit nervous. If I had to go back into treatment was that fair to the dog. I had recurred two years after finishing initial treatment for ovarian cancer and the science said if I might recurred it most likely would be sooner. I really didn't know what the future held but we decided to give dog ownership another try. 

Once we decided to adopt, we visited the ASPCA in the next county. I wanted a Cavalier King Charles size dog. My husband was open to any medium sized dog and we both knew we wanted a dog with a long nose. Our two prior dogs were a Boston  Terrier and a Pug. 

We found a smaller hound dog named Kelsey and asked to spend some time with her. We went into the play yard and played catch. She sat when I said sit.  She seemed to be a fun and well tempered dog. When we said we wanted to adopt her, we were told we could not because we did not have a fenced in yard. We live in a 55+ community and not allowed to fence our property. They said sorry. We said we were retired and could walk her multiple times a day. They said sorry we can't allow you to adopt her. We were disappointed to say the least. 

The next month on a Sunday we decided to go for a ride with no actual destination in mine. We would pick a different road to travel down to explore the area around our home. We didn't know that we would be finding our new best friend that day. 

We came home from that road trip with a new dog, complete with a longer nose and floppy ears. We were told she was a  a lab /beagle mix. We named her Amber because of the Amber areas on her white body.  Little did I know how important a role Amber was to play in my life after cancer.

When we brought her to the local vet for an exam he was positive she was a Jack Russell Terrier mix.  He recommended that she go for obedience training at a local kennel that trains dogs and owners. The Vet also told us don't be surprised if her ears end up pointing up . And that is exactly what happened.

After the obedience class, we were given the opportunity to try out some agility equipment. Amber loved the tunnel - she ran right in . Then she jumped on the table. ( Yes, this is allowed in agility.) Those moves changed her life and mine. 

We started to train to do agility. What fun we had. No one there knew I was a cancer survivor until years later. These classes allowed me to do something totally unrelated to my cancer diagnosis. It gave me time to not worry about a recurrence or think about cancer. Instead I was worrying about if Amber cleared the jump or made contact at the end of the A frame. We registered Amber with the AKC as a All-American Dog. Her full AKC title was Amber of Ashton. After she was measured (18"), we were able to compete.  

Oh what fun we had. We were no way as fast as those Border Collies but we were partners. I called her Ams and she kept me to my promise of cheese or hot dogs after running the course. We competed outside at horse parks and inside at sports arenas from Staten Island to Gloucester County, NJ. And we met lots of other amazing canines and their handlers. Friendships formed. We cheered on our friends who competed on the national level in agility at Westminster. 

 

She was my confidant. I could tell her when I was worried about a test result and why I was sad. When ladies with ovarian cancer would ask me what I did when I had scanxiety ,waiting for CT or CA-125 test results, I would say I take my dog on a long walk. And that is exactly what I would do. When Nick had surgery she made me feel safe at night and that everything would be OK. She was the best listener.  

Then she developed a calcium issue cause by an enlarged parathyroid. We stopped competing for a bit after her surgery this happened to coincided with Covid. We competed a few times in 2021 and then she was diagnosed with Cushings Disease and we retired. ( She did achieve the AKC Excellent title in Jumps with Weaves.) 

Amber loved to  travel. We would put on her harness and she knew she was going for a ride in the car. She was welcome at family and friends homes across the country from PA to Kansas to North and South Carolina, Georgia and Alabama.  She was a great traveling dog. 

 

We took lots of long walks around the town and then shorter ones around the neighborhood as she and I aged. 


She lost her mobility and her hearing, was having kidney and liver issues along with the Cushings. We had conversations with her vet about her health and quality of life. 

Yesterday, after 15+ years my husband and I said goodbye to our best friend. She was so much more than a pet. She was a special girl who helped me get through some rough times. I am heartbroken. 


But, I have wonderful memories of all our adventures in the rink and on the road.  She was good for my soul and my survivorship.  

I wrote about Amber a few times in my New Year Aspiration blog posts and when I discussed being grateful as well as this one about Parallels ( https://womenofteal.blogspot.com/2022/07/parallels-in-life.html ) 

 

Dee 
Every Day is a Blessing! 


Friday, January 9, 2026

Hello 2026!

We are one week into the New Year. I hope my readers have had a good start to 2026. 

Through the years I have always started my year off with a blog post of aspirations for the New Year. Those who know me know that I don't make resolutions. This way when things don't work out I don't have to be hard on myself. 

 But this year I'm going to try something a bit different. I am going to aspire to only one thing - to be "present". That's it. I have found myself rushing around, getting interrupted by a text or a call ( which usually isn't urgent)  or letting myself be sucked down the rabbit hole of social media - be it on Facebook or X or Pinterest or Instagram. Then I wonder why I feel stressed about having so much to do. 

So what does this being "present" look like for me?
I am going to focus on what I am doing at the time I am doing it. 

When I am playing pickleball, I will focus on my play not what I will be doing later that day. 

When I am walking Amber I will concentrate on my time with her. Checking on nature and listening to the sounds around me.  Not checking my phone. 


When I am reading I will try not to be distracted. Not always easy when Nick is watching TV in the same room. 

When I am speaking to friends and family,  I will keep my phone in my pocket on silence. 

When I set aside time to do my art, I will turn on some music and try to place all the other things I have to do out of my mind. And if I mess up a painting ( those watercolors mix so easily if I am not patient) so be it.  No harm in trying again. 

When I am focusing on growing in my faith - I will find a quiet spot and work on the bible study that I am doing or pray. 

When I am working on my advocacy work I will concentrate on the task at hand - reviewing grants or sharing new research results on X or Instagram. ( This one will be difficult. I start reading posts from the the organizations or people I follow on X and find myself to scrolling.  Bam ... 20 minutes go by and I've shared one post about ovarian cancer. 

When I am doing volunteer work with my local historical society, I will try to focus on my roles. 

So you might wonder how those aspirations for 2025 work out. I was pretty successful at most of them although in my cancer advocacy work I did accept a position on the State's Survivorship Workgroup and no surprise,  I still have not visited Maine. But there is always this year.  

 Wishing everyone a Happy and Healthy 2026! May your presence light up the world. 

 Dee
Every Day is a Blessing!  
 

 

Sunday, December 21, 2025

Friendships, Joy and an Anniversary

Past December posts have included photos and stories about the ornaments on my tree. This year there are three new additions and they each bring their own story.  

This year's Mount Vernon ornament is of George Washington kneeling in prayer. Over the course of 2025, I have said many prayers for friends and family members. Those Prayers were not always answered.  Over the past few days,  the losses I experienced break through the festivities and happy times and tinge it with sadness. 


The next ornament was from a friend of 30+ years. This time of year, the value of those long time friendships means so much. This friend came from a time before cancer and has remained by my side when I was diagnosed and is still part of my life's journey today.  It sounds cliche' but those friendships are a blessing. 


Since my cancer recurrence I moved to a small  55+ community. The move 15 years ago has brought new people into my life. These neighbors have become friends. We go out to dinner regularly,  we play pickleball and hang out at the pool and laugh and share our reviews of the new restaurants in town. They haven't walked my entire cancer cancer journey but they have added a sparkle and joy to my life. One of these new friends gave me the ornament you see below.

 

I hope that your friends, old and new, will bring you JOY this holiday season. 

On December 30th, I celebrate the 18th Anniversary of this blog. I am not as consistent now as I was during the first ten years of blogging to post but please stick around! In the new year, I'll be writing posts on newly approved FDA drugs for treating ovarian cancer, antibody drug conjugates currently in clinical trials and the importance of biomarkers and genetic testing in cancer patients. 

Wishing you all a Happy and Healthy New Year. See you in 2026!

 

Dee

Every Day is a Blessing!  

Friday, December 5, 2025

Finding our WAZE

I haven't written a blog post in quite some time. It seems that life got in the way of my writing. Then, once I had time,  I couldn't seem to find the spark to get me writing, until yesterday. 

We were heading out to an appointment and set up Carplay to use Waze on the built in screen in my husband's car. That got me thinking about how I found my way to different places when I first learned how to drive. This was many years ago, so what follows might not make much sense to some of my readers and for others - yes, we are that old! 

I would ask my Dad for one of his ESSO road maps.  I'd look up the street coordinates and using  the rows and columns, find my destination. Then I would plan my route. I'd usually write down the directions -  Take Route 22 till Route 82 and go north etc. I would bring those notes in the car with me and off I went. I tried to gauge how long it would take based on how far away my destination was. If there was road work I'd just have to hope they had detour signs telling me where to go. And if there was traffic, I'd just sit in it. I wouldn't take other roads because I wasn't sure if they would take me closer or further from destination. 

Yesterday process for directions was different. We plugged in the address in the app and the screen in the car  highlighted our route in blue on a map as a voice gave us directions. The screen showed us our speed and our arrival time. As we drove, I saw so many other Waze users ( cute little icons)close to our route. Most were getting on or off the NJ Turnpike. Then the app gave us notifications about two cars on the shoulder of the road. These notifications came way before we even saw the vehicles. This happens because other Waze users tell the app they just passed a disabled car on the shoulder or they saw a police car.  The app also told us how far it was to our next turn. And soon it told us we had arrived at our destination on the right. 

Now you might ask why am I talking about directions and traffic alert applications.  What did this have to do with cancer? Over the past 20 years, I have gone from reading books about ovarian cancer, seeing brochures about peer support programs in my gyn oncs office and looking at flyers about support groups on the bulletin board in the waiting room. Just like using a paper map to find a location. 

Today, I read published journal articles about ovarian cancer online the day they are published.  I interact with fellow survivors and health care professionals on various social media platforms from Inspire and Smart Patients to Facebook, X and BlueSky. The ability to find support and information online is like those fellow Waze drivers giving me an update of traffic ahead. Those drivers have already experienced the traffic accident and can warn me of what lies ahead. Just as there are fellow cancer survivors who can act as a "driver" to tell me what side effects to expect when in chemo, what it is like being in a clinical trial or how important it is to have genetic testing.  

I know we do have cancer centers and organizations that offer resources and support such as  OCRA, FWC, SHARE, FORCE, Cancer Hope Network, and others. But are those resources readily available to all women with a gynecologic cancer as easily as those drivers on Waze can warn me of cars on the shoulder?  Or are women turning to AI or Dr Google to find answers?   We all know that some sources can be misleading and offer solutions that may even be harmful. 

So lets all make an effort to have information available for women diagnosed with gyn cancers and make sure that information is from reliable and accurate sources.  We can help "drive " and support the experience of women with cancer. 

 

Dee 

Every Day is a Blessing  

 

 

 

Tuesday, September 16, 2025

#GCAM Diagnosis and Types and Stages of Ovarian Cancer

I spoke about how there are symptoms of ovarian cancer( gloating, freq urination etc) in my previous post. What happens when you go to your gynecologist or primary care physician with these symptoms? Your doctor may image your pelvis with an ultrasound. If something is abnormal you may have a CT or MRI. You also may have a blood test for a protein in the blood called CA-125. The marker is raised in most serous ovarian cancers ( I'll discuss the types a little later in the post) but it may not be elevated  in other types . It can  also be elevated if the women is still menstruating which is why the CA-125 is not used as a screening test for ovarian cancer. The Foundation for Women's Cancer has an informative book on CA-125 ( https://foundationforwomenscancer.org/wp-content/uploads/2023/07/FWC_CA-125-Levels-Your-Guide.pdf )

If these test come back abnormal it is important to see a specially trained gynecologic oncologist. Studies show that survival rates for women treated by a gyn onc are higher than those who have treatment.   

Staging OC 

It is important to know if the cancer has spread from the ovaries to other areas of the pelvis or abdomen. Two organizations the  International Federation of Gynecology and Obstetrics and the AJCC  (American Joint Committee on Cancer) have systems for staging called the FIGO and TNM staging systems.  Both look at the size of tumors,  Lymph node involvement and spread beyond the ovaries. 

The stage is determined by the amount of spread and size of  tumors. 

 Below is a diagram of the stages from FWC. 


 Types of OC 

 The most common type of ovarian cancer ( 85%) is Epithelial ovarian cancer. The develop on the Fallopian tubes or on the surface cells of the ovaries. These epithelial cancers can be from mutations in the BRCA1 or BRCA2 genes. Epithelial ovarian cancer can be high grade or low grade. Knowing the difference provided information to develop the best treatment. There are a number of histological ( structure at the cell level) subtypes of epithelial ovarian carcinomas :

Serous - most common type may be high grade or low grade 
Endometriod 
Clear Cell
Mucinous
Transitional Cell  

 

Germ cell cancers make up about 5% of OC diagnosis. Germ cell cancers start in cells that are found in the follicles or eggs in the ovary. Usually adolescents or young women develop this disease.   

Teratoma
Dysgerminoma
Immature Teratoma
Yolk Sac tumors 
Mix germ cell tumors 

Sex cord- Stromal Cell Cancers develop in the cells that produce female hormones ( such as estrogen). 

It is important when treating ovarian cancers that information about the histology, molecular structures and morphology be considered. 
 
Next week I'll share resources on Treatments. 
 
 
Dee
Every Day is a Blessing!  

  

 

Sources https://foundationforwomenscancer.org/gynecologic-cancers/gynecologic-cancer-types/ovarian-cancer-primary-peritoneal/ 

https://www.cancer.org/cancer/types/ovarian-cancer/detection-diagnosis-staging/staging.html

https://pmc.ncbi.nlm.nih.gov/articles/PMC8774015/ 

https://my.clevelandclinic.org/health/diseases/6186-ovarian-germ-cell-tumors 

https://www.mskcc.org/pediatrics/cancer-care/types/germ-cell-tumors-sex-cord-tumors

Tuesday, September 9, 2025

#GCAM Ovarian Cancer Risk Factors

Since there is no screening test for ovarian cancer understanding your risk for the disease is important. 

Family history is a strong risk factor for being diagnosed with ovarian cancer. 

Does your family - mother, sibling or daughter have ovarian cancer?  According to the American Cancer Society your risk is 4 times the general population. If your mother, sister or daughter has been diagnosed with breast cancer your risk is increased by 70%. This increased risk is due to mutations in the BRCA1 and BRCA2 genes. If you are of Ashkenazi Jewish ancestry you have a 1 in 40 chance of having a BRCA1 mutation placing you at risk for ovarian cancer and breast cancer. There are a number of online resources that can help you have that conversation with relatives about family history. The CDC has an app My Family Health Portrait: Cancer app you can use to collect family history.

Other risk factors for ovarian cancer include:

Lynch Syndrome ( 12% lifetime risk of ovarian cancer)  

Your history of other cancers( breast, uterine, colorectal) 

Your history of endometriosis ( Associated with Low-grade serous carcinoma, Clear cell carcinoma, Mucinous carcinoma, Endometrioid carcinoma)

Age ( the median age of diagnosis is 63)

Early menstruation, no childbirth,  child birth after 30 , no oral contraceptive use  and infertility 

Obesity

  

We may not be able to prevent cancer but there are ways to reduce your risk of ovarian cancer? 

If you use oral contraceptives for five years you can reduce your risk by 50%. Multiple pregnancies ( ovulating less)  and pregnancy before 26 years old can also reduce your risk. 

Another way to reduce risk is to have your Fallopian tubes removed. Many High grade serous ovarian cancers originates in the Fallopian tubes.  The surgery to remove the Fallopian tubes when done during another gynecologic surgery such as a hysterectomy is called opportunistic salpinectomy. This surgery leaves the ovaries intact. 

For women with a BRCA1 or 2 genetic mutations risk can be reduced by having a  bilateral  salpingo-oopherectomy where the fallopian tubes and ovaries are removed surgically. Primary peritoneal cancer may still occur after this surgery but it is rare. 

Sources : https://ocrahope.org/for-patients/prevention-risk/ , https://www.cancer.org , https://www.basser.org/brca/brca-ashkenazi-jewish-community

 In my next post I'll talk about diagnosis and types of ovarian cancer. 

 Dee

Every Day is a Blessing! 

Thursday, September 4, 2025

#GCAM Symptoms of Ovarian Cancer

I follow the Foundation for Women's Cancer and loved the design of this graphic for #GCAM. I would change the hashtag #ASKHER to #ASKME. 

Image 

 

There is NO screening test for ovarian cancer. That is why it is so important for women to know the symptoms of the disease. If these symptoms last more than 2 weeks please see your gynecologist. 

bloating, 

urinary symptoms (urgency or frequency), 

pelvic or abdominal pain,

 difficulty eating or feeling full quickly

Mentioning the pain I was having on the left side of my pelvis to my gynecologist during my annual exam made a difference in my life. I thought it was nothing - a pulled muscle maybe. But she knew it didn't sound right and she sent me for a transvaginal ultrasound.  I was on my was to a diagnosis. 

Next post will be about Family History and Risk Factors for Ovarian Cancer. 

Dee

Every Day is a Blessing! 

Monday, September 1, 2025

September is OVARIAN CANCER AWARENESS MONTH

I am not sure where the month of August went and here we are starting September. If you have followed me for any period of time you are probably already aware that September is Ovarian Cancer Awareness Month. Teal is the awareness color for ovarian cancer. 

Teal Awareness Ribbon for Ovarian Cancer Awareness Month 

 Let me start with these important facts:

There is no screening test for ovarian cancer. 

Approximately 20,890 women will be diagnosed with ovarian cancer in the US in 2025. *

Approximately 12,730 women will die in the US in 2025 due to  ovarian cancer.* 

 

I have been an advocate for ovarian cancer research for 15+ years While we have made strides in treatments( VEGF inhibitors, Anti-body drug conjugates,  immunotherapies) there is no cure.  That is why raising funds for research is so important. 

This year due to NIH funding cuts raising awareness of ovarian cancer and more importantly funds for research take on a greater urgency. I will be posting symptom and risk information as well as other resources throughout the month in my small effort to raise awareness.  

I will be raising funds for research this year by walking on Sept 28, 2025 at the Kaleidoscope of Hope Ovarian Cancer Foundation walk at Loantaka Brook Park in Morristown. Join me, my family and friends as we walk as Team Determined. We are walking to honor the memory of a dear friend, Mary Lu, who passed away in July due to ovarian cancer. Donate to Team Determined at https://www.classy.org/team/766060

If you live in other areas of the country, check to see if there will be walks or other fundraising events being run by ovarian cancer organizations by you. Or donate to support research through OCRA or Foundation for Women's Cancer .

Thank you in advance. 

 Dee

Every Day is a Blessing!  

* https://www.cancer.org/cancer/types/ovarian-cancer/key-statistics.html

 

 

Tuesday, July 29, 2025

Grateful for Ten million , five hundred and ninteen thousand, two hundred minutes

The song, Seasons of Love from the Broadway show, RENT is a favorite of mine. 

"Five hundred twenty-five thousand six hundred minutes.
Five hundred twenty-five thousand moments so dear.
five hundred twenty-five thousand six hundred minutes.
How do you measure,
Measure a year?"

For this year's Cancerversary the verse might read...

"Ten million , five hundred and nineteen thousand, two hundred minutes.
Ten million , five hundred and nineteen thousand, two hundred moments so dear.
Ten million , five hundred and nineteen thousand, two hundred minutes. 
How do you measure, 
twenty years?"

Here's how I would measure the past twenty years. 

It all started counting on July 29, 2005.  I woke up from surgery and heard Dr Rodriguez, my gynecologic oncologist say to me " I am sorry Dee, you have stage 3B ovarian cancer. I will do everything I can to make you well. " My plans for my future changed in an instant on hearing those words. 

Those early months included a phase 1 clinical trial,  nine cycles of chemotherapy, fatigue, neuropathy, loosing my hair and so many blood tests and scans. My chemo schedule took over my life. I never knew if low blood counts would cause chemo to be postponed and how that would impact time with family and friends.   I missed out on many family gatherings.  I worried if I would survive a year, let alone five years. (Only 30% of women diagnosed with late stage ovarian cancer live five years. ) I was thrilled when I was able to attend my niece's wedding in May of 2006.   I finished treatment disease free with the help of my wonderful gynecologic  oncologists, Drs. Rodriguez and Gibbon and the caring nurses and staff at Rutgers Cancer Institute. My family and friends were there every step of the way. 

In 2006, Dr. Gibbon set me on the path of ovarian cancer advocacy by suggesting I attend the LiveStrong Survivors Summit in the Fall of  2006.  I came back with a plan to start a gyn cancer survivors support group at my cancer center , started writing this blog and began volunteering with a local non-profit , Kaleidoscope of Hope Ovarian Cancer Foundation to raise funds for research and awareness of the disease. 

Hanging teal ribbons at the Cancer Center

I went back to my high school teaching job. I was happy to work at a school where I had the support of the administration and  fellow staff members during my treatment and on my return.  

After missing so many family gatherings during treatment, the next  two and a half years included many wonderful times.  We visited my son in Switzerland where he spent his Junior year abroad. There were also graduation celebrations including my son graduating college, my daughter graduating with her masters degree and latter that May she was married.

At the two year mark my follow-up plan was to have a CT scan , CA-125 blood test and check-up every 6 months. In late 2008, a follow-up CT scan, showed a recurrence on my liver and spleen even though my CA-125 was normal at 17. At the time, I was upset knowing I would once again be disrupting the family schedule and plans with my treatments. But I also felt somewhat at ease since I was familiar with the cancer center nurses and staff and knew the side effects of taking carboplatin and taxol.  I decided to have surgery to remove my spleen and resection my liver in November followed by 6 rounds of carboplatin and taxol chemotherapy starting in January. I experienced one stumbling block though during chemo.  On my second chemo (eleventh chemo overall) I had a severe allergic reaction to carboplatin where I ended up in the hospital and had a Cardiac catheterization.  Thankfully my heart was functioning properly.  I finished the last four chemo cycles with taxol only even though it caused an increase in the neuropathy in my toes and led to toe nail loss.  In the spring of 2009, I was disease free once again. My husband and I celebrated by going on a cruise to Alaska with our Rutgers Football tailgating friends. 

As time progressed, I wondered when my CA-125 would rise to 35 , a signal my cancer may have returned or when a CT scan  would show a recurrence. I stressed at every scan and follow-up oncology appointment.Scanxiety is real!  Many survivors talk about finding a new normal. For me I think of it as a different normal. 

Being diagnosed with ovarian cancer and being in treatment was hard, scary and physically challenging. My faith helped me through so many rough patches as did so many of the survivors I met online especially those ladies on the ACOR listserve.  I won't say having cancer was good or a blessing. Rather my cancer diagnosis lead me to travel down a different path that of cancer research advocate.

 
Connections to other LiveStrong advocates led me to the Research Advocacy Network and MedX. A friend started #bcsm ( Breast Cancer Social Media) on Twitter ( now X). I met Christina Lizaso , an ovarian cancer advocate on a #bcsm chat about fear of recurrence and together we started the #gyncsm ( Gyn Cancer Social media ) chat and community on Twitter. We offered support, shared information and connected cancer survivors, caregivers and gyn oncs, researchers and other health care providers during chats.  Interacting and working with some of the top ovarian cancer gyn oncs on Twitter/X opened doors I didn't know patients or survivors could open. The #gyncsm community partnered with researchers and published papers on the needs of women with ovarian cancer,  gynecologic cancer caregiver support services and the needs and perspectives when considering PARP inhibitors. I provided the patient voice for two editions of a book I co-authored with Dr Don Dizon. I became an ASCO ( American Society of Clinical Oncology) member and served on the clinical practice guideline committee as well as on three ASCO guideline panels (Anti-emetics, Neoadjuvant Chemotherapy for OC and Germline and Somatic testing). I joined SGO and served on their Communication Committee. Some of the best moments in my advocacy work was presenting at two ASCO Annual meetings (a Fireside chat and a Social Media as an Educational Tool presentation) and working with other advocates on two abstracts accepted for presentation at the SGO Annual meetings in 2023 and 2024. 

After my Fireside Chat presentation with Dr Dickson at ASCO 2019.
 

Since my recurrence, I have been able to be a part of so many joyful and fun events.   I shared the joy of the birth of my two grandsons, my son's wedding and when he was awarded his PhD. My children led me to travel more too. I visited Australia with my son when he gave a presentation there and flew to Fiji to visit my daughter when she lived there with her family. 

In 2010 we welcomed Amber a mixed breed dog into our home. Her high energy level lead to our participation in dog Agility. It was a sport I knew nothing about but it has lead to amazing friendships. 

As you can see from reading this post that I have been blessed to measure twenty years. 

Today, July 29, 2025 I am most grateful for the compassionate, excellent care provided by my gynecologic  oncologists and their nurses, the love and support of my husband, my children, their spouses and grandsons and the prayers and support of my friends. 

Dee 

Every Day is a Blessing.  

Monday, June 23, 2025

The Needs of Cancer Survivors in NJ

I am pleased to serve as a member of the NJ State Cancer Coalition Survivorship Workgroup. This month we have been sharing a information about survivorship, quotes from survivors and resources on social media ( Facebook, X, BlueSky, Instagram) Our group is committed to addressing the needs of cancer survivors and their caregivers in our state.  

To help us better understand those needs, we invite survivors and caregivers in NJ to share your perspectives in a short 3-5 minute survey. We are interested in learning what types of information, resources and support you find meaningful as well as the topics that matter most to you. 

The survey is completely voluntary and confidential. Your responses will be anonymous, used for planning purposes only and no identifying information will be collected.

For this Survey, survivorship is defined as beginning at the time of diagnosis and continuing throughout your lifetime.

 

http://healthsurveys.nj.gov/NoviSurvey/n/zz4hf.aspx 

 

 


 

 Thank you for participating. 

 

Dee

Every day is a Blessing !  

 

 

Sunday, June 15, 2025

Looking Back at #ASCO2025 Research

It has been a busy June for me with family and personal commitments. I was able to attend the ASCO annual meeting virtually and have picked studies I found interesting to share with you.  I'll start with two studies that were not gyn cancer focused.  

1) A randomized phase III trial of the impact of a structured exercise program on disease-free survival (DFS) in stage 3 or high-risk stage 2 colon cancer: Canadian Cancer Trials Group (CCTG) CO.21 (CHALLENGE).  lba 3510 

This was a phase 3 trial of 889 patients with stage III and high-risk stage II colon cancer. Half the patients received a structured exercise program working with a physical activity consultant twice a month for coaching sessions and supervised exercise sessions . After six months they met with the consultant once a month. The other half of the group received educational materials on exercise and nutrition. 

Conclusion:" ... exercise program initiated shortly after completion of adjuvant chemotherapy improves disease free survival, overall survival, patient-reported physical functioning, and health-related fitness. Health systems should incorporate structured exercise programs as standard of care for this patient population." 

My Take:  I'm happy to see a randomized clinical trial of exercise show results that improved overall survival. More info https://www.asco.org/about-asco/press-center/news-releases/movement-medicine-structured-exercise-program-challenge

 

2) Glucagon-like peptide-1 receptor agonists (GLP-RAs) and incidence of obesity-related cancer in adults with diabetes: A target-trial emulation study.

The study of 85,015 adult patients from 43 U.S. health systems investigated whether GLP-1RAs reduce the risk of obesity-related cancer in adults with diabetes and obesity compared to dipeptidyl peptidase-4 inhibitors (DPP-4is), a weight-neutral class of diabetes medication. 

Conclusion: GLP-1RAs were associated with a lower risk of obesity-related cancer compared with DPP-4is in a large, real-world cohort of patients with diabetes and obesity. 


 My take: Women in the study who used a GLP  had an 8% less chance of developing obesity related cancers. Could use of GLPs impact the number of women diagnosed with endometrial cancers? https://www.moffitt.org/endeavor/archive/glp-1-drugs-may-lower-risk-of-obesity-related-cancers-in-people-with-diabetes/

 

3) ROSELLA: A phase 3 study of relacorilant in combination with nab-paclitaxel versus nab-paclitaxel monotherapy in patients with platinum-resistant ovarian cancer (PROC) (GOG-3073, ENGOT-ov72).

Relacorilant is an investigational, oral, selective glucocorticoid receptor antagonist (SGRA) that increases tumor sensitivity to chemotherapy-induced apoptosis.Patients were randomized  to either relacorilant (150 mg the day before, day of, and day after nab-paclitaxel) + nab-paclitaxel (80 mg/m2 on days 1, 8, and 15 of each 28-day cycle) or nab-paclitaxel alone. 
Patients in the Relacorilant arm had progression free survival(PFS) of  6.54 months compared to patients in the nab-paclitaxel arm with PFS of 5.52 months. At the Interim analysis the overall survival (OS) for those in the Relacorilant arm was 15.97 months  versus the nab-paclitaxel arm of 11.50 months, which is clinically meaningful. It was found that patients in the relacorilant arm had less ascites. Adverse events:
 

 
Conclusion  "Relacorilant + nab-paclitaxel is the first treatment regimen to demonstrate a PFS and OS benefit in patients with PROC compared to a weekly taxane, the most efficacious comparator. These positive efficacy data and a favorable safety profile position relacorilant + nab-paclitaxel as a new standard for patients with PROC, without the need for biomarker selection."
 
My take: So many studies show good PFS numbers but then end up at final analysis showing no significant difference in overall survival. While there is a meaningful difference  at this point, and it looks promising we'll have to wait for those final numbers to say if this will change care. 
 
 

4) A phase II trial of pembrolizumab and lenvatinib in recurrent or persistent clear cell ovarian carcinoma ( CCOC) (NCT05296512).

This study was a single-arm two-stage phase 2 trial to investigate the clinical activity of the combination of the PD-1 inhibitor pembrolizumab with the anti-angiogenic tyrosine kinase inhibitor lenvatinib in patients with CCOC. The study combined an immune checkpoint inhibitor and an anti-VEGFR inhibitor. There were  Seventeen of the 30 patients enrolled were alive and progression free at 6 months. No Grade 4/5 adverse events. 
 
Conclusion :"The combination of pembrolizumab/lenvatinib demonstrates encouraging evidence of clinical activity in CCOC, with 9 pts experiencing a confirmed response and 16 pts alive and progression-free at 6 months. "
 
My Take: CCOC is a rare cancer and this combination seems promising. I look forward to the results of a Phase 3 trial. 
 

5) TRUST: Trial of radical upfront surgical therapy in advanced ovarian cancer (ENGOT ov33/AGO‐OVAR OP7). LBA5500


This study was an international randomized multicenter phase III trial in patients with stage IIIB-IVB OC and good performance status (ECOG 0/1) comparing primary cytoreductive surgery (PCS) followed by 6 cycles of intravenous (iv) chemotherapy to 3 cycles of neoadjuvant iv chemotherapy (NACT) followed by interval cytoreductive surgery (ICS) and 3 further iv cycles.  Medium PFS was 22.1 months for the PCS arm and 19.7 for the ICS arm. Medium OS was 54.3 for the PCS arm and 48.3 for the ICS arm. 
QOL:

 
 

Conclusion "In expert centers with proven surgical quality, PCS followed by iv chemotherapy resulted in a significantly longer median PFS and a numerically longer OS compared to NACT/ICS in non-frail OC pts." Statistical significance in the primary endpoint  which was overall survival was not reached. 

My Take: It has been known for some time that having surgery by a gyn onc at an expert / NCI center provided better results for women diagnosed with ovarian cancer. Better results were also found when the smallest amount of disease is left after initial surgery (R0). As stated during the study distillation by Dr Barber maybe there  are subpopulations that could benefit - age, tumor size, molecular factors, stage III vs IV? I have a personal bias since I had surgery first on my stage 3 initial diagnosis and also again on my recurrence. But I feel the decision whether or not to have surgery first should be made between with the patient and her gyn onc based on the patients health, age and preference. 

~~~~~~~~~~~ 

6) Since there is no screening test for ovarian cancer , I am always looking for abstracts about early detection methods. This poster discusses work to develop and validate a high-throughput Ovarian Cancer detection test based on plasma extracellular vesicle (EV)-associated biomarkers. (Carlos Salomon, Abstract 5582/Poster 480). Plasma from 1553 women ( healthy ,benign and ovarian cancer) was used to develop the test. The test achieve a sensitivity of 77% and a specificity of 99.6%. Though more validation work needs to be done these results are an improvement over the CA-125 and has promise in my opinion. 

Every year after attending ASCO, in person or virtually, I hopeful for the future of cancer patients. 

 Dee

Every Day is a Blessing!