DANBURY, Connecticut, September 4, 2018 — Marion Roth was not expecting her cancer diagnosis. She has no family history of cancer. She follows a healthy lifestyle full of hiking, kayaking, running, and yoga. Yet in October 2016 she learned that a grapefruit-sized mass in her lower abdomen was granulosa cell tumor of the ovary. This malignant tumor is a rare type of ovarian cancer that accounts for about 2 percent of all ovarian tumors. Ms. Roth has Type 1 diabetes, which complicated her cancer diagnosis further. A multidisciplinary team of medical specialists at Danbury Hospital, including Ms. Roth’s OBGYN, gynecologic oncologist, medical oncologist, endocrinologist, and the staff at The Praxair Cancer Center successfully treated her cancer.
For several months before her cancer diagnosis, Ms. Roth, a 56-year old woman from Ridgefield, Connecticut, felt persistently bloated and nauseous after meals. She had constant indigestion and was frequently urinating. She assumed these symptoms were the normal signs of aging that many women experience. But then she started to gain weight and noticed a bump in her stomach, similar to when she was pregnant with each of her two children.
Back pain ultimately brought Ms. Roth to her OBGYN Richard Ruben, MD, of Physicians for Women’s Health. Dr. Ruben conducted tests and ruled out other conditions that might be causing her symptoms. He quickly referred Ms. Roth to Danbury Hospital Gynecologic Oncology, under the care of Vaagn Andikyan, MD, gynecologic oncologist, Western Connecticut Health Network (WCHN).
Ms. Roth was diagnosed with Stage 1C2 granulosa cell tumor of the ovary. The tumor in her right ovary had ruptured and malignant cells were in her abdomen.
Dr. Andikyan counseled Ms. Roth to have surgery to remove the cancer. On October 14, 2016, Ms. Roth had a hysterectomy with bilateral salpingo-oophorectomy to remove her uterus, cervix, and both ovaries and fallopian tubes. Dr. Andikyan also performed a pelvic and paraaortic lymphadenectomy to remove lymph nodes from her pelvis and from in front of her lumbar vertebrae near her aorta and vena cava, and an omentectomy to remove fatty tissue near the stomach. Dr. Andikyan dissected her lymph nodes to determine the extent of the cancer in order to best guide further treatment for Ms. Roth.
There is limited recurrence data for this type of cancer because granulosa cell tumor of the ovary is so uncommon. Therefore, Dr. Andikyan and Kevin Jain, MD, medical oncologist, Danbury Hospital, recommended 18-rounds of chemotherapy for Ms. Roth to reduce the risk of the cancer spreading and of recurrence.
Ms. Roth has been managing Type 1 diabetes for nearly 48 years. Diabetes can complicate cancer treatment for many reasons. For instance, steroids are often administered to alleviate common side effects of chemotherapy, such as nausea. However, steroids interfere with insulin and can make it more difficult to regulate blood sugar levels.
Ms. Roth underwent six months of chemotherapy and completed her treatment in May 2017. She continues to see Drs. Andikyan and Jain at Danbury Hospital to monitor her health through routine follow up appointments.
Ms. Roth said the support of her care team, her community, and her mindset helped her to overcome cancer.
“Dealing with cancer takes perseverance. You need a lot of buoying up. It’s important to seek out the type of support that will make you feel safe and cared for,” said Ms. Roth. “I’m very thankful for The Praxair Cancer Center at Danbury Hospital. Everyone there was kind, patient, and caring, including the therapy dogs! They embraced my situation and from when I first checked in to when I left, I felt like I was part of a family. They also connected me with a host of outpatient services, including Ann’s Place, which helped me to better manage my cancer,” she said.
Ms. Roth’s friends and community rallied behind her, too — and she is forever grateful.
“I want others to know that when you do something nice, it goes so much farther than you might imagine. When I think of what people said to me and did for me, well, that’s what got me out of my bed. I was bald, and I didn’t feel good. But, I still got out of bed,” said Ms. Roth.
Although she could not control the cancer, Ms. Roth learned she could control her outlook. She thought about the culmination of all of the good and challenging times in her life and realized that she had the skills and strength to handle her cancer diagnosis.
“I considered myself a survivor from day one of my diagnosis,” said Ms. Roth. “I focused on having a positive outcome. I set a goal to get through my treatments and overcome the cancer so I could go on an African safari.”
In September 2017, her doctors cleared her for her trip. “I went to Africa with my friend and her charitable organization. I taught women to sew and I went on a safari. My trip emphasized what I learned from having cancer — to see life from a different perspective, to have compassion, and to practice gratitude,” said Ms. Roth.
Ovarian cancer by the numbers
In the United States, ovarian cancer ranks fifth in cancer deaths among women and about 20,000 women are diagnosed with ovarian cancer each year. Ovarian cancer causes more deaths than any other gynecologic cancer mainly due to delayed symptom presentation and lack of early detection strategies.
Ovarian cancer risk factors
Early detection increases survival rate. WCHN encourages women to speak with their primary care providers and gynecologists if they have risk factors that may increase the likelihood of getting ovarian cancer. Risk factors include: genetic predisposition (BRCA1 or BRCA2 gene mutation, Lynch syndrome or family history of breast, colon, or ovarian cancer), personal history of endometriosis or breast, colon, or uterine cancer, or increasing age.
Signs and symptoms of ovarian cancer
Women should also speak with their doctor if they have persistent symptoms of ovarian cancer that are not normal for them. Symptoms include: back pain, bloating, nausea, vomiting, constipation or menstrual changes, fatigue, feeling the need to urinate urgently or often, pain during sex, pelvic or abdominal pain, trouble eating or feeling full quickly, upset stomach or heartburn, or vaginal bleeding or discharge.
WCHN Gynecology Care and Gynecologic Oncology Cancer Program
Please visit WCHN’s websites to learn more about gynecology care and our gynecologic oncology cancer program: