Cathy Phinney, 76 can handle stress and adversity. She had worked as an Emergency Department nurse for more than 48 years and was quite comfortable providing support, encouragement and positivity to the sickest of patients. She just never expected one day to be one of them.
In May, 2023, Cathy experienced lower abdominal pain and pelvis floor prolapse. After an initial trip to a urologist showed an abnormality, a follow-up revealed a shocking diagnosis: stage 3 ovarian cancer, with the disease already spread throughout her abdomen.
“It’s very common for ovarian cancer to grow and spread prior to symptoms developing,” said Katina Robison, MD, Chief of Gynecologic Oncology at Tufts Medical Center. Patients usually have vague symptoms that are often misdiagnosed as something much less serious. As a result, 75 percent of women will have stage 3 or 4 disease at the time of diagnosis. This makes ovarian cancer one of the most difficult cancers to treat.
Even with the standard treatment regimen, chemotherapy followed by surgery, the long-term prognosis for stage 3 ovarian cancer is not particularly good: a five-year survival rate of about 41 percent, with a better than 70 percent chance of recurrence within 5 years. But a promising new treatment option has recently become available, that research has shown increases life expectancy and may even result in complete cure for some women. And Tufts Medical Center is the only hospital in Massachusetts currently offering it.
Hyperthermic intraperitoneal chemotherapy (HIPEC) is an innovative procedure used to treat cancers that have spread to the surface of the abdominal cavity. It has previously been used for appendiceal cancer, and in recent years, has become an option for some late-stage ovarian cancers. Immediately after removing all visible tumors during surgery, the surgeon delivers a targeted dose of heated chemotherapy directly into the patient's abdomen. Research has shown that integrating HIPEC into late-stage ovarian cancer surgeries increases average survival by more than a full year.
“HIPEC is very institution-intensive and is not offered in most places because of the time, cost, expertise and bandwidth necessary to get a program off the ground,” said Dr. Robison. “It requires team members from anesthesia, perfusion and pharmacy, as well as additional surgical support. The complexity, resources and special technical expertise really requires a substantial investment from the hospital. But HIPEC also helps completely cure more women of a disease that is hard to cure, and that benefit clearly makes it worth it.”
Upon joining Tufts Medical Center in September 2022, Dr. Robison studied under experienced HIPEC surgeon Martin Goodman, MD, Director of the Peritoneal Surface Malignancy Program at Tufts MC, and one of the most prominent and earliest adaptors of this approach in the country. In February, 2023, Tufts Medical Center began offering the HIPEC option to qualifying ovarian cancer patients (women with stage 3 ovarian cancer who require chemotherapy prior to surgery, because the cancer has spread and/or can’t all be removed at the time of diagnosis).
When Dr. Robison first met Cathy, it was clear the cancer would not be able to be fully removed with immediate surgery. So Cathy went through 3 cycles of chemotherapy before surgery; a CT scan showed the cancer shrunk considerably. Prior to surgery, Dr. Robison explained the HIPEC option and its potential benefits. Cathy was all for it. Cathy underwent surgery on September 19, 2023. Dr. Robison removed the cancerous tumors and delivered the HIPEC therapy. The surgery was successful and Cathy was out of bed and walking around the next day.
“Everything at Tufts Medical Center was absolutely wonderful and everyone was very nice and helpful,” said Cathy. “The whole experience was much better than I expected. I leaned on my experience as a nurse, trusted my care team and didn’t let myself get overwhelmed. And things went as well as they possibly could have gone. I was feeling so well in between my chemotherapy rounds, that I felt like a fraud.”
“Cathy has recovered tremendously well,” said Dr. Robison. “She looks great and her tumor markers have normalized completely. After her December appointment, she will go on maintenance therapy. At that point, she will be considered in remission, with the ultimate goal of complete cure and many healthy years ahead.”
“I am thoroughly enjoying every day I have,” said Cathy. “I could have been consumed by thoughts about how I was going to die, but you only die once. The rest of the time, you have to live.”
Learn more about the innovative ways we’re treating gynecologic cancers.
