Understanding Ovarian Cancer Treatment: Chemotherapy & Surgery
- It has been a few weeks since tennis legend Chris Evert, 67, announced that she is fighting stage 1 ovarian cancer, and the support has been pouring in.
- Evert posted a photo of herself and ex-husband Andy Mill on Twitter, writing, “Happy you took me to my second chemo today Andy; just like old times!”
- Doctors have two main approaches to treatment when they are working with ovarian cancer patients, and both methods offer patients a combination of chemotherapy and surgery; both groups of women get chemotherapy and surgery, it is just the sequence that changes, one SurvivorNet expert explained.
Evert’s loved ones, as well as strangers online, are showing up for her during a trying time in her life; including people like her ex-husband, Andy Mill.Read More
— Chris Evert (@ChrissieEvert) February 1, 2022
The tweet prompted hundreds (maybe thousands) of responses from people online, many of whom do not know Evert personally, but one person stood out among the rest: legendary sportscaster Dick Vitale.
Wishing you all the best in ur battle @ChrissieEvert / loved the pic I saw of Andy M taking u to ur Chemo treatment / we both r going to WIN THE BATTLE / Chris cancer can’t Stop us. Keep fighting,” Vitale posted to Twitter on Feb. 1.
Wishing you all the best in ur battle @ChrissieEvert / loved the pic I saw of Andy M taking u to ur Chemo treatment / we both r going to WIN THE BATTLE / Chris cancer can’t Stop us . Keep fighting. My 🙏🙏🙏❤️❤️❤️with u to be CANCER free!
— Dick Vitale (@DickieV) February 1, 2022
Evert responded, thanking Vitale for his kind words, adding, “I am praying for you as well.” (Vitale is a cancer survivor/warrior himself; in October 2021, the 82-year-old announced he had been diagnosed with lymphoma, just two months after revealing that he beat melanoma over the summer.)
Chris Evert’s Cancer Battle
Chris Evert shared the news of her ovarian cancer diagnosis in an ESPN article published last month. Her diagnosis and what it took to get there was described in vivid detail.
Her story is unfortunately not an uncommon one, but it has a more positive outcome than most ovarian cancer patients because the disease is often caught too late. In Evert’s case, she is just stage 1.
When speaking about Evert’s case specifically, world-renowned gynecological oncologist Dr. Beth Karlan of UCLA Health told SurvivorNet, “when she found out, at age 67, that her sister had this mutation (BRCA1), she got tested, found she had too, acted on it, had the prophylactic surgery, and serendipitously was found to have a very early and likely curable ovarian cancer.”
However, that was not the case for Evert’s younger sister, Jeanne Evert Dubin, who was also a professional tennis player. Dubin died from advanced-stage ovarian cancer in February 2020. She was 62 years old.
When Dubin was diagnosed with cancer, it was in its later stage, and it had spread. That is often the case with ovarian cancer, many SurvivorNet experts tell us. Ovarian cancer is almost impossible to diagnose early — like in Evert’s case — because women do not begin to show symptoms until the disease has reached its later stage. There are also no routine screening tests recommended for women who are at an average risk for ovarian cancer.
How did Evert catch her ovarian cancer so early? She found out she had the BRCA1 gene mutation and began to get regular cancer screenings.
The BRCA1 (BReast CAncer 1) or BRCA2 (BReast CAncer 2) genes help cells repair their DNA damage. Having a change, or mutation, in one of these genes increases a woman’s risk of developing ovarian and breast cancer. These gene mutations are commonly passed down in families; if a parent carries a BRCA gene mutation, there is a 50-50 chance you could be carrying it as well.
When Dubin, Chris Evert’s sister, was going through cancer treatment, she had tested negative for the BRCA1 gene. Because of this, her family members, including Evert, were not encouraged to seek genetic testing themselves.
However, it was later proven that Dubin did in fact have the pathogenic BRCA1 gene, which increased her chances of developing ovarian cancer. This prompted Evert to “immediately” send her blood in for genetic testing, which revealed she also had the pathogenic variant of the BRCA1 gene. (Gene mutations can either be benign or pathogenic.)
Due to her increased risk of developing ovarian cancer, Evert decided — in collaboration with her doctor — to have a hysterectomy, which is a surgical procedure to remove the uterus. She had this procedure done first as her sister died from a type of gynecological cancer, but a mastectomy — surgery that removes the entire breast — was planned for later down the line as BRCA1 can also increase a woman’s chances of developing breast cancer.
But a proactive measure — Evert’s hysterectomy — turned out to be a necessary step in her own cancer journey, as pathology following surgery revealed malignant cells and a tumor originating in Evert’s left fallopian tube.
Ovarian Cancer Treatment: Chemotherapy & Surgery
Doctors have two main approaches to treatment when they are working with ovarian cancer patients, and both methods offer patients a combination of chemotherapy and surgery, according to Dr. Jose Alejandro Rauh-Hain, a gynecologic oncologist at MD Anderson Cancer Center.
“Both groups (of women) get chemotherapy and surgery,” he explained during a previous interview with SurvivorNet, “it’s just the sequence of how we do it.”
If a doctor is confident they can remove the ovarian tumor completely without initial cycles of chemotherapy, the doctor will go ahead with a surgical procedure. Chris Evert’s case was unique in that her cancer was discovered after she had preventative surgery, so the surgery part of treatment has already been taken care of.
The group that receives surgery first still goes through chemotherapy, like Evert is going through now, following the operation to ensure that the cancerous tissue is fully excised. This process is known as adjuvant chemotherapy, or a therapy given after initial treatment to ensure effectiveness.
The other group is made up of women whom doctors are not confident they can perform successful surgical tumor removal. This group receives chemotherapy before surgery; this group usually receives a final chemotherapeutic treatment after surgery as further assurance that the cancerous tissue is gone.
This necessary combination of both treatments is related in part to the particular virulence of ovarian tumors. The cancer is particularly difficult to detect, so the average woman has a sizable tumor once she is diagnosed. Because of this, both chemotherapy and surgery are needed to remove the cancer.
Contributing: SurvivorNet staff