Ovarian Cancer

I work in Philanthropy at MD Anderson, and I’m a cancer survivor. This means I can say I’ve been both an employee and a patient at the greatest cancer hospital in the world.

In 2018, I was diagnosed with a type of ovarian cancer called dysgerminoma. I was 32 years old, so this was a rare cancer for someone my age. I found out about my cancer diagnosis through my annual well-woman exam. My normal gynecologist was pushing down on my belly and felt something hard that shouldn't be there. I ended up having surgery to remove it. It turned out to be cancer. I immediately knew that MD Anderson was where I wanted to be treated.

Getting a cancer diagnosis at such a young age is shocking and terrifying. It's not supposed to happen; it’s odd, scary and overwhelming. But, as an MD Anderson employee, I knew firsthand how patients are treated and how care is individualized to the patient. I knew my best chance for treatment was going to be at MD Anderson.

Hands down, it was the best decision I ever made.  

Today, I’ve been cancer-free for six years. Here are three perspectives I learned through my cancer treatment.

1. A deeper understanding of individualized care

As an employee, you're always told that we prioritize individualized care at MD Anderson. But it's not until you become a patient that you experience it. Making that shift connected so many dots and allowed me to understand another side of MD Anderson. 

Going in for your first appointment is terrifying and overwhelming because of all the unknowns. Chemotherapy was a huge fear of mine because I'd seen chemo portrayed on television and in movies as people who get really sick and just waste away. But my care team did such an amazing job of making me not just feel welcome, but also safe. They were one of the biggest reasons why I felt like I was going to be OK. I'm a person who wants to know as much as possible, so my team provided me with a lot of information. That way, I wouldn’t have to wonder and worry. They were so caring, warm and professional; they knew exactly what we were dealing with. My cancer is a rare cancer, but at MD Anderson, it's not rare. 

My care team also asked me questions about my daily life so they could tailor my treatment plan to my needs. The very first day that I met my doctor, he asked if I got motion sick. I said yes, and a couple hours after I saw him, he gave me a call and said that we were going to change my chemo regimen to a different drug that would help me avoid that. Then, before starting treatment, I met with a pharmacist to learn about the medications I'd be taking. When we discussed anti-nausea medications, she told me to let her know if my medication didn’t work so she could find me a better option. Little things like that really made me feel special and cared for.

2. The importance of ‘just another Thursday’

I tried to keep my life as normal as possible during treatment. This included both my routine and my relationships.

I couldn't go into the office when I was having chemo, so for the week after chemo, I would work from home. Then, when I went to the office, I’d try to make it just like another Thursday. At times, chemobrain made it hard to remember things, which would get very frustrating, so I started writing lots of things down. I had to learn to be gentle with myself when those times happened; it was a moment, it wasn't forever. 

For my own mental sanity, I still needed to joke with my friends and have typical conversations with people. I talked to family and friends about acting normal around me. I told my parents, “It's going to be fine. Everything is normal. We can talk about it. Ask me questions, but let's not tiptoe around anything."

My care team also provided me with a sense of normalcy in a time when nothing felt normal. Before my chemo appointments, we would chat about our personal lives and upcoming trips. These casual conversations made me feel comfortable messaging them with all my treatment questions. I never felt like I was bothering them; instead, it really felt like they loved talking and chatting and hanging out.

I also meditated, practiced yoga and journaled during treatment. One of my neighbors would drop by to do art projects during lunchtime when I was working from home. That connection was a little pick-me-up that helped as I tried to keep everything as normal as possible.

3. What it means to be a cancer survivor 

Even though I am a cancer survivor, I’m still very connected to MD Anderson. My post-cancer care and support has been great. My care team is wonderful and optimistic. If I'm ever feeling like I need extra support, I can talk to our Social Work team or reach out to support groups.

Today, my experience as a patient gives me a unique perspective in my role on the Philanthropy team. Donations are pivotal. Fundraising is a huge reason why MD Anderson is so successful and can invest so much in research, clinical trials, support programs like our Adolescent and Young Adult Program and Children’s Cancer Hospital, and other resources for patients and their networks. Cancer doesn't just affect the patient, it affects everyone in that patient's life. MD Anderson provides patients and their families and friends with so many resources to help them get through a really difficult time.

My role as a survivor is a huge milestone and accomplishment. It’s also a reminder of my responsibility to encourage other people to get preventative exams. If my cancer diagnosis can help somebody else down the road, then it was all worth it.

Request an appointment at MD Anderson online or call 1-877-632-6789. 

I’ve always sought out opportunities to advocate for women and women’s health. That’s what drew me to the field of gynecologic oncology.

As a gynecologic oncologist at MD Anderson, I treat cancers of the female reproductive system, including endometrial cancer, cervical cancer, ovarian cancer, vulvar cancer and vaginal cancer. My passion aligns with MD Anderson’s mission to end cancer. I’m thankful I get to work with so many incredible people who share my passion and dedication to Making Cancer History® and improving the lives of our patients.

Connecting with patients is crucial to personalized care

As an oncologist, I’ve learned that there’s no one-size-fits-all approach to treating cancer.

Cancer treatment is a personal experience. As cancer care evolves, we often have multiple ways to approach a challenge. We need to understand how the cancer is affecting the person in front of us so we can make a treatment plan that will get them through treatment and beyond.

That’s why I start by asking questions. I want to get to know my patients and their caregivers. I want to understand what their goals are. After that, I can determine what diagnostic tests we need to do. Then we can create a treatment plan that aligns with best practices and meets the needs of the patient and their support system.

MD Anderson’s multidisciplinary care sets us apart from other institutions. We offer the best specialized care, whether it's medical oncology, surgical oncology or radiation oncology. Having multiple specialists review your care plan before we start treatment means that you're going to receive the right care at the right time and have the best chance for a positive outcome.

Why I value my team at MD Anderson

When you become a gynecologic oncology patient at MD Anderson, you have an entire team supporting you, including nurses, advanced practice providers, medical assistants or my colleagues in the operating room.

I'm always inspired when I come to work because I know that my team is incredible, they're energized and they care about our patients as much as I do.

I think the key to having an effective team is respecting and trusting one another. For example, I know that if I need to have a difficult conversation with one of my patients, I can rely on my team to handle everything outside of that room so that I’m able focus on the patient and their loved ones.

I hear from my patients all the time about how much they love their care team and feel like they can always turn to them with questions or concerns.

My guiding principle when caring for each patient is, ‘Would I be doing the same if this patient was my family member?’ We get to know our patients so well – through surgery, chemotherapy, surveillance and survivorship. We do consider them family. We’re there through the highs and lows of treatment, and it’s a privilege to be able to offer support and guidance to them during that time.

Clinical trials help us better treat patients

Clinical trials are a critical part of our work to end cancer. There’s so much that we need to understand, learn and improve on to conquer a disease that is always changing. Clinical trials help us do that.

It's important for patients to have access to clinical trials, so we can offer them the very best cancer treatments. In addition, we may be able to extend their life and improve their quality of life.

MD Anderson is doing a lot of research in the field of gynecologic oncology. I encourage all patients to ask their doctors about clinical trials to see if they would be a good option for you.

Why you should come to MD Anderson for cancer treatment

MD Anderson only focuses on cancer, so we're able to provide the best comprehensive care to patients from the moment they're diagnosed through their treatment and onto survivorship. You won't be a number here or just another patient. We'll develop a multidisciplinary treatment plan that's right for you.

Because we focus only on cancer, we understand the highs and lows our patients go through better than anyone else. We focus on cancer care, we specialize in cancer care, and I believe we provide the very best cancer care there is.

Jolyn Taylor, M.D., is a gynecologic oncologist at MD Anderson.

Request an appointment at MD Anderson online or call 1-877-632-6789. 

A woman could have her fallopian tubes removed for any number of reasons. Sometimes, it’s necessary to treat an ectopic pregnancy or to resolve an infection caused by pelvic inflammatory disease. In other cases, it’s done as a form of permanent birth control.

But a growing body of evidence suggests that the distal fallopian tube — or flower-shaped section located nearest the ovary — is the site of many cases of high-grade serous ovarian cancer, the most common type of ovarian cancer and one of the most aggressive. 

Research also suggests that an opportunistic salpingectomy — the complete removal of the fallopian tubes during an unrelated pelvic surgery — could help reduce the chances of one day developing ovarian cancer.

So, who should consider having their fallopian tubes removed, and when? And, should anyone who’s finished childbearing seek out the procedure, even if they’re only at average risk of ovarian cancer? We asked Michaela Onstad-Grinsfelder, M.D., a surgeon specializing in gynecologic cancers. 

Why do women typically have their fallopian tubes removed? 

Women don’t usually go in just to have their fallopian tubes removed unless it’s for permanent birth control or to treat an ectopic pregnancy.

Having the fallopian tubes removed is one form of surgical sterilization, or “having your tubes tied.” Until fairly recently, it was more common for surgeons to use a metal clip or a ring to constrict and physically block the tubes, rather than removing the structures themselves.

Why has that changed?

A growing body of data suggests that the fallopian tubes may be the origin of many ovarian cancers. So, a lot of surgeons have changed their practice to remove the fallopian tubes entirely to give patients additional protection against ovarian cancer. 

In the United States, the Society for Gynecologic Oncology and the American College of Obstetricians and Gynecologists both support the removal of fallopian tubes as permanent sterilization for women at average risk for ovarian cancer, but it’s also recommended by professional organizations in Australia, Canada, Germany and New Zealand.

How was this information discovered?

After the BRCA gene was linked to an increased risk for breast and ovarian cancers, doctors started removing the ovaries and fallopian tubes as a type of risk-reduction surgery, once BRCA-positive women were finished with childbearing. 

Most ovarian cancers are diagnosed at stage III or IV, so we don’t usually see the disease in its earliest stages. But what we noticed when we started performing these surgeries is that there were often pre-cancerous lesions present in the fallopian tubes. 

This was a really exciting discovery because, before that, we hadn’t known there was a lesion that could one day become ovarian cancer. So, we were able to start finding ovarian cancers really early that we hadn’t been able to catch before.

How did that discovery lead to the recommendation of opportunistic salpingectomies?

There was a lot of excitement in the medical community at that point about the possibility of reducing the risk of ovarian cancer by removing the fallopian tubes during hysterectomies or when patients were having their “tubes tied.” Before that, whenever someone had a hysterectomy, we would normally only take out their fallopian tubes if we were also taking out their ovaries.

But as the new data emerged, there was an increased interest in removing the fallopian tubes along with the uterus when performing hysterectomies. Because if a woman is pre-menopausal, her ovaries might still be benefitting her. But once she’s finished childbearing, the fallopian tubes serve no real purpose.

So, who should consider having their fallopian tubes removed? 

People who are at increased risk of developing ovarian cancer, such as those who carry the BRCA genetic mutation, are recommended to have a stand-alone surgery to remove fallopian tubes with both ovaries (called a risk-reducing salpingo-oophorectomy).

Otherwise, it’s only recommended as an opportunistic salpingectomy: something to be done when you’re already having another type of gynecologic procedure, such as a hysterectomy.

Are any related clinical trials available?

We have a clinical trial going on right now for BRCA-positive women who are done with childbearing but are not quite ready to have their ovaries removed. 

In this clinical trial, participants will have their fallopian tubes removed now, but delay the removal of their ovaries until later (between the ages of 35 and 45 for patients with BRCA1 and between the ages of 40 and 50 for those with BRCA2). The goal is to determine if it may be safe to delay the removal of both ovaries for women at high risk of developing ovarian cancer.

Do you ever foresee a time in which an opportunistic salpingectomy could be combined with another procedure, such as an appendectomy or a hernia repair?

Right now, we don’t typically bundle other types of surgeries with the removal of fallopian tubes. That’s partially because only OB-GYNs are specifically trained in that procedure. 

But we’re actively looking for ways to team up with other surgeons to offer this service together. It could be an exciting strategy in the future to further reduce patients’ risk of ovarian cancer.

Request an appointment at MD Anderson online or by calling 1-877-632-6789.