Cancerwise

Caitlin Koehler was just 27 years old when she was diagnosed with ovarian cancer.

After a year of severe abdominal pain, visits to different doctors and specialists, diet changes, a colonoscopy and an endoscopy, it was a CT scan that revealed an 11 cm mass on her right ovary. The mass had also attached to her abdominal wall, peritoneum and sigmoid colon.  

Caitlin underwent a right salpingo-oophorectomy to remove her right ovary and fallopian tube. The tissue from the mass was biopsied, and her gynecologist shared the results at her follow-up appointment. Caitlin was diagnosed with squamous cell carcinoma arising in a teratoma, an extremely rare type of ovarian cancer. It was stage 2B. 

“My doctor wanted to refer me to a cancer care provider in Texas, but they had missed my dad’s cancer in 2018,” says Caitlin, who lives in New Braunfels. “And once they slapped the word ‘rare’ on the end of my diagnosis, I knew I wanted to go to UT MD Anderson.”

Caitlin’s dad called that day to make an appointment.

UT MD Anderson develops plan to treat rare, aggressive cancer

Caitlin met gynecologic oncologist Roni Wilke, M.D., on Jan. 3, 2024. She explained that the pathology from her surgery would undergo expert review by pathologists at UT MD Anderson, and she’d have imaging to see if the cancer had spread. That imaging showed a postoperative complication from her prior surgery.

That week, the Interventional Radiology team placed a surgical drain to collect fluid that had collected after Caitlin’s surgery. Shortly after that, a multidisciplinary team of experts met to review Caitlin’s diagnosis and develop a treatment plan.

She started with the chemotherapy drugs carboplatin and paclitaxel and targeted therapy bevacizumab administered intravenously every three weeks.

Molecular testing of the tumor revealed high expression of the PD-L1 protein, so on her third chemotherapy cycle, Wilke added immunotherapy drug pembrolizumab.

She completed a total of six cycles of chemotherapy.

“I’d spend six hours at UT MD Anderson getting infusions,” Caitlin recalls. “My mom would be there with me. I’d crack a lot of jokes, just trying to make the best of it.”

Caitlin took the anti-nausea medication her doctors recommended, so she didn’t experience much nausea during treatment. She temporarily lost her sense of taste and smell, but it came back once she completed chemotherapy.

In June 2024, she continued taking bevacizumab and pembrolizumab as maintenance therapy.

“I was really satisfied with my care team and the information I was getting from them,” she says. “They would say, ‘This is a unique situation. But we have a plan.’”

Surgery successfully treats ovarian cancer recurrence

In February 2025, a routine scan found a new growth in Caitlin’s right abdomen and a growth along a small portion of her small bowel.

Again, a multidisciplinary team of experts reviewed her case and recommended surgery to treat the cancer recurrence.

On April 24, 2025, Wilke performed a debulking surgery to remove the new growth as well as a small portion of Caitilin’s small intestine and omentum – the layer of fatty tissue in her abdominal cavity. She was able to preserve her uterus and left ovary. General surgeon Celia Ledet, M.D., repaired Caitlin’s abdominal wall using a mesh flap. 

Caitlin remains on maintenance therapy. All her scans since the second surgery have been clear and shown no evidence of disease.

Coping with cancer-related fertility challenges

Facing a rare cancer diagnosis as a young adult wasn’t easy for Caitlin; there were a lot of unknowns.

“The fertility challenge was a lot harder for me than the actual cancer diagnosis because I thought, ‘OK, I can take cancer.’ But tacking on possible infertility as a result of treatment was tough,” she recalls.

Caitlin met with oncofertility specialist Terri Woodard, M.D., before starting treatment to discuss her options for fertility preservation. But, she ultimately opted not to move forward with preservation so as not to delay treatment since the cancer was so aggressive. 

“I've spent a lot of time reflecting the last couple of years, and I've looked at other options if I can’t conceive naturally,” she says. “I could ask my siblings if they want to help, and my best friend said she’ll help with whatever I need. I just look at it like another bridge to cross when I get to that point. But it’s nice to know I have their support.”

Managing emotions during treatment

With her parents’ support, the right mindset and available resources, Caitlin learned how to manage the range of emotions that came with her cancer diagnosis.

“After my first surgery, I had to pick whether I was going to live in that immense feeling of pity and sorrow for myself, or if I was going to go fight to live. And I chose to fight,” she says.

Caitlin stayed with her parents after both of her surgeries. Her dad, also a cancer survivor, told her that a lot of times, people just don’t know what to say to someone with cancer.

“I heard a lot of, ‘I’m here if you need anything,’ and ‘I’m so sorry,’” she says. “I would always say, ‘There’s nothing to be sorry about. No one can control what happened.’ And of course, you're going to lose some people through the process, but the ones who stick around are the ones who truly matter.”

Once Caitlin completed chemo, she began seeing a therapist to help sort out her feelings about not knowing what’s next. It’s been beneficial.

“I am a lot less likely to worry these days,” she says. “I just take what comes.”

Thankful for UT MD Anderson

Since Caitlin travels from New Braunfels for her infusions and follow-up appointments, it’s more convenient for her to go to UT MD Anderson West Houston. 

“I asked Dr. Wilke to move any appointments that we can, and it’s definitely been easier because I don’t have to go through so much traffic,” she says. “It is so convenient, fast and easy. And I love the staff at UT MD Anderson West Houston.”

Caitlin also praises Wilke and Advanced Practice Registered Nurse Crystal Teague for touching base, keeping her informed and reassuring her throughout the process.

“Every time I talked to Crystal or Dr. Wilke, they reassured me that things were looking good. That's all I could ask for,” she says. “They always responded to my questions. And if they didn't have an answer, they would tell me, ‘Caitlin, we know as much as you know right now.’ And that made me feel better.”

Caitlin continues to take maintenance therapy, though she may be able to stop soon. Either way, she’s happy her scans remain clear with no sign of cancer.

“A lot of emotions come with a cancer diagnosis. It's OK to sit with them, but it's not OK to stay,” she says. “Attitude is important, so I keep a positive outlook. Even on my worst days, I put a smile on and tell myself to keep going. I'm still going.”

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