‘Living miracle’ beats stage 4 cervical cancer
Rachel Turner is a 31-year-old Puyallup resident who works at HomeStreet Bank in mortgage loan servicing.
Never having any medical issues in the past, it was a complete surprise to her when she had a seizure around this time last year and ended up at MultiCare Good Samaritan Emergency Department.
After various exams, tests and imaging, doctors found a spot on her brain. She was told she needed to have brain surgery at MultiCare Tacoma General Hospital, and was transferred there.
“It was mind-blowing that my world imploded in the span of a day, and it snowballed from there,” says Turner.
Once at Tacoma General, she had more tests, and doctors found an 8-centimeter tumor on her cervix.
Turner met with Wafic Massry, MD, gynecologic oncologist, who told her they weren’t going to do brain surgery just yet; she needed to have a biopsy of her cervical tumor first.
“I was put on anti-seizure medication and was told not to work, as they didn’t want any chance of stress triggering another seizure,” she adds.
An unexpected diagnosis
When the biopsy results came back, Turner found out she had stage 4 glassy-cell cervical carcinoma, a rare and aggressive type of cervical cancer that had spread to her brain. This type of cancer metastasizes early and is typically difficult to treat, especially in advanced stages.
Despite this diagnosis, Dr. Massry says, “I never saw Rachel worried. She showed tremendous courage throughout her treatment. I had to tell a 30-year-old, ‘You have a rare, aggressive cancer.’ Yet, she was always positive, upbeat and very gracious.”
Turner has a naturally optimistic, bubbly personality, but she also acknowledges the impact her care team’s positivity had on her outlook.
“Even when Dr. Massry told me it was stage 4, there was never a ‘you can’t survive this,’” Turner says. “He said, ‘Yes, it’s aggressive; yes, it’s rare; but we’re going to hit it with everything we’ve got.’ That really helped me with my mindset. I told myself, ‘I’m going to beat this. Cancer isn’t going to be my story. I’m going to overcome this.’”
Cervical cancer is most common in women ages 35 to 44. Symptoms may include abnormal bleeding or discharge between periods, pelvic pain, or pain and bleeding during and/or after intercourse.
Turner didn’t have any of these symptoms.
“Without having the seizure, I wouldn’t have found out about the cervical cancer, and it would have progressed further,” she says.
Utilizing advanced brain radiation treatment
On Valentine’s Day, Turner went in for a scan to check the spot on her brain. When she got home, she couldn’t stop throwing up. It continued for about 24 hours. She thought perhaps it was a reaction to the contrast dye used in the scan, but when results came back, she found out her brain lesion had doubled in size since the last scan in January. The pressure of the growing lesion on her brain was what caused the vomiting.
Her team at MultiCare Regional Cancer Center mobilized. Because the brain lesion was growing rapidly, her treatment began with radiation. Radiation oncologist Chan-Kyung Jane Cho, MD, targeted the spot on Turner’s brain with three sessions of an advanced radiation treatment called stereotactic radiosurgery.
This treatment delivers high doses of radiation with pin-point accuracy. The radiation beams focus precisely on the tumor, minimizing damage to the surrounding healthy tissue.
“Even though her cancer has spread to her brain, given the limited amount of spread, we wanted to give her the best shot and aim for cure,” says Dr. Cho.
Treatment of her primary cancer
External beam radiation, combined with chemotherapy administered by Sunil Rangarajan, MD (Dr. “R”), to treat the primary cancer on her cervix was up next. This meant external radiation five days a week for six-and-a-half weeks, with chemo every Friday.
Getting chemo in conjunction with the radiation sensitizes cancer cells, making the radiation more effective.
“It’s a standard yet very intense regimen, but Rachel did extremely well. Her attitude definitely helped her get through it,” says Christopher Premo, MD, a radiation oncologist on her team who specializes in external radiotherapy.
The cancer on Turner’s cervix was locally advanced, meaning cancer was found in tissue surrounding the cervix.
“She had positive lymph nodes as well, which meant complex treatment planning was required,” Dr. Premo says. “It doesn’t get much more complex than this, but her cervical tumor responded well to radiation — even better than we thought.”
The next and final phase of Turner’s treatment concluded with two weeks of internal radiation (intracavitary brachytherapy), performed by Dr. Cho. This type of treatment delivers a high dose of radiation directly to the tumor via an internal applicator.
Dr. Cho explains brachytherapy was a critical part of Turner’s treatment plan, as it has been shown to greatly improve cervical cancer cure and survival rates.
Surrounded by a compassionate care team, supportive friends and family
“My entire care team, from Dr. Massry, Dr. R, Dr. Premo and Dr. Cho, to the nurse navigators and office staff, was so awesome,” says Turner. “They were always willing to answer questions, willing to help. Everyone was so welcoming, nice and uplifting.”
She recalls her team telling her, “You got this, you can beat this, you are so positive.”
“That made the whole process so much better, knowing the doctors and nurses genuinely cared about me,” she adds.
In addition to her compassionate team, Turner had tremendous support from her friends and family.
“I wasn’t allowed to drive for six months, but I’m lucky enough to have family and friends in the area,” Turner says. “They brought over food and drove me to my appointments. My best friend was basically my secretary. She kept track of who was taking me to which appointment at what time.”
No evidence of active cancer
Turner’s doctors are happy to share that she is in complete remission and has no evidence of disease.
“Rachel’s whole journey was pretty remarkable,” says Dr. Premo. “From the start, we didn’t know what to expect because it was an aggressive, complex case. But she was positive the entire time, and we were able to provide a potentially curative treatment.”
A benefit of receiving care at a comprehensive cancer center when a patient has a complex situation like Turner’s is that the care team is composed of providers who work together, communicate well and can offer complex treatment in a multidisciplinary fashion, Dr. Premo explains.
“It was truly a team effort that has yielded a good outcome,” says Dr. Cho.
Turner will continue to have checkups with Dr. Massry, Dr. Premo and Dr. Rangarajan every three months, with a brain MRI every three to six months and a PET scan every six months. The frequency will decrease over time, so long as she remains cancer-free.
“Take my advice and don’t avoid doctors,” advises Turner. “I went so long without a primary care provider since I never had any medical issues.”
She has a primary care provider (PCP) now — Elizabeth Montgomery, ARNP, MSN — and says that’s not going to change.
“Rachel is a living miracle. She overcame a rare, aggressive cancer and is now in complete remission,” says Dr. Massry.
It is recommended to begin cervical cancer screening between the ages of 21 and 25. This test, commonly referred to as a Pap smear or Pap test, can include cervical cytology testing and HPV co-testing. With normal test results, you may not need another screening for three to five years. Discuss with your doctor or other health care provider the best schedule for your individual circumstances.
If you do not have a primary care provider, you may search for a provider here.
