Client Story
Presentation
She was diagnosed with grade 2 endometrioid ovarian carcinoma of the left ovary with a uterine implant.
After undergoing cytoreductive surgery that included a left oophorectomy, myomectomy, and lysis of adhesions, she was treated with six cycles of carboplatin and taxol, resulting in a determination of no evidence of disease.
However, follow-up imaging revealed PET uptake in the right cul-de-sac, and subsequent imaging identified three masses, two of which were hypermetabolic. Following completion surgery and tumor debulking, she began chemotherapy with carboplatin, Doxil, and Avastin, followed by maintenance Avastin.
Unfortunately, her primary provider left the practice just before treatment commenced, but she received support from a secondary provider until she was assigned a new primary.
PHM Actions
This critical oversight was sent for expert review, resulting in corrected labeling and an upstaging to Stage 2B disease.
To ensure an accurate diagnosis and optimized care plan, PHM engaged additional onco-fertility and gynecologic oncology experts, focusing on preserving the uterus and right ovary to safeguard the client’s fertility.
Recognizing the urgency, PHM arranged last-minute pre-treatment egg harvesting to enhance the client’s chances of future pregnancy. The team also provided comprehensive patient education and emotional support throughout the process.
PHM navigated fertility and treatment concerns while researching the cost-benefit of various treatment options. Additionally, PHM researchers identified the need for molecular profiling testing and advocated for further assessments, including HER2 testing.
Outcome
Reduced anxiety and uncertainty regarding diagnosis, treatment planning, and long-term quality of life.
Arranged consultations in-between providers, accelerating assignment to a replacement.
Identified additional treatment options for long-term surveillance and recurrence prevention.
The PHM Difference
PHM expertly navigated two challenging diagnoses of endometrioid ovarian carcinoma in a young female, extending her fertility window and enhancing her quality of life. Upon recurrence, PHM advocated for expedited imaging, successfully detecting the recurrence within weeks of a biomarker spike.
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