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  • Writer's pictureDr. Robert A. Nagourney, MD

Stage 4 Ovarian Cancer: Elizabeth Panke, MD

In 1999, I had an extremely aggressive form of advanced ovarian cancer and my life expectancy was measured in weeks to months.

Today, I am cancer free.

When all other physicians wrote me off for dead, Dr. Robert Nagourney gave me life.

Here Is My Story…

During the first half of 1999, I was in the prime of my life.

My youngest child just graduated from college. I had a successful career as a practicing physician, as a research scientist, and as a medical director of a national DNA laboratory in Cincinnati, Ohio.

In July of that year, I was diagnosed with ovarian cancer.

But that was not the worst news.

Within two months of my diagnosis, I discovered that the chemotherapy effective in treating most ovarian cancers had no effect on the growth of my tumor.

The second line chemotherapy treatment was also ineffective.

Diagnosis: Stage 4 Ovarian Cancer

My tumor continued to grow extremely fast.

I developed malignant ascites (fluid in the abdomen containing malignant cells). By October 1999, more than two quarts of malignant ascites were removed from my abdomen every five days.

My life expectancy for what was now Stage 4 ovarian cancer was measured in months.

My Search for a Cure

My physicians and I did not know what chemotherapy treatment we should try next.

My husband, a medical director of several hospital laboratories in Cincinnati, and I turned to several highly respected national Cancer Centers for treatment consultations.

The experts agreed that there were several chemotherapeutic drugs available for treatment of what was now advanced ovarian cancer.

Each of these drugs potentially had a small chance of producing a treatment response.

However, no one knew which one of these drugs had the best chance of treatment response so my treatment could only be dictated through sheer trial and error.

Was my body strong enough to test out several chemotherapy regimens? There was clearly no chance that I would live long enough to test all the various treatment options.

Could tumor chemosensitivity testing help determine which of several possible drugs should be used?

The oncology experts at the national Cancer Centers I contacted throughout the country were aware of the tumor chemosensitivity testing assays. But, they were quick to add that, in their experience, tumor assay results did not correlate well with clinical response and that these assays would not be useful.

Performing Functional Profiling vs. Cell Proliferation Testing

In desperation, I decided to perform two separate chemosensitivity tests.

My doctor collected malignant ascites from my abdomen.

We sent these collected tumor cells simultaneously for two separate tumor chemosensitivity studies using different methods. We did not know if these different methods would produce the same or different results, but time was of the essence.

One laboratory we sent the cells to is called Oncotech in California. Their method of testing used "cell proliferation" as the endpoint of testing. This method cultured my tumor cells in the presence of single chemotherapy drugs and observed which drugs prevented the tumor cells from growing.

In my case, the report generated by this method showed that the three drugs that best prevented the growth of my tumor were the same three drugs I just failed in chemotherapy!

Needless to say, this type of assay method did not provide me with clinically useful information. The results from this method of testing certainly confirmed the belief of physicians who informed me that tumor chemosensitivity studies do not provide clinically useful information.

The other laboratory that we sent my tumor cells to was Rational Therapeutics (now Nagourney Cancer Institute) of Long Beach California. They used a different method (EVA-PCD) to perform tumor functional profiling studies on my tumor cells.

It's a "tumor death (apoptosis)" method of testing. Rational Therapeutics exposed my tumor cells to chemotherapy drugs and observed which drugs actually killed my tumor cells.

In my case, they identified a combination of drugs that were able to kill my tumor cells in the laboratory.

My Treatment and Results

Based on their recommendations, I immediately received treatment.

My ascites completely resolved within 3 weeks of receiving their recommended chemotherapy regimen.

Following 6 cycles of this chemotherapy, I had no evidence of tumor by CT scan, by PET scan, by ultrasound, and by physical exam.

Today, over 22 years later, I can confidently say that I am cured of my Stage 4 ovarian cancer!


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