What does a woman do when she receives a diagnosis of ovarian cancer at age 19? In 1981, Joan Scott had to answer that difficult question.
A sophomore in college at the time, she looked at her then-limited choices and took the path that many other young women took: surgery and chemotherapy. As Joan put it, things were "under control" for the next 21 years. She went on to marry, to have a child, and to fulfill her professional dream of becoming a teacher and school administrator.
At age 40, Joan's world was shaken by another diagnosis of ovarian cancer. This was considered a new case because of the many years that had elapsed since the first diagnosis. Chemotherapy was determined to be the best route for this particular growth. The treatment plan was successful, but three years later, a large mass was discovered in Joan’s lower pelvis. This time, the growth was too big for traditional radiation, surgery was not an option (due to the involvement of, and potential damage to surrounding organs) and chemotherapy was ineffective. On top of it all, Joan was in constant, excruciating pain. All she wanted was to find a way to make lemonade out of the lemons she had been given.
A divine intervention
Then, as Joan likes to say, she experienced "divine intervention."
She returned home one day to a telephone message from the mother of a former student. This woman had heard about Joan’s health struggles. Fortunately, this woman was also married to the medical director of surgery for HealthEast Care System and a member of the CyberKnife Center—located at St. Joseph's Hospital in St. Paul—and she had shared Joan’s challenges with him. He (Andrew Fink, MD) and his team believed they could help Joan and they were waiting to meet her for an evaluation.
Joan recalls that, at first, she was only looking for pain management or palliative care for that mass which was pressing against a nerve. "I had done research which showed ovarian cancer was hard to treat; I wasn't necessarily looking for a cure, but for a better quality of life."
Joan underwent five CyberKnife sessions in 2007, each about one hour in length. Within one to two treatments, her pain was manageable. Within one month, her pain was gone, and she went skiing which, Joan says, "was much to her physician's chagrin."
PET scans (non-invasive technique which accurately images the cellular function of the human body) followed every three months, showing the mass shrinking in size. Then, in April 2008, a small spot was detected in her upper clavicle. The next month, she underwent five more CyberKnife treatments.
Ongoing follow-up visits and scans over the next 18 months showed the spot decreasing in size.
"The best part," says Joan, "was that I was able to keep raising my son and living my life over all this time. I had minimal side effects, maybe being a little tired, but I never felt sick from the treatment."
In January of 2010, Joan's physicians detected a new spot in her pelvis and on the other side of her clavicle. But Joan was undaunted. She and the CyberKnife team worked on creating a plan that delivered five treatments to each location. Her condition is currently being monitored.
A compassionate team
A teacher at heart, Joan is passionate about sharing her most important life lessons with others. "I am so lucky. My CyberKnife team and I have been able to treat my ovarian cancer as a chronic disease; I’m getting results that are not typical and it’s allowed me to see my son grow and become the person he was meant to be. How did this happen? I’m working with people who have hearts of gold, who do amazing follow up, who treat my family like their family. You can have all the technology and knowledge in the world, but it’s not worth a hill of beans without the compassion, professionalism and careful planning this team demonstrates. These people are phenomenal; you can trust them to make things happen."
Mostly, Joan wants others to know that while not every hospital or health care system has a CyberKnife of its own, they can refer patients to a place like St. Joseph's Hospital for an evaluation.
"Not every patient will be a candidate for CyberKnife, but everyone benefits when physicians go outside of their own hospital or health care communities to look for the best treatment options. That’s what my oncologist did. My success story is what great medical collaboration looks like in the Twin Cities."
Joan's CyberKnife radiation oncologist has been a partner in her care since day one. She summarizes Joan’s journey this way: "We’re cautiously optimistic for Joan. Dr. Fink and I first met her four years ago when all of her other options had run out. Over that time, she has been able to join her family in many activities that have built important memories for everyone. Our entire CyberKnife team feels a great sense of joy and satisfaction when we hear her stories of downhill skiing, fun vacations, or just enjoying the simple things each day can bring. This technology has helped her to live her life rather than just exist."