In early 2021, Susan Martin of Vancouver noticed light spotting, a surprise since she had gone through menopause 10 years earlier. She did not think much of it, but called her doctor anyway. Her doctor immediately referred Martin to a gynecologist, who ordered a biopsy — and she tested positive for endometrial cancer.
Taking an aggressive approach, Martin underwent a total hysterectomy in April 2021 and four weeks later was off vacationing in Hawaii with her sisters. Two weeks after that, she was already back at work at Legacy Emmanuel Medical Center, where she worked as a nurse in the neuro trauma unit for 34 years.
“Honest to God, working in the COVID unit before there was a vaccine was more stressful than cancer,” Martin said.
A few months after returning to work, Martin began to feel sick and noticed light spotting once again.
In July 2021, four months after the total hysterectomy, she got a CAT scan revealing that she had metastatic endometrial cancer. Her physician, Dr. Gina Westhoff, a Legacy Health gynecologist and oncologist, promptly recommended chemotherapy and offered Martin a spot in a trial for women with advanced or recurrent endometrial cancer.
The Legacy Cancer Institute participated in a National Cancer Institute Trial, NRG-GY018, for aggressive forms of endometrial cancer — the trial Martin participated in. The trial involved adding an immunotherapy agent, pembrolizumab, to a chemotherapy regimen. Initial trial data looks promising, according to Westhoff.
In fact, the results were so promising that the trial was ended early so that all participants could be unblinded and given pembrolizumab if they were on the placebo and not already on it, according to Westhoff.
“This means that there is a significant increase in response so that cancers are shrinking, being controlled for longer,” Westhoff said.
When Martin first joined the trial, she did not know if she was being given pembrolizumab or a placebo, though she says she could feel her tumors shrinking.
A few weeks ago, Westhoff confirmed that Martin was in fact getting pembrolizumab infusions.
“When I got told I was on the actual medicine, I wasn’t actually surprised,” Martin said. “And I believe that the study drug prolonged my life.”
Martin spent around three months on chemotherapy and the pembrolizumab infusions that started in September 2021 will continue until July. She goes in every six weeks for an infusion and every 12 weeks Martin gets a CAT scan and a pelvic exam. After she stops receiving the drug in July, Martin will continue to get regular testing done every 12 weeks for the next year followed by yearly testing as long as everything looks healthy.
While chemotherapy was an all-day process for Martin, the pembrolizumab infusions take around 30 minutes. For Martin, she has had virtually no symptoms from the pembrolizumab infusions, a relief since she did not feel well during chemotherapy.
“Joining this study, its a hopeful unknown,” Martin said. “And I thought even if it doesn’t work for me, it gives information that’s helpful.”
At this point, Westhoff is hopeful that pembrolizumab will be granted accelerated approval soon.
Coping with a diagnosis
On the same day Martin got the second diagnosis, confirming she had metastatic endometrial cancer, her oldest daughter told her she was pregnant.
Martin worried she would never be able to meet the newest addition to the family — now her grandbaby is nearly a year old and her younger daughter has a baby on the way, due in August.
“Hopefully I’ll get to meet her, I know she’s a girl,” Martin said. “I’m not naive to think that the tumors will never come back, but I hope they never come back.”
For Martin, her support system has largely consisted of family and work friends, including almost daily walks with one of her neighbors.
Beyond that, Martin expressed extreme gratitude for having a doctor who was looking out for her best interest and helped her get into the trial.
“I wish that these kinds of studies were accessible to everyone,” Martin said.
Westhoff encourages anyone interested in participating in a trial to talk to their doctors, as there are many options out there. At Legacy, there are currently 31 trials for different cancer tumor types, according to Westhoff.
Martin and her family credit the trial drug with having helped prolong Martin’s life.
“She’s my best friend, my soulmate, my whole life,” Martin’s daughter, Jennifer Leow, said with tears in her eyes. “I’m really grateful for Dr. Westhoff and the whole team.”