A Journey Through Fallopian Tube Cancer Treatment with Precision Medicine
Gynecologic cancers are formidable foes for women worldwide. When cancer is hereditary and intertwined with genetics, no matter how diligently one maintains health, it remains an unavoidable risk. At 40, “Ms. Som or Poonsri” had to confront “fallopian tube cancer.” Yet, the power of modern medicine transforms her crisis into a fresh start in life. Let us explore how her story unfolded in this article.
A “Mysterious Mass” Detected in the Abdomen...
Ms. Som had never had any abnormal symptoms until one night when she developed abdominal pain that radiated to her back.
“At first, I thought it was menstrual cramps, but the pain lingered and did not improve with rest. I went to a nearby hospital. After the doctor administered an injection, the pain initially subsided but soon returned. I underwent a CT scan, which revealed a mass in the lower abdomen.”
In addition to the lower abdominal mass, a larger mass was also present in the upper abdomen. At that point, the doctors had not yet confirmed whether these masses were malignant.
“I am a firm believer in seeking a second opinion, so I decided to consult doctors at two other hospitals. Doctors advised me to have the mass surgically removed, even without a confirmed cancer diagnosis.”
“Both hospitals could perform surgery to remove the mass in the lower abdomen, but they had not yet determined whether the upper one could be safely removed, as it abutted the main artery and vein in the upper abdomen—a risky and challenging area for surgery. That is why I sought a fourth hospital that could comprehensively manage my care. That was how I came to MedPark Hospital.”
From Uncertainty to Hope: Navigating Cancer Treatment
Upon arriving at MedPark Hospital, Dr. Sudpreeda Chainitikun, an oncologist, reviewed Ms. Som’s medical records from other hospitals, conducted a thorough evaluation, and gathered additional history. He discovered that multiple family members had been affected by cancer. Consequently, he recommended genetic testing to investigate possible hereditary cancer syndromes. He then consulted Prof. Dr. Siriwan Tangjitgamol, a gynecologic oncologist, to design an appropriate treatment plan and provide comprehensive counseling.
“The surgical removal of the lower abdominal mass is straightforward without major issues. However, the mass in the upper abdomen posed a significant challenge due to its precarious location with high surgical risk. The treatment options included laparoscopic surgery to assess whether the mass is resectable. If the tumor turned out to be malignant or deemed only partially removable, a biopsy would be necessary, followed by chemotherapy to shrink the mass before attempting surgery. Alternatively, the doctor could attempt complete surgical resection as is standard, and for further tissue diagnosis. Both physicians carefully planned a comprehensive evaluation to ensure the highest level of safety for me.” Ms. Som recounted.
Upon reviewing the CT scan results and images, Dr. Siriwan noted that the image clarity were inadequate. She observed that the mass on the uterine adnexa was smaller than the mass in the upper abdomen, which is unusual since the primary tumor is typically more bulky. At the same time, there is minimal evidence of widespread disease in the abdominal cavity, an atypical presentation for ovarian or fallopian tube cancer. Therefore, the doctor ordered an abdominal MRI to provide a higher resolution and more detailed assessment of the various masses compared to the CT scan. Additionally, Dr. Shinawatt Visutdiphat, a surgeon, was consulted to participate in comprehensive treatment planning, particularly for the challenging surgical removal of the upper abdominal mass. Both specialists concluded that complete removal appeared feasible. They provided counseling and proceeded with the surgery, alongside plans for further genetic testing, with a special focus on the BRCA1 gene.
The Power of Teamwork for a Complex and Challenging Fallopian Tube Cancer Case
Dr. Siriwan and Dr. Shinawatt collaborated meticulously and expertly during the surgery, enabling effective fallopian tube cancer treatment.
“Gynecologic oncologists are highly skilled in lower abdominal surgery, i.e., excising the uterus and adnexa that are affected by cancerous growths. However, they are less experienced in removing larger tumors located near major arteries and veins in the upper abdomen, as these surgeries are more technically demanding and carry greater risk. Fortunately, we had the collaboration of Dr. Shinawatt, an expert in comprehensive abdominal surgery. The complete excision of the tumors was successfully performed, including the challenging mass adjacent to major blood vessels, without breaching the tumor capsule or injuring the blood vessels.” Prof. Dr. Siriwan recounted.
Dr. Sudpreeda explained the postoperative treatment plan:
“After the successful removal of the entire tumor, the next step involves administering medication to prevent cancer recurrence. Given that the genetic testing revealed a BRCA1 mutation, we must adjust the treatment regimen accordingly. Additionally, we need to remain vigilant for the potential development of cancers at other sites, such as breast and pancreatic cancer. We cannot afford to be complacent, as these risks may arise anytime.”
Controlling Cancer with Chemotherapy and Targeted Therapy
After surgery, Prof. Dr. Siriwan determined that immediate chemotherapy was necessary. Dr. Sudpreeda then took the lead in tailoring and administering an appropriate chemotherapy regimen, followed by the addition of targeted therapy precisely designed for patients with BRCA1.
“The doctor outlined the treatment plan for me, including the duration of chemotherapy and subsequent targeted therapy. He also scheduled follow-up evaluations and health screenings to monitor any potential malignancy. The latest results were reassuring, showing no cause for concern. What initially appeared to be a complex and challenging case was ultimately managed seamlessly thanks to the multidisciplinary team approach,” Ms. Som shared.
On the day Mrs. Som gave an interview with the team, she had already completed chemotherapy, with only the targeted therapy medication remaining on schedule. Ms. Som discussed the side effects she experienced, including a low-grade fever, numbness in her hands and feet, muscle pain, and hair loss, but no nausea. Dr. Sudpreeda prescribed medication and recommended light exercise, such as muscle stretching, to reduce pain that was interfering with her daily life.
“The efficacy of the medications, results of blood work, and various patient parameters are quite good. There is a good chance we can treat this to a complete recovery. However, we need to continue monitoring and watching for other cancers that may be at risk of developing. Beyond treating the current condition, we also must keep the patient safe from future diseases, which medical technology and genetics can now predict.” Dr. Sudpreeda emphasized.
“Attentive Care” You Can Feel… Every Step at MedPark
Ms. Som shares her deep appreciation for the remarkable experience she had at MedPark—marked by prompt diagnosis, seamless collaboration and consultation among specialists from relevant disciplines, and the dedicated support of the hospital staff and nurses, who consistently demonstrated attentiveness, empathy, and a genuine commitment to care throughout her treatment journey.
MedPark Hospital's caliber as a comprehensive cancer center, advanced technology, and multidisciplinary specialists was particularly evident in the case of Ms. Som, who required the combined expertise of gynecologic oncology, surgery, and genomic medicine. The close collaboration among these highly skilled specialists significantly enhanced the diagnostic and treatment process, ultimately enabling Ms. Som to overcome her fallopian tube cancer.
“The current treatment outcomes have been very satisfactory. The medications prescribed by the doctor have shown a good response from the tumor, and the physical examination results are normal. It was the right decision to have comprehensive treatment coordinated in one place.” Ms. Som concluded.
This narrative is yet another testament to the remarkable advancements in modern medicine, demonstrating how the integration of cutting-edge technology with the dedicated collaboration of medical teams and multidisciplinary experts can effectively manage complex conditions at MedPark Hospital.
