Sometimes, things sneak up on you.

In November of 2020, Victoria Theogarajan had a sharp, shooting pain in her back. She thought maybe she had a kidney stone.  So she went to her doctor, who ordered an ultrasound. The results showed nothing abnormal.

Then Victoria started experiencing cramping in her lower abdomen. Nothing severe, just annoying at first. She ignored it and went on with her life: spending time with her family, working as a quality assurance manager and staying fit.

Then the cramping got worse.  By January of 2021, Victoria was getting needle-like pains. So she went back to her doctor, who ordered a CT scan.

“Before I even got home, they had called my doctor and said the scans don’t look good,” she said. “They wanted me to see an oncologist. I knew what that meant.”

A tough cancer diagnosis: advanced uterine cancer

On the recommendation of her doctor and a friend, she sought out Dr. Saketh R. Guntupalli, a specialist in gynecological cancers at UCHealth University of Colorado Hospital on the Anschutz Medical Campus.

Guntupalli saw Victoria right away.

“He looked at the results of my scan and said, ‘Let’s get a biopsy of the uterus,’” Victoria recalled.  “It was malignant.”

Victoria had to face a tough diagnosis: stage IVb uterine cancer, the most advanced type.

Among gynecological cancers, uterine cancer is the most common, but stage IVb is quite rare, said Guntupalli, who is also an associate professor of obstetrics, gynecology and gynecologic oncology at the University of Colorado School of Medicine.

Thankfully, Victoria received care at a cutting-edge cancer center where Guntupalli could offer hope and more: top-notch treatments supported by breakthroughs in medical science.

How genetic testing has ‘revolutionized’ treatments for uterine cancer and other gynecologic cancers

Guntupalli and his colleagues use genetic testing to see which treatment options will work best for each patient. Genetic testing also gives doctors insights on which medications might cause the fewest side effects for patients.

Because of genetic testing, “We can predict a drug regimen that will work as opposed to one that won’t work, or won’t work as well,” he said. “It’s turning out to be very valuable in picking out the right protocol. Genetic testing has completely revolutionized the way we look at cancer.”

Victoria’s success also might be due to the fact that “we have a very aggressive surgical approach. We go after every bit of tumor that we see. We can be pretty surgically aggressive because we have an outstanding support system” of other medical professionals.

The survival rates for someone with Victoria’s diagnosis are about 20 to 30%, but Guntupalli’s patients fare even better thanks to the team’s aggressive treatment approaches and access to clinical trials.

Eerily calm and focused as she fought advanced uterine cancer

Before she got her diagnosis, Victoria had a feeling that something was seriously wrong. Then, when Guntupalli gave her the news, she was eerily calm and intently focused on getting past her cancer.

“I knew something was brewing. I think I was prepared,” Victoria said. “My husband was shaking but I was pretty calm. I thought, ‘I just need to figure out how to fight this, that’s all.’”

Victoria opted to receive care as quickly as possible and Guntupalli scheduled her for surgery during the first available slot in early February.

“It all went very fast,” Victoria said.

During surgery, Guntupalli discovered that the cancer had spread to Victoria’s ovaries, colon and nearby lymph nodes.

“He removed everything and two weeks later they started the chemo,” Victoria said.

She had six chemotherapy sessions, 21 days apart, and finished in June.

That’s when she received great news.

Tests showed that the cancer was gone.

“I was surprised at how my body responded to it all,” she said. “I had very few side effects. I had a little numbness in my arms and legs and a little tiredness. No nausea or sleep problems. I think that is pretty rare,” she said.

Now she gets a scan every three months and she still is cancer-free.

“I hope I stay that way,” Victoria said.

Uterine cancer survivor now participating in a clinical trial

To try to keep Victoria’s cancer at bay, Guntupalli offered Victoria the chance to participate in a clinical trial, another benefit of receiving care at an academic medical center.

“One of the things that is great about what we could offer her is that we have this amazing clinical trial portfolio available,” he said. “We try to get every cancer patient on some type of clinical trial. We have about 50 of them. It’s the most of any group in this part of the country.”

Victoria is taking part in a study that is testing whether medications that are used for ovarian cancer can also prevent recurrences for people with uterine cancer.

“We want to make sure our patients get their basic treatment, but also a bonus. They can get some rare and sometimes very expensive drugs. The one that Victoria is on costs $8,000 a month, but she gets it for free,” Guntupalli said.

“We’re one of only three such practices the U.S. doing this particular trial. My partner actually wrote this clinical trial and because he wrote it, it’s available here. We’re trying to see if it is effective for uterine cancer as well as ovarian cancer,” Guntupalli said.

Of course, Victoria doesn’t know if she’s on the trial drug or a placebo. Nor does Guntupalli know if the experimental medication will work. But, “so far she’s doing very well,” Guntupalli said.

Her positive attitude no doubt has helped her during her cancer battle, Guntupalli said.

“I am impressed with her equanimity. I don’t think I have heard her complain once. Also, she is fairly religious and she gets a lot of that from her religion.”

So far, uterine cancer is not returning

Victoria remains convinced that her cancer ordeal is behind her.

“I had the best care. The best doctor,” Victoria said. “I don’t think anything could have been better.

“I would say that I had wonderful family support, too. Also from my friends. Lots of calls and prayers. I had angels around me.

“I always try to help others and never thought I’d be in a position to ask for help. But I let it happen. I thought, I need food. I need prayers. I accepted that.”

In some ways, she said, that was the hardest part.