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Surviving Sweet 16

Twenty-five years ago, Mary Frances McAndrews—and her Abington specialists—battled her ovarian cancer
with everything they had

AUGUST 1984

Mary Frances McAndrews sat on the floor of her living room, doing sit-ups to ease her stomach pain.

"My family doctor thought I pulled a muscle," she recalls. "But I was growing increasingly nauseous and gaining weight around my abdomen."

Her symptoms quickly grew worse, with searing pain and heavy menstrual bleeding. Her parents rushed the 16-year-old to Abington's Emergency Trauma Center.

An ultrasound revealed a grapefruit-sized mass on Mary Frances' left ovary. In the operating room, the mass proved malignant. It had spread to the bowel and into the peritoneum (membrane surrounding the abdominal cavity).

Fortunately Mary Frances' father, a pharmaceutical representative, had heard of Parviz Hanjani, M.D., and his leading reputation in treating female cancers.

The Willow Grove parents wanted the best for their daughter, and requested Dr. Hanjani. Twenty-five years later, Dr. Hanjani and his chief oncologic nurse, Susan Nolte, Ph.D., still work to provide the latest in gynecological cancer care at Abington Memorial Hospital's Hanjani Institute for Gynecologic Oncology.

They are part of Abington's Rosenfeld Cancer Center, where specialists across disciplines of pathology, radiation oncology, surgery and oncology come together to focus all their expertise on individualized treatment plans. Dr. Hanjani explains, "I did not know Mary Frances before I was called into the operating room. It was a very difficult decision on how far to go, based only on the frozen sections of tumor prepared in our Pathology Department.

"The recommended treatment for her advanced-stage germ cell tumor would have been a hysterectomy," the oncologist continues. "But with such a young woman, you want to do less, not more. And because of Abington's participation in advanced clinical trials through the National Cancer Institute's Gynecology Oncology Group, there was another option." Dr. Hanjani is a principal investigator in the GOG.

After removing the cancerous tissue, Dr. Hanjani chose to preserve her uterus and her healthy ovary. But Mary Frances would have to undergo three intense doses of chemotherapy as follow-up.

Mary Frances remembers, "My parents looked shell-shocked when they heard what was ahead. Like a typical teenager, I was concerned with making sure the principal knew why I wasn't going to start my junior year on time. And, of course, the fact that I was going to lose my hair."

Susan Nolte says the teen's experience was different in so many ways. The team didn't want to admit her to the adult oncology unit, so she went to the Pediatric Unit.

"I remember coming to see her one day," Nolte continues. "She was laying there, a teddy bear at her side, so very sweet. And so very sick. Twenty-five years ago, cancer treatment was much less refined, particularly when it came to combating nausea. Mary Frances didn't respond well to the anti-nausea medicines we had then. So her body fought three very toxic drugs alone."

Mary Frances was beyond scared. Enduring fevers of 104 degrees that chilled her to the bone. Watching her white counts plummet to the point she had to be placed in an isolation room. "Dr. Hanjani and Susan were my lifeline to what was going on," she explains. "To have two such wonderful people helping me through this unknown made all the difference."

"I was the only young person with cancer I knew. I didn't really fit into either world. I wasn't an adult or a child. I struggled with a lot of issues that a cancer patient — younger or older — wouldn't encounter today."

The absence of people her own age weighed heavily on her shrinking frame. One day, however, she was visited by a young man fighting lung cancer. "He was only 19, and also on the Pediatric Unit. I had met someone who really understood," Mary Frances adds. "He knew that even with all the pieces of us that cancer took, our spirits were strong. He cared about me as I was and vice versa."

Mary Frances' parents waited until she was much stronger to tell her the young man did not survive. She still holds a very special place in her heart for him.

In the space of just three-and-a-half months, her world turned upside down, and righted again. In November 1984, Mary Frances underwent "second-look surgery" to see if the treatments worked. She was cancer-free.

PRESENT-DAY, 2009

Now 41, Mary Frances has earned two Master's degrees, and works with blind and visually impaired veterans in Washington, D.C. She is still cancer-free, with no side effects from that long-ago treatment.

She's also a major advocate for ovarian cancer awareness. She even started an ovarian cancer survivor's group near her home in McLean, Virginia.

"I think if you can give hope to people, like Susan and Dr. Hanjani did for me and my parents, then you must do it," Mary Frances says.

The vision rehabilitation therapist applauds Abington Memorial's outstanding oncology care at a time when clinical trials were almost unheard of in all but a few hospitals. "All the reading I've done makes me realize that Dr. Hanjani was on top of the latest thinking even then," she exclaims.

"When I was diagnosed, Dr. Hanjani represented the best of three worlds.

He became my gynecologist, my surgeon, and my oncologist. He's not just diseasefocused. Both he and Susan are so compassionate and caring. I'll always be connected to them through the clinical trial, and our friendship."

Mary Frances McAndrews is as sweet as ever. It's nice to know she's grown up so well.

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