Marilyn Hoffman was first diagnosed with gynecologic cancer in 2020. She would fight cancer with several teams at IU Health, including North, University and Methodist hospitals.
By Charlotte Stefanski, marketing associate, email@example.com
For many, September signifies the beginning fall, with cooler weather, football and bonfires.
For Marilyn Hoffman, the month marks the two-year anniversary of her gynecologic cancer diagnosis.
September is Gynecologic Cancer Awareness Month; a type of cancer that includes malignancies of the uterus, cervix, vulva, vagina and fallopian tubes. Endometrial cancer, which involves the innermost lining of the uterus, is the fourth most common cancer in women in the United States.
Back in 2020, just a few months after retiring and moving back to Indiana, Hoffman had scheduled her annual exam with her gynecologist.
During the exam, she remembered him saying, “Oh, we better take a look at this,” followed by, “That doesn't look good.”
She was sent to an IU Health obstetrics (OB) oncologist, Dr. Paul Mayor, who diagnosed Hoffman with vulvar cancer, more specifically, cancer of the labia. Hoffman knew her family had a history with breast and skin cancers, but nothing like this.
“Shock and awe are the right words. I was scared,” Hoffman said. “What's the prognosis? What's next?”
From there, Hoffman would begin a two-year-long journey of care with several teams at IU Health, including North, University and Methodist hospitals and the Simon Cancer Center downtown.
At first, she underwent lymph node surgery in October 2020. Four nodes were positive for cancer on the left side, which is the same side where the labia cancer was present. Later that November, she had a chemotherapy port placed and was scheduled for 32 rounds of radiation as well.
Hoffman was treated with cisplatin in small doses, and she remembered having a small amount of side effects, including losing her hair. But by week five of radiation, she was in serious pain. Those treatments were completed in January, and she’d have to wait until March for her next PET (positron emission tomography) scan to detect cancer cells.
There were questionable spots on her scan, so Dr. Mayor did another biopsy. It appeared that the chemotherapy and radiation didn’t work; Hoffman’s cancer was back.
“I then had a radical lobectomy in June of 2021, where they took away six of the major body parts,” Hoffman explained. “I was able to continue to urinate and have bowel movements normally, but there were other parts that were taken away.”
Hoffman’s care team then worked with a plastic surgeon at University Hospital to complete the procedure. But that August, some of her wounds opened back up. She then started comprehensive wound care at IU Health Methodist. Hoffman’s twin sister, Carolyn, drove her every day to her 61 hyperbaric oxygen therapy treatments at the hospital.
“That was about a three-hour process. So, she got to enjoy Methodist lunch every day,” Hoffman joked.
However, another PET scan that November showed that her cancer had come back. Dr. Mayor had moved on to another practice, and Hoffman was introduced to Dr. Lisa Landrum, who had just come to Indiana that September to lead the Gynecology- Oncology team as the division director at IU School of Medicine.
Currently, she sees patients at the IU Health Joe & Shelly Schwarz Cancer Center in Carmel for cancers involving the uterus, cervix, ovaries, fallopian tubes, vulva and vagina, as well as gestational trophoblastic neoplasia.
Dr. Landrum’s practice includes both surgery and prescribing chemotherapy, and she works closely with providers in radiation oncology when the treatment is appropriate.
“She was very proactive. She did another surgery, just to make sure what was shown on the PET scan was cancer, and she did come back and say it was cancer,” Hoffman said. “At that point, she recommended a total pelvic exenteration.”
The surgery would include removing 13 more organs, and Hoffman would need to use an ostomy bag. It was a big decision, and Hoffman and her care team decided to wait until after the holidays so she could spend time with her family and prepare herself.
“In Marilyn’s case, the only opportunity for curative treatment was a very extensive surgery,” Dr. Landrum explained. “We discussed the lifelong changes that this surgery would have on her, but she understood this was her only hope for cure.”
Since the procedure, Hoffman has been cancer free. She still visits the Schwarz Cancer Center every three months for her PET scans and for any check-ups with Dr. Landrum.
She doesn’t know where she would be without family. All four of her sisters are in the area and have helped take care of her, and she currently lives with her twin, Carolyn, and her husband.
“When things were getting pretty tough, I couldn't sleep or eat. My nieces and nephews would send pictures of their beautiful babies and told me to get better,” Hoffman said. “I just feel for people that aren't surrounded by family like that, because I don't know how they could get through it.”
While Hoffman has had a long journey with IU Health, she’s extremely thankful for all of her providers, surgeons, nurses and team members. During some of the hardest moments of being treated for cancer during a pandemic, she remembered those working the front desk at Schwarz Cancer Center.
Due to COVID-19, she had to go in alone, but those at the front desk were always warm, welcoming and remembered her name. She also thanks Dr. Landrum, who was not only a physician, but an advocate.
“She was very attentive, very proactive. I know all doctors probably do this, but it was just a special experience with her. Her personality is just very calming—she just really sets you at ease and you have her undivided attention the whole time you're with her,” Hoffman says.
When it comes to advice, both Hoffman and Dr. Landrum encourage all women to continue getting their annual exams to detect early signs of gynecologic cancers.
“It’s very important for women to be attuned to changes in their body. Postmenopausal bleeding is not normal and should be immediately evaluated by your primary OB/GYN. Please get your annual exams with pap tests to evaluate for precancerous changes in the cervix,” Dr. Landrum advised. “I would also encourage vaccination with human papillomavirus vaccine to reduce risk of cervical, vaginal, and vulvar cancers as well as smoking cessation. Women should also pay attention to discomfort or pain in the abdomen and pelvis that doesn’t resolve, or changes in bowel or bladder function.”
“Just make sure you go see your doctor, and don't wait. There's always this fear of the unknown that sets us all back,” Hoffman said. “But you have to face it and go do it. Don't be afraid.”