It was quite a red flag.
Alla Feldbeyn was stunned by unexpected vaginal bleeding in November 2020, many years after she had gone through menopause.
The Florida grandmother of four was diagnosed with Stage 1 endometrial cancer. The disease — which develops in the lining of the uterus — has become more common in the US in the past two decades, primarily due to rising obesity rates and the aging population.
Feldbeyn had her uterus removed and was told that she didn’t need chemotherapy or radiation because the hysterectomy was enough to rid her body of the cancer.
Everything was OK until 2022, when Feldbeyn started coughing incessantly and experiencing unusual pain in her side.
She thought there was a problem with her gallbladder — she was shocked to learn that she had red spots covering her lungs.
Feldbeyn said her doctor didn’t believe her endometrial cancer had returned and suggested it was a different type of cancer. His office kept rescheduling her appointment.
Dissatisfied with the wait, Feldbeyn sought a second opinion and was referred to Dr. Brian Slomovitz, director of gynecologic oncology at Mount Sinai Medical Center in Miami.
“[The appointment] was Thursday,” Feldbeyn, 68, told The Post, “and on Tuesday, I already started chemo.”
Feldbeyn’s endometrial cancer had spread to her lungs — she was deemed Stage 4.
After lung surgery and three months of chemotherapy, Feldbeyn enrolled in a clinical trial that evaluated the effectiveness of selinexor, a prescription oral medication used to treat certain blood cancers, on endometrial cancer.
Because it was a blinded study, neither Feldbeyn nor Slomovitz knew if she got selinexor or a placebo. Either way, it didn’t work for her.
She stopped participating in the trial in October 2023. The following month, she had a tumor removed from her lung that was dangerously close to her spine.
Last year, she joined a second clinical trial that’s assessing non-chemotherapeutic treatments for endometrial cancer.
“In the past, hormonal therapy by itself has been used for the treatment of this disease,” Slomovitz told The Post.
“However, the response rates are relatively low, and the duration of response is only a couple of months.”
Slomovitz said the focus is now on combining anti-hormonal therapies with targeted therapies tailored to specific tumor biomarkers, a more personalized treatment approach aimed at the hormonal and cellular drivers of the cancer.
As part of this trial, she takes the hormonal medication letrozole every day and receives thrice-monthly infusions of Nab-sirolimus, which is used to address a very aggressive and rare form of soft tissue tumors.
“The agent that we’re looking at now, Nab-sirolimus, has yet to be studied in women with endometrial cancer,” Slomovitz said.
“The ‘nab-‘ drug delivery system is better than traditional methods because it increases effectiveness and reduces severe side effects.”
Feldbeyn said she has experienced several side effects to the treatment, including nosebleeds, coughing, itching, fatigue and high cholesterol — but her cancer hasn’t progressed.
As she enters the second year of the clinical trial, she continues to work remotely as a senior director for a day program serving developmentally disabled adults.
“The great news about Alla is not only her response to the therapy, but she’s definitely maintaining her quality of life,” Slomovitz said.
“She and her husband love to take cruises and they go on many trips each year,” he added. “For the clinician taking care of her, this is very satisfying and what we want of our patients.”
Feldbeyn encourages advocating for your own health, seeking second opinions when warranted and considering participation in clinical trials.
Only 7% of adults with cancer enroll in clinical trials in the US each year, Slomovitz said.
Researchers have been expanding trials nationally and even globally to ensure that medical treatments are safe and effective for everyone, not just a narrow demographic.
“I’m loving [being a] guinea pig,” Feldbeyn said, “because it can save not only your life, it can save a bunch of other people’s lives.”
Concerning cancer signs to watch for
“We used to think that it was very unusual for endometrial cancers to recur after hysterectomy,” Slomovitz said. “We’ve learned that that’s not the case.”
About 30% of endometrial cancers have advanced disease or recurrent disease, he added, which makes endometrial cancer more deadly than ovarian cancer in the US.
The American Cancer Society predicts about 13,860 deaths from uterine cancers and 12,730 ovarian cancer deaths this year. Endometrial cancer is the most common type of uterine cancer.
Slomovitz recommends that women with abnormal, persistent bleeding see their healthcare provider.
Post-menopausal women should not have any bleeding. Just one spot of blood should prompt a visit to the doctor.
Also, watch for pelvic or stomach pain, discomfort with urination or abnormal vaginal discharge.
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