Avid Traveler Finds Best Cervical Cancer Care Close to Home

In January 2022, Timea Keller started experiencing frequent irregular periods and vaginal bleeding, which her physician told her could be a side effect of her COVID vaccination or perhaps a result of menopause. “I didn’t worry about my symptoms because the explanations seemed plausible,” says the 45-year-old teacher, who had just moved with her husband and two children to Fort Lauderdale from Budapest, Hungary.

Six months later, she was visiting her family back home in Budapest when her symptoms suddenly worsened.

“I started bleeding so intensely that within a few days I got very weak and the bleeding wouldn’t stop, even when I was given strong medication,” recalls Ms. Keller, who ended up having to undergo emergency surgery to stop the bleeding and receive a blood transfusion to replace all the blood she had lost.

It was then that Ms. Keller was diagnosed with stage 3 cervical cancer. Her doctors advised her to seek treatment somewhere in the United States with more advanced technology, which she was agreeable to.

Seeking the Best Available Cancer Care Close to Home

“I knew I wanted to get treated in the U.S. because back home I would not have been able to get access to the treatments offered here. And I was looking for the best available care near where I lived,” says Ms. Keller. Some “amazing” friends connected her “devoted” husband to a few cancer specialists in the area, as the couple was still unfamiliar with South Florida’s healthcare landscape.

“After meeting a few doctors at several different hospitals who all advised me to seek treatment as soon as possible, I met the team at the Eugene M. and Christine E. Lynn Cancer Institute,” Ms. Keller says. She decided to entrust them with her care because “they seemed very professional and confident and had cutting-edge technology” for fighting cancer.

Her team at Lynn Cancer Institute, which is part of Baptist Health Cancer Care, included Thomas Morrissey, M.D., director of gynecologic oncology; Hina Saeed, M.D., deputy director of radiation oncology at Baptist Health City in Boynton Beach, and medical oncologist Lloyd Berkowitz, M.D.

Dr. Saeed recalls her first meeting with Ms. Keller. “When I first saw her in August 2022, she was experiencing significant vaginal bleeding and advanced imaging revealed a diagnosis of Stage 3 cervical cancer with lymph node involvement.” Given the locally advanced nature of Ms. Keller’s disease, surgical intervention was not a viable option, she says.

“In such cases, the standard curative approach involves a combination of external beam radiotherapy with concurrent chemotherapy, followed by daily online adaptive MRI-guided intracavitary high-dose-rate tandem and ovoid brachytherapy,” Dr. Saeed explains. “This comprehensive treatment plan aims to maximize tumor control while minimizing exposure to surrounding healthy tissues.”

Ms. Keller underwent a treatment regimen that “utilizes the power of all possible therapies in order to kill cancer cells as soon as possible.”

Possible Side Effects of Therapy

While chemoradiation is effective in treating cervical cancer, it can lead to various side effects, both short-term and long-term, according to Dr. Saeed.

Short-term chemoradiation side effects can include:

• Fatigue: A common experience during treatment, leading to a persistent feeling of tiredness. 
• Gastrointestinal Issues: Patients may encounter nausea, vomiting, diarrhea, or loose stools due to the impact on the digestive system. 
• Skin Changes: Radiation can cause skin irritation in the treated area, ranging from mild redness to peeling. 
• Bladder Irritation: Known as radiation cystitis, this can result in discomfort, frequent urination, and occasionally blood in the urine. 
• Increased Infection Risk: Chemotherapy can lower white blood cell counts, heightening susceptibility to infections. 

Long-term side effects of chemoradiation can include:

• Vaginal Stenosis: Radiation may lead to the narrowing or shortening of the vaginal canal, causing discomfort during sexual activity or medical examinations. 
• Premature Menopause and Infertility: Damage to the ovaries from treatment can induce early menopause and affect fertility. 
• Lymphedema: Swelling, typically in the legs, can occur if lymph nodes are affected by radiation. 
• Bowel and Bladder Changes: Some patients may experience chronic issues such as persistent diarrhea, bowel obstruction, or bladder dysfunction. 

“Side effects vary among individuals and not all patients will experience all these effects,” Dr. Saeed notes. “Most side effects gradually diminish in the weeks or months following treatment. However, some may persist or develop later. Advancements in treatment techniques aim to minimize these side effects.”

For instance, Dr. Saeed says, Intensity-Modulated Radiation Therapy (IMRT) targets tumors more precisely, reducing radiation exposure to healthy tissues and potentially lessening side effects. Similarly, daily MR-guided adaptive brachytherapy allows for greater normal tissue sparing and tumor dose escalation than standard CT-based or point-based systems.

One of the side effects experienced by Ms. Keller was premature menopause. “I went into abrupt menopause right at the start of my treatment, which meals I cannot have any more children.” While this was disappointing news for her husband, she has accepted her circumstances and is grateful to have survived her cervical cancer.

Closely Coordinated Cancer Care from a Team of Experts

Dr. Saeed says that patients such as Ms. Keller require regular follow-up care and adherence to treatment plans. “These are crucial for managing cervical cancer with lymph node involvement. Fortunately, advancements in treatment strategies continue to improve outcomes for patients with this condition.” She was seeing Ms. Keller every three months but now sees her every six months.

“Ms. Keller's unwavering optimism and courage throughout her treatment were truly remarkable,” comments Dr. Saeed. “Her positive mindset played a significant role in the success of her treatment, exemplifying the profound impact of resilience in overcoming adversity.” 

Ms. Keller says that being treated at Lynn Cancer Institute was quite literally a lifesaver. “The professionalism of the team there and the availability of cutting-edge technology saved my life, and I am beyond grateful that I can still be here to raise my children,” she says. “Everyone I came into contact with was encouraging, helpful, patient and kind. I felt they were always doing their personal best to care for me.”

She adds that her successful outcome was a result of the closely coordinated care she received from her team of experts at Lynn Cancer Institute. “Dr. Saeed, Dr. Morrissey and Dr. Berkowitz cooperated to give me the best complex care available in the treatment of my cervical cancer. Without one or the other, I most likely would not have achieved the same success,” says Ms. Keller.

Dr. Saeed agrees, saying that Lynn Cancer Institute is dedicated to providing exceptional care to its patients. “Our multidisciplinary approach to personalized care, combined with our passionate and skilled team, state-of-the-art technology, and commitment to delivering the gold standard of treatment, positions us at the forefront of cancer care and innovation.”

Her Cancer Journey Brings Her Family Closer Together

Although her treatment was challenging at times, Ms. Keller says her husband and her two children, ages 10 and 12, were supportive every step of the way.

“They supported me by becoming as independent as possible for kids of their age; going easy on me when I was feeling really sick from chemotherapy; laughing with me at my issues from radiation therapy – like occasionally having to quickly find a bathroom so I could pee! – and praying for me, loving me and enjoying whatever we could do together,” says Ms. Keller, adding that her cancer journey brought them all closer together. “We became really bonded.”

More Travel on the Horizon

Today, Ms. Keller says that she is feeling “good as new – well, almost!” and is completely back to her normal daily activities, including work, exercise and travel. “I’m feeling great in my skin and don’t feel limited in my life in any way,” she says.

In addition to regular visits with her family in Budapest, Ms. Keller and her family spent three weeks last summer exploring the southern parts of Germany and Luxembourg. This summer, they plan to go to Great Britain. “My sister is getting married there and we had been planning a trip there in 2020 but Covid made us cancel our plans,” Ms. Keller says. “But now, nothing can stop us!”

Who Is At Risk for Cervical Cancer?

Cervical cancer can develop at any age, but certain age groups are at higher risk. According to the American Cancer Society, cervical cancer is most frequently diagnosed in women between the ages of 35 and 44, with the average age at diagnosis being 50. It rarely develops in women younger than 20. Therefore, the organization says, “women aged 40 and above are at a greater risk for cervical cancer compared to younger women” and “regular screening is crucial for early detection and prevention.

For more information about Baptist Health Cancer Care, click here.

Hina Saeed, M.D., radiation oncologist at Lynn Cancer Institute and deputy director of radiation oncology at Baptist Health City in Boynton Beach

Thomas Morrissey, M.D., director of gynecologic oncology at Lynn Cancer Institute, part of Baptist Health

Lloyd Berkowitz, M.D., medical oncologist with Lynn Cancer Institute, part of Baptist Health