A road map to survivorship

Throughout her cancer journey, Elizabeth Barr set goals for herself, from meeting her frst grandchild to dancing at her son’s wedding. The UK Markey Cancer Center helped her achieve each one.

When Elizabeth Barr (E, as she’s known to everyone), started to feel pain in her abdomen in March 2017, she had no idea that it was the beginning of a four-year rollercoaster ride that would nearly kill her — and an incredible recovery that would lead her doctors to nickname her Lazarus.

She visited a urologist to rule out a UTI, then underwent a colonoscopy. Her test results came back normal, but the pain continued to intensify. During another exam, Barr’s gynecologist felt something unusual and referred her to UK HealthCare, where she met Dr. Fred Ueland, chief of the Division of Gynecologic Oncology at the UK Markey Cancer Center. He recommended surgery to confirm Barr’s diagnosis: a malignant ovarian tumor.

Barr already has a complicated health history: She was born with only one kidney and had an ovary removed in her 20s due to a non-cancerous tumor. Because of this and the aggressive nature of her cancer, Ueland and his team removed Barr’s remaining ovary and uterus as well as a portion of her colon. The surgery was followed by 10 hours of chemotherapy every three weeks.

“We looked forward to it because we got to know those nurses, doctors and staff, and they became like family,” Barr said.

The end of her treatment regimen was in sight by late 2017. But in January 2018, shortly after completing chemo, Barr’s pain returned. By February, a scan confirmed that her cancer was back. Barr and her husband, Cary, met with
Dr. Avinash Bhakta, a colorectal surgeon at UK HealthCare, to undergo a minimally invasive laparoscopic right colon resection. The team felt confident they had removed all recurrent tumors.

However, in May 2018, Barr felt pain again. A PET scan revealed more disease in her abdomen, and she began having severe gastrointestinal bleeding.

“At that point, chemo was out of the question, surgery was out of the question,” Barr said. “I was pretty weak.”

Barr began a series of blood transfusions to strengthen her body and was referred to Dr. Mark Bernard for radiation therapy to treat the cancer and stop the bleeding. The palliative care team came in to speak to the couple, but Barr was only interested in one thing.

“I wanted to live long enough to see my frst grandchild who was due on my birthday, June 30,” she said.

Barr came home from the hospital in early June, weak from radiation and on a liquid diet, but determined to make it through.

“For the month of June we waited for the radiation to work,” Barr said. “On July 1, 2018, William Palmer Dycus was born, and I got to see my grandchild the day he arrived. So then I gave Dr. Ueland another goal: that I wanted to be here for my son’s wedding in October 2019.”

Following another surgery, Ueland ordered whole genome sequencing on Barr's cancer specimen to look for mutations or abnormal genes in the cancer tissue. As Barr recovered at home, the Molecular Tumor Board at Markey met to review her case. This team of physicians, surgeons, scientists, researchers and pharmacists specialize in interpreting genomic test results and translating them into personalized cancer treatments. They recommended a type of immunotherapy called pembrolizumab, which helps the immune system recognize and attack cancer cells.

After three treatment cycles, Barr walked into Ueland's office and told him that for the first time in a long time, she felt normal. Six months later, her scans were cancer-free.

"It really highlights what the Markey Cancer Center can do: provide individualized, multidisciplinary and innovative cancer care in a truly personal way," Ueland said.

Thanks to the Molecular Tumor Board, Barr received her lifesaving treatment two years before it became widely available for her type of cancer. Today, she has been entirely off therapy for over a year and is doing well. Barr credits Markey with giving her a road map to survivorship — allowing her to meet her grandchildren, dance at her son's wedding and plan for the future.

"I just always needed to know we had a game plan," she said. "and UK HealthCare did it. They thought outside the box and gave someone like me a chance."