It was a significant warning sign.
Ala Feldbain experienced unexpected vaginal bleeding in November 2020, which was particularly surprising since she had gone through menopause years before.
In that timeframe, four grandmothers in Florida received a diagnosis of stage 1 endometrial cancer. Over the last two decades, conditions affecting the uterine lining have become more prevalent in the U.S., largely attributed to rising rates of obesity and an aging population.
Initially, Feldbain was informed that she wouldn’t require chemotherapy or radiation; the uterus could be removed to address the issue.
Everything seemed fine until 2022, when she began to experience a persistent cough and unusual pain in her side.
She thought it was her gallbladder acting up, but she was stunned to discover spots on her lungs.
Her doctors were skeptical that the endometrial cancer had returned, suggesting it might be a different form of cancer. It wasn’t long before her appointments were postponed repeatedly.
Frustrated by the delays, she sought a second opinion from Dr. Brian Slomovitz, a director of gynecological oncology at Mount Sinai Medical Center in Miami.
“At my appointment on Tuesday, I started chemotherapy,” Feldbain, 68, shared.
Her endometrial cancer had advanced to stage 4, now affecting her lungs.
Following lung surgery and three months of chemotherapy, she joined a clinical trial testing the effectiveness of Seranexol, an oral medication aimed at specific cancers.
Since it was a blind study, neither she nor Dr. Slomovitz knew if she was receiving the actual drug or a placebo. Regardless, it didn’t yield results for her.
She concluded her participation in the trial in October 2023, and in November, she underwent surgery to remove a tumor dangerously close to her spine.
Last year, Feldbain enrolled in another clinical trial focusing on endometrial cancer treatments.
“Previously, hormone therapy was a standard treatment,” Dr. Slomovitz noted. “But the success rates were relatively low and typically lasted just a few months.”
Now, the strategy shifts to combining antihormonal therapy with targeted treatments based on specific tumor markers.
In this new trial, she takes a daily hormone medication, Letrozole, and receives three injections of Nab-sirolimus, a drug for rare, aggressive tumors.
“Nab-Sirolimus hasn’t been extensively studied in women with endometrial cancer,” Dr. Slomovitz explained.
He added that this drug delivery system tends to be more effective and leads to fewer serious side effects than traditional methods.
Despite the medical hurdles, Feldbain remains positive. She’s dealt with several side effects from her treatment, but, importantly, her cancer hasn’t progressed.
As she embarks on her second year of clinical trials, she continues to work remotely as a senior director of a program for adults with developmental disabilities.
“It’s fantastic to see not just how she responds to treatment but also ensuring her quality of life,” Dr. Slomovitz remarked.
He noted that she and her husband enjoy cruising and travel several times a year, which is truly fulfilling for the medical team caring for her.
Feldbain encourages others to be proactive about their health, seek second opinions when possible, and consider joining clinical trials.
Dr. Slomovitz mentioned that only about 7% of cancer patients in the U.S. participate in clinical trials annually.
Researchers are expanding trials both nationally and internationally to ensure diverse representation in healthcare.
Feldbain expressed her belief: “Being a guinea pig can help save not just your life, but others’ too.”
Signs of Cancer to Watch For
“We used to think it was rare for endometrial cancer to return after a hysterectomy,” Dr. Slomovitz said. “But that’s not the case.”
He stated that around 30% of endometrial cancer cases can experience progression or recurrence.
The American Cancer Society projects this year that there will be about 13,860 fatalities from uterine cancer and 12,730 from ovarian cancer. Endometrial cancer remains the most common uterine cancer.
Dr. Slomovitz recommends that women experiencing unusual and persistent bleeding consult their healthcare providers.
Postmenopausal women should not be bleeding; any instance of it should prompt a trip to the doctor.
Other warning signs include pelvic or abdominal pain, discomfort during urination, or abnormal vaginal discharge.
