“In Great Hands”

New treatment protocol aids in successful fight against ovarian cancer.

It took her about 15 years, but Roseann Esposito finally followed her mother’s and brother’s lead and moved from Ronkonkoma, New York to Trinity, Florida in 2006. Selling her husband, Joe, on the move was one of the easiest aspects of the venture.

Photo by Jordan Pysz.

Roseann and Joe Esposito

After 30 years of working feverishly, especially in the winter, to keep New York City’s sanitation trucks running, Joe was more than ready to leave New York and his job as The Big Apple’s fleet maintenance supervisor behind.

“Thirty years of fighting snowstorms was enough for me,” says Joe, who slowly eased into retirement while Roseann got busy working part-time as a cafeteria and teacher’s assistant at an elementary school near the couple’s new Florida home.

It was during a break from that job last May, while she and Joe were on a brief visit back home to celebrate their grandson’s first Holy Communion, that Roseann began to experience some abdominal discomfort, bloating and fatigue.

“I first thought something gastrointestinal was going on, but I went to a doctor and had some blood work done that all came back negative,” Roseann relates. “After that, I got the okay to fly home, so we came home the day after Mother’s Day as planned.

“I went to see my primary care physician the next day just to be safe, and he scheduled me for a sonogram a few days later. But I never made it to the sonogram because two days later, I was in such pain that Joe said, We’re going to see what’s going on here.

Joe’s concern sparked a trip to the emergency room, where a sonogram was performed that showed Roseann was suffering from ascites, which is an abnormal build-up of fluid between the abdominal wall and large intestine.

Roseann was admitted to the hospital that day, and the next day, a procedure was performed during which two liters of the fluid were removed. The fluid was then sent to a lab for testing, the results of which presented Roseann with the shock of her life.

“It takes forty-eight hours to test the fluid, and they were giving us updates as they went,” Joe says. “When ninety percent of it came back negative, it was looking like it was just a gastro infection. But then the doctor called and said they found cancer cells in the last ten percent.

“He then said his wife was going to come see us the next day. I thought that was rather nice of her, but it turns out she’s a doctor, and she told Roseann, I’ve read the pathology, and you have ovarian cancer. But it’s very treatable.

The Good Wife

The doctor who visited Roseann and Joe at the hospital that day is Mamta T. Choksi, MD, an oncologist at Florida Cancer Specialists & Research Institute. Her husband is Roseann’s primary care physician, Tarak S. Choksi, MD, of SunMed Primary Care. He presented her case to his wife later that evening.

“My husband came home one day and said, I have a patient I’m concerned about,” Dr. Choksi relates. “He said, I’m concerned she might have cancer, and I’d like you to take a look at her. The next day, I looked at the pathology, and I’ve been treating her ever since.”

Dr. Choksi says Roseann’s symptoms of abdominal pain, bloating and the collection of fluid are common among people suffering from ovarian cancer, which typically affects women between the ages of 60 and 70.

When her fears were confirmed, Dr. Choksi followed the National Comprehensive Network’s guidelines for treatment in recommending a regimen in which radical surgery was sandwiched around a series of chemotherapy treatments.

“We started with three cycles of chemotherapy that ran from June to August of 2018,” Dr. Choksi confirms. “Roseann then had the radical surgery, where her uterus, ovaries and fallopian tubes were removed. We then gave her two more cycles of chemotherapy.

“The last two cycles of chemotherapy began in early September of last year, and at that time, we added another agent called bevacizumab, which is a vascular growth inhibitor that basically blocks the blood vessel supply to the tumor to kill the cancer.”

Feeling Great

Until a year ago, the use of bevacizumab, also known as Avastin®, was used only if an ovarian cancer patient’s cancer returned following the initial treatment and surgery. It can now be used as a first line of treatment and as a maintenance treatment in addition to a second line of treatment.

In Roseann’s case it was administered intravenously once every three weeks for 15 months following the completion of her chemotherapy treatment. Roseann is now nearing the end of that 15-month maintenance period and says she has not experienced any of the side effects associated with Avastin, which can cause an increase in blood pressure, a runny nose and either dry or watery eyes.

“Roseann is doing extremely well,” Dr. Choksi reports. “She’s completely asymptomatic. The fluid has not returned, nor has the cancer. She’s doing great, and part of that is because she has a good, positive personality, which is very important in fighting cancer.”

Having a good doctor may be even more important, and Roseann says she is fortunate to have two. She sometimes wonders how her situation might be different had her primary care physician not referred her case to his wife.

“I’ve been in great hands since the very beginning of this,” Roseann enthuses. “I’m very confident in Dr. Choksi, and when you’re going through something like this, it’s very important to know your doctor is on top of everything and doing the right thing for you.

“She’s been absolutely wonderful, and so has everyone else at Florida Cancer Specialists. Everyone there is just so nice and accommodating. It’s strange to say, but I love seeing everyone every three weeks because they’re all so sweet, friendly and warm.

“And best of all, I’m feeling great now. I have more energy, and I feel like I’m back to normal and back to being myself again. As I said before, I really could not have been in better hands.”

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