Juana Espino and her husband were excited to welcome their third child. But two weeks before her due date, she started spotting blood.
Espino contacted her obstetrician right away. During an exam, the doctor found a mass near her cervix and recommended a biopsy after the baby was born. Espino’s daughter was delivered healthy via C-section but Espino’s biopsy revealed she had Stage 4 cervical cancer.
“From there, it was just a rollercoaster, at first,” says Espino. “I didn’t have health insurance. You always have a pap smear at the beginning of your pregnancy, and mine was normal. The cancer had really grown while I was pregnant, and the doctor was worried about it metastasizing.”
Treatment options
Espino’s cervical cancer was rare. Only about 1% – 3% of woman who are diagnosed with cervical cancer are pregnant or postpartum.
She and her obstetrician discussed several treatment options. The doctor advised her to meet with Dr. Joseph A. Lucci, a board-certified gynecologic oncologist at The University of Texas Health Science Center at Houston (UT Health). He was also the principal investigator of a clinical trial treating Stage 4 cervical cancer.
Espino agreed to participate in the trial, which included a hysterectomy, followed by six weeks of chemotherapy and radiation.
“The good thing is, I have a big family,” said Espino. “I talked about it with my husband and my six sisters went with me to talk with Dr. Lucci about the clinical trial. I am grateful that I had a big support system. I was truly blessed.”
Espino’s chemotherapy and radiation were delayed for two months since she was a mother of a newborn.
She still faced another challenge: caring for her baby since it’s not recommended for patients who receive certain types of radiation treatment to have contact with children under the age of 18 or pregnant women.
“We decided that my mother would take care of our baby, to be on the safe side,” says Espino, who acknowledges it was tough not being her baby’s primary caregiver.
Her mother took good care of the baby and Espino still got to see the infant. Her whole family, including her sisters and her niece – who postponed going to college to be with Espino – were supportive during her treatments.
Empowered
The clinical trial was a success. Espino was impressed with the care she received, especially from Dr. Lucci and the coordinator, Carole Robazetti.
Three years after the trial concluded, she participated on a Patient Advisory Board for the Center for Information and Study on Clinical Research Participation, (CISCRP), a non-profit 501(c) 3 organization advocating for clinical research education. During the panels, patients share feedback on a variety of critical clinical study related areas.
Espino related when she heard fellow patients describing the physical and emotional impacts of severe atrophic vaginitis, a condition marked by the thinning, drying and inflammation of the vaginal walls that can happen if the body has less estrogen. She had the same symptoms but hadn’t told Dr. Lucci or Robazetti. The panel environment empowered her.
“I was afraid to speak up and after I heard the others share their stories, I decided to talk with Carole,” says Espino. “She asked me why I hadn’t said anything before, and I just hadn’t felt comfortable.”
Espino was prescribed medication which significantly improved her condition. These days, she’s friends with Robazetti, who inspired her to help other patients, by connecting her to WOW, the Women Well Program, under the umbrella of the Latattore Foundation and the University of Texas.
The program provides pap smears and mammograms at no cost to low-income/uninsured women through monthly community health fairs. Espino started as a volunteer and now works for WOW.
She’s an advocate for clinical trials too: “We need to speak and let people know what’s happening,” she says.
