More than two years, Susan Rosati remembers her first suspicion that “something just wasn’t right.” She had been feeling very tired for some time and began experiencing an extremely painful burning sensation when urinating.
Rosati made an appointment with her gynecologist, who did not identify anything unusual at first. When symptoms persisted, a biopsy confirmed it was vulvar cancer — a rare gynecologic cancer that can affect older women. Rosati was referred to Virtua gynecologic oncologist Randolph Deger, MD, who diagnosed Rosati with bi-lateral vulvar cancer, which is cancer on both sides of the vulva.
“I jotted a million questions on index cards and brought them to my first appointment with Dr. Deger — and he took the time to answer every single one,” explained Rosati. “You can research a disease, but every case is different. I needed information that was specific to my situation. They say that knowledge gives you power. In my case, it also gave me the strength and confidence to get through my journey.”
Dr. Deger believes Rosati’s proactive approach to her health was crucial.
“It is so important to take care of yourself,” he said. “Don’t disregard changes in your body — any pelvic issue you notice should be addressed by your gynecologist.”
Rosati had surgery in November 2018 and spent three weeks at a rehabilitation center to increase her mobility before going home in time for Christmas.
“I was able to get up and dance while the guests cheered me on,” she recalled. “Life goes on, and I don’t want to miss any of it.”
By March 2019, Rosati’s recovery was well underway; however, a mammogram that same month revealed a suspicious area indicating that her medical journey would continue. Her diagnosis was ductal carcinoma in situ (DCIS), a non-invasive breast cancer that has not spread beyond the milk ducts. Based on her positive experience with Dr. Deger, Rosati decided to continue her care at Virtua with breast surgeon Lori Timmerman, DO. In May 2019, she had a lumpectomy, which is the surgical removal of the tumor and surrounding tissue.
After her lumpectomy, Rosati completed radiation therapy and “rang the bell,” a celebratory gesture that signals the end of treatment on Sept. 23, 2019. Since then, she has received genetic counseling. While she has a significant family history of cancer, her genetic tests did not reveal a BRCA gene marker.
“I wanted to be tested for my daughter,” Rosati explained. “She was happy to see my results, but she also knows how important it is for women to know their bodies and to seek medical advice when something seems wrong.”
Rosati believes her “prayer warriors,” a positive outlook — her glass is “always more than half-full” — and knowledge about her diagnosis and treatment were essential to her recovery from both cancers.
She feels lucky to have received her cancer care at the Penn Medicine | Virtua Cancer Program.
“I was so impressed by all of the physicians I had contact with — particularly Drs. Deger and Timmerman,” Susan said. “They were there for me and treated me like family. They are excellent physicians, but they are also direct, kind, and relatable. They truly made my cancer journey much easier to endure.”
Rosati says she is now grateful for her journey.
“I am very thankful that both of my cancers were diagnosed and successfully treated,” she said. “My mantra is to keep looking forward, not back. I’m happy to say that I’m having the time of my life.”
Gynecologic Health Recommendations:
• Get annual PAP and HPV tests. The HPV vaccine is available to people age 45 or younger.
• Stay current on mammograms and colonoscopies because the statistics of being diagnosed with gynecologic cancers increase when you have colon or breast cancer and vice versa.
• Be aware of your family history. Genetic testing is an option for many women. The U.S. Preventative Services Task Force recently updated its recommendations for genetic testing of the BRCA1 and BRCA2 gene mutations. This updated group now includes women who have been diagnosed with breast, ovarian, or tubal cancer, and those who have completed treatment and are considered “cancer free.” Also included are women of ancestries associated with the BRCA 1 and BRCA 2 mutations, such as being of Ashkenazi Jewish descent.
• Educate yourself on gynecologic cancers and speak to your physician.
Gynecologic Cancers and Symptoms:
• Cervical Cancer – Pain, abnormal bleeding, vaginal discharge.
• Ovarian Cancer – Pelvic discomfort, bloating, urinary tract infections that do not respond to antibiotics.
• Uterine/Endometrial Cancer – Abnormal bleeding, including bleeding between periods and post-menopausal bleeding.
• Vaginal Cancer – Unusual vaginal bleeding; pain, lump, or mass in the vagina; bowel or urination problems; vaginal discharge.
• Vulvar Cancer – Itching/burning that does not go away; pain, bleeding or discharge; lump; open sore; change in sensation.
• Gestational Trophoblastic Disease (GTD) – pregnancy-related tumors that develop after conception and lead to abnormal development of the placenta.
Primary Peritoneal Cancer (PPC) and Fallopian Tube Cancer – abdominal bloating, changes in bowel habits, early feeling of fullness after eating, nausea, and vomiting.