July 14, 2022

A remarkable outcome

Phyllis Stokes
Phyllis Stokes

In Fall 2019, Phyllis Stokes and her husband, Bill, were working to clear poison ivy from the native prairie around their home near Mazomanie.

Despite wearing long sleeves, blue jeans and boots to protect herself, Stokes still had a bad reaction to the toxic oil secreted by those plants. Her rashes were severe enough that she went to the local clinic for treatment.

While there, Stokes also mentioned a lump she had on her neck. Follow-up examination and testing determined that the lump was related to stage IV cervical cancer that had spread to her neck and lymph nodes.

“I was shocked,” Stokes said. She was active and feeling well, and she always maintained healthy habits.

She immediately began treatment at UW Carbone Cancer Center. First up were three cycles of chemotherapy, and Dr. Stephen Rose, director of the UW Gynecologic Oncology program, said Stokes’ scans afterward revealed continued growth of her cancer despite chemotherapy.

He then started Stokes on immunotherapy, because testing showed she had high levels of PD-L1, a protein that helps keep immune cells from attacking normal cells. Those high levels indicate immunotherapy could be an effective way to shrink tumors.

Stokes was treated with pembrolizumab, a drug that binds to PD-L1 proteins in order to help her immune cells kill cancer cells. Her initial results were very positive.

“We began to see a response right away,” Rose said.

In fact, after two years of regular immunotherapy treatments, along with some radiation on her main tumor site, Stokes was told in March 2022 she had no evidence of the cancer left in her system. She couldn’t believe it.

“It was too good to be true,” she said.

Rose said her response was even better than he expected. Prior to the advent of immunotherapy, the average lifespan of someone diagnosed with stage IV cervical cancer was about a year. And even though immunotherapy has been a significant advancement in treatment, it’s still not a guarantee.

“Even being PD-L1 positive, many patients still don’t have a response to pembrolizumab,” he said. “For her to have those treatments for two years and then have no evidence of cancer anywhere is just remarkable.”

The National Cancer Institute estimates about 300,000 women in the U.S. are living with a cervical cancer diagnosis. The disease now represents about 0.7 percent of all new cancer cases, compared to decades ago when it was a leading cause of female cancer death.

The increased use of screening techniques, namely Pap testing, has improved early detection. Vaccines against HPV, which can cause cervical cancer, also have helped decrease the number of new cases. Symptoms of cervical cancer include abnormal bleeding and pelvic pain.

UW Carbone is committed to providing world-class care for cervical cancer and other gynecologic cancers, as well as researching better methods of prevention, early detection and treatment. The annual Sparkle of Hope gala, a major fundraiser for those efforts as well as a night to honor patients and caregivers, will take place on Sept. 16 at Monona Terrace in Madison.

While she was dealing with a scary situation, Stokes said Rose and other members of her treatment team at Carbone were very caring and answered any questions she had about her treatment options.

Stokes will continue to be monitored to see whether her cancer has returned. She is anxious about that possibility, but she also has a new outlook on life.

“Now I can think about the future again.” she said. “I can go traveling and have more adventures. I have more of a happier outlook on life.”