September 4, 2019
When Darlene Riva, now 72, of Jackson, New Jersey, first started bleeding vaginally, she suspected a simple urinary infection. But after a year of urinary testing and no answers, the retired teacher went to see Joanne Chang, M.D., a gynecologist affiliated with Hackensack Meridian Health. An ultrasound showed a thickening of the uterus, and a biopsy revealed an alarming finding: Darlene had endometrial cancer.
Dr. Chang referred Darlene to James Bosscher, M.D., a gynecologic oncologist at Riverview Medical Center. He confirmed the diagnosis and recommended a full hysterectomy, the standard treatment for her type of cancer.
The cancer diagnosis came as a shock to Darlene, whose only symptom was an occasional small amount of bleeding. “I was convinced it was a urinary infection or a problem of that kind. It wasn’t a lot of blood, and it didn’t happen that often,” she says.
“I was very surprised but encouraged by [my doctors’] confidence that the hysterectomy would resolve the problem because it was caught early. They were right.”
But Darlene also had an incarcerated ventral hernia, making it difficult to access her pelvis for surgery. So Dr. Bosscher brought in general and robotic surgeon David Dupree, M.D., FACS, a robotic hernia specialist at Riverview. To save Darlene the challenges and risks of two separate surgeries, the pair of doctors worked together in one operation to repair the hernia and perform the hysterectomy.
“We’ve worked together for several years. If I have patients with hernias, Dr. Dupree addresses the hernia and I do the gynecological part of the procedure,” says Dr. Bosscher.
The surgery was performed robotically, a minimally invasive procedure that allows surgeons to operate with greater control and precision.
“The robots have become more sophisticated with time and the new generations have a wide range of motion, so it’s as if you’re actually operating with your own hands,” says Dr. Bosscher, who has operated with robots since 2008.
With robotic surgery, there’s a lower chance of infection, less post-operative pain and a shorter healing time compared to traditional open procedures. This means patients can return to their daily routine and lifestyle quickly.
“With a traditional open procedure, you’ll have a 15- to 20-inch incision. With Darlene, if you add up all of her tiny incisions, it’s maybe 2 inches all together. That’s why there is less pain,” Dr. Dupree says.
Darlene is thrilled with how easy her recovery has been. She went home the day after surgery in June 2018.
“I walked out of the hospital,” she says. “I was a little uncomfortable for about two weeks, but I had no pain.”
This wasn’t Darlene’s first experience with cancer. In 2015 she was successfully treated for breast cancer by radiation oncologist Nathan Kaufman, M.D., and William D. Adams, M.D., who performed her lumpectomy. Darlene worried that the previous cancer was related to her new endometrial cancer diagnosis, but Dr. Bosscher reassured her that one had nothing to do with the other.
“What I love about Dr. Bosscher is he let me talk and answered all my questions. He’s just so easy to talk to,” Darlene says.
As most of us would, Darlene had concerns before surgery, but the care and attention of her medical team reassured her. She was particularly worried about the anesthesia. Her sister previously had problems with anesthesia, and Darlene was being tested for sleep apnea at the time, a condition that can complicate surgery.
Her anesthesiologist, James Dooley, M.D., played a big role in her confidence. “He called me the night before the surgery and talked to me for almost an hour. I got to ask him all these things I was concerned about. He answered all my questions. He was absolutely wonderful,” Darlene says.
The stage 1 cancer required no treatment beyond the hysterectomy. With the help of her multi-disciplinary medical team, Darlene has recovered and is back to enjoying retirement with her husband, William, three daughters and three grandchildren.
“We resumed our retirement life. We have fun and everything is good,” says Darlene, who enjoys traveling to Vermont and South Carolina with her husband. “I feel very lucky that it was caught before it got worse.”
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