Gynecologic Cancer

A Life Saving Move

It’s clear from even the outside of Georgina Krain’s attractive Cape Cod-style home that animals are an important part of her life. The penguin figure and giant clamshell birdbath that overlook the front yard speak to this and provide a peek into her work life as box office manager at New England Aquarium. Two dogs – Opie, a chow-border collie mix, and Mary Jane, a rat-terrier cross – romp through the backyard. Inside, seven lovebirds coo in their cages.

“They’re my babies,” says the 45-year-old Gigi, who is single. “I love them. They give me lots of companionship.”

Gigi moved to Bellingham from the Boston suburb of Arlington five years ago so she could have a peaceful garden and room for her animals. She didn’t realize then that her relocation would not only improve the quality of life for her multi-species “family,” but that it would ultimately save her own life.

Following her move, Gigi switched from her Boston-area gynecologist to Dr. Brenda Coutinho, whose practice Milford-Hopkinton Obstetrics & Gynecology is located at 221 East Main St. Milford and at 77 West Main Street in Hopkinton. She had not had a menstrual period in almost a year and felt her previous doctor dismissed her symptom as perimenopausal, a phase of hormonal changes leading up to menopause. However, Gigi had started to bleed again. So, she was very pleased when Dr. Coutinho paid special attention to her circumstances. “She definitely listened to my concerns,” Gigi states.

Not only had Gigi stopped menstruating at an early age, Dr. Coutinho explained to her that she had other risk factors for cancer, including being overweight, never giving birth and having a history of fibroids. “It could have been perimenopause, but she had risk factors for cancer,” Dr. Coutinho points out. “Anything out of the normal should be checked.”

An ultrasound showed unusual thickening of Gigi’s endometrium, or uterine lining. Dr. Coutinho performed a dilation and curettage [D&C] at Milford Regional’s Surgery Center, in which she scraped some cells from the uterus for diagnosis. Gigi had cancer.

The hysterectomy Gigi required would be challenging, Dr. Coutinho recalls. Her lymph nodes would need to be removed along with the uterus, fallopian tubes and ovaries. And Gigi’s weight was a complicating factor.

Fortunately, Milford Regional’s partnership with Brigham and Women’s Hospital includes the expertise of Dr. Neil Horowitz, a gynecologic oncologist who has been coming to Milford once a month for the past two years to provide specialized cancer surgery and consultation. Dr. Coutinho made sure Dr. Horowitz could be there for Gigi’s hysterectomy. “She was going to be a tough case,” Dr. Coutinho recounts. “If he didn’t come, she would have been referred out.”

According to Dr. Horowitz, the Boston-Milford partnership means patients can receive the highest level of care close to home. “What we offer is the ability for some of these patients with cancer to stay locally in Milford and get the same level of surgery as in Boston,” Dr. Horowitz asserts. “It’s convenient for the patient, without sacrificing quality, and it keeps local doctors in the loop for follow-up care.”

With Dr. Horowitz as part of Gigi’s surgical team, the nodes were able to be removed to determine whether the cancer had spread, all in one operation. Gigi recalls how reassuring it was to hear quickly that although the tumor had partially invaded the uterine muscle, her cancer hadn’t spread.

A huge benefit of having a gynecologic oncologist like Dr. Horowitz at Gigi’s surgery is having one surgery rather than two. “If she were somewhere else, she wouldn’t have had the nodes done,” he explains. It would have required a second operation.

After a two-night stay in the hospital, Gigi was walking around and feeling good. “The healing went fine,” she says with a smile. “I was able to do everything but drive in three weeks, and I was back to work in six weeks.”

“Because Dr. Horowitz was there, I didn’t have to go through another surgery,” she continues. “That would have been more difficult, there would be more scar tissue, and it would have been more stress for me. I feel very good that they were able to do it all at once and close it up.”

Dr. Horowitz praises the surgical skills of Milford Regional’s gynecologists and the thoroughness of their diagnostic work-ups. However, when cases require his specialized care, it’s reassuring to know that Dr. Horowitz’s expertise can be accessed right here at Milford Regional.

“He’s a huge resource that keeps patients close to home,” Dr. Coutinho emphasizes. “Gigi didn’t have to travel into Boston, and she got an incredible specialist in Dr. Horowitz.”

Life is back to normal now for Gigi. In fact, she says she’s feeling better than ever “I have more energy, more interest in life, I’m happier,” she says. She will see Dr. Coutinho every six months for a pap smear for the next five years. And she’s got plans to work on her house and garden. After all, she intends to enjoy her home with her companion animals for a long time to come.

Read more about Brenda Coutinho, MD or call her office for an appointment at 508-482-5405.