Vim & Vigor - Fall 2021 - 8

8
bags of feed and tossing hay bales day aſt er
day. Her faith, toughness and resilience
defi ne her; they are part of her DNA. But
intermingled, she suddenly learned, was
this mutation that may eventually threaten
her life.
Doing nothing was not an option for
Knicely. Doing something meant putting
her otherwise healthy body under the knife
and out of commission for several weeks.
" Th is really challenged me, " she says. " I
was angry and frustrated. At that time, I felt
the best I have ever felt in most of my life. I
was healthy mentally, emotionally, spiritually,
and then this gets dropped in my lap. I have
always been a very positive, faithful person,
but this made me question and doubt. I spent
some time in prayer and I realized I needed
an attitude adjustment. I needed to be grateful
that, unlike my grandmother, I had options
to take care of this. "
Knicely decided to rid her body of any
places where cancer could potentially
appear. " I just wanted it gone, " she says.
" I wanted a total hysterectomy. And I was
going to have a double mastectomy. "
Aſt er speaking with UVA breast surgeon
Shayna Showalter, MD, about the
risk-reducing surgeries available, Knicely
learned she had other options. Th e surgery
she chose was a fl ap procedure, which
involves removing the breasts and reconstructing
them using skin and fat from
the abdomen. In addition to maintaining
her feminine shape, another bonus of this
procedure was the potential to remove her
uterus, fallopian tubes and ovaries all at
the same time.
" Th e fl ap procedure is a big surgery on its
own, but it's possible to combine this procedure
with the hysterectomy. Th e abdominal
wall is already open, so the surgeon has easy
access, " says gynecologic oncologist Kari
Ring, MD. Th e greatest advantage of combining
these two procedures: one surgery,
one recovery period. " I knew that if I had
to do two separate surgeries, " Knicely says,
" I might not follow through. "
Well-Rounded Care
As the day of the procedure got closer,
Knicely still had reservations about her
decision. " Around two weeks beforehand,
I got really anxious and nervous, " she says.
" In the past, I have suff ered with major
FALL 2021 VIM & VIGOR
depression, and that was a big concern for
me. Would this trigger my depression? "
Dr. Ring says, " We oſt en underestimate
Shayna Showalter,
MD, UVA breast
surgeon
the mental toll this experience takes on
women, especially those who have seen a
loved one go through this cancer course.
It's terrifying to realize you are at risk
for that. " Plus, the impact of the surgery
goes beyond recovery from the procedure
itself. Removing the ovaries results in early
menopause, and the side eff ects of this-
decreased libido, fatigue, mood swings and
more-can greatly aff ect quality of life.
Th is is why the UVA High-Risk Breast and
Kari Ring, MD,
UVA gynecologic
oncologist
Ovarian Cancer Program provides resources
women need to navigate every aspect of their
treatment, including physical and mental
healthcare. " Th ey thought about the whole
person, not just the physical, " Knicely says.
A woman's risk
of developing ovarian
cancer is as high as
if she tests positive
for the BRCA1 mutation.
The risk is
54%
<2%
if she doesn't have
the mutation
When I heard the
percentages about
my increased risk
for cancer, that really
resonated with me.
-LaDawn Knicely
" Th ey listened to my concerns and connected
me with a psychologist to counsel
me before, during and aſt er surgery. "
Choosing Her Future
Five months out from surgery and almost
entirely recovered, Knicely is confi dent she
made the right choice. Th e post-surgery
pathology report gave her an added dose
of reassurance. " When they removed my
fallopian tubes, they found precancerous
cells, " she says.
" We now know from recent studies that
a majority of cancers of the ovaries may
actually start in the fallopian tube, " Dr. Ring
says. " So we did this surgery right in the
nick of time. We will be following LaDawn
closely to look for any signs of cancer in
the future. "
To help advance this research further,
Studies show
that most ovarian
cancers start in the
fallopian tubes.
Knicely is participating in a clinical trial
(see page 7) that will further investigate the
source of ovarian cancer and how best to
treat it. " When I thought about all of the
women who have come before me who
have participated in clinical trials who may
no longer be here, there was no question, "
she says. " I had to do this to help advance
technology and prevent other women from
having a cancer diagnosis. "
Top of mind for Knicely is her 21-yearold
daughter. " She will have to wait until
she's 25 to get the BRCA test, " Knicely says.
" My sister was negative, so my prayer is that
she is going to be negative as well. But it's
reassuring to know this can be prevented. " *
PHOTOS BY UVA HEALTH
Vim & Vigor - Fall 2021

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