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NEJM EvidenceMy Experience in a Clinical Trial for a Rare Gynecologic Cancer

What can the personal journey of a historian through an experimental treatment for vulvar cancer teach the medical community?

In an insightful patient platform piece, Susan W. Wade, PhD, offers an intimate look into her journey with vulvar cancer and participation in a phase 2 clinical trial. Combining chemoimmunotherapy and radiation, the experimental approach represents the cutting-edge, yet humanized, aspect of oncology. Wade’s unique perspective as a participant and historian adds depth to the understanding of the treatment and potential lessons for the field.

Key Points:

  • Susan W. Wade was diagnosed with vulvar and cervical cancer in May 2022, subsequently joining a single-arm phase 2 study for chemoimmunotherapy and radiation.
  • The 8-week treatment included daily radiation, weekly cisplatin infusions, and pembrolizumab every 3 weeks, initially showing promising tumor shrinkage.
  • Post-treatment, a biopsy revealed that the tumor was still cancerous, requiring extensive surgery, including reconstruction of her vaginal area, excision of vulva, and rectum removal.
  • The treatments of the clinical study had diminished the tumor’s size by 35% but were not effective enough to remove the cancer entirely.

Additional Points:

  • Wade’s initial misdiagnosis of her symptoms as pelvic floor collapse.
  • The personal and psychological toll of the treatment, reflecting on both the physical aftermath and her identity and relationship with her body.
  • The comparison of modern treatment with medieval practices, contemplating the future perception of today’s oncology procedures.


  • Despite the treatment’s failure to fully eradicate the cancer, Wade’s experience provides valuable insights into patient perspectives and the complexities of experimental treatments. Her reflections prompt further considerations for physicians in the fields of oncology and gynecology.

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“But as a historian, I sometimes wonder how future generations of physicians will view the treatments that I received for my vulvar cancer. However, it is possible — perhaps even likely — that in the future, chemotherapy, radiation, and my posterior resection will be considered as grisly and unnecessary as some medieval practices appear to my modern students.”

Susan W. Wade, PhD
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