patient - Tatum Miller

Mom-to-be found to have rare ovarian cancer

When 22-year-old Tatum Miller volunteered for a moms-to-be study being conducted by UCI Health, she thought participating would be a great way to have more ultrasounds to document her first pregnancy.

She never imagined that first ultrasound in May 2011 would ultimately save her life and that of her baby girl after UCI Health obstetrician Dr. Judith Chung detected a rare ovarian cancer.

"I didn’t have any symptoms,” Miller recalls. “But when someone tells you there’s something on your ovaries, you take it seriously."

When UCI Health sonographer Valerie Pham detected a mass on Miller’s ovary, she alerted Dr. Judith Chung, a UCI Health obstetrician specializing in high-risk pregnancies who was helping to conduct the study. Chung suspected ovarian cancer.

A baseball-sized tumor

The mass — a tumor nearly the size of a baseball — turned out to be granulosa cell ovarian cancer. This rare type of cancer accounts for only 2% of all ovarian tumors. Its symptoms can include vague bloating, discomfort in the pelvis or bladder, and bowel changes. Miller hadn’t noticed anything.

Dr. Robert E. Bristow, then chief of UCI Health gynecologic oncology, recommended surgery. The tumor was situated underneath the uterus, which meant he couldn’t remove it using a minimally invasive laparoscopic technique.

Instead, a month after the mass was first detected, he performed open surgery, gently pushing aside the uterus to remove the tumor and the ovary it was attached to.

There is some risk to the surgery, which in the best case is performed during the second trimester, but Bristow said the chance of the cancer worsening tipped the balance in favor of proceeding immediately.

Miracle baby ‘saved my life’

“Going into the surgery, I was really nervous — there was a chance I could lose my child,” says Miller, who was 16 weeks into her pregnancy.

“Dr. Bristow made me feel really comfortable. He explained what would happen step-by-step. Afterward he came into the recovery room and told me the baby was safe.”

Bristow, a nationally regarded gynecologic oncologist who now leads the UCI School of Medicine’s Department of Obstetrics & Gynecology, says the ability to successfully intervene during Miller’s pregnancy to take out the tumor and make sure it was in the early stages was key.

“If we waited to remove the tumor until she delivered several months later, we risked it developing into a much higher stage cancer.”

Had the expectant mother not chosen to participate in the study, Chung says the tumor may not have been detected until much later in the pregnancy, if at all.

“It’s a miracle they found it,” says Miller, her voice thick with emotion in retelling the story more than 10 years later. “I call Payton my miracle baby — she saved my life.”

Because it was an early-stage cancer, she did not undergo other treatments such as chemotherapy. Ten years later, she remains free of cancer. Bristow says her risk of recurrence is very low, although she still needs to remain vigilant.

A lucky turn of fate

After Payton’s birth, Miller believed she couldn’t have more children. However, she and her partner, Evan Rankhorn, have been happily surprised by the arrivals of their son, Easton, now 3, and daughter Evie, now 6 months.

All three of Miller’s children were brought into the world by Chung, who saw no evidence of cancer when she delivered Evie in July.

“I won’t go to anyone else,” vows Miller, who switched to Chung’s care after her obstetrician at the time told her not to worry about the mass revealed by the UCI Health ultrasound. “Dr. Bristow was amazing, too. UCI is a fantastic hospital, and I will never go anywhere else. They saved my life.”

Miller still participates in the NuMoM2b study, which now includes more than 100,000 U.S. women. It was launched in 2010 to identify markers or mechanisms underlying adverse pregnancy outcomes in participants with first-time pregnancies. Such work is something only an academic medical center such as UCI Health can offer patients.

“Besides providing top-notch medical care, the research we are able to do furthers medical knowledge,” Chung says. “And it helps all our patients in the process.”

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