From Awareness to Action: Empowering Change in Gynecologic Cancer

09/16/2026

Written by Rachel Miller-Garcia, NRG Oncology Patient Advocate Committee Member

September is Ovarian and Gynecologic Cancer Awareness Month. As an ovarian cancer patient, and patient advocate, my mission is to empower, educate and inspire those at risk for gynecologic cancers—to connect and drive change and create a world where these cancers no longer exist.

Ovarian cancer remains the deadliest of the gynecologic cancers—the majority are diagnosed at advanced stage (3 or 4), and over 60% will die within 5 years. While progression free survival (PFS) has improved measurably with advanced cytoreductive surgeries and targeted treatments, overall survival (OS) still lags– especially in certain minority groups: black women continue to face higher risks of death from the disease compared to white women.

Too many people are unaware these cancers exist. We need to destigmatize the “organs down there” that grandma died of and identify them: ovarian and fallopian, peritoneal, uterine, endometrial, vaginal, cervical, vulvar. We need to determine who is at risk, educate regarding the warning signs and symptoms, and that there are ways to prevent these diseases.

I’d like to see more robust, and earlier conversations within families and clinicians. Conversations between patients and nurse practitioners, general physicians, OB GYNs, and inside public clinic. We need to acknowledge the full continuum of women’s health: from menses to menopause. For teens just starting to menstruate (and/or their moms) to perimenopause through menopause and post menopause –the highest risk era– we need to talk about their health, family history, and risks. Education and awareness will save lives!

When there is a diagnosis, I hope to see clinicians drive the conversation to support patients toward more self-advocacy. When a patient hears that they have CANCER, they need to be given the space to process individually, privately, physically and emotionally first! The decision, or approach to treatment, may take time. How aggressive the treatment should be (short-term goals or long-term goals?), weighing toxicity, quality of life, are all considerations for patients and should also be for clinicians. Together, patients and clinicians define these choices.

My message to clinicians: please share with your patients that second opinions are ok —even encouraged as standard of care. Order biomarker testing as standard of care. Order ctDNA testing to determine the efficacy of treatment instead of waiting for several cycles of a regimen and then scanning. I believe we are over scanning and exposing patients to excessive radiation along with ignoring serious, sometimes debilitating side effects from treatment, when ctDNA could reveal efficacy or progression months earlier.

We need to address toxicity and side effects in clinical trials and reduce dosages earlier to determine efficacy and consider that a lower dose may be as effective, and more manageable.

Some very good news: 

• Increased awareness of ovarian and gynecologic cancers, and genetic testing when there is risk assessment (although less than 20% of the patient population have a known genetic risk) including preventative surgeries like opportunistic salpingectomy, have impacted prevention and decreased the mortality rate in some populations of ovarian cancer by 39%. I help teach medical students about ovarian cancer and Gyn diseases to help them identify risk, diagnose earlier ,and potentially prevent these deadly diseases in their practices. Ruling out ovarian cancer before diagnosing overactive bladder and IBS among other gastrointestinal issues will save lives.
• We can celebrate the advances in treatment in just the last 7 years with PARP inhibitors (PARPi), Antibody Drug Conjugates (ADC’c) and novel therapies like intraperitoneal immunotherapies currently in clinical trials. Precision medicine: personalized, targeted therapies based on known biomarkers and genomic testing is a huge advancement. Yet, while it’s great that we have these newly targeted therapies like ADC’s, the payload can result in unintended and very difficult side effects, including reduced quality of life. These side effects are often under reported when comparing real world patient outcomes vs. clinical trials and are often dismissed by clinicians. We need to address toxicity and side effects in clinical trials and reduce dosing earlier to determine efficacy–a lower doses may be just as effective and more manageable. It’s my hope that oncologists will recommend symptom management and/or palliative care services to patients to manage.
• There are clinical trials progressing at major centers of excellence like Johns Hopkins where they are testing menstrual flow at the cellular level to determine risk. This could be groundbreaking and impact prevention.

Along with other advocates and clinicians, I’m proud to have impacted millions of dollars of funding for ovarian and cancer research. Federal funding was $15MM in 2019, stagnant for years — $50MM in 2026! This funding is crucial to earlier detection, finding new treatments, clinical trials, and ultimately prevention. This gives me hope.

www.linkedin.com/in/rmillergarcia