Collaborative Approach Helped Karen Cefalo Through Uterine Cancer With Less-Invasive Surgery

Always emphasizing that each person’s cancer is different, the oncology team at Lehigh Valley Topper Cancer Institute, part of Jefferson Health and Sidney Kimmel Comprehensive Cancer Center brings all its knowledge together in one room to find the best treatment for each patient. This discussion, called the tumor board, is a meeting of surgical, medical, and radiation oncologists, all others involved in cancer care, and the patient. Such a collaborative approach offers huge advantages. 

It certainly did for Wyoming, Pa., resident Karen Cefalo, an active 60-year-old who loves to read and travel. With no symptoms, she was diagnosed with uterine cancer in 2025. This multi-specialist board’s brainstorm saved her from having extensive surgery. 

During Karen’s office examination, gynecologic oncologist M. Bijoy Thomas, MD, Chief, Division of Gynecologic Oncology with the Cancer Institute, discovered a large tumor. He recommended an examination under anesthesia with biopsies, which were performed in December 2025.

“It became apparent that Karen had a large pelvic tumor involving the uterus, cervix, and upper vagina, with the tumor extending very close to the rectum,” Dr. Thomas says. “The biopsy showed a high-grade uterine cancer, and additional testing determined the tumor was HER2-positive, an important finding because it allowed us to use targeted therapy.”

High levels of human epidermal growth factor receptor 2 (HER2) can be linked to more aggressive cancers. A positron emission tomography (PET)-computed tomography (CT) scan fortunately confirmed no evidence of cancer outside the pelvis. Regardless, the diagnosis was devastating to Karen. 

“Saying it was a punch in the gut is an understatement,” she says. “I didn’t have any symptoms, but I go for regular appointments. It was during a regular visit that my gynecologist found something.”

Next, Karen saw medical oncologist Roberto Fratamico, MD, who is part of the collaborative tumor board. “We recommended treating Karen with chemotherapy before surgery rather than proceeding directly to an operation,” he says. “She received six cycles of specialized chemotherapy drugs because of the HER2-positive nature of her tumor.” 

The response was nothing short of remarkable. Dr. Thomas reported that when he examined Karen in June 2026, the large tumor involving the cervix and vagina had disappeared.

“I was just as shocked at the response as I was to the diagnosis,” Karen says. “It was such a blessing. I believe whatever guides us works through people in our lives. And for me, God was working through Drs. Thomas and Fratamico.” 

From a medical perspective, Karen’s case illustrates the value of personalized cancer care. Had the team operated immediately, Karen may have required an extremely extensive pelvic exenteration, an operation that involves removal of multiple pelvic organs and often results in a permanent colostomy. 

Instead, by not just relying on standard therapy, discussing her case at the tumor board, and incorporating targeted HER2-directed therapy, the team was able to dramatically shrink the tumor before surgery.

“The difference was extraordinary,” Dr. Thomas says. “Rather than undergoing one of the most complex operations in gynecologic oncology, Karen was able to have a minimally invasive robotic hysterectomy and a rapid recovery.”

The surgery, conducted in July 2026, was completed through small 8-mm incisions, with only minimal blood loss, and she was able to go home the same day. Her recovery was uncomplicated. She says she doesn’t know how to thank the clinicians and staff for the individualized care she received. “I don’t know how they do it,” Karen says, ”but I felt like I was their only patient.” 

The most exciting finding came from the final pathology report: There was no remaining visible cancer in any of the surgical specimens, representing a complete response to treatment. 

Still recovering from surgery, Karen is happy to report her hair is growing back, and she is doing many of the everyday things she used to do. “I love to cook and I’m cooking again,” she says. “I’m walking gently, taking the dog out for walks, and I’m going back to work in August. I just went to the bookstore – that’s exciting to me. I feel more normal.” 

Karen says cancer has made her “humble,” and she’s always looking over her shoulder now, no matter how well she takes care of herself. “I don’t take anything for granted,” she says. “I don’t miss any of my appointments or annual screenings. This experience has demonstrated that things can still happen. Cancer can sneak up on you.”

“More than anything, Karen’s journey demonstrates what is possible when innovative therapies, multidisciplinary collaboration, and compassionate patient-centered care come together,” Dr. Thomas says. “It is a story of hope – one that we are privileged to share with our community.”