How a Film Star Got a Second Act after Advanced Ovarian Cancer: Manisha’s Story
Manisha Koirala, one of India's most celebrated actors, was stunned when she was diagnosed with stage IV ovarian cancer in 2012. She opted to travel halfway around the world for treatment at Memorial Sloan Kettering.
When Manisha Koirala, one of India’s leading film actors, was diagnosed with advanced ovarian cancer in 2012, she was in shock and a state of disbelief. She had suspected that her persistent sickness and abdominal bloating were most likely a liver problem. But she found herself in a hospital room in Kathmandu, Nepal, with her lifelong doctor and family gently trying to reassure her that treatments for her disease had gotten better.
“I remembered in movies that if someone has cancer, doctors will just cut it out and they are fine,” she recalls. “I asked, ‘Can’t you just cut it out and throw it away?’ ” Unfortunately, the disease was stage IV, which meant it had spread to other organs.
“That’s when reality hit that I was in a bad state,” Manisha says. Over the next day, she felt hopeless and began resigning herself to “saying goodbye to everyone and everything,” she says.
But at the same time, Manisha and her family were not ready to give up. They traveled to Mumbai for a second opinion from a top doctor. He confirmed the diagnosis and said that because the cancer had spread, she should receive chemotherapy to shrink the tumor first, then have surgery.
Aware of the gravity of Manisha’s situation, her family began urging her to go to the United States to seek treatment. Manisha agreed, thinking, Why should I risk my life by not going to the best place in the world? Her mother has friends who are doctors in the United States, and one name kept coming up in conversations about the top surgeon for gynecologic cancers: Dennis Chi at Memorial Sloan Kettering in New York.
Manisha remembers her first meeting with Dr. Chi in early December 2012: “I asked him, ‘Have you done surgery on someone with a cancer so advanced like mine?’ And he answered, ‘Yes. She’s alive and doing fine.’ At that moment, I could finally breathe. I was confident I was at the right place with the right doctor.”
Dr. Chi has more than two decades of experience treating women with gynecologic cancers. He leads MSK’s Section of Ovarian Cancer Surgery. The doctors in this specialized program have expertise in removing advanced disease that has spread beyond the ovaries.
“MSK is one of the first places to have a team dedicated to doing surgery on people with this specific cancer,” Dr. Chi says. “We have five surgeons focused on ovarian cancer, and this enables us to achieve very good results.”
Getting All the Cancer
MSK’s ovarian cancer team is especially skilled in radical debulking surgery. In this procedure, doctors remove as much tumor tissue as possible before giving chemotherapy to destroy any lingering cancer cells. Dr. Chi uses the analogy of breaking a glass: You sweep up the big pieces first (surgery) and then use a vacuum (chemo) to get everything else.
Manisha was relieved that Dr. Chi wanted to do surgery before rather than after chemotherapy — she felt more comfortable with that approach, which was the more standard treatment at the time.
Dr. Chi and his team performed what is called an optimal debulking surgery, meaning that only microscopic tumors that cannot be seen with the naked eye are left remaining. In Manisha’s 11-hour operation, they removed all the visible tumors, even those as small as a grain of sand.
But surgery was only one part of her care plan. The second critical phase was chemotherapy, managed by medical oncologist Vicky Makker.
“This was a great outcome surgically, but it’s not always that way,” Dr. Chi says. “Sometimes when cancer has spread, you can get everything out. Sometimes you can’t. Sometimes we get all the cancer out, and the patients don’t respond to the chemo. But in this case, we put Manisha in the best position with the surgery, and then Dr. Makker drilled it home with the chemotherapy.”
The Right Chemotherapy Combination
Manisha’s chemotherapy treatment consisted of six cycles of two drugs, paclitaxel (Taxol®) and cisplatin, delivered over the first four months of 2013. Dr. Makker guided Manisha through the powerful chemotherapy regimen, which can take a big physical and emotional toll.
“She knew exactly what chemo combination to give me, and she stood by that,” Manisha says. “I was responding well to the treatment, but I was gripped by fear. There was one time that I broke down and said, ‘I can’t take it anymore,’ and Dr. Makker actually sat on the floor with me and held my hand, saying, ‘You’re doing so well.’ It really encouraged me during sad and depressed moments.”
Chemotherapy medicines can cause many symptoms and side effects. Dr. Makker says, “They can affect multiple systems, and they really require careful management. There are also complex emotional and psychosocial issues that can arise that we must anticipate and be ready to manage.”
Over those four months, Manisha developed a deep bond with Drs. Chi and Makker. Both doctors credit Manisha’s strong support system of family and friends with keeping her in strong spirits. Foremost were her parents, who stayed in New York with her throughout the treatment. April 30, 2013, was a momentous day. Manisha received her last round of chemotherapy and was declared cancer free by Dr. Makker.
A New Platform
More than six years later, Manisha remains in remission. She is living in Kathmandu and returned to film acting in 2017. Manisha uses her celebrity status and personal story to draw attention to ovarian cancer. She is also a motivational speaker and active with groups that promote women’s rights and work toward the prevention of violence against women and human trafficking.
In 2018, Manisha published Healed, a book about her cancer experience intended to inspire others with ovarian cancer. In September 2019, she appeared at a literary festival in New York and was reunited with Drs. Chi and Makker onstage.
Both of her doctors emphasize the importance of the highly specialized, comprehensive care at MSK, which makes it possible for Manisha and others to overcome long odds.
MSK’s expertise was recognized by U.S. News & World Report when the magazine ranked MSK as number one for gynecology in its 2019–2020 listing of the nation’s best hospitals.
“What makes the gynecologic cancer group special is the collaboration, not just between the surgeons and oncologists but also the subspecialties, like pathology, radiology, and radiation oncology, as well as the nurses and other medical staff,” Dr. Makker says. “We communicate beautifully, we value one another’s opinions, and we count on one another. It all translates into exceptional patient care and drives us to continue to raise the bar.”