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Innovative Clinical Trial Offers New Hope for Ovarian Cancer Patient

balance-blog-edited-dawn-harter-ovarian-cancer-survivor-4After receiving her initial ovarian cancer treatment at another facility, Dawn Harter of Green Bay, Wisconsin, started researching clinical trials and discovered one that offered the possibility of taking a new maintenance medication. The opportunity gave her hope for preventing recurrence. At the time, Avera Cancer Institute in Sioux Falls, SD, was one of only two sites in the United States to have that particular trial open. Dawn chose Avera Medical Group Gynecologic Oncology and asked to be enrolled.

“Thankfully, she reached out to us just in time,” recalls Luis Rojas, MD, a gynecologic oncologist at Avera. “We only had a 12-week window in which we could enroll her in the study and she’d completed her first line of therapy eight weeks prior.  So in those last few weeks, we were able to make it happen and enroll her in the trial.”

“I feel blessed to have found Dr. Rojas,” says Dawn. “He and his staff moved mountains to get me admitted. Everyone has been pleasant, kind and hopeful – qualities I was in desperate need of. I believe being part of the study has given me a new chance at life. As a biologist, I like the idea of stopping this cancer for good!”

Although it’s difficult to know where Dawn would be without the clinical trial, the promising news is that she has been in remission for 33 months.

“When you look at the behavior of ovarian cancers, the median time of cancer recurrence is around 18 months, so Dawn is doing well,” explains Rojas. “Her outcome from the clinical trial makes us all very happy.”

Clinical Trials

While participating in a clinical trial includes potential pros and cons, oftentimes the benefits outweigh any drawbacks.

“Clinical trials are very important,” says Rojas. “The best way to describe their importance is to say that if I ever get cancer, I’ll participate in a clinical trial if I can. They open new doors of treatment options to the patients – options that are potentially better than standard therapy.  They also provide the information needed to forward the field of cancer treatment. The reason we’re more effective at treating cancer today is because of clinical trials that took place 10-20 years ago.”

Targeted Cancer Therapy

In addition to standard therapy and clinical trials, patients also have access to innovative, targeted cancer therapy through the Avera Cancer Institute Center for Precision Oncology.

“We can offer patients a combination of standard chemotherapy and targeted therapy based on their tumors’ genetic profile,” says Rojas. “We have many ovarian cancer patients receiving that kind of treatment now and doing amazingly well. For example, we have multiple patients with ovarian cancers who, after multiple lines of therapies, developed a cancer-related intestinal obstruction. Statistically speaking, most of those women had a median predicted survival of 60 days and now they’re still with us several years later.”

Dr. Rojas describes targeted therapy as a two-in-one punch. “With that combination, we hit the cancer with chemotherapy that kills the cancer cells. At the same time, we use the targeted therapy to hold the hands of the cancer cells, so they can’t defend themselves by mutating and becoming resistant to the treatment. I believe this is the future of cancer treatment. It’s here and now at Avera.”

Learn more about cancer clinical trials and precision oncology at Avera Cancer Institute.

Bone Marrow Transplant Offers Chance for “Normal Life” After Leukemia

katie-martindale-edited-image-balanceA nurse and young mom with two young children, Katie Martindale of Sioux Falls led a busy life that could lead to fatigue. Yet she had the medical background to know that some unusual symptoms weren’t normal – especially a troubling rash on her legs.

For nearly six months, Martindale had experienced pain in her face and upper jaw and initially saw a dentist about it before going to the doctor. After numerous X-rays and tests showed nothing, a blood platelet count showed she had a dangerously low count of 7,000, compared to normal range of 150,000 to 450,000.

Immediately, she was referred to Avera Medical Group hematologist and bone marrow transplant specialist, Kelly McCaul, MD, who diagnosed her with acute myeloid leukemia (AML) on May 26, 2015. The next morning, she started chemotherapy.

“Being a nurse was both a blessing and a curse. I knew how close to death I was,” Martindale said. One round of chemotherapy put her into remission, and she had three following rounds to complete her treatment.

Martindale did well until nearly a year later, when she relapsed in March of 2016. The possibility of bone marrow transplant was already in the back of her mind, and her brother had already been identified as a good match. “Chances of survival are higher with a sibling donor,” Martindale said. Her brother donated his stem cells through a process called apheresis, which is similar to giving blood.

On May 24, 2016, almost a year to the day of her initial diagnosis, she had her transplant. While it was a special time with almost 15 people in the room, after a 10-minute infusion, it was over and seemed a bit anticlimactic after all the tests and preparation.

Yet as her brother’s stem cells began to take hold and form new blood cells, they began to save her life.

Immediately after a bone marrow transplant, there are days of waiting for the infused cells to begin doing their work. Martindale compared it to the movie Apollo 13 and the anxious minutes of silence while the ground crew in Houston waited to hear from the astronauts after re-entering the earth’s atmosphere. “My brother cheered on his stem cells and was very interested in my counts.”

Martindale’s counts, in fact, were pretty amazing. “For most people, it takes 20 days or so to bring their counts up. My counts started going up at day 11.”

As she recovered, she took it one day at a time. “I would always day-dream about that day when they would say, ‘You’re done. You no longer have cancer.’”

So Martindale recently asked her doctor when she would be considered cured. “He said now. That relief was so refreshing.”

Having the option of a bone marrow transplant in her home community meant the world to Martindale, who didn’t have to leave her young family to go seek treatment hundreds of miles away. Because she was a nurse and did so well in her recovery, she was allowed to spend more time at home, rather than in the hospital.

Dr. McCaul; Kristen Hurley, CNP; and the entire team began to feel like family, Martindale said. “You learn you’re not just a number to them. They all know my kids’ names, my birthday… they just know my life. I don’t think my care would have been this personalized somewhere else.” She also credits her husband, Mark, her parents, family and friends as well as her brother who donated his stem cells.

Realizing that her transplant had worked turned her thinking around. “I no longer thought I was going to die.” It felt good to continue on with “normal life” – being a stay-at-home mom for her 3-year-old while considering a return to the workforce. “I’m trying to figure out who I am and what I’m going to do next. I hope that I become stronger, better and happier after all this. I feel like everything happens for a reason.”


The Reward of Faith: Bone Marrow Transplant Patient Shares Story of Hope

balance-blog-erika-allen-main-imageWhen Erika Allen looks down into the smiling face of her 8-month-old daughter, Hope, she smiles back as she reflects on the journey – one with many scary chapters – that led to this amazing little person she sees as a gift from God.

“Once you are a survivor of cancer, you never really go back to being who you were before,” said the 35-year-old mother of three. “My husband and I really see Hope as a reward for our faith through all the dark times. God saw us through the cancer, the transplant – and on the other side of that battle, we were blessed with her.”

Allen’s battle began in 2010, and as she reflects on it, she said it was truly like a battle, with many sacrifices and lots of fear. It started when she found a lump in her right underarm while doing a routine self-exam of her breast at her home in Rapid City, where the Allen family makes their home.

It led her to the Avera Cancer Institute and an important interaction with Kelly McCaul, MD. That interaction also was one she said was driven by faith.

“It was in November 2010 when I found a lump, and after an ultrasound, the doctors saw it as a cyst, but I just felt terrible, almost all the time,” Allen said. “I felt anxious all that winter, and in the spring, it had not improved, and I had another ultrasound, a CT scan and a biopsy. That’s when the cancer was confirmed. The prognosis I received was really poor.”

Her care team in Rapid City confirmed that Allen had a rare non-Hodgkin’s lymphoma. When the news was official, the results were what most of us would expect, Allen said. “I was scared to death and the news, to me, seemed like a death sentence,” she said. “My care team recommended that I look into going to Omaha, because there were specialists and the team we would need there. But it seemed so far away. I didn’t really want to go to Omaha.”

That’s when she met Kelly, as she said McCaul insisted she call him. “It was a godsend, I really feel God put him in my life,” she said. “He explained everything to me, my husband, Nic, and my mom and dad. He sat with us for two hours during that first meeting. I felt from that instant that he would fight for me. It gave me the hope that I could battle this thing and win.”

Three hours later, she was in an operating room to remove the tumor.

That surgery began the multi-part process that led her to an autologous bone-marrow transplant. Autologous means the patient will donate his or her own stem cells to be reinfused. Like most people, she imagined such a process would involve drills into bone and pain. It seemed terrifying, she said.

“Kelly really cared about me and he took the time to explain that this kind of transplant is not like an organ coming from a donor.”

The Avera transplant team collects stem cells through a process called apheresis. It’s like giving blood, but the team will include chemotherapy to kill cancer cells, and then reinfuse the stem cells to grow healthy blood cells.

Amidst the pre-transplant chemotherapy, the six-day process that was the bone-marrow transplant itself and post-procedure recovery, the many challenges added up. Allen said she never felt alone, even with the travel across South Dakota with her mom and the nights on Avera McKennan Hospital & University Health Center’s third floor, where she recovered as her immune system rebuilt itself after her stem cells were reinfused.

balance-blog-erika-allen-second-image“We all had to fight, but I had many allies in the battle,” she said. “From the gift shop in the Prairie Center to the nurses on 3 East, to Kelly and my other doctors – I felt like they were fighting alongside me.” The transplant took place in 2011, and slowly but steadily she began to get her life back, to regrow her hair and to return to her full-time role as mom to son and daughter, Luke, 9, and Lily, 7.

That’s why when she found out she was pregnant last July, some fear returned, but so too did a sense of success. “Due to the chemotherapy, and all that we’d been through, it was scary – at times terrifying,” Allen said. “But it seemed to be God’s way of saying ‘You have made it through the battle, and this is your gift.’ This was a miracle to me and my family.”

Hope was born in February 2016, and she embodies her name. Allen says her message for those who face the same news is clear: find a doctor who will fight for you, and then together fight fiercely.

“There’s so much to live for and it’s not easy,” she said. “When I look at Hope, I realize all the sickness, the travel, the surgeries – it was all worth it.”



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