Just this one short word is enough to strike fear in the heart of anyone diagnosed with cancer. But Sunnybrook researchers are making strides toward a future where chemotherapy will be simpler, safer and highly effective – and its devastating side effects a thing of the past.
Photo Credit: Tim Fraser
Delaney Janhunen was approaching her 36th birthday when she discovered a lump in her right breast. “You feel invincible when you’re young and then all of a sudden you have this wake-up call,” says Delaney, a Kitchener, Ont., mother of three, who is now 42.
Living in St. Catharines, Ont., at the time, Delaney was diagnosed with HER2-positive breast cancer, an aggressive type associated with overexpression of HER2 receptors on the cancer cell. “We were shocked and devastated when we realized how aggressive it was,” Delaney recalls. It was an “additional devastation” when she and her husband, Paul, learned the cancer had produced seven tumours in her liver.
The young family was turned upside down. Delaney’s new reality became surgery and ongoing drug therapy to eliminate the cancer and prevent its return. It worked for about two-and-a-half years, but the HER2-positive cancer returned, this time appearing in her left armpit.
It wasn’t surprising to Delaney that it came back – doctors had been telling her the odds of recurrence were high. But it was still a crushing blow: “I had started hoping and wondering and praying that I was actually cured.”
Delaney had a back-up plan. Before the recurrence, an acquaintance who also had HER2-positive breast cancer told her about a promising drug clinical trial underway at Sunnybrook’s Odette Cancer Centre. The drug was T-DM1, which is a novel combination of a targeted drug therapy (Herceptin) and a chemotherapy drug (DM1). The combination drug is effective at zeroing in and killing breast cancer cells, while producing minimal side effects.
TRIALS AND TRIBULATIONS
Delaney’s oncologist wasted no time in contacting Dr. Sunil Verma, a Sunnybrook medical oncologist and the lead author of the international T-DM1 study, which included patients from 213 centres around the world. Delaney received her first T-DM1 infusion in September 2010. She continues to make the trek from Kitchener to Sunnybrook once every three weeks to get her 30-minute infusion. Her tumours quickly shrank and she now has no detectable cancer on her CT imaging. “It’s been a miracle drug, that’s for sure,” she proclaims.
“Delaney is one of hundreds of people who gain access to leading-edge cancer drug treatments every year through the Odette Cancer Program’s clinical trial activities,” says Dr. Calvin Law, the program’s interim chief. “These trials are carried out at our Odette Cancer Centre’s newly renovated and expanded chemotherapy unit.”
Sunnybrook researchers, such as Dr. Robert Kerbel, are also pushing the frontiers of cancer drug therapy by developing less toxic, unconventional chemotherapy drug strategies that can be combined with other drugs, including Herceptin and T-DM1.
Innovation in therapy isn’t limited to the treatments themselves. Odette Cancer Program staff are continually focused on improving the patient experience through technological and process improvements.
For Delaney, being selected for the T-DM1 trial “was like winning the lottery. I was jumping up and down.”
Most importantly, the drug has kept her cancer at bay, but also key for Delaney, her husband and kids (ages ranging between nine and 14) is that there have been very few side effects. “The fact that you don’t lose your hair and you don’t feel sick has been wonderful,” Delaney reports, although she does experience dry mouth and occasional tingling in her fingers.
“These findings [the T-DM1 study] create the framework for a new direction for the treatment of cancers, and potentially for earlier stages of the disease.” Dr. Sunil Verma, Medical Oncologist
Compare this to the side effects of the drug therapy she received when she was first diagnosed with cancer in 2007. She lost her hair, eyebrows and eyelashes, and experienced fatigue for a few days after every round of treatment. “Losing my hair was very difficult to go through,” she recalls, “difficult for my kids, too, because up until then you can go through life and not show everybody that you’re sick.”