Having fathers who both passed away due to cancer, they had generously donated funds to help finance the patient navigation program at Avera Cancer Institute.
In 2011, they were on site for the ribbon cutting and gala opening of the Prairie Center in Sioux Falls, home to the Avera Cancer Institute. Doug’s experience as a caregiver and navigator for his father led him to become an executive volunteer for Livestrong.
But that “inside knowledge” didn’t temper the shock when Mary herself was diagnosed with triple negative breast cancer. It happened after the couple had moved from their long-time home of Sioux Falls to enjoy a warmer climate and proximity to family and grandchildren in Arizona.
Just a year earlier, Mary’s mammogram had been normal. But her most recent one was flagged as abnormal and worse yet, she felt a lump under her arm.
Doug wanted the very best care for his wife. So he asked his friend, Matt Ellefson, founder and president of SURVIVEiT, a non-profit cancer care rating resource based in Sioux Falls, where the “best place on planet earth” was for breast cancer treatment. “He said Avera,” Doug said.
The couple came to Sioux Falls for testing and consultations. “After three days, we had a game plan, and I would not have had it any other way. I have a great team of doctors and caregivers working on my behalf,” Mary said. Overseeing her care is Amy Krie, MD, Avera Medical Group Medical Oncologist who specializes in breast cancer.
“Triple negative breast cancer is particularly aggressive and can be difficult to treat, because many standard treatments available today target one of the three receptors, including estrogen, progesterone and HER2. We looked immediately to genomics because this science can help us identify the best possible treatment as early in the disease process as possible. For Mary, these results provided great insight into helping us to optimize her treatment recommendation,” Krie said.
Diagnosed at stage III, Mary’s cancer had reached her lymph nodes. Her treatment plan included genomic testing with the Avera Cancer Institute Center for Precision Oncology, which finds the specific genetic mutations or tumor drivers and matches them with targeted therapies.
“We knew we had one shot at this to do it right so we moved back to Sioux Falls for the next year. We’re all in and committed to doing it the right way,” Doug said.
In Mary’s treatment plan, she would have chemotherapy first to kill as much cancer as possible, followed by surgery.
“Cancer often has not just one genomic driver, but two or three genomic drivers. For example, one may sustain the proliferation of the tumor. Another may help it build a blood supply. Another may help it to invade and metastasize,” said Brian Leyland-Jones, MB BS, PhD, Vice President of Avera’s Center for Precision Oncology. “What we do differently is that we try to hit all drivers together with combination therapy at the earliest possible opportunity.”
“Cancer continues to grow, deviate and become more resilient. It is learning more tricks as the disease progresses. Catching it early is absolutely key,” Leyland-Jones said.
Mary remembers the day her chemo began last fall. Ironically, as she browsed through the Facebook feed on her phone, she saw a memory from five years ago pop up – the day she was at the Prairie Center opening event.
When she comes for her chemo infusions, Mary says it’s not unusual to be visited by four to five Avera team members, from nurses to art therapists, patient navigators and chaplains. “They’re all great people and they all care. I couldn’t do this alone.”
Adding to the expert care team is the environment of the Prairie Center. “From the time we walk in the door, we have this sense of peace and serenity because we know we’re in the right place,” Doug said.
Mary is still progressing through her pre-surgery treatment plan. “She’s just doing incredibly well,” Doug said.
“It’s not easy to hear the words, ‘you have cancer.’ That’s very frightening,” Mary says. Yet the treatment is not taking the toll she expected. “I’m able to exercise, ride my horses, play with my grandchildren and do everything I did before. I have some slow days, but I’ve learned to listen to my body. Living with cancer is OK for me because I’m going to beat it.”
“With our targeted therapy, we modulate doses so people can live normal lives,” Leyland-Jones said.
Genomic research is taking place all over the world, yet much of this new knowledge does not yet reach the patient bedside. “Here at Avera, we are piecing together all of the published literature and applying it now. We attempt to crush the tumor at the earliest possible time frame using evidence-based genomic marker-targeted therapy matches,” Leyland-Jones said. “In the end, the only focus is each and every patient and their families.”