How a daughter’s cancer diagnosis saved her mother’s life

After Christina Sherrill was diagnosed with cancer in her lungs and brain at just 26 years old, she and her mother underwent genetic testing.

Christina Sherrill was your typical active Southern California teenager growing up in Simi Valley.

“Cheerleading, dance, volleyball,” she recalled. “I’m always doing something.”

When he reached his 26th birthday, the cough started. Not one to run to the doctors, Sherrill initially ignored this new annoyance. But the cough kept getting worse, making it difficult to speak and even breathe at times.

Their local doctors prescribed cough syrups, inhalers, over-the-counter medications – all without much improvement. When exhaustion, nausea and dizziness began to accompany her cough, Sherrill went for an X-ray. She was immediately sent to an emergency room to deal with the accumulation of fluid (“totally white,” she said) around her right lung.

“They told me that if I had waited another 24 hours, I could have drowned” in his own lung fluid, he said.

His doctors suspected pneumonia. But after eight days in the hospital, multiple tests and a biopsy, Sherrill had a much more serious diagnosis. He had metastatic cancer spread to his lungs, spine and lymph nodes, a large tumor pressing on his vena cava (which directs blood to the heart) and 20 tumors in his brain. She needed chemotherapy and more. Immediately.

“I coped by turning off my emotions,” Sherrill said. “I shut down to keep my sanity.”

“We were shocked,” recalled Elisabeth Metzidis, Christina’s mother. He wondered about a possible family connection: Sherrill’s father had died of lung cancer.

As it turned out, genetics played a role. But not the way mom suspected.

The oncologist who started Sherrill’s treatment (chemo and radiation to the head/chest) happened to know City of Hope lung cancer expert Ravi Salgia, MD, Ph.D., the Arthur &amp ; Rosalie Kaplan Chair in Medical Oncology. They argued their case, and before long Sherrill found herself on the Los Angeles campus, where her shock and fear began to dissipate.

“I loved that place from day one,” Sherrill said. “I felt less afraid. I knew they were taking care of me.”

Lung cancer at 26 is very rare. But Salgia had seen it before.

“It’s not unusual for me. My youngest patient was 16 years old,” he said.

Although her treatment was working, Salgia knew Sherrill could do better. He took advantage of the infrastructure and new tools, some pioneered in City of Hope that were not available just a few years ago. In the process, he may very well have saved two lives, not just one.

Taking a Genetic Approach

Precision medicine looks at how a genetic mutation could affect a person’s risk of cancer or – if they already have cancer – how their genes or the genes in their tumors could affect treatment options. On the same subject : I am a retired cheerleader and tried on my old clothes from years ago – the top was a lot smaller than I…. This approach uses information from genetic tests, which could provide a more accurate or earlier diagnosis and improve treatment results.

Salgia sent Sherrill for genetic testing, hoping to discover a mutation, such as EGFR, in her tumors, which would allow treatment with the latest generation of targeted therapy drugs. This is a sea change in the diagnosis and treatment of cancer. Long championed by City of Hope, analyzing tumors at the molecular level, the DNA level is quickly becoming the standard of care, for good reason. Researchers have identified more than 150 genetic abnormalities linked to cancer, and nearly 20% of all City of Hope patients who had their genome screened had “actionable encounters” that impacted their treatment plan.

“The future of cancer care is here now, and it’s precision medicine.” says Stephen Gruber, MD, Ph.D., MPH, vice president of City of Hope National Medical Center and director of its Center for Precision Medicine. “It has blossomed in the last five years. It is an indispensable tool to optimize treatment.”

Gruber says City of Hope is now extending genomic analysis to patients seen at the organization’s comprehensive cancer center, and will eventually be offered at the newly acquired Cancer Treatment Centers of America, which has centers in Arizona , Illinois and Georgia. This offer is far ahead of other institutions and is not yet universally recognized as necessary by insurance companies.

This means that City of Hope patients receiving treatment at City of Hope Los Angeles can opt to receive cutting-edge personalized cancer treatment that uses big data, including a tumor’s molecular profile and a person’s inherited genetics, to improve their treatment options. All patients are offered the opportunity to have a diagnostic evaluation and accurate management, which includes follow-up with genetic counselors.

In Sherrill’s case, however, his tumor sequence came up empty.

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No Targetable Mutations

“It had no targeted mutation, no action for which we could give a pill,” explained Salgia. Read also : Bold eagles and mascot to visit Downingtown on April 29.

But that’s only half the story because City of Hope goes beyond tumor analysis. The tests also examine the patient’s “germline” DNA: the genetic core inherited from the parents. This can often give critical information. “We’re at the forefront of this thinking,” Salgia said.

Sherrill’s germline DNA results were significant: she had the BRCA2 mutation.

Normally associated with a high risk of breast and ovarian cancer, BRCA2 may also indicate susceptibility to other cancers. Men who test positive, for example, may be at increased risk for prostate cancer.

This knowledge made all the difference in Sherrill’s treatment. Salgia replaced her chemotherapy with the relatively new immunotherapy drug Keytruda (approved in 2019), and also administered Lynparza, a so-called “PARP inhibitor” known to achieve favorable results in BRCA2 patients. “I wasn’t sure if Keytruda alone would work as well,” he explained.

For Sherrill, the change had a profound effect. Gone are the toxic effects of chemo.

“Oh my goodness!” she blurted out. “It was night and day. Chemo was poison. I had lost 20 pounds, couldn’t eat or drink. Less nausea with immunotherapy. I was alive again!”

If the results confirm an increased hereditary genetic risk, City of Hope offers to test every person in the patient’s nuclear family and bring the family members with an increased risk for screening and care. And because BRCA2 is inherited, Metzidis was also tested.

Stacy W. Gray, MD, deputy director of the City of Hope Center for Precision Medicine and associate professor and head of the Division of Clinical Cancer Genomics, supervised their testing and provided the results. Sherrill’s mother was revealed to have the same mutation. She was horrified to realize that she had passed it on to her daughter.

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‘A Whole Different Ballgame’

“That made it a whole different ball game,” he said, adding, “With the gravity of the information, they really went above and beyond to make us feel informed and supported. On the same subject : These football fans don’t have to cross the pond to see Nebraska play.”

She worried about developing cancer while her daughter was fighting the disease at the same time. Metzidis took action right away, having prophylactic surgery—a radical mastectomy and a hysterectomy—to improve her chances.

Thus, directly or indirectly, the knowledge generated by precision medicine has very possibly helped to save the lives of two people at once. Mom rests easier knowing that she has reduced her chances of developing cancer. And Sherrill responded well to his treatment. Barely able to walk or breathe a year ago, she has now returned to work, taking cycling classes and studying for a new career as a cosmetologist. And remember how he “shut down” when he received his diagnosis? The opposite happened recently, when Salgia reported that she is in remission.

“I left the room, I started telling people, I told mom, and right then, I started crying. I could barely get the words out,” he recalled, smiling.

There are, however, a few words that she wants to pass on to every patient facing equally terrible conditions:

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How do families cope with cancer diagnosis?

Here are some tips to be as supportive as possible when a loved one is diagnosed with cancer:

  • listen …
  • Give advice only when asked. …
  • Educate yourself about cancer. …
  • Support your loved one’s treatment decisions. …
  • Remember the caregiver. …
  • Stay connected. …
  • Keep things normal.

How do people cope with a cancer diagnosis? If you can, have a consistent daily routine. Make time every day to exercise, get enough sleep and eat healthy meals. Exercising and participating in activities you enjoy can also help. People who exercise during treatment not only deal better with side effects, but may also live longer.

How to deal with cancer emotionally? Seek emotional support in different ways. It may help to talk to other people who have cancer or to join a support group. Or you may feel better just talking to a close friend, family member, counselor, or a member of your faith or spiritual community.

What makes cancer patients feel better?

Try to include strength training at least two days a week, with at least one day off in between. As you recover and adjust, you may find that more exercise makes you feel even better. Sometimes you don’t need to exercise, and that’s okay. The side effects of the treatment, such as fatigue, can keep you away.

What do cancer patients hope for? We hope for remission. We hope to prolong life by avoiding death through medical treatment and supportive care. Or, if the disease progresses, we hope to control the pain, side effects and suffering.

What makes a cancer patient happy? Tell jokes, talk about what’s going on in the neighborhood or at your kids’ school, favorite TV shows, etc. This can briefly help take the patient’s mind off the cancer. Make them laugh. Tell jokes.

How do you calm down after cancer diagnosis?

Express Your Feelings Some people resolve their feelings by talking to friends or family, other cancer survivors, a support group, or a counselor. But even if you prefer not to discuss your cancer with others, you can still sort out your feelings by thinking about them or writing them down.

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