Section: Saint Barnabas Medical Center News

New Weapons Against Cancer

08/12/2015

When Ide Mills' doctor called to tell her about her X-ray results, she suggested that Mills sit down first. That wasn't a good sign.

"I've been an oncology social worker for 20 years," says the 57-year-old Maplewood resident. "I knew that probably meant I had cancer."

Since the previous November, Mills had had a persistent cough that got so bad she had trouble talking without gasping for breath. "I thought it was bronchitis," she says. "Until I learned I needed the X-ray, I didn't think I was dealing with something so serious."

But the X-ray, along with additional testing, revealed she had metastatic lung cancer that had spread to her lymphatic system and bones. "That's when I learned I was dealing with advanced disease," Mills recalls.

She was referred to Stuart Leitner, M.D., section chief for Medical Oncology at Saint Barnabas Medical Center. A biopsy determined she had non-small-cell lung cancer, in which malignant cells form in the tissues of the lung. Unfortunately, her cancer had advanced too far to be cured with surgery.

Especially because she was relatively young and a nonsmoker, there was a chance that Mills' cancer had been caused by a mutation in a gene called anaplastic lymphoma kinase (ALK)—3 percent to 5 percent of non-small-cell cancers are associated with this mutation. After her tumor specimens were sent for genomic tumor testing, she was started on three-drug chemotherapy, which was the standard of care for advanced adenocarcinoma of the lung.

She responded well to treatment. "It stabilized the disease, and Dr. Leitner said the protocol was to stay on maintenance therapy," she says. She received two chemo drugs every three weeks for what turned out to be two years, but in July 2013 a new CT (computed tomography) scan showed slight increases in bone tumors. She wasn't too surprised. "I knew the disease would progress—it was just a question of when," she says.

But since Mills' original diagnosis, two things had changed. Further testing had revealed that she was in fact ALK -positive, and a new drug for such cases called Xalkori was now FDA -approved. In August 2013 she began that therapy, which required two pills a day, and scans since then have revealed a 40 percent reduction in her tumors. "That's pretty miraculous," she says. "Pretty impressive."

Mills' disease is now stable again, but cannot be considered cured, so she will continue to take Xalkori for the foreseeable future. Passing the three-year anniversary of her diagnosis, however, felt like something of a triumph. Her mother was diagnosed with lung cancer at the same age she was, but lived only three years with the disease. "It was incredibly emotional to me, to have lived past my mother's age," she says. Her mother was a smoker, so there is no way to know for sure what factors were critical in her contracting cancer.

What is known is that Mills has the advantage of new drug therapies and protocols that weren't available for the treatment of her mother. She also feels fortunate to have a hospital like Saint Barnabas Medical Center so close by. The Cancer Centers at Saint Barnabas provided a number of ancillary services— including the expertise of a dietitian, who helped Mills deal with weight loss that followed her chemotherapy.

"Because my type of lung cancer is a rare one, Dr. Leitner has consulted about it with specialists at various institutions in the area, but he remains my primary oncologist," she says. "I'm glad I have him, with his expertise and compassion, and I also had great confidence in the nurses and social workers at Saint Barnabas Medical Center."

Concludes Mills: "I feel really blessed and very lucky that I have such excellent care just two miles down the street from where I live."

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