November 04, 2022
Dawn Wheeler was an active 50-year-old going about her day when she received a text from her older sister. “She texted because she didn’t think she’d be able to get through a phone call, but she wanted to let me know she’d just been diagnosed with breast cancer,” Dawn recalls. In shock, Dawn gasped and brought her hand to her chest — and that’s when she felt a lump.
That day everything changed as Dawn began her own cancer journey. Dawn’s health history included follow-up mammography and even a breast biopsy, which revealed benign calcifications. Unconcerned, she had forgotten to return for a recommended 6-month follow-up scan, and it was 18 months later when she discovered the lump in her right breast.
In May 2017, Dawn, a resident of Edwardsville, Kansas, met with an oncologist and surgeon at another healthcare facility. She soon after had a double mastectomy with reconstruction, 5 rounds of chemotherapy and 4 stereotactic radiation treatments. But the cancer, initially diagnosed as HER2+ stage II was reclassified as stage IV when doctors discovered it had spread to Dawn’s liver and sacrum, a bone located at the base of the spine.
No one-size-fits-all treatment
There are many different types of breast cancer, and they respond best to different treatments. HER2+ breast cancer involves a protein known as human epidermal growth factor receptor 2, which promotes malignant cell growth, making this type of breast cancer more aggressive than some others.
“We have access to drugs that are very effective and efficient in treating this type of metastatic disease,” says Priyanka Sharma, MD, an oncologist specializing in breast cancer at The University of Kansas Cancer Center, a National Cancer Institute-designated comprehensive cancer center. “HER2+ breast cancer responds well to the HER2-targeted treatments that have become available in the past decade, and new treatment options are being developed on a regular basis. There are many clinical trials underway that may offer even more effective treatments in the coming years.”
Access to the newest therapies led Dawn to the cancer center when her initial chemotherapy stopped working in January 2019. “My son wanted me at The University of Kansas Cancer Center all along, and my first doctor referred me there because it offers the most treatment options,” she says. “From my first visit with Dr. Sharma I felt I was in great hands. She knew right away that there was a new drug that could be effective against my cancer, and I was the first person in Kansas City to get it.”
Higher quality care benefits patients
NCI-designated comprehensive cancer centers like The University of Kansas Cancer Center are recognized for their scientific excellence, including their depth and breadth of research. They are the backbone of innovative research and care across the country, helping to pioneer today’s most groundbreaking advances in cancer treatment. We are the only National Cancer Institute-designated comprehensive cancer center in the region, and 1 of only 53 in the nation, to receive this elite distinction.
“One of the benefits we have here as an NCI-designated comprehensive cancer center is the ability to provide our patients with the latest and greatest therapies,” Dr. Sharma says. “Patients treated at our NCI-designated comprehensive cancer center have access to the entire spectrum of clinical trials, ranging from newer treatments, novel diagnostics, quality of life and survivorship studies. It’s a complete package.”
Dr. Sharma, like her colleagues at the cancer center, not only treats patients, she also participates in development and execution of clinical studies. This means designing new studies, publishing new findings and collaborating with other research physicians nationwide to understand what causes and drives the disease process and how to effectively treat it. She refers to her work at the research bench, not only at the bedside, as “elevated care.”
Dawn agrees that her care at The University of Kansas Cancer Center is top-notch and expresses her gratitude. “I am so thankful I found Dr. Sharma and the whole team here,” she says. “I love the nurses and the rest of the staff, too. Dr. Sharma is kind and positive and doesn’t look at me with pity. She knows about the most recent advances, and I know I’m getting the best information out there.”
Latest and most promising treatment
The new drug Dr. Sharma prescribed for Dawn, Enhertu®, shows promise as a highly effective second-line treatment for metastatic HER2+ breast cancer. Studies show that the drug prevents the cancer from progressing for a longer period of time than previous treatments. It is FDA-approved for use in people whose disease progressed during or after initial treatment.
Enhertu is an “antibody drug conjugate,” a term used to describe a newer class of drug treatments that combine a chemotherapeutic agent with a monoclonal antibody. In this case, the antibody targets the HER2 receptor on cancer cells. The result is a treatment in which the cancer-killing drug is delivered directly to the part of the cell responsible for cancer growth, short-circuiting the cell’s ability to continue dividing as new cancer cells. Because the drug is targeted only at the HER2 receptors, healthy cells are spared the toxic effects of chemotherapy. Some physicians refer to this type of treatment as “smart chemotherapy.”
“I feel really confident,” Dawn says. She receives Enhertu via infusion every 3 to 4 weeks, has scans to check the metastases in her liver and sacrum every 2 months, and sees Dr. Sharma once a month. During the first 18 months of Enhertu treatment, Dawn’s liver metastases and the tumor in her sacrum stabilized and stopped growing. The only side effect she noticed was fatigue following the short, 30-minute infusions. “I tend to be very tired for about a week after the treatments,” she says. “But I’m still very active. I do CrossFit, and I’m an avid gardener. So I rest when I have to, but I’m feeling really good.”
Because Enhertu can cause abnormal liver function, and Dawn’s liver is already compromised due to the metastases, she took a summer break from the drug. Dawn used the time to travel, enjoying a family reunion and spending time with her 4 children and 4 grandchildren. She will resume her treatments this fall and is in a clinical trial of cancer patients who recovered from COVID-19, a study that Dr. Sharma knew about as a result of her dedication to research and the cancer center’s role as one of the nation’s research centers.
Looking forward with optimism
“Dawn is a great example of how people with metastatic breast cancer can live a normal life, doing the things they enjoy,” Dr. Sharma says. “It’s very gratifying to be able to offer our patients access to specialized teams and the absolute best treatment options available.”
Dawn is facing the future with optimism. “I tell all my friends my own story and that if they want the top cancer specialists in the area, they need to go to The University of Kansas Cancer Center. It’s just the best.”