The Case of Kerryanne
Kerryanne was a 77 year old woman from Saskatchewan, Canada whom had been diagnosed with stage IIA Hodgkin’s Lymphoma and had whom had just failed two regimes of standard chemotherapy.
As a senior on disability with rheumatoid arthritis, Kerryanne had limited financial resources and was dependent on the treatments provided to her by her public medical system oncologist.
Since she had failed two previous attempts at controlling her disease, her oncologist told her that they had run out of treatment options and she was offered palliative care with a chemotherapeutic drug called vincristine, that was unlikely to provide her with any benefits and had significant side effects. She was told to enter palliative care and to get her affairs in order.
Kerryanne wasn’t ready to just accept this and so she reached out to us.
How we helped Kerryanne using our 5 step system
1. Introduced Advanced Diagnostics
N/A – See records review
2. Personalized Records Review
First, we requested access to Kerryanne’s medical files and performed a complete review. Interestingly, we found that there was considerable confusion about the diagnosis of Hodgkin’s lymphoma by her treatment team/tumor group due to the lack of a specific type of cells known as Reed Sternberg cells, which characterizes Hodgkin’s Lymphoma. Therefore, her public health care team had sought a second opinion from a prominent well known lymphoma pathologist.
The prominent lymphoma pathologist had concluded that while Kerryanne had a malignant lymphoma consistent with Hodgkin lymphoma, she also had some features of another rare subtype of lymphoma called the lymphocyte-rich subtype. However, due to the lack of a typical nodular pattern of that subtype, the pathologist listed this case as classical Hodgkin’s lymphoma subtype.
The diagnosis of classical Hodgkin lymphoma seemed inappropriate to us, and more than likely based on the treatment options available in this province for this unique case.
3. Conducted Patient Specific Research
We conducted a peer review study of Hodgkin’s lymphomas with lymphocyte-rich features and found out that this subtype had universal expression of a specific cell surface protein called CD20.
We further identified new clinical trial data that showed that when patients with lymphocyte-predominant Hodgkin lymphoma were treated with a common non-chemotherapy drug that targets CD20 (rituximab), the patients had a 100% response rate to the drug. Furthermore in this trial, all of the patients were still alive 5 years after treatment. In addition since rituximab is a monoclonal antibody that only targets cancer cells with CD20, there were no grade 3 or 4 adverse effects.
4. Interim Treatment Support
Next, we researched the Saskatchewan Cancer Agencies treatment guidelines for Hodgkin’s lymphoma and identified provisions in the guidelines to treat patients such as Kerryanne with rituximab, with or without chemotherapy/radiation.
We immediately wrote up a 2 page patient report for Kerryanne’s public health care treatment team, sharing our findings, and suggesting that Kerryanne be given rituximab and a PET-CT to monitor the efficacy of her treatments.
Unfortunately, our requests fell on deaf ears and Kerryanne was once again offered palliative chemotherapy and care and denied the option of rituximab, regardless of whether she paid out of pocket or not.
5. Clinical Trial Support and Advocacy
With our knowledge that rituximab was also used to treat rheumatoid arthritis, we had Kerryanne contact a local Rheumatologist and after sharing our research with him, he prescribed rituximab for Kerryanne, and the drug was covered by her public medical system due to her rheumatoid arthritis.
Rituximab is working very well for Kerryanne more than 2 years after starting it, and is known to delay disease progression significantly, reduce hospital visits, and increase her comfort as it is a non-chemotherapy targeted drug.
Since this drug was approved and covered for a secondary condition that Kerryanne had (rheumatoid arthritis), she got the treatment she needed with much less stress and financial strain.
As you can see, even a brief CTOAM records review and consultation of 4-5 hrs can result in significant benefits to a patient’s outcome. Having access to a team of knowledgeable scientists, doctors and patient advocates that WORK FOR YOU and NOT THE MEDICAL SYSTEM, can make all the difference in the outcome of your disease!
If you or a loved one is fighting cancer, give us a call so we can do a brief review of your medical records. It is important to be sure that you KNOW that you are doing all you can, and that you have access to the best treatments for your own unique case. (778) 999-5463