October 1999
Patient Profile
Sarianna Swing
Russell and Bonnie Swing, parents
Fort Wayne, Ind.
Contact: Mary Hardin
Indiana University School of Medicine, Media Relations
317.274.7722
Cyclist Lance Armstrong isn't the only cancer comeback kid of note. This summer 11-year-old Sarianna Swing, known throughout the Wallen Girls' Fast Pitch League of Fort Wayne for her fielding prowess and snappy double plays, was wowing the crowds. She also spent the summer pursuing her other favorite hobbies, swimming and reading, before she returned to her hectic schedule at Hickory Center Elementary School.
It's hard to believe that only six years ago, before she had even begun kindergarten, Sarianna was diagnosed with neuroblastoma, a frequently lethal childhood cancer which develops from the tissues that form the sympathetic nervous system. This is the part of the nervous system that regulates involuntary body functions by increasing heart rate and blood pressure, constricting blood vessels and stimulating certain hormones.
Neuroblastoma most commonly begins in the abdomen in the tissues of the adrenal gland. It usually spreads rapidly, as it did in Sarianna's case, to the lymph nodes, liver, bones and bone marrow. Neuroblastoma, which occurs in approximately one out of 100,000 people, is the second most common solid tumor in children after brain tumors and is most commonly diagnosed in children before age five. While curable in more than 90 percent of babies under a year of age, the outlook for older children is poor. Until recently only 20 percent survived.
Sarianna's Allen County pediatrician sent a very sick little girl to Riley Hospital for Children, where Indiana University School of Medicine doctors diagnosed the little girl's cancer and immediately began treatment. The preschooler had nearly two dozen tumors, most of which were surgically removed from her spine, kidneys, liver, skull and hip joints.
Sarianna was the first patient to receive treatment under a pilot protocol developed at IU that employs even more intensive therapy than that given to neuroblastoma patients on the National Children Cancer Group (NCCG) protocol. The recently completed NCCG protocol has demonstrated that giving more intensive chemotherapy followed by stem cell transplant could cure 35 percent of patients.
"We hope that the increased intensity of the IU treatment protocol will even further improve survival rates," says Susan Kreissman, M.D., Sarianna's IU physician.
The young girl was given high dose chemotherapy and peripheral blood stem cell infusions to help decrease the side effects of the chemotherapy and shorten the time until the next chemotherapy dose could be safely given. Her peripheral blood stem cells were collected from the blood stream using a machine similar to a dialysis machine. They were then frozen until needed. These cells are the "mother" cells of all blood-forming cells. Following chemotherapy, they were given back intravenously to Sarianna. They found their way to the bone marrow and developed into mature cells needed to fight infection and carry oxygen and nutrients to the body.
Bonnie Swing, Sarianna's mother recalls that her daughter's high spirits and optimism got the whole family through a very difficult time. Mrs. Swing looks back on the many months spent in medical treatment at IU as a "time of growth and strength." The licensed beautician, who is a full-time mother, and her husband Russell, who works in the insurance industry, have six children ranging in age from 11 years to 24 years. Sarianna is their youngest child and only girl.
These days Sarianna, like Lance Armstrong, isn't spending too much time in doctors' offices. She visits Dr. Kreissman only once a year, giving her plenty of time to hone her fielding skills and to think about the many baseball seasons ahead.
October 1999
Patient Profile
Stephen Jamieson
Indianapolis
Contact: Mary Hardin
Indiana University School of Medicine, Media Relations
317.274.7722
A pop culture expression from the early 1970s plastered on posters and bumper stickers said, "If life gives you lemons, make lemonade." Nearly 25 years later, Stephen Jamieson is living that adage. Jamieson is a testicular cancer survivor, having been diagnosed at the age of 27. He has turned his experience with cancer into an opportunity to educate and inform other young men about the disease.
"Throughout all my schooling, I never heard of testicular cancer," he explained. That's why, when at the height of his treatment, Jamieson approached the Marion County Health Department about going to high schools and discussing the disease with teenage boys. Health officials were thrilled to accept his offer.
Jamieson's treatment regimen was very taxing; he was weak, lost 40 pounds off his already lean frame and lost all his body hair. At age 27, his wife teased that without his hair he looked like a 10-year-old. It was during this period that Jamieson began going to high schools in Indianapolis speaking to young men about the warning signs of testicular cancer, how to do self-exams and other things that he felt if he had known, his disease would have been caught long before it had metastasized to his abdomen, chest and neck.
"I needed something to occupy my time and I thought it would have a dramatic effect on the students when someone my age walked in totally bald," Jamieson said.
The treatment regimen for testicular patients was developed nearly 20 years ago by Lawrence Einhorn, M.D., now a distinguished professor of medicine at the IU School of Medicine. It now is considered standard protocol for testicular cancer patients the world over.
It includes a rigorous chemotherapy regimen, radiation and nerve-sparing surgery. Jamieson said he endured the therapy better than most, in part, he believes, due to the support he had in his wife, family and friends. Other patients he encountered were not as lucky, so he would make a point to visit with them while they were hospitalized and to this day he still does that every time he has the opportunity.
October 1999
Patient Profile
Michael Cornman
Ellettsville, Ind.
Contact: Mary Hardin
Indiana University School of Medicine, Media Relations
317.274.7722
Michael Cornman has made a career of serving others; he has been an Ellettsville firefighter for 20 years, has served on the City Council for five years and as council president for the past four years. What he didn't realize was that it would take a very serious illness to slow him down enough so that others could "return" some of that service.
Not that it preys on his mind, but he can tell you the exact day he was diagnosed with chronic myelogenous leukemia -- Nov. 5, 1990.
"We were at the Monroe County Airport fighting what we thought was a hangar fire when I had a head rush and collapsed," he said. Blood work at the hospital revealed he had leukemia. Other than having had a cold that wouldn't go away for the previous month or so, Cornman considered himself in excellent health. It all came as a shock.
Now he speaks of it passively, but it had to be an ordeal.
The standard protocol at that time for CML was the "wait and watch" theory -- delay treatment until the disease becomes acute. Cornman, however, became a pioneer. His Bloomington physician sent him to the IU Medical Center to be examined in anticipation of future treatment. Instead, he was enrolled in a study with a novel approach to CML -- to treat the disease before it becomes acute.
Because of the kind of leukemia he had, Cornman's spleen was removed seven months after the initial diagnosis to prevent the manufacture of additional T-cells which "feed" the disease.
Statistics show that only one in four siblings are a match for bone marrow transplantation. Cornman has two brothers and two sisters and, the statistics held true, a sister was a match. He had a bone marrow transplant on Aug. 1, 1991 -- another date that casually rolls off his tongue. He was hospitalized in isolation for 31 days to prevent infection and to monitor potential rejection following the transplant.
Cornman has a rather unique view of a hospital. He has been an inpatient 17 times and has had 122 outpatient visits.
"Being at the hospital has a soothing effect on me," he said. "IU Hospital is kind of a sanctuary. They take such good care of me."
"Things happen for a reason, I'm a firm believer of that," he said. And, as Cornman will explain, his disease gave others a chance to touch his heart in a unique way.
A group of 28 firefighters, their spouses and friends spent 13 hours at the Cornman house while he was undergoing treatment for his leukemia. The friends put on a new roof, repaired a ceiling, added a deck, and completed miscellaneous other handyman chores. All of those repair projects had been planned by the Cornman's -- they even had the money set aside -- but instead the extra cash went to health care expenses. So, his friends and colleagues made it happen.
October 1999
Patient Profile
Linda Ewing
Lafayette, Ind.
Contact: Mary Hardin
Indiana University School of Medicine, Media Relations
317.274.7722
If you want to know about student life at Purdue University, Linda Ewing can tell you. She is associate dean of students there. And, if you want to know about cancer therapy, she can tell you about that, too. She is a cancer survivor.
It started in July 1986, just as she was about to leave on vacation. Ewing noticed that her abdomen felt "funny." By August, she was in Home Hospital in Lafayette where she underwent a nephrectomy (surgical removal of a kidney) for renal cell carcinoma. All went well for nine years.
Then in May 1995, an x-ray during a routine physical revealed a suspicious image on the lung. She was told that her cancer had spread to her lungs. That resulted in the removal of a lobe of her left lung and no additional treatment was recommended.
Again, all went well -- for a while.
Then in the fall of 1996, a nodule on her sternum took her back to the doctor where a scan showed evidence that her kidney cancer had again spread. By this time, Ewing was seeing a newcomer to the health care scene in Lafayette, Nancy DiMartino, M.D. Dr. DiMartino had previously worked at a teaching hospital and had made contact with the faculty physicians at Indiana University School of Medicine when she moved to Lafayette. Dr. DiMartino referred Ewing to Michael Gordon, M.D., associate professor of medicine at the Indiana University School of Medicine, and a member of the IU Cancer Center team. Her treatment was radiation to the sternum.
But, cancer can be insidious, as Linda Ewing well knows.
Since the spring of 1998 when malignant spots were found in her left hip and a lung, she was enrolled in or has considered nearly half a dozen clinical trials. They may hold the answer for her recovery. Those trials involve everything from use of the chemotherapy agent Interleukin-2 to a stem cell transplant which is considered experimental treatment for Ewing's form of cancer.
Ewing says she sees each opportunity for participation in a clinical trial as a "window of opportunity."
October 1999
Patient Profile
Izora Chenoweth
Cambridge City, Ind.
Contact: Mary Hardin
Indiana University School of Medicine, Media Relations
317.274.7722
Twenty-three years ago when Izora Chenoweth first started coming to the Indiana University Medical Center there were no oncologists in Richmond. But, times have changed and so has the growing field of cancer therapy. Now, she is able to save herself the drive to Indianapolis; she gets some of her cancer care in Richmond, but she still journeys to the medical center for other portions of her care.
As a long-term cancer patient, Chenoweth has seen lots of changes in the way cancer is treated, including a decrease in the toxicity level of the drugs used to fight cancer. She also has witnessed changes in the facilities and technology available to cancer patients and she has seen the IU Cancer Center mature into the program it is today.
Chenoweth has non-Hodgkin's lymphoma. There are various kinds of NHL, but hers is called low-grade, meaning it is slow growing and treatable. After treatment, this form of lymphoma goes into remission where it can stay for an indefinite period of time before it becomes active again. So, from time to time, Chenoweth has undergone chemotherapy and she has taken a drug called prednisone for years.
One of those chemotherapy agents, cyclophosphamide, may have kept her lymphoma under control, but Chenoweth says it has caused malignant tumors to grow in her bladder. Now she is fighting another cancer battle -- one that requires more chemotherapy and occasional outpatient surgeries to remove tumors in the bladder.
Throughout it all she has maintained an optimistic attitude. "Family and friends were my motivation," she said. "That and I loved my work." That work just happened to be helping others with health problems as a financial counselor at Reid Hospital.
October 1999
Patient Profile
Chaka Chandler
Indianapolis, Ind.
Contact: Mary Hardin
Indiana University School of Medicine, Media Relations
317.274.7722
At 6-foot-4 and 185 pounds, Chaka Chandler was the picture of health. He worked out regularly and ate healthy foods. The former University of Evansville basketball standout still played basketball and lifted weights. At the age of 28, he had no reason to suspect he had cancer.
Instead, Chandler said he was being treated for an infection that was causing one of his testicles to swell. It wasn't until he watched a television program detailing Olympic skater Scott Hamilton's battle with testicular cancer that he grew suspicious. He approached his urologist about his suspicions and ended up at Indiana University Cancer Center being treated for the disease that temporarily turned his life upside down.
First he underwent surgery to remove the malignant tumor. Then he underwent chemotherapy for nine weeks. That regimen ended in June. Although he lost all his hair, Chandler says he only lost about 10 pounds. He was able to maintain his weight training to some degree, which he believes is making his recovery a bit easier.
"Being an athlete and working out, eating the right foods, you can't believe it has happened to you," he said. "But, if it can happen to me, it can happen to anybody."
Like many young men who develop the disease, Chandler said he had never heard of testicular cancer until he saw the program on Hamilton's battle with the disease. Now he is very aware of the disease that primarily strikes young men. He is confident of his recovery and is moving ahead with his life. In fact, over the Fourth of July holiday, Chandler became engaged to a woman he met in college.
Chandler, who now works as a customer service representative for BMG Entertainment in Indianapolis, played guard forward on three University of Evansville teams that made it to the NCAA tournament in 1989, 1992 and 1993. He scored 790 career points and pulled down 198 career rebounds from 1989 to 1993. (He was red-shirted in 1990.) He ranks tenth in the school's history in assists (226) and tenth for three-point field goals (77).
October 1999
Patient Profile
Abigail Brown
Dale and Rhonda Brown, parents
Elizabethtown, Ind.
Contact: Mary Hardin
Indiana University School of Medicine, Media Relations
317.274.7722
Elizabethtown resident Abby Brown was only six years old when doctors found that her body had been invaded by 14 tumors of advanced Ewing's sarcoma, an aggressive bone cancer. Although Abby's parents, Dale and Rhonda Brown, were initially told their daughter had no chance of survival, Abby was given the opportunity to become the fifth child in the world to enter an experimental chemotherapy treatment protocol at the Indiana University Cancer Center. Her parents opted to enter her into the protocol, and she began treatment at Riley Hospital for Children within 48 hours of her diagnosis. She was given a rigorous regimen of five consecutive days of 12- to 18-hour chemotherapy treatments each month for four months.
Abby's mother said that of the five children in the initial research protocol, Abby responded best to the drugs. Although her initial x-rays showed her lungs to be three-quarters full of white "cancer clouds," the clouds dissipated after just 10 days of the experimental treatment. The tumors eventually disappeared completely.
"If it hadn't been the Lord's direction to send us to Riley via our doctor, Abby wouldn't be alive today," Mrs. Brown said. "There isn't one bad thing I can say about the nurses and the staff at Riley. They dedicate their lives so that my child can have hers."
Abby's cancer relapsed in December 1998 and she had a stem cell transplant in March at Riley Hospital for Children. She was the first patient to receive the transplant according to a novel, phase I protocol that utilized the drug Interleukin-2. Her mother happily reports that her bone scans were completely clear at her recent check-up.
"The thing I really admire about the IU doctors is that before they would do or say anything, they spent hours and hours on the phone talking to doctors all over the world just trying to find out what they thought would give my child the best chance at life," Abby's mother said.
October 1999
Patient Profile
Howard Hull, Ed.D.
Zionsville, Ind.
Contact: Mary Hardin
Indiana University School of Medicine, Media Relations
317.274.7722
In May, Howard Hull, superintendent of the Eagle-Union School Corporation in Zionsville, smiled proudly as he conferred a high school diploma on his daughter Emily. Emily is already enrolled in the pre-medicine program at Indiana University Purdue University Indianapolis. She says her interest in medicine began when she was only 10 years old and was visiting her father in the bone marrow transplant center for 38 days.
It was 10 years ago when Howard Hull, Ed.D., underwent a routine physical only to learn that he had an elevated white blood cell count. He was diagnosed with chronic myelogenous leukemia and was told his condition was terminal.
He and his wife Lisa were not, however, willing to accept this dire diagnosis. Through library research and contact with the American Cancer Society, Dr. Hull learned that the Indiana University Medical Center was one of the few sites in the country at that time where he could receive an experimental bone marrow transplant.
After several members of Dr. Hull's family were found to be incompatible for his bone marrow transplant, the Indiana University Cancer Center conducted an international donor search and as a result located a perfect bone marrow match in North Carolina.
"When I came to the IU Cancer Center, I felt like I was coming to a place that had absolutely everything necessary for my treatment: all the machinery and personnel were within walking distance. Although I was in a large place, the people made it seem like a small place. All were well trained not only in medical but in social skills as well," Dr. Hull said.
Dr. Hull is a native of the South Bend area. He served as a high school principal and superintendent in Fort Wayne for 20 years before relocating to the Zionsville area.
October 1999
Patient Profile
Karie Trudeau
Newburgh, Ind.
Contact: Mary Hardin
Indiana University School of Medicine, Media Relations
317.274.7722
In January, Karie Trudeau, age 43, was stunned when her local physician's office called her at work to tell her the lump she had found in her breast was indeed cancerous. Her son Eric immediately got on his computer and pulled up basic questions for her to ask her oncologist. Despite this preparation, Trudeau did not feel that her fears were entirely alleviated by her initial physician visits. That's when she spoke with a representative of the American Cancer Society and was given the names of several local breast cancer survivors. All those with whom she spoke referred her to the Indiana University Medical Center for treatment.
"God must have been guiding me to the IU Cancer Center, because my oncologist and surgeon there truly were angels," Trudeau said as she described the physicians who cared for her in Indianapolis.
"The doctors kept me very well informed and they never sugar-coated things," she said. "But the way they presented information to you was always warm and caring. No matter how bad the bad news was, they always kept your feelings in mind."
Trudeau went through nearly four months of chemotherapy to shrink the tumor in her breast before she underwent a complete mastectomy.
"I haven't had one minute of pain," she said. "I even went back to work 10 days after my surgery."
October 1999
Patient Profile
Kyla Buchanan, age 8
Indianapolis, Ind.
Contact: Mary Hardin
Indiana University School of Medicine, Media Relations
317.274.7722
Cheri Buchanan can only remember being shocked beyond words when she took her 23-month-old daughter Kyla to a local Indianapolis emergency room for treatment of what appeared to be either an ear infection or a respiratory infection. Only 10 minutes after their arrival, Ms. Buchanan said, doctors diagnosed Kyla with leukemia.
Doctors rushed the toddler to Riley Hospital for Children, where a team of doctors quickly discovered she was suffering from acute myelogenous leukemia, a rare disease.
At age two, Kyla was given nine months of intensive chemotherapy and was sent home, only to relapse just five months later. Immediately following her third birthday, Kyla underwent an autologous bone marrow transplant procedure.
But only five months later, just three days after her third birthday, she relapsed a second time.
"At this point, things were getting pretty intense," Ms. Buchanan said. "She was only four years old and had already had almost all the high-toxicity chemotherapy she could tolerate in her lifetime."
But, following a meeting of Kyla's parents, IU Medical Center physicians and the Riley Hospital for Children bone marrow transplant coordinator, it was decided to give Kyla a highly experimental cord blood transplant, in which blood is taken from a newborn's umbilical cord and transplanted into the patient. The transplant coordinator was able to locate two potential matches for Kyla. Kyla was prepared for the cord blood transplant with chemotherapy and total-body radiation. The transplant was successful and now, at 8 years of age, Kyla enjoys a normal childhood.
"People should really open their eyes to experimental medicines and procedures," Ms. Buchanan said. "Because I believe that one day, through somebody's experimental treatments, they'll find a cure."
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