Ellis Winter 2011-2012 : Page 4

Patient Care Teacher battles back from cancer By cheri Ghan “Marie has always been highly motivated to do everything possible to fi ght her leukemia. Even when she was diagnosed and soon after completing therapy she was working on her teaching, preparing lectures and studies, reading extensively.” Donald Doll, MD arie Spence had plans. In September 2006 she was starting her ninth year of teaching at Columbia’s Blue Ridge Elementary School, and she was working on her master’s degree in education. Marie and her husband, Kraig, had just been put on a waiting list to adopt a child to start their family. Her life was going just as she had planned. And Marie Spence is a planner. Th en, following a routine radioactive iodine dose for a long-time thyroid condition, something happened. Spence suff ered extreme fatigue, was getting winded walking up stairs, was lightheaded, started bruising easily and suddenly had red pinpoint dots all over her legs. Finally, one day after school, she was so ill she went to the emergency room where she needed four pints of blood. Following testing and a bone marrow biopsy, Spence got news that changed all her plans. She had cancer. She turned to Ellis Fischel Cancer Center for treatment. Th e diagnosis was acute myeloid leukemia, AML, a type of cancer in which the bone marrow makes abnormal myoblasts, red blood cells or platelets. It is the most common type of acute leukemia in adults and typically occurs in people over age 65. Spence was 32. “I was blindsided,” Spence said. “Th is was random, a fl uke, completely off my radar.” Th e following days were critical as Spence’s condition worsened and she was moved from an oncology unit to an intensive care unit at University Hospital. For three weeks she lay in a medically-induced coma. M She was bleeding into her lungs and going into multi-organ failure. Kraig Spence slept in the waiting room every night. When Spence stabilized, chemotherapy was started to treat the cancer, and by December her blood levels were clean. Chemotherapy was halted and she returned to school, using colorful wigs as accessories and thriving in the accepting atmosphere only second graders can provide. Her respite was short-lived, however, because the cancer returned in April 2007. Once a patient has AML twice, the only treatment is a stem cell transplant. Th ere were no matches on the national registry of donors, but two on the international list. One year after the Sept. 20, 2007 transplant operation in St. Louis that saved Marie Spence’s life, she now trades emails with the German donor who is exactly 11 months younger than the woman he helped save. 4 Ellis / Winter 2011-2012 / www.ellisfi schel.org

Unplanned Lessons

Cheri Ghan

Marie Spence had plans. In September 2006 she was starting her ninth year of teaching at Columbia’s Blue Ridge Elementary School, and she was working on her master’s degree in education. Marie and her husband, Kraig, had just been put on a waiting list to adopt a child to start their family. Her life was going just as she had planned. And Marie Spence is a planner.<br /> <br /> Then, following a routine radioactive iodine dose for a long-time thyroid condition, something happened. Spence suffered extreme fatigue, was getting winded walking up stairs, was lightheaded, started bruising easily and suddenly had red pinpoint dots all over her legs. Finally, one day after school, she was so ill she went to the emergency room where she needed four pints of blood. Following testing and a bone marrow biopsy, Spence got news that changed all her plans. She had cancer. She turned to Ellis Fischel Cancer Center for treatment.<br /> <br /> Th e diagnosis was acute myeloid leukemia, AML, a type of cancer in which the bone marrow makes abnormal myoblasts, red blood cells or platelets. It is the most common type of acute leukemia in adults and typically occurs in people over age 65. Spence was 32.<br /> <br /> “I was blindsided,” Spence said. “This was random, a fluke, completely off my radar.” <br /> <br /> Th e following days were critical as Spence’s condition worsened and she was moved from an oncology unit to an intensive care unit at University Hospital. For three weeks she lay in a medically-induced coma.<br /> <br /> She was bleeding into her lungs and going into multi-organ failure. Kraig Spence slept in the waiting room every night.<br /> <br /> When Spence stabilized, chemotherapy was started to treat the cancer, and by December her blood levels were clean.<br /> <br /> Chemotherapy was halted and she returned to school, using colorful wigs as accessories and thriving in the accepting atmosphere only second graders can provide. Her respite was short-lived, however, because the cancer returned in April 2007. Once a patient has AML twice, the only treatment is a stem cell transplant.<br /> <br /> Th ere were no matches on the national registry of donors, but two on the international list. One year after the Sept. 20, 2007 transplant operation in St. Louis that saved Marie Spence’s life, she now trades emails with the German donor who is exactly 11 months younger than the woman he helped save.<br /> <br /> Family ties<br /> <br /> At Blue Ridge Elementary School, cancer is, unfortunately, all too common. Within a three-year period, four staff members had a cancer diagnosis. Like a tight-knit family, staff rallied around Marie by reading to her class, visiting her with treats and giving her special pajamas embroidered with the school’s logo.<br /> <br /> “They’re just amazing,” she said. “They spent a lot of time talking to Kraig. They took his mind off it for awhile and lifted his spirits. You know, my husband didn’t sign up for this, and he needed support, too.” <br /> <br /> Cheryl Brewer, secretary to the principal, another cancer survivor and Ellis Fischel Cancer Center patient, drew support from Spence.<br /> <br /> “Part is in my own hands, like taking care of myself and getting all my checkups,” Brewer says. “But I am hopeful for myself And other cancer patients who come from all over to Ellis Fischel. Knowledge is power. Marie researched so much she has helped herself recover and thrive, which trickles down to others. You learn from each other with this cancer business because we’re all in it.” <br /> <br /> Spence’s master’s classmate and friend, Cherri Westbrook, also leaned on Spence when she was diagnosed with breast cancer in 2008.<br /> <br /> “When Marie was diagnosed, I was devastated,” Westbrook, a kindergarten teacher at Columbia’s West Boulevard Elementary School, said. “But Marie was one of the first people I called when I found out I had cancer. I had a ton of questions and Marie was there like a rock for me. The Moving Forward support group at Ellis was one of the best experiences of my life and I learned so much from the staff. I felt that For the first time I really understood and had a handle on what was going on in my body.” <br /> <br /> For Marie, the circle of friends is a critical part of her life.<br /> <br /> “We’re all part of the sorority nobody wants to be a member of,” she said quietly.<br /> <br /> DeFininG moments, not life <br /> <br /> Sept. 20 is Marie Spence’s new birthday, more significant to her than her real one. She’s had four and can’t wait for No. 5. Her friends shower her each year with fun cards and words of encouragement.<br /> <br /> Graduate school is on hold indefinitely,And she now teaches smaller reading intervention classes to get struggling students up to grade level. She and Kraig have indeed adopted their first “child,” a pug-beagle mix named Bosley who accompanies Spence to school each day, serving as a reading buddy to her students.<br /> <br /> She still has regular check-ups with Donald Doll, MD, a hematologist and oncologist at Ellis Fischel Cancer Center, and enjoys participating in patient support groups. She appreciates the personal attention she has received at Ellis Fischel Cancer Center, from nursing staff that know her entire cancer medical history, to getting reading suggestions from Doll.<br /> <br /> “Marie has always been highly Motivated to do everything possible to fight her leukemia,” Doll said. “Even when she was diagnosed and soon after completing therapy she was working on her teaching, preparing lectures and studies, reading extensively. She was involved in several physical activities to maintain her health. Such positive thinking and activity and determination have helped her both mentally and physically to undergo all of the treatments and complications associated with her disease.” <br /> <br /> In addition to adopting a healthy lifestyle, Spence is encouraging Blue Ridge students to do likewise by sponsoring the school’s walking and running club. She was ready to participate in her first full marathon this fall when a stress fracture sidelined her.<br /> <br /> “Worse things have happened to me,” she said with a shrug.<br /> <br /> Worse things may have happened in her life, but they don’t define her life.<br /> <br /> “Cancer isn’t always a death sentence, but it doesn’t mean it won’t be hard,” she said. “I’ve found maybe I’m a little tougher than I thought I was and that I now don’t get as bent out of shape over things. I don’t have time to waste on that. “<br /> <br /> To learn more about patient services and support groups at ellisfischel Cancer Center, visit www.ellisfischel.org.<br /> <br /> The ABC’s of AML<br /> <br /> There are various risk factors and signs of acute myeloid leukemia. Donald Doll, MD, a hematologist and oncologist at Ellis Fischel Cancer Center, provides information about those, as well as treatment options.<br /> <br /> Risk fACToRs foR AduLT AcuTe MyeLoid LeukeMiA:<br /> <br /> Having a risk factor does not mean that you will get cancer; not having risk factors doesn’t mean that you will not get cancer. People who think they may be at risk should discuss this with their doctors.<br /> <br /> PossiBLe Risk fACToRs foR AML inCLude The foLLowing:<br /> <br /> • Being male<br /> <br /> • Smoking, especially after age 60<br /> <br /> • Having had treatment with chemotherapy or radiation therapy in the past<br /> <br /> • Having had treatment for childhood acute lymphoblastic leukemia (ALL) in the past<br /> <br /> • Being exposed to atomic bomb radiation or the chemical benzene<br /> <br /> • Having a history of a blood disorder such as myelodysplastuc syndrome<br /> <br /> • Having pre-existing genetic disorders, such as Down syndrome and Fanconi’s anemia<br /> <br /> PossiBLe signs of AduLT AcuTe MyeLoid LeukeMiA:<br /> <br /> The early signs of acute myeloid leukemia may be like those caused by the flu or other common diseases. A doctor should be consulted if any of the following problems occur:<br /> <br /> • Fever<br /> <br /> • Shortness of breath<br /> <br /> • Easy bruising or bleeding<br /> <br /> • Petechiae (flat, pinpoint spots under the skin caused by bleeding)<br /> <br /> • Weakness or feeling tired<br /> <br /> • Weight loss or loss of appetite<br /> <br /> Treatment of adult acute myeloid leukemia at Ellis Fischel Cancer Center<br /> <br /> All members of the staff at Ellis Fischel and the 5 East oncology unit at University Hospital, including physicians, fellows, nursing, pharmacy and nurse practitioners, may be involved in the care of patients with acute leukemia.<br /> <br /> Treatment varies depending on cell type, subtype, cytogenetics and gene mutations. Patients with acute myeloid leukemia may be treated in University Hospital with a standard regimen of seven days of cytarabine and three days of daunorubicin. Such patients may be in the hospital for a total of 28 to 35 days.<br /> <br /> After hospital treatment, patients are then monitored as outpatients at Ellis Fischel Cancer Center for a few months, then every two or three months routinely. If the patient is participating in a clinical trial or protocol, the visits, labs and other care will be determined by the clinical trial.<br /> <br /> “The patient is advised to contact us if there is any sign of infection, fever, bleeding, headache or any other complaint,” Doll said. “We have a multidisciplinary team of health care professionals trained in social services, nursing, nutrition, and other areas that might be necessary to ensure our patients have the best and most appropriate care.”<br />

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