In August 2015, Eileen Kelly woke up in her Upper Darby home with neck pain. Did she sleep in a weird position or wrench her neck over the weekend? She didn’t know, but she also wasn’t that concerned.
But then the pain quickly became so severe that Kelly went to Delaware County Memorial Hospital’s emergency room. MRIs and other imaging revealed cancer almost everywhere—her spine, brain, liver, lung, breasts, pancreas. She was 47 years old.
Metastatic is the medical term. Biopsies showed that lung cancer was the origin of all those tumors. But how did the cancer get so advanced without Kelly knowing? Many of the symptoms—coughing, being tired and sore—came with her job description. Kelly was a kindergarten teacher and spent her days chasing 5-year-olds with runny noses.
With her four siblings in tow, Kelly went to see an oncologist at Delaware County Memorial Hospital. He recommended radiation and chemotherapy, but cautioned the family to prepare for the worst. “He told me to start thinking about hospice,” Kelly remembers. “Just like that, my life is over? I don’t think so.”
The Kelly clan didn’t think so, either. They got her an appointment with the best oncologist they could find: Dr. Sameer Gupta of Bryn Mawr Medical Associates. In October, Kelly’s three sisters and her nephew crowded into a patient room to hear Gupta’s opinion. “He said, ‘Let’s get hospice out of our minds,’” Kelly says, her voice cracking with emotion at the memory. “My sister asked if I’d be alive for Christmas. Dr. Gupta said, ‘Let’s believe that this is not her last Christmas.’”
Hope is important to Gupta. Fear and depression can disable patients. Still, Gupta doesn’t promise miracles. “I believe in being honest,” he says. “If patients have metastatic disease, I explain that we have short-, medium- and long-term goals. The short-term goal is to get the disease under control. If I can’t do that, the medium and long-term goals are irrelevant.”
Still, the first doctor wasn’t wrong; Kelly’s short-term future looked bleak. “Statistics? Yes, they are important,” Gupta says. “But if a physician says he knows exactly how a patient will respond to treatment, he is guessing and hoping—at best.”
Regardless, Kelly put her faith in Gupta. “I wanted a doctor who’d fight for me,” she says. “He did.”
The months that followed her diagnosis were awful for Kelly. Brain radiation was torturous, and three kinds of chemotherapy unleashed horror on her body. She lost her hair and 30 pounds. Pain medication created a fog into which she retreated. Refusing to give up, Kelly’s family took over her medical care.
In November 2015, scans showed positive results: Kelly’s liver lesions and lung nodules had reduced. Then, in January, her pain skyrocketed. A PET scan showed that the cancer was back with a vengeance. “Her disease was exploding,” Gupta says. “It was a fire out of control, worse than in October.”
Cancer cells can morph, becoming resistant to chemotherapy. How does that happen and why can’t immune systems kill cancer cells? Those questions are the foundation of immunotherapy, a field that focuses on boosting immune systems so they can fight cancer.
At the time Kelly started to deteriorate, a new immuno-therapy drug called Nivolumab got FDA approval for use in patients with lung cancer. Immunotherapy doesn’t work for every patient, and the medications can have side effects. Still, Gupta wanted Kelly to try it. By that point, she was making funeral arrangements. But with her family’s support, she tried Nivolumab. Gupta also added radiation to Kelly’s regimen. “Radiation, when it kills cancer cells, may stimulate the immune system,” Gupta says. “It’s not the standard of care, but preliminary data shows that it may increase the efficacy of immunotherapy medication.”
Kelly started treatment in February 2016. In April, scans showed her body responding positively. Slowly but surely, the tumors receded. By June, Kelly was in radiological remission. Cancer may be lurking in her body, but it’s not showing up on scans. To Kelly, her recovery is a miracle. “Not a miracle,” Gupta clarifies. “Science.”
Kelly is still disabled by pain from damage to her spinal cord. She gets Nivolumab infusions every three months and struggles with severe side effects from various medications. But she’s alive. Yet, she doesn’t see herself as a fighter. Cancer isn’t something you consciously battle, she says. You withstand its assault on your body; you endure the treatment. “And when you can’t fight for yourself,” says Kelly, “you find people who will fight for you.”