Health Watch: Breast Cancer
Spirit of a Survivor Meet the terminal breast cancer patient chairing this year’s Komen Race and the MD trying to research his way to a longer life for her. By LAURIE ALLEN + Photo by JODI MILLER
I
n March 2016, Tori Geib was working as a chef at Ohio State University’s James Cancer Hospital and living with undiagnosed Stage 4 breast cancer. Hundreds of miles away, Dr. Daniel Stover was completing his training as a research fellow in cell biology at Harvard Medical School and had recently joined the faculty at DanaFarber Cancer Institute in Boston. Three years later, the two are working together to overcome an ominous, hard-to-treat cancer that claims a disproportionate number of breast cancer patients every year. After their paths led them both back to The James at Ohio State, Stover became Geib’s oncologist. It was the week of her 30th birthday when Geib learned she had metastatic cancer that had spread to her liver, lung and bones. Her back pain, which had been misdiagnosed earlier, turned out to be a vertebra that was 70 percent crushed. Her disease is terminal. When she passed the three-year mark since diagnosis this year, Geib outlived most patients with metastatic cancer, who succumb to the disease about two years after being diagnosed. Geib has triple-negative breast cancer (TNBC), which accounts for about 15 percent of all breast cancers. It is most common in younger women, African-American women and those with the BrCa1 gene mutation. It’s
88 ColumbusCEO l May 2019
Victoria Geib and Daniel Stover, MD also the most difficult to treat. In TNBC, the three most common receptors that fuel breast cancer, estrogen, progesterone and the HER2 protein, aren’t present. For that reason, hormone therapies and many chemotherapy agents don’t work. Furthermore, triple-negative cancers are more aggressive, recur faster and develop resistance to chemotherapy,
leaving patients and doctors in a race against time. Geib responded to treatment for two years, but her disease began to progress again. When her oncologist at the time decided to leave her practice, Geib was devastated. “As a cancer patient, that relationship is one of the biggest bonds you have,” she says. In searching for a new phy-
Victoria (Tori) Geib
Daniel Stover, MD
AGE: 33
AGE: 38
HONORARY CHAIR: 2019 Komen Columbus Race for the Cure
ACADEMIC TITLE: Assistant professor,
EDUCATION: B.A. in Criminal Justice from Mount Vernon Nazarene University; associate’s degree in baking and pastry arts from Columbus State Community College ADVOCACY: Awareness, support and
research funding for metastatic breast cancer; news and media advocacy, including Good Morning America and Health.com; legislative advocacy
LIVING BEYOND BREAST CANCER:
Hear My Voice outreach program advocate and 2019 program mentor. She lives in Bellefontaine, where she receives love and support from family and friends. WEBSITE: metastaticmillennial.org
medical oncology and biomedical informatics and medical oncologist with Ohio State University Comprehensive Cancer Center-Arthur G. James Cancer Hospital and Richard J. Solove Research Institute; member of the translational therapeutics program
EDUCATION/BACKGROUND:
M.D., Vanderbilt University, where he also completed his residency. Fellowship, Dana-Farber Cancer Institute, Boston. Prior to joining OSU, he was on the faculty at Harvard Medical School and saw breast cancer patients at Dana-Farber Cancer Institute and Brigham and Women’s Hospital in Boston. PERSONAL: Resides in Upper Arlington
with his wife and two sons
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OhioHealth Grant Medical Center making cancer care more convenient at new site Cancer care has become highly specialized and personalized in recent years. And many of the breakthroughs that have transformed cancer treatment were developed at a few cancer centers in the county. But with more than 1.7 million new cases of cancer diagnosed annually in the United States, according to the National Cancer Institute, hundreds of thousands of people are logistically unable to travel great distances to receive care. One of the top considerations for patients choosing a cancer care site, aside from insurance coverage, is simply the ability to access care conveniently. That’s because living with cancer often feels like a full-time job, with dozens of appointments for consultations, testing, treatment and follow-up. When your doctors are scattered across hospital campuses and across town, it can make the cancer care experience challenging. The difference of a few miles, over time, can add up to significant costs and time away from work and family. And there are days during treatment where even the thought of walking from one office to the next is exhausting. OhioHealth believes cancer patients shouldn’t have to compromise between convenience and quality, so they’re making changes that simplify the care experience for cancer patients downtown and in communities south of Columbus while continuing to provide access to the top treatment options in the country.
a program of MD Anderson Cancer Center, a world-renowned leader in cancer care. MD Anderson is one of the nation’s original comprehensive cancer centers designated by the National Cancer Institute to help pioneer the guidelines that set the standard of cancer care today. Patients at the Wilkins Professional Building can connect with MD Anderson Cancer Network certified physicians like Cripe, as well as oncology-trained nurses and patient navigators. Combining cancer services into one facility also aids real-time collaboration among the team of specialists involved in caring for a cancer patient.
Coming June 2019, cancer-related services at OhioHealth Grant Medical Center will move to the adjacent William W. Wilkins Professional Building on 285 East State Street, giving patients a single location for care.
“We’ll have easier access to other specialists in the building, for questions about imaging and biopsies, for example,” says Cripe. “And if one of my patients needs to see another provider, I can send them up a flight of stairs instead of to another building.”
The new care site combines surgical services, oncology, infusion, imaging, laboratory services, pharmacy, genetic counseling, neurology, palliative care and wound care, among other services.
“It’s a wonderful improvement to what is already a great service line.”
“The expansion emphasizes our continued focus on patientcentered care,” says OhioHealth breast and skin cancer surgeon Mark Cripe, DO. “We already do a great job taking care of cancer patients. This just makes it easier for patients to be taken care of by putting nearly everything they need under one roof.” People who choose cancer care at the Wilkins Professional Building will also have access to nationally recognized expertise without having to leave their support systems. That’s because OhioHealth is a certified member of MD Anderson Cancer Network®,
To learn more about cancer care at OhioHealth’s Wilkins Professional Building, visit OhioHealth.com.
sician, she knew she wanted someone with both clinical experience and a passion for research. She began following Stover’s work while he was at Dana-Farber. Geib became Stover’s patient when he moved to back to his hometown and joined the translational therapeutics program at Ohio State University Comprehensive Cancer Center—Arthur G. James Cancer Hospital and Richard J. Solove Research Institute. Stover and Geib are unwilling to accept that cancers like hers must be terminal. Their aim is to turn these diseases into chronic conditions, not life-ending ones. “To have more time with family and friends is everything,” Geib says. “Moms want to see their babies grow up, not die when they are 3 years old.” Geib, who lives in Bellefontaine, is honorary chair of the 2019 Komen Columbus Race for the Cure. Despite her illness, she has been a tireless advocate for those with TNBC and metastatic breast cancer, traveling across the country to educate and inform legislators and others who can make an impact. “I’m OK right now, I can
speak for this community. I also have every intention of having a beer with Dr. Stover when he retires. My goal is to be at his retirement party.” Stover is 38. With $450,000 from Susan G. Komen Columbus, he and his team are studying why patients develop resistance to the drugs used to treat TNBC. “We’re focusing on the most aggressive cases. We’re trying to tackle the worst of the worst,” he says. The research focus is computational oncology, using “big data” to characterize the genetic changes leading to drug resistance. His lab’s mission is to more accurately forecast
“I’m OK right now, I can speak for this community. I also have every intention of having a beer with Dr. Stover when he retires. My goal is to be at his retirement party.” TORI GEIB, honorary chair, 2019 Komen Columbus Race for the Cure and metastatic breast cancer patient
a patient’s likelihood of developing resistance and target therapy accordingly. Ultimately, researchers hope to identify high-risk patients at the time of diagnosis. Tumor DNA is obtained from blood samples, or “liquid biopsies” that are easier to acquire than conventional biopsies and enable physicians to take samples more frequently. Improved genetic algorithms also being studied provide a closer look at mutations in a tumor. Not far from his lab, Stover sees patients at OSU’s Stefanie Spielman Comprehensive Breast Center. Being both scientist and physician gives him valuable insight, he says. “The patients I see inform the questions I ask and identify the areas where I feel like we need to do more. Feedback from my patients was one of the things that drove me to pursue the liquid biopsy,” which causes less anxiety and pain than a conventional biopsy. At the same time, patient samples make research timelier and more relevant. Stover first experienced this connection when he was a 15-year-old lab volunteer at The James. Because of the
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May 16, 2019 | 8:00-11:30am | Grandview Yard Event Center 820 Goodale Blvd. | Columbus, OH 43212
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Artwork: “Dahlia Walk” by Caroline Rowntree
92 ColumbusCEO l May 2019
hospital’s configuration at the time, the Upper Arlington High School student rode the elevators alongside patients receiving treatment. “That had a very striking impact,” he says. Researchers and clinicians all want the same outcome, Stover says. “I worry about my patients. I go to bed thinking about TNBC, and I wake up thinking about TNBC.” He says the last two years have seen an acceleration in potential new treatments and hope is on the horizon for one or two additional drugs becoming available in the near future. Earlier this year, the FDA approved an immune therapy protocol for metastatic TNBC. “At this point it looks like a combination of chemo and immunotherapy may be the key,” he says. Julie McMahon, director of mission and strategy for Komen Columbus, says Stover’s research and Geib’s voice reflect the organization’s shift in focus. A goal of reducing the U.S. death rate from breast cancer by half by 2026 means more attention to aggressive, late-stage and resistant cancers and finding therapies for those who don’t now have options. “We want to keep the pipeline full of new drugs, and we don’t want to waste time using drugs that aren’t working,” McMahon says. “There is a sense of urgency.” Even the language Komen uses reflects a change in perspective, McMahon says. At this year’s race, the Survivor Celebration Tent is now Hope Village. Race participants with metastatic disease can opt to wear a shirt that doesn’t emphasize the survivor element. For patients like Geib, those changes provide hope and a feeling of being recognized and less isolated from the larger group of breast cancer patients. “Some people ring a bell at the end of their treatment,” she says, “and that’s something a metastatic patient never gets to do. When I was diagnosed, I thought this would be a year, and then I could go on with my life. For many, life doesn’t go on.” Geib connects with the drive to reduce cancer deaths by honing in on cancers like hers. “We’re the worstcase scenario. If you cure the worst, you save everybody. Without the research, we’re not going to be here.” Laurie Allen is a freelance writer.
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