In 2013, Kathryn Stagg was 33 years old and studying to sit the New York and New Jersey bar exams when she noticed her breast was red and swollen.
Kathryn, from Ottawa, had just recently graduated law school in New Jersey. There was no lump in her breast, so she wasn’t too worried. She eventually visited her doctor to get it checked out.
“A mammogram followed by a biopsy revealed it was cancer,” Kathryn said. “And when I was diagnosed, it had already spread to my bones and my liver.”
Inflammatory breast cancer is a rare and aggressive form of breast cancer that grows and spreads quickly. Its symptoms include a dimpling of the skin on the breast, swelling, pain and most commonly a change to the colour of the skin of the breast.
Kathryn left the United States and returned to Ottawa for treatment and to be nearer to her mom Bonnie Laurie and sister Wallis.
“It was a lot to take in, having cancer,” Kathryn said. “There I was expecting to take the bar exam and launch my career; that didn’t pan out.”
Kathryn underwent chemotherapy, radiation and surgery to keep the cancer at bay. Still, it spread. The breast cancer eventually spread to her brain.
Earlier this year, her care team indicated they’d reach a treatment conundrum with respect to her brain metastases. She had already undergone full brain radiation, the CyberKnife twice (which delivers high dose radiation to the brain tumours) and surgery.
“They said I had reached the limit of radiation that can be given to the brain,” Kathryn recalled. “They referred me back to my surgeon.”
That’s when Kathryn received serendipitous news: her surgeon, Dr. Brian Drake, had an old school-mate in Toronto starting a new clinical trial involving the use of focused ultrasound for HER2+ breast cancer that had spread to the brain. And Kathryn might be eligible for the trial.
Delivering chemotherapy to the brain is challenging because of the blood-brain barrier, a protective membrane that keep toxins out of the brain. The team at Sunnybrook is using focused ultrasound to temporarily open the blood-brain barrier while the patient receives the chemotherapy drug Herceptin, making it easier for the therapeutic to reach the tumour directly.
Kathryn would become the first patient treated in the trial.
“Being first didn’t bother me at all. I know they’ve opened the blood brain barrier in this way before, and the difference for me would be the drug Herceptin, which had already worked really well for me from the neck down.”Learn more about this trial
For FUS, a helmet-like device, containing over 1,000 individual transducers (which convert electrical energy into sound energy), converges ultrasound waves on to points in the brain. The idea is to temporarily open the BBB to allow the passage of chemotherapy to regions surrounding the tumour.
Patients in this trial wear this special helmet and go inside an MRI that helps target the specific area of the brain where FUS is directed to temporarily open the BBB.
Trial participants are given Herceptin, a chemotherapy drug that is used to treat both early stage and metastatic breast cancer. The drug typically does not cross fully the blood brain barrier, so the researchers hope that by opening the BBB, they can better deliver Herceptin straight to the tumour.
The participants will receive MRIs after 24 hours, one month and three months, to see if there was any affect on tumour growth, as well as other cognitive functioning tests to see how the treatments are being tolerated.
“I just feel so lucky to be part of this trial,” Kathryn said. “I thought, I might as well try it and if it helps other people in the future, then all the better.”Learn more about focused ultrasound clinical trials