By Mary Brolley, MD Anderson Staff Writer
Talk to Cheryl Jolly for five minutes, and her sense of humor shines.
Despite a harrowing health crisis in the past four years, the Sugar Land, Texas, wife and mother of two young boys is quick to laugh about aspects of her extensive treatment for triple-negative metastatic breast cancer.
She recalls that her concerned husband Chad "passed out cold" in the doctor's office four years ago at the news she had cancer.
She jokes about the many types of treatment she's endured. "I rang the bell twice when I finished chemo and once when I finished radiation," she says. "I don't like the look of those bells any more."
And she makes light of the strain of keeping up with rambunctious sons Chase and Cole, now 7 and 4 years old, during nearly constant cancer treatments.
"If I didn't laugh at them, I'd kill them," she says wryly.
Out of the blue, a scary diagnosis
Jolly was 33 years old in the fall of 2006, with a toddler and an infant, when she thought she had developed a clogged milk duct. After weeks of pestering her physician and a local hospital, she got a mammogram, then an ultrasound, and was diagnosed with stage IIB ductal carcinoma.
Even more disturbing: Her tumor was characterized as "triple-negative" -- a subtype of breast cancer defined by what it lacks.
Accounting for 10% to 15% of the more than 192,000 cases of breast cancer diagnosed each year in the United States, triple-negative tumors are not driven by estrogen and progesterone hormones and do not express the HER2/neu protein.
Triple-negative characteristics limit treatment choices
About 20,000 to 25,000 American women are diagnosed annually with this aggressive subtype, which is more common in younger women and in those of African descent. Because several promising therapies for other types of breast cancer are ineffective due to the tumor's chemical characteristics, triple-negative status narrows a patient's treatment options.
Though the cancer is initially responsive to chemotherapy, relapse is often swift. For that reason, triple-negative breast cancer also accounts for far more than 10% to 15% of all deaths from breast cancer.
Jolly was treated with chemotherapy and radiation in 2006 and 2007, then was healthy for more than a year. But in January 2009, a bout of pneumonia revealed a tumor on her right lung. She had surgery to remove it, then received six more rounds of chemotherapy.
Still, nothing worked. Despite more chemotherapy, scans in the fall of 2009 revealed lesions on her liver.
PARP trial yields good news -- finally
Then, Jolly was accepted into a clinical trial at MD Anderson led by Jennifer Litton, M.D., assistant professor in the Department of Breast Medical Oncology. Limited to breast cancer patients with triple-negative metastatic disease, the Phase III trial involves the pairing of a poly (ADP-ribose) polymerase (PARP) inhibitor with targeted agents gemcitabine and carboplatin.
A protein, PARP is involved in a number of cellular processes involving DNA repair and programmed cell death. By preventing this repair, PARP inhibitors increase the effectiveness of other types of chemotherapy. (For more information, see link to the related story below.)
The treatment seems to be working for Jolly, who began the trial in February. Her scans have shown that the tumors are shrinking.
"It's been four years now with nothing but bad news. This was the first time we got good news. It's been life-changing," she says.
'What's driving us to live'
Her busy life now includes shuttling the boys to and from school and day care, taking care of the house and her family, and countless trips to and from MD Anderson for tests to make sure the treatment is safe and effective.
The boys are used to it, she says. "They understand that I spend a lot of time at MD Anderson. When a certain treatment might make me lose my hair, I say, 'Mommy's just sick, she's not going anywhere.'"
Jolly is a one-woman cheering section for her physicians, including Litton, as well as Ana Gonzalez-Angulo, M.D., associate professor in the Department of Breast Medical Oncology; Isadora Arzu, M.D., Ph.D., assistant professor in the Department of Radiation Oncology; and Stephen Swisher, M.D., professor and chair of the Department of Thoracic and Cardiovascular Surgery.
And don't get her started on her nurses, Silvia Hodge and Carol Stalzer.
"They're my advocates, my shoulders to cry on. I adore them."
Because of the intensity of the clinical trial and all she's been through in this "very emotional journey," Jolly feels a strong connection with her whole medical team, which she calls phenomenal.
"We talk. They know about my life, about Chad and Chase and Cole," she says, then pauses.
"We don't always want to talk about what's killing us, per se. We want to talk about what's driving us to live."
Q&A: New Treatment For Triple-Negative Breast Cancer
Early findings from Phase I and Phase II clinical trials using a new class of drug to treat patients with triple-negative breast cancer are showing promising results.
New treatments show promise for breast cancer patients
MD Anderson resources:
Genetic testing for breast cancer: Who should get tested?
Nellie B. Connolly Breast Cancer Center
After Four Years of Bad News, Cautious Optimism for Breast Cancer
By Mary Brolley, MD Anderson Staff Writer
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