Margaret Adams' decision to try a different cancer treatment proved to be the right solution.

As a former high school math instructor, solving problems is something that has always come naturally to 66-year-old Margaret Adams. Having taught geometric formulas and algebraic equations to high school students for nearly 40 years, she knows a thing or two about finding answers.

So when in the spring of 1996 she was told that she had stage IV non-Hodgkin's lymphoma, the process of solving a tough problem suddenly became very personal.

"I started not being able to breathe well, so I went to my doctor," says Adams. "I certainly didn't expect that diagnosis, but I have the will of a person who accepts things and I dealt with it."

Adams underwent treatments for seven months — intensive chemotherapy for the first four months; chest and upper abdominal radiation therapy for the next three. Adams continued to teach school at the beginning of her treatment and even took a college course after the school year ended, but it was a bounty of willpower that kept her going. She lost her hair and with it, her energy. After teaching in Massachusetts for 25 years and in Ft. Lauderdale another 11, she decided it was time to retire to focus on her health. Adams and her husband moved to North Florida to make it easier to receive ongoing treatments at Mayo Clinic.

"Not teaching was difficult," says Adams. "It was who I was, and I did it for so many years."

The treatment worked, though, and Adams' cancer was dormant for nearly a decade. The Adamses moved back to Lauderdale-by-the-Sea and had been there for about two years when she felt two enlarged lymph nodes on her neck under her left ear. On Valentine's Day 2005, a biopsy was taken; the cancer had recurred. This time around, her Mayo Clinic oncologist,
Dr. Gerardo Colon-Otero, told her about a new radioactive iodine treatment called BEXXAR.

BEXXAR was approved by the Food and Drug Administration in 2003 for patients with CD 20 positive, B-cell, follicular non-Hodgkin's lymphoma who have relapsed following chemotherapy.

Instead of months of treatment, she could have a single course over one to two weeks. She would not lose her hair, but she would have to live with a new side effect — being radioactive for a few weeks.

"BEXXAR is an intravenous monoclonal antibody that's directed against the proteins located in lymphoma cells," says Colon-Otero. "The antibodies are coupled with a radioactive iodine substance. Monoclonal antibodies identify the bad cancer cells and attach to them; then the radioactive iodine gives off radiation and kills them. It's a double-whammy approach against non-Hodgkin's lymphoma."

Adams would be radioactive for about seven to 12 days and would have to be in isolation. That meant being in separate rooms when her husband was at home, washing hands constantly, using gloves while cooking, doing separate laundry and avoiding being in public.

"I was apprehensive at first because of the possible side effects, and it was a long process for me to decide that this was the right treatment," says Adams. "But I did a lot of research and learned as much as I could about it."

A year after non-Hodgkin's lymphoma recurred, Adams is still cancer-free.

In the end, the equation was simple. One treatment plus a therapy that showed early signs of success in patients who had a recurrence added up to a solution she wanted to try.

The Adamses moved back to the Jacksonville area. In April 2005, she began the process. Mayo Clinic radiation oncologist Dr. Steven Buskirk administered a small diagnostic dose of BEXXAR through an IV in her arm and then took a series of body scans over a few days' time to determine where the cancer was located and how much of the solution Adams would need to fight it. On her final visit, Buskirk gave her the major infusion, which lasted about 90 minutes, and discharged her home.

"The anxiety was the most difficult part," says Adams. "I felt no extreme nausea, fatigue or illness during treatment. The isolation was lonely, but I got through it."

Her enlarged lymph nodes receded within two weeks. Follow-up tests in July and November showed no sign of cancer.

"She has responded very well," says Buskirk. "These targeted therapies are being developed because they make more sense and are very effective. The idea is to get a favorable therapeutic ratio — a high dose of radiation to the cancer and a low dose to the surrounding healthy cells. Targeting the cancer cells directly with the 'smart bomb' approach versus treating large areas with radiation and using different types of chemotherapy is the new way of thinking."

Buskirk says that the BEXXAR treatment can only be used once in a patient's lifetime. Two-thirds of patients respond to it — one third have a long-term, multiyear remission and the other third respond with about a two-year remission.

"Hopefully she'll get another long-lasting remission," says Colon-Otero.

With the tenth anniversary of her original diagnosis approaching, Adams is greeting 2006 with open arms, feeling healthy and positive. She spends time walking on the beach, riding her bicycle, exercising three times a week at a fitness center and reading. She even keeps the old No. 2 pencil sharpened for when her teenaged grandson, who lives nearby, needs a little help with algebra.

She keeps her sense of humor sharpened, too.

"Instead of being radioactive, now I'm just active!" jokes Adams. "I say 'Hey, hey, 2006, let's go'!"

(This story first appeared in the March 2006 issue of The Mayo Clinic Checkup, a complimentary newsletter available to anyone interested in the latest news from Mayo Clinic in Jacksonville, Fla.)