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Life's Second Chances

Clinical trials offer hope to woman with malignant brain tumor

In addition to her other hobbies, Emmy Holliday reads two books at a time to keep up with both of her book clubs.

Emmy Holliday was an active retiree, becoming acquainted with her new surroundings in Savannah after a move from New York. But on a fall day in 2002, just as she and her husband prepared to head out for a game of golf, Emmy collapsed and experienced a grand mal seizure. An MRI at a Savannah hospital found nothing concrete.

"I was told there was no evidence of a brain tumor and it was probably just a form of epilepsy and put on an anti-seizure medication," says Holliday. "The doctors told me that I was lucky it wasn't a brain tumor."

A month later, Holliday, 66, knew it was time for another opinion.

"I was quite a wreck physically," she says. "I was still having seizures, the medicine they gave me was making me shaky and I couldn't focus."

The Hollidays knew of Mayo Clinic from relatives in Minnesota and from neighbors in their retirement community who had visited the Jacksonville clinic. Holliday had her first appointment in December 2002. Doctors reviewed her previous MRI and decided to biopsy her brain. She was scared, but going through the procedure paid off — doctors found out that the cause of her seizures was a glioblastoma multiforme (GBM). Holliday had a malignant brain tumor after all.

"Glioblastoma is the most common tumor to start in the brain, and it accounts for about 60 percent of all primary brain tumors diagnosed each year," says Dr. Kurt Jaeckle, the Mayo Clinic neuro-oncologist who treated Holliday. "It's the highest grade tumor there is, which is why with current treatment the cure rate is less than 1 percent. People tend to survive an average of only 14 months."

Holliday, who had stereotactic surgery to biopsy the mass, began oral chemotherapy and received radiation for seven weeks for her inoperable tumor.

"I expected that I'd have six months — maybe a year — with various medications," Holliday says. "I really thought that I wouldn't make it through that next year."

A year later, Holliday was surprised that she was still "bopping along." Unfortunately, doctors found a second mass during a routine follow-up visit. Once again Holliday endured a brain biopsy and weeks of radiation and chemotherapy.

At Jaeckle's suggestion, Holliday also enrolled in a clinical trial for a drug that was being tested for treatment of brain tumors. As chair of the North Central Cancer Treatment Group, one of the National Cancer Institute's 11 government-funded cooperatives that conduct research and clinical studies to advance the treatment of brain tumors, Jaeckle had first-hand knowledge of the trials available.

"Despite 40 years of work, there is no established standard of care for recurrent glioblastoma," says Jaeckle. "No one has come up with a drug or group of drugs or therapy that is clearly heads above the rest for treatment of these tumors. A 14-month median survival rate is unacceptable, and drug trials are one of the only ways to make progress."

Currently, Mayo Clinic has eight clinical trials at its three sites studying new therapies for brain cancer.

"I've always been realistic and I wasn't really planning for the future, but I was hit hard when they told me I had another option," Holliday says. "I'm not a big risk-taker, but the information was not presented in a scary 'this is it, you have no other choice' way. It was presented as an option, and I never felt frightened, especially if it would work for me or help someone else."

Holliday now is receiving a drug called bevacizumab. Although it has not been approved by the Food and Drug Administration (FDA) for treatment of brain tumors, Jaeckle says it shows promise. "While we don't know if it will prolong survival or cure people, it's producing very high response rates," Jaeckle says. "It's very promising."

The original seizure affected Holliday's right leg and a stress fracture impaired her left, so Holliday's ability to golf, ride a bike and participate in other athletic activities is limited. But using a cane helps her stay active.

"It's strange that you find me home," she says. "I can walk and I have much more focus and concentration now. I play mahjongg, belong to an art group and two book clubs and maintain an active social life with friends. I know I'll never be cured, but I know I have hope. I'm still here."

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