Right on Target

Avoid surgery with focused antibody treatments.

While working in the reservations department of one of the world’s largest and best-known hotel chains, Denelda Berkley made sure to take full advantage of one of the great perks that come with such a job.

“I was allowed to stay at any of the company’s hotels for about 20 dollars a night, so my husband and I traveled quite a bit while I worked that job,” Denelda confirms. “We went all over. We mostly liked Aruba, Saint Thomas and Hawaii, anywhere it’s warm.”

A native of Wyandotte, MI, Denelda spent many of her working years hoping for a chance to move to a warm-weather climate. She finally got that chance when she and her husband moved from Connecticut several years ago to run a retirement home in Port Richey.

“My husband and I were managers of a retirement home in Indiana, and we moved from there to Connecticut to run another retirement home there,” Denelda explains. “When we got the chance to run a retirement home in Port Richey, we jumped at it.”

Denelda, 72, has since retired. She still lives in Port Richey, where she loves to read fictional detective books in her free time. About three years ago, Denelda detected a problem on her own.

“I noticed a lump in my right breast one day, and right away, I went to see my primary care doctor,” Denelda remembers. “He sent me for a mammogram, and the mammogram showed something suspicious.

“After that, I was sent to a breast surgeon, and a biopsy was done that showed I had breast cancer. But the breast surgeon didn’t want to do surgery until I saw an oncologist, so she sent me to see Dr. Choksi.”

Mamta T. Choksi, MD, is a hematologist and oncologist at Florida Cancer Specialists & Research Institute. She discovered that Denelda’s cancer had metastasized to her liver and a lymph node in her right underarm.

“The diagnosis was stage IV breast cancer because the cancer had moved from my breast to other parts of my body,” Denelda says. “When I heard that, I thought, Oh, my God, because I watched my husband die of cancer in 2007.

“He lasted just nine months after he was diagnosed, and that was with chemotherapy and everything, so I asked Dr. Choksi to be honest with me. I asked her, How long do I have? and she said, I don’t put an expiration date on anybody.”

Advances in Care

Dr. Choksi takes that approach because major progress in the treatment of all types of cancers is being made all the time. In the past 15 years, many of those advancements have been made in the treatment of breast cancer.

Dr. Choksi describes the developments as “earth-shattering” because they are allowing patients such as Denelda to put off or avoid surgeries that were previously considered mandatory.

“We now have what’s known as a HER2/neu receptor-based treatment that acts as a targeted antibody,” Dr. Choksi explains. “That is what we prescribed for Denelda.”

Dr. Choksi’s prescription called for Denelda to receive a combination of three cancer-fighting drugs once every three weeks for 12 weeks. At the end of that initial period, Dr. Choksi discovered the treatment was working as intended.

“After 12 weeks, Denelda was given a PET scan that showed significant improvement of the liver metastasis, the breast mass and the lymph node,” Dr. Choksi confirms. “She was having a good response to the treatment.”

That PET scan was performed in March 2018. Shortly after, Denelda suffered what she refers to as a “mental breakdown.” Imaging of the brain was obtained to be sure the breakdown wasn’t cancer related. When that imaging came back negative, Denelda’s cancer treatment was put on hold to allow her to focus on her mental health.

It wasn’t until August 2018 that Denelda was allowed to resume her cancer treatments. By then, tumor markers were on the rise, and a restaging workup showed that while the mass in her right breast remained stable, other metastases had developed in the liver.

Dr. Choksi responded by reinitiating Denelda’s chemotherapy but with a slightly different combination of drugs. Denelda’s response was much like her response to the first treatment.

“My Miracle Worker”

“By December 2018, her tumor markers were back to normal, and since then her cancer has remained very, very stable,” Dr. Choksi reports. “It is now under control, and she is having a very good response to the treatment.”

Denelda is now on a maintenance regimen of medications that she receives once every three months. Her response is closely monitored with special imaging, like PET/CT scans, once every three months to ensure the regimen continues to work.

For the past year, those scans have shown Denelda’s situation to be stable.

“I get no side effects from the maintenance treatment I’m on now, other than a little fatigue,” Denelda says. “I think that just goes with the territory, because I’m probably never going to be like my old self again.

“But that’s okay, because there’s a new me now, and that’s why I call Dr. Choksi my miracle worker. She is absolutely wonderful, and it’s not just because of the work she does clinically but because of how positive and encouraging she is.

“When I was first diagnosed with cancer, she said, You go on living your life and we’ll take care of this. To hear that meant so much, and now I can honestly say that Dr. Choksi is not just my doctor, she’s my friend.

“She’s someone I can turn to at any time with questions I might have. Having a good oncologist who really cares about you and helps to give you a positive outlook is so important.
“Thanks to her, I have a saying I tell everybody who asks me how I’m doing. I tell them, Yes, I have cancer. But cancer doesn’t have me.

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