Beating the Odds Again
A young woman's battle against metastatic brain tumors
When Maciej Lesniak, MD, met Eloise Orr, she had already survived not one, but five cancer diagnoses. She was diagnosed with breast cancer in 2002 at 20 years old. It started in the duct of her right breast, a type of cancer that doesn’t usually spread. But even after a double mastectomy and radiation, the breast cancer came back the next year, spreading from her breast to her lymph nodes -- and eventually to her brain.
In December 2004, after Orr had been treated twice for breast cancer, a team of surgeons at the University of Chicago Medicine discovered two brain tumors. One was the size of a golf ball on her cerebellum, causing her brain to swell against her skull. That tumor was removed with surgery. The surgeons administered total brain radiation and then precisely targeted stereotactic radiation to a smaller tumor, which they found on her right frontal lobe. Despite the aggressive treatment, the frontal lobe brain tumor still came back.
“Every time, I never felt my life was in danger,” Orr recalled. “I’m just a practical person in general, and cancer always came up at an inconvenient time.” Her previous cancer treatments were often scheduled around extended trips to Spain, Puerto Rico or the Florida Keys, or sometimes even holiday parties and birthday celebrations. “I just said, ‘Let’s fix it. Let’s get rid of it.’”
When Lesniak saw Orr’s MRI in January 2007, he knew this tumor was too vicious for traditional treatment. With stereotactic radiation therapy -- a precisely targeted, high-dose treatment technique -- the frontal lobe brain tumor was shrinking. But months later, it somehow started to grow again -- to double its original size.
When breast cancer metastasizes, or spreads to other parts of the body, the brain is one of the most common places it goes. Lesniak, director of neurosurgical oncology at the University of Chicago Medicine, estimates that up to 50 percent of breast cancer patients develop metastatic brain tumors. The prognosis is usually not good. “By the time you have a brain mass, survival is about a year,” Lesniak said. Orr was only 25 years old. “She was so young, so active. If this tumor kept coming back, it would kill her.”
His only option was to try something that had never been tried for metastatic breast cancer: Gliadel wafers.
Gliadel wafers are tablets the size of a dime that are used to treat brain tumors. After the tumor is surgically removed, several wafers are implanted directly onto the tumor site. The wafers gradually release doses of chemotherapy as they dissolve over a period of three to four weeks.
Lesniak trained at the institution that developed this technique and was a member of the team that shepherded it through FDA approval. He knew the treatment was safe. In fact, in comparison to standard chemotherapy, it reduces side effects and damage to healthy cells. But Gliadel wafers had only been used for patients with primary brain tumors, which start in the brain. He had never used it for metastatic (or secondary) brain tumors, which occur when cancer starts somewhere else and then spread to the brain.
“I talked to her at length about this,” Lesniak recalled. “The thing about Eloise is that she has this wonderful spirit. She was always in control. She wasn’t afraid of death. She was afraid of being a less-than-functional member of society.”
Lesniak performed a five-hour operation to remove the brain tumor. He then lined the area with eight Gliadel wafers.
That was in January 2007. Since then, Orr has continued to travel abroad, finished her master’s degree, completed the Avon Walk for Breast Cancer and has been teaching elementary school at Francis M. McKay Elementary School on Chicago’s Southwest Side.
Most importantly, she and Lesniak have not seen another sign of cancer.