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Like Daughter, Like Mother

Decades after a woman’s successful treatment for leukemia, her mother’s tumors disappear during a colorectal cancer clinical trial 

Debby Thompson, Dr. Manish Sharma and Margaret Harrington

When Indiana resident Margaret Harrigan was diagnosed with stage 4 colorectal cancer at age 73, she knew exactly where she needed to go for treatment -- the University of Chicago Medicine. 

Harrigan’s daughter Debby Thompson had been a patient at UChicago Medicine in the early '90s when she battled stage 4 acute lymphoblastic leukemia (ALL) at age 34. A grim diagnosis, ALL is less common and harder to treat in adults than in children. Thompson was rejected by multiple hospitals before a doctor at UChicago Medicine agreed to take her case. 

At UChicago Medicine, Thompson learned that her cancer carried the Philadelphia chromosome, a mutation that is relatively uncommon in ALL and is associated with poorer survival outcomes. Fortunately, Thompson’s doctors also discovered that her brother was a perfect match for a bone marrow transplant, which another hospital had failed to identify. 

Thompson received the bone marrow transplant in February 1991, and went from near death to complete remission. It was a long road to recovery, and she continues to be grateful for her transplant care team.

“When my mother got sick, there was no question where I was taking her.”

“For all the things that were wrong, everything went really well,” Thompson said. “I’ve never ever had such care in my life. At UChicago Medicine, from day one they take the fear out of your diagnosis. You become part of a team that cradles you all the way.  Whether you're a patient or a caregiver you can reach your doctor, their assistant, your nurses -- even the grill guy in the cafe -- in minutes. There are truly no words to describe that kind of comfort and security.  When my mother got sick, there was no question where I was taking her.”

'Complete Response' to Chemotherapy

Nearly 20 years later, Thompson found herself back at UChicago Medicine with her mother to consult with Blase Polite, MD, and Manish Sharma, MD.

“All the drugs were different and all the procedures were different, but cancer is still cancer and that will never change emotionally,” Thompson said.

Harrigan’s cancer had metastasized, or spread, to her liver and lymph nodes. “Sure, I was scared,” she said. “But, I know you don’t get anywhere without a positive mental attitude. I just said that I wasn’t going to let it get me down.”

Sharma had recently developed a clinical trial for metastatic colorectal cancer that tested how patients tolerate higher doses of certain standard chemotherapy treatments. The trial tested a combination of chemotherapies that work by blocking angiogenesis -- the growth of new blood vessels -- to prevent tumor growth.

Harrigan qualified for the trial and began a regimen of chemotherapy treatment every two weeks. She continued treatment for eight months before she was given a break to allow her body a chance to rest. Typically, Sharma said, the cancer will grow during this break period. Remarkably, Harrigan’s cancer kept responding. 

“The tumors kept shrinking and shrinking and then finally were gone.”

“It evolved into what we call a complete response after the chemotherapy was stopped,” Sharma said. “The tumors kept shrinking and shrinking and then finally were gone. We were fully expecting that at some point it would grow and we’d have to put her back on chemotherapy. But, as it turned out, we didn’t because it disappeared. It’s extremely rare.”

Harrigan’s recovery was so incredible that Sharma and his colleagues decided to make her the subject of a research study, which was recently published in the journal JCO Precision Oncology. 

Researchers discovered that her tumor had many more mutations than the average colorectal cancer patient -- what they call a hyper-mutated phenotype. And, she also had an unusual POLD1 mutation that wasn’t in her germline, meaning she did not inherit it from her parents but acquired it during life. 

“We think the POLD1 mutation and the associated phenotype may have something to do with her great response to the chemotherapy,” said Sharma, adding that future studies will need to be done to confirm this hypothesis. He hopes the study will inspire other researchers to further investigate the correlation.

Harrigan recently had surgery to remove a small tumor in her colon that was identified through a virtual colonscopy at UChicago Medicine. Unrelated to her first cancer, the tumor was successfully surgically removed by Konstantin Umanskiy, MD, along with a portion of Harrigan’s colon due to severe diverticulitis scarring. She has since made a full recovery.

“We know there’s an increased risk of second cancers in people who have had one cancer,” Sharma said. “That’s why we do surveillance with colonoscopies more frequently, and that’s why we caught it early.”

Finding 'Tremendous Positives'

During treatment for her first cancer, Harrigan made a bucket list to help her stay positive. So far, she’s crossed at least a dozen activities off the list, she said, including visiting the Grand Canyon and Mount Rushmore. It has been more than six years since she stopped chemotherapy and she remains cancer-free.   

“What’s been really gratifying about the whole story is that not only did she have this awesome response, but she’s gone on to continue to have a great quality of life,” Sharma said.

Harrigan and her daughter, a fun-loving duo who refer to themselves as Lucy and Ethel, said their battles with cancer have brought them closer together. Both women have been actively involved in patient advocacy and want to help others by sharing their stories. 

“I just live day to day and do as much good as I can do,” said Harrigan, who continues to volunteer weekly at her local hospital as well as to garden, golf and travel.

“It’s very, very life changing,” Thompson said. “But I have found, and so has my mother, tremendous positives. If I get to talk to people and one person gets inspiration or looks in the mirror and says, ‘If she can do it, I can do it,’ then it was worth it.”
 
May 2017