Whistler local at forefront of innovative cancer research
What Devon Brusse thought was a recurring bladder infection for over a year, turned out to be non-Hodgkin's lymphoma, a type of cancer for which there is no current cure.
But the 34-year-old, mother of one, is helping scientists find the cure.
Brusse, who has been living in Whistler for about 10 years, was the first British Columbian to take part in a new vaccine therapy clinical trial in Vancouver. There have been 12 others in B.C. to follow her lead so far.
In addition to a Vancouver site, the study is also taking place in Edmonton, Toronto and across the U.S.
It is a novel way of targeting follicular B-cell lymphoma, which Brusse was diagnosed with in July 1999 – the same time she found out she was pregnant with her first child.
The study is the first lymphoma immunization trial ever to be done in Canada and represents the culmination of years of painstaking research.
For Brusse however, it represents hope.
The basic idea of the study is to fool the immune system into effectively attacking the disease.
"This is the principle behind any attempt to recruit the immune system into part of cancer treatment," said Dr. Joseph Connors, head of the lymphoma tumour group at the B.C. Cancer Agency.
"This is built on work that has taken 20 years to accomplish."
To trick the immune system into attacking the lymphoma, doctors took a needle biopsy from Brusse's bone marrow to extract proteins from the cancerous tissue.
That sample was then manufactured into a customized vaccine by California based Genitope Corp. They created a unique vaccine, which is only good for Brusse's body.
The vaccine is injected, along with immune boosters to help it spread throughout her body, with the hope that the immune system will begin to fight the malignant cells.
"(We) give her back the protein that was derived from her own lymphoma," said Connors.
Trial participants received six months of chemotherapy, followed by six months of rest. This phase of the study consists of seven vaccine injections into both thighs once a month for seven months.
There is no guarantee that the vaccine will work.
There is no data on the long-term effects.
And it's a randomized blind trial – only two-thirds of trial participants will get the active shots and one-third will get a dummy shot to ensure the trial is accurate.
Despite the unknown and the potential risks, it's still worth it for Brusse.
She thinks the study is her best chance.
"I really wanted to get into this," she said.
If Brusse's reasons for the trial are selfish, it's because she has a lot to live for, like her husband Eric and her two-year-old boy Noah.
"I figured it was an added bonus to potentially find a cure for cancer," she said, in the matter-of-fact way she talks about her cancer.
Non-Hodgkin's lymphoma has no cure, with roughly seven to 10 years life expectancy after diagnosis.
And, it was recommended she terminate the pregnancy.
But a second opinion before a panel of five doctors gave her the go-ahead to have her baby.
"We had a positive note in not a great situation," she recalled, as she watched her talkative two-year-old toddle around the house.
Noah, who was named in the womb, gave her an outlet to focus her energies and not dwell on her disease.
"I consider him my little angel baby," she said of the friendly toddler with the mop of blonde hair.
Having Noah gave her the will to hold out for the study. Her energies were concentrated solely on getting through the pregnancy and then delighting in the new arrival.
In order to be eligible however, Brusse could not go through any cancer treatment until the study was given the go-ahead.
Over the course of the two-year wait her cancer, which had attached itself to the lymph nodes in her intestine wall, had grown from the size of a golf ball to the size of a grapefruit.
She was starting to feel sicker and the cancer was beginning to interfere with her life, making her more and more tired.
"In January (of 2001) I knew in my gut that I should have been starting treatment by then," she said.
It was delayed so long that she almost had to forgo it and go straight into chemotherapy.
But by April the study was given the go-ahead and Brusse began her chemotherapy treatment at the time suggested by the study.
That reduced her cancer to the size of her thumbnail but she was told that if it grew over a six-month period she would not be able to participate in the study.
She talked to her stomach all the time, the same way she talked to Noah when he was in the womb.
This time she was asking it not to grow. It didn't.
Now she is in the second stage of the study, after a six-month rest from her chemotherapy treatment.
Looking back there isn't much Brusse would do differently. She can't imagine life without Noah and she's relieved she had the chance to join in the study.
But there is one thing she would change.
"I now totally believe in the continuity of one doctor," she said.
She had been to walk-in clinics, doctors’ offices and the emergency room with the same symptoms, believing she had a bladder infection, only she got lost in the shuffle of different doctors and new charts.
Her cancer turned out to be next to her kidney and would periodically aggravate the organ, causing the same symptoms as a bladder infection.
That was about three years ago and since then life has been one big waiting game.
Now having to wait the roughly three years until the results of the study are analyzed isn't too much to ask.
In order to make the study scientifically worthwhile there needs to be at least 25 participants from B.C. and that's why Brusse is telling her story – to encourage others with the same diagnosis to get involved.
"I'd like more people to get into the study to make it a legitimate study," she said.
In B.C. in 2002, at least 600 estimated new cases of non-Hodgkin's lymphoma will be diagnosed, and about 300 people will die from the disease.
Connors said for people under 65 who are diagnosed with the disease, 70 per cent are still alive after 10 years.
After 20 years, 20 to 30 per cent are still alive.
Non-Hodgkin's lymphoma is the fifth most common cancer in Canada, and its incidence rates have doubled in the last 20 years.
Brusse's doctor holds out hope for the new study.
This trial could definitively prove if tricking the immune system works or not, said Connors, which could ultimately effect research into other types of cancer treatments.
