Pregnant Patient Overcomes Cancer With Help from UC Team, Proton Therapy
First birthdays are special occasions for parents who can reflect on the milestones of the past year while laughing at their little one getting messy with a smash cake.
For Whitney Hoffer, the celebration for her daughter Madison’s birthday on June 22 was a bit more than that, as she reflected with thankfulness and hope for the future.
This is because at 18 weeks pregnant, she found out she had cancer.
In November 2015, Hoffer, 31, and her husband Billy learned that they were going to have baby No. 2, just a year and a half after the birth of their daughter Makenzi.
But a few months later, Hoffer began noticing some symptoms that she attributed to pregnancy.
"I noticed a swollen area on my neck, and I told my dad, who is a physician’s assistant,” she says, adding that he recommended ibuprofen for what he thought was likely just inflammation. "I also had some neck and back pain, but I didn’t think anything about that.”
When the pain and swelling had not gone away, Hoffer decided to see her obstetrician for an ultrasound and possible MRI.
"The radiologist saw the scan and noticed something,” she says. "It was Feb. 15—I’ll never forget that date. They thought I had lymphoma.”
A Difficult Diagnosis
Many tests were run and a needle biopsy on the swollen lymph node was performed, but all results came back inconclusive.
She was referred to two specialists in UC’s Department of Otolaryngology-Head and Neck Cancer, Alfred Sassler, DO, and Keith Wilson, MD, both associate professors in the Department of Otolaryngology and UC Health physicians, but the cause was still undetermined.
"It was when I saw Dr. (Saulius) Girnius that I was able to officially get a diagnosis; I had classical Hodgkin’s lymphoma,” she says. "While my whole team was great, Dr. Girnius is just the best, and thanks to his expertise, I was able to find out what my next steps were.” Girnius, MD, an assistant professor of medicine at the UC College of Medicine and a member of the hematological malignancies center within the UC Cancer Institute, set up a treatment plan for Hoffer to begin chemotherapy.
"When I was officially diagnosed, I was 28 weeks pregnant, and I felt like it was God’s way of saying the tough decisions were over,” she says. "I knew my doctors had my care in their hands, and I had God to take care of me; I had to fight for myself. Being a mom was my top priority, and I needed to be there for my babies. It’s just what I had to do.”
Hodgkin's lymphoma occurs when an infection-fighting cell, called a B cell, develops a mutation in its DNA, causing cells to divide rapidly and outlive their normal lifespan. This causes a large number of oversized, abnormal B cells to accumulate in the lymphatic system, where they crowd out healthy cells and cause the signs and symptoms of Hodgkin's lymphoma, including swollen lymph nodes such as what Hoffer experienced.
"I had four rounds of chemotherapy and then a C-section on Wednesday, June 22 (2016); I was back that Monday for my chemotherapy—I didn’t miss a beat,” says Hoffer. "I just kept thinking, ‘This isn’t just about me; this is about my kids and my family.’”
The Advantage of Proton Therapy
The Edgewood, Kentucky resident along with Billy by her side, traveled every other week to the UC campus to have daily treatments and completed her last chemotherapy infusion on Oct. 3.
However, Hoffer’s treatment was not quite finished, and thanks to a unique option in the region, she was able to get the most cutting-edge therapy available.
"Because they weren’t able to do some of the necessary scans when I was pregnant, due to concern for the baby’s health, they wanted to do follow up with radiation as a precaution,” she says. "They decided that I was a good candidate for proton beam radiation therapy.”
Proton therapy is a form of radiation treatment used for certain types of cancers and lymphomas. A major advantage over traditional forms of radiotherapy is its ability to deliver radiation to a tumor area with remarkable precision, sparing healthy tissues.
Hoffer began her treatment at the Cincinnati Children's Hospital Medical Center/UC Health Proton Therapy Center, housed on the Cincinnati Children’s Liberty Campus, under the care of Luke Pater, MD, assistant professor of radiation oncology at the UC College of Medicine and a radiation oncologist at UC Health, in November 2016. The Proton Therapy Center officially opened one year ago in August 2016.
"I had 20 rounds of radiation—daily treatments (for four consecutive weeks)—on my neck and chest area,” she says.
"It’s weird, but I was almost sad to be done because of all of the wonderful relationships I’d formed with the staff at the facility,” she says. "I can’t say enough about how awesome they were.”
A Return to Normalcy
Hoffer says she had very few side effects from her treatments, some problems swallowing, skin irritation and fatigue, to which she adds, "But who wouldn’t be tired with two little ones at home?”
As a way to further celebrate treatment being in her rearview mirror and her ability and strength to overcome anything, she ran the Flying Pig Marathon in spring 2017.
"I wanted to do the half-marathon just to show that cancer wasn’t going to get me, and a group of 20 of us went out and did it,” she says. "It was a great experience, and the further love and support of everyone who stood by me throughout my treatment meant so much.”
Now, with her scans showing no sign of cancer, Hoffer is just happy to return to normal, everyday life.
"When I was undergoing treatment, I always yearned for normalcy,” she says. "Now, I don’t have to be on a schedule anymore, and we have time as a family to do whatever we want.”
"I’m just extremely blessed,” she adds. "The physicians, nurses and staff here are wonderful; they are truly the best. I never thought about getting a second opinion or going elsewhere for treatment. I knew they were always looking out for my best interest—from the biopsy to the radiation treatment. They’ve helped me get back to my life.”