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Choosing to fight
Jess Senn Salmonowicz was diagnosed with a fatal form of leukemia, but she's won the battle and been declared cancer-free

By CATHY BREITENBUCHER
Photos by Matt Haas

October 2015

The day before Thanksgiving 2011, Jess Senn Salmonowicz was looking forward to her mom’s traditional Black Friday party.

Instead of enjoying food and fellowship that day, though, Salmonowicz found herself being admitted to Froedtert Hospital to begin treatment for acute lymphoblastic leukemia (ALL).

No patient is prepared for that kind of diagnosis, according to Salmonowicz’ oncologist, Dr. Ehab Atallah. Salmonowicz, then a seemingly healthy 29-year-old high school Spanish teacher, was no different.

She’d been fatigued for a while — falling asleep early, feeling achy after only a little exercise, just run down. Suspecting she was merely anemic, she went to her primary care provider for a blood test on Thanksgiving Eve. Friday morning, she got a call saying she had to see a doctor that very day.

"You walk into the room and tell someone, ‘You have leukemia, and I am starting chemotherapy in a couple hours,’" explains Atallah. "There’s no time to even wrap your head around what is going on."

With her brother Garret at her side, Salmonowicz had to call her parents and break the news. "It scared them, and me even more. I think I cried pretty much the whole first day because it is such an emotional overload," recalls Salmonowicz, who grew up in Richfield.

Fortunately for Salmonowicz, Atallah — a hematologist who specializes in leukemia care at Froedtert & the Medical College of Wisconsin — had a gameplan. He got his new patient enrolled in a clinical trial that put Salmonowicz on a chemotherapy schedule commonly used for children.

Most times, adults begin treatment by being admitted to a hospital for about a month. This is called the induction phase. Next comes outpatient intravenous chemo — four days a week, for six to eight months (consolidation or intensification phase). Then comes 18 to 24 months of oral and IV chemo (maintenance phase).

    

Dr. Ehab Atallah with patient Jess Senn Salxmonowicz

Child patients go through those same phases, but "the regimens are more dose-intense," says Atallah. For instance, child patients receive approximately 20 shots of chemotherapy directly into the spine; adults, an average of just eight.

No matter how you cut it, Salmonowicz would not be going back to her classes at St. Francis High School after the holiday weekend. In fact, she was out the rest of the academic year.

With ALL, there’s no time to waste. It is a type of cancer in which the bone marrow makes too many lymphocytes (a type of white blood cell). These abnormal cells can reproduce quickly and spread to other parts of the body. Untreated, leukemia can be fatal within a few months. Nearly one in 10 of all cancer deaths is from leukemia, lymphoma or myeloma.

"Once I got a map of the plan, it sunk in that, ‘This is how we’re gonna beat this,’" Salmonowicz says. "That put me at ease."

Until she was diagnosed, Salmonowicz’ days revolved around soccer (she played all four years at St. Norbert College in DePere) and running, going camping, teaching and spending time with her boyfriend, friends and family.

Then, her life became a series of tests and appointments and drugs. Her side effects included intense nausea and no appetite. A couple months into her treatments, she even had to be readmitted for three days to due to a blood clot in her lung.

"Time kind of stood still from when I went home from the hospital (in mid-December 2011) until I went back to work in the fall (of 2012). It was just me and my body, figuring out how we were going to deal with this," she recalls. "Everybody was super supportive and surrounding me with love and care. But in the end, you’re the only one who knows how you’re feeling and what you’re going through.

"You battle with those feelings every day. You have to wake up and make that decision — am I going to be positive today, or am I just going to stay in bed and cry about it?"

So, she fought through it. She was declared cancer-free on March 16, 2012. Two months later, on a picnic in Door County, her boyfriend Bill proposed; they were married in 2013 and now live in Madison, where she works as a trainer for Epic Systems Corp.

Today, Atallah considers Salmonowicz cured because she is three-plus years out from her diagnosis. "Somewhere between three and five years, the number of (relapse) events goes down significantly," he adds.

And this year’s Black Friday party? The celebration is bound to be the best yet. Jess will be there … along with her husband and their newborn baby.

Common symptoms of leukemia:

•Feeling tired, weak, dizzy or lightheaded

•Shortness of breath

•Fever

•Infections that don’t go away or keep coming back

•Bruising easily

•Bleeding, such as frequent or severe nosebleeds and bleeding gums

•Swelling in the abdomen

•Joint or bone pain

Source: American Cancer Society

 

Spyglass Aids in Early Diagnoses

A picture, often said to be worth a thousand words, can also save lives.

Spyglass, a tiny digital camera inserted into the bile duct, transmits stunning images from inside the duct that help doctors better locate potential sources of gastrointestinal cancer.

"The view is spectacular," said Dr. Pankaj Vashi, chair of the Department of Medicine at Cancer Treatment Centers of America, Midwestern, located in suburban Chicago.

Prior to Spyglass, which Cancer Treatment Centers of America began using last spring, patients undergoing ERCP (endoscopic retrograde cholangiopancreatography) procedures would have dye injected into the bile duct. Doctors would then X-ray the area to determine a diagnosis.

Spyglass allows precise views inside the bile duct to determine if cancer or a gallstone is causing a blockage. It also enables doctors to take accurate biopsies of potentially cancerous growths.

"With this technology you can differentiate those two (cancer or gallstones) very easily," Vashi says. "It is very specific for all gastrointestinal cancers and bile duct cancer.

"The benefit of this is that you can stage the patient better," Vashi says. "You can diagnose problems earlier, and the patient can benefit from some type of surgery. The benefit is tremendous to the patient."

Vashi says while Spyglass is used now for diagnostic purposes, he could see a day when the technology will also be used for treatment supplying medication inside the bile duct.

— Mark Concannon

Diffusion Aids in Detecting Cancer in Bone Marrow

Until recently, multiple myeloma, a condition where cancerous plasma cells accumulate in the bone marrow, was difficult to diagnose.

"Before, for clinicians needing to know how much of the bone was involved by cancer, the only way to gauge this was X-rays," said Dr. Narayan Sundarum, a radiologist at Cancer Treatment Centers of America in suburban Chicago. "But X-rays are not very good at looking at the bone marrow."

Now, a full-body MRI of bone marrow can be done in less than 45 minutes, leading to earlier detection and treatment and a higher likelihood of better outcomes. A technique known as diffusion examines the way water molecules move in the bone marrow, determining exactly where the cancer spots are and how many there are.

"It’s a much more sensitive reading than X-rays," says Sundarum. "And if there’s a particular area we’re worried about, we can do a target biopsy to help get more tissue for the clinician and help with the treatment."

The full-body MRI does not have radiation and affords patients the chance to have "a safe test without any extra radiation."

Sundarum says the MRI has the potential to treat other forms of cancer in the future.

— Mark Concannon

 







 


This story ran in the October 2015 issue of: