ROGER MARIS CANCER CENTER

Triumphant journey ensues after childhood cancer

Ann Bailey — Mon, 10 Jul 2023 10:30:00 GMT

Although bad news often dominates the headlines, there are positive stories out there that I believe are important to tell.

It is especially satisfying for me to write stories about people who have overcome a major obstacle and achieved success.

This time I’m writing about my daughter, Ellen, whose story started out sad and has pivoted into a happy one.

I began telling Ellen's story 15 years ago in June when our family doctor told my husband, Brian, and me that our then-5-year-old had leukemia.

The diagnosis of acute lymphoblastic leukemia on June 3, 2008, explained why Ellen had a respiratory illness she had not been able to shake, bruises on her legs and joint pain. The diagnosis was scary and we worried about an uncertain future.

She was a seriously ill little girl, and we were aware that the cancer was life threatening. But Brian and I and Ellen’s brothers, Brendan and Thomas, knew that we had to overcome our own worries to present a positive front. We also knew that leaning on our Catholic Christian faith and support from Ellen’s medical team, our extended family, friends and neighbors would help us to help Ellen.

Ellen had spirit and spunk, and, with the love of God and her personal and medical support teams, not only survived cancer but came out on the other side of it stronger.

At the age of 20, already Ellen has made a mark on the world through her volunteer work to organizations like Make-A-Wish, her church and Meals on Wheels. She has made appearances on television and talked on the radio about the importance of volunteer work for non-profit organizations.

She is fiercely loyal to her brothers and her sister-in-law, considerate of her parents and, to quote a line from a Tim McGraw song, “a friend a friend would like to have.”

Ellen is a thoughtful, selfless young woman who lives to make others happy, and that is demonstrated by her surprising them with parties marking milestones in their lives, lending them a listening ear and writing — yes, the kind where she puts a pen to paper — notes celebrating happy times or offering sympathy during sad ones.

A serious student throughout her elementary and high school years, Ellen also is excelling at the University of North Dakota in Grand Forks, where she has achieved a 4.0 all four semesters and was awarded a large scholarship, which will pay for her junior year tuition as she pursues her degree in early childhood education.

Her passion for running, a sport in which she achieved great success in high school, has continued and she is training for a half marathon this fall. This summer she is living and working in North Carolina for ChicknLegs, a running shorts company, which gives her an opportunity to market a brand she loves and to run with a new group of friends.

As the years have passed since Ellen’s diagnosis, she has been adamant that she didn’t want her life to be defined by cancer, so Brian and I have worked to make sure that it isn’t.

Instead, guided by God, Ellen has not let a cancer diagnosis limit her, but instead, created a life that is characterized by who she is: a kind, compassionate, intelligent, faith-filled strong, young woman.

That is the good news that I, as her mom, am happy to proclaim, She is living proof that adversity does, indeed, build character and that life is what you make of it.

As Ellen travels the journey of her adult years, with God as her guide, we await to see more of her incredible story unfold.

Ann Bailey lives on a farmstead near Larimore, North Dakota, that has been in her family since 1911. You can reach her at 218-779-8093 or abailey@agweek.com.]]>

Sanford investing over $100M to make Roger Maris Cancer Center in Fargo a 'destination' for treatment

Patrick Springer / Forum News Service — Thu, 25 Apr 2019 13:12:48 GMT

FARGO — Sanford Health plans a major expansion of its Roger Maris Cancer Center, including the addition of bone marrow transplant and immunotherapy programs, in a bid to make it a "destination" for cancer treatment.

The plans follow a “reimagining” of the cancer center at its downtown site and aim to improve what Sanford regards as “one of the crown jewels” among the health system’s medical services, said Nate White, chief operating officer and Sanford Fargo president. Over time, the entire downtown campus — which served as Sanford's main campus until the new medical center opened in 2017 near Veterans Boulevard — will be dedicated to the cancer center and affiliated programs.

Sanford has developed a 20-year master plan for its downtown medical campus that envisions investing more than $100 million, including $40 million to transform space now occupied by its heart and vascular center, which will move to the new medical center campus. Groundbreaking for the new heart center is scheduled for next year.

The announcement of new cancer facilities and services — which also include inpatient hospice care as well as research and specialized education initiatives — coincides with a gala on Thursday, April 25, that will kick off a fund drive with a goal of raising $15 million over the next three years. The gala will include a performance by singer Rachel Platten, whose hit “Fight Song” was a Billboard top-selling song in 2016.

“There’s been more advances in cancer research over the past five years than in the last 25,” resulting in better treatments that save and prolong lives, White said. “It’s moving more to a chronic disease than a deadly disease. People are living longer. It’s a good story to tell.”

Bone marrow transplant services are slated to begin in 2021 and will spare at least 50 to 60 patients a year from having to travel hundreds of miles for care.

Dr. Anu Gaba, a hematologist-oncologist and medical director of the Roger Maris Cancer Center, said a consultant has said the clinic is well-positioned to expand into bone marrow transplant services.

“We’re excited about this,” she said. “It’s something we’ve been talking about for many years.”

Besides eliminating the need for patients to travel long distances for bone marrow transplants, the program will serve patients from around North Dakota as well as eastern Montana, enabling them to get care closer to home, Gaba said.

“We will be able to draw a lot of other patients,” she said. “We want to be a cancer center destination.”

Immunotherapy services, which involve engineering patients’ cells to treat cancer by strengthening the immune system, will be added later, after specialists are recruited and the program gains approval.

“We’ve declared that we want to be the immunotherapy center for Sanford and the upper Midwest,” White said.

To expand into immunotherapy, and to upgrade cancer services generally, the Roger Maris Cancer Center will have to increase its research capabilities, White said. To do that, Sanford will hire two oncologist-researchers and establish an oncology fellowship program to train and hire top-notch specialists.

“If you want to be in the game, you have to be involved in research,” White said. The oncologist-researchers will spend half their time seeing patients and half their time working on clinical research, he said.

Cancer specialists at Roger Maris Cancer Center have been involved in research, including patient trials of new therapies, for years.

The center also conducts research in partnership with the University of North Dakota �� of Medicine and Health Sciences as well as North Dakota State University, including work under a federal grant to help counter high cancer rates in North Dakota and South Dakota. Cancer is the leading cause of death for people ages 35 to 64 in the Dakotas.

The Roger Maris Cancer Center aims to become the first in North Dakota to offer bone marrow transplant services, White said. The Avera Cancer Institute in Sioux Falls, S.D., performs bone marrow transplants.

In perhaps five years, once specialists are on staff and laboratory equipment is acquired, the center will launch its immunotherapy program, which would become the first along the northern tier of states between the Twin Cities and Seattle.

Sanford’s downtown campus, which still houses its main clinic, has about 2,500 employees, White said. That number will decline as more clinical services shift to the Sanford Medical Center near Veterans Boulevard, but then should grow to 2,500 to 3,000 by the end of the decade, he said.

“It will be an evolution,” White added. “As we look at the downtown, it’s Roger Maris.”

Long-term plans for Sanford’s downtown medical campus also include a hotel as well as a subsidized, long-term stay option for patients and their families. Sanford hasn’t yet identified a hotel company, but will be seeking a partner, because Sanford would not be the owner.

The downtown campus also will have in-patient hospice care, which apparently would be the first in North Dakota.

Starting later this year, a 10-bed, in-patient hospice care unit will be housed in a former women’s hospital wing, which has large patient rooms. “Long-term, we’d like to have that as a stand-alone,” White said.

Strong philanthropic support will be required to realize Sanford's ambitious plans, but will pay dividends for the area, White said.

“It’s a wise investment for the money,” he said. “This has a huge economic impact not only for the state of North Dakota, but downtown Fargo.”

Roger Maris Cancer Center highlights
Opened in July 1990, more than 50 years after the former St. Luke's Hospital started treating cancer in 1939. 85 percent of the current 65,046-square-foot center space was built through donations. Serves a patient radius of 100 miles. Has grown from seven physicians in 1990 to 29 providers, including 13 medical oncology/hematology, three pediatric oncology, and four radiation oncology specialists. Oncology visits have grown from 10,387 to more than 28,000 over the past decade. Cancer center patients are enrolled in 135 active oncology clinical trials.
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Radiation as a scalpel: Technique spares healthy tissue, treats inoperable tumors

Patrick Springer — Sat, 16 Dec 2017 01:29:26 GMT

FARGO - Meredith Staker's life depended in part on the accuracy of a face mask that vaguely resembles the type worn by hockey goalies. It had to be sculpted to the contours of her face in order to immobilize her head.

She would have to lie perfectly still while a machine delivered multiple beams of radiation that would converge in the back of her brain, in the location that enables her to see, with great precision.

The bursts of radiation were intense - much more intense than standard radiation treatments - but can be delivered with a degree of accuracy that spares the surrounding healthy tissue.

She would have to lie as still as a corpse. To help her do that, she was outfitted with a tailor-made mask, a sheet of heated plastic that would assume the shape of her face, and would be paired with another plastic sheet at the back of her head, forming a locking "sandwich" to prevent her head from moving, even slightly.

"I kind of pretended I was having a hot-wax spa treatment," she said later.

Staker was given a mild sedative to help her relax. Soothing music played in the background as the machine made multiple passes overhead, working its magic with a hum that she tried to think of as reassuring.

"I probably dozed," she said.

The single session, which would last 20 to 25 minutes, would be her best hope of eliminating the small tumor lurking deep inside her brain, the latest cancer threat facing the 61-year-old Fargo woman.

Her battle began seven years ago, when she was diagnosed with breast cancer, treated with surgery, chemotherapy and radiation. All was well until several years later, when a chest X-ray revealed that she had lung cancer.

Her lung cancer was treated with chemo and radiation. But life dealt her another wallop when a recent scan found the brain tumor. The lung tumor appears unrelated to her breast cancer, but her brain tumor had spread from her lung.

Rather than risk brain surgery - her tumor was inoperable - her first line of treatment at Sanford's Roger Maris Cancer Center was a technique called stereotactic body radiation therapy, sometimes called stereotactic radiosurgery.

The stereo reference involves matching images mapping the tumor with the pinpoint delivery of the beams of radiation - a marriage of sophisticated scanning and radiation enabled by advanced computing power.

The pinpoint radiation technique, which also is available at Essentia Health in Fargo, is suitable for small tumors, often in places that are inoperable, including the brain, lungs, liver, kidneys, prostate and spine.

Because healthy tissue is spared, side effects are minimal or nonexistent. Patients typically receive from one to five treatments.

"My skin never got red," Staker said. "I would not have known that I had any radiation." Better yet, her oncologists consider her brain and lung cancer cured. "I do feel blessed."

'Like Microsoft Paint'

Extensive imaging studies and planning are required before administering the radiosurgery. The radiation oncologist collaborates with a team that includes a medical physicist, dosimetrist and nurses.

"By the time we actually do it, it's easy," said Dr. Miran Blanchard, the radiation oncologist who treated Meredith Staker.

Before the radiation treatments, Blanchard uses a computer mouse to trace the area on a scanned image that will receive the radiation. "Just like Microsoft Paint," he said, referring to the computer painting program.

"You can really sculpt the radiation to funny, oblong shapes," he said.

The machine delivering the radiation travels along six arcs, rotating, twisting and twirling, delivering an "infinite number of beamlets as it travels along its arc," he said. "Each of these contains an insignificant dose, but when they all meet in the center it delivers a significant dose."

Treatments involving the lungs or abdomen are more complex, sometimes requiring hours of preparation, because the patient's subtle movements, including breathing, must be taken into account. They are captured in a "movie" of images that are then fed into the machine that delivers the radiation, so the radiation beams move in synchrony, sparing healthy tissue.

The four-dimensional scans required for pinpoint radiosurgery have been available for six or seven years, and, as techniques and equipment improve, applications for the procedure expand.

But the pinpoint radiosurgery has limitations. It doesn't work for cancers in bone or blood, or in tubular organs, such as the esophagus or intestines, or for large tumors.

Not long ago, many brain cancer patients had treatments that subjected the entire brain to radiation, causing side effects including cognitive deficits, including memory loss.

Now, with pinpoint radiosurgery, only the cancer is radiated, and most patients have no side effects. Blanchard compares the precision to "picking weeds" instead of "spraying the whole lawn with weed killer."

For three of every four patients treated with the technique, the expected outcome is to cure the cancer, Blanchard said, "or at least buy them tremendous amounts of time."

Now, for instance, half of patients with the most advanced form of lung cancer are eligible.

"Even a year ago, a curative attempt wouldn't have been made," Blanchard said. For those who aren't cured, "The vast majority have improvements in their quality of life."

Pinpoint radiation

Russell Koenig knew something was wrong when he woke up one morning with swollen legs. His doctor ordered blood work and promptly got on the phone with a kidney specialist, whom he saw the same day.

"My kidneys were shutting down on me," Koenig said. "It got worse and worse."

At one point, his kidney function was only 17 percent of normal - bad enough to qualify for a transplant, requiring five months of dialysis. The problem originated nearby in his pelvic region, where scans found cancer that had spread to a lymph node.

As with Meredith Staker, Koenig was treated with radiosurgery, as well as chemotherapy. Along the way, because of his weakened immune system, he developed a severe intestinal infection. But now he has rebounded, and there is no sign of cancer recurrence. As with Staker, he goes in every three months for screening scans.

His cancer involved small, scattered tumors, all bombarded with pinpoint radiation, delivered in five treatments.

"I feel fantastic," he said.

He is thankful for his recovery - but he and Staker must live with uncertainty and the gnawing possibility their metastatic cancer will return. Both view their lives differently as a result of confronting their cancer, and its rude reminders of human frailty and mortality.

"The little things are just little," said Koenig, a 59-year-old warehouse worker who lives in West Fargo. Now Koenig, who once routinely worked two jobs, and 65 hours a week, works part time. He and his wife recently traveled to Europe, a trip of a lifetime. He finds comfort in his faith.

"I've learned life is short. If you can do it, spend some time with your family and friends."

Staker's outlook is similar. "I can honestly say this journey has changed me completely," she said. "I've come to a place of surrender. If He calls me home, that's OK. I feel healthy right now."

Both try to get regular exercise and to avoid stress. Both are looking forward to spending time with family over the holidays.

"We just assume this is going to give me some more years," Staker said of her treatments. "How many, I don't know. It's up to the Lord.

"Right now, I'm just enjoying my life," she added. "It's a gift. I honestly feel like I can do whatever I want right now."

Radiation as a scalpel: Technique spares healthy tissue, treats inoperable tumors

Meredith Staker of Fargo is undergoing treatmeant for brain cancer that uses pinpoint beams of radiation. (David Samson / Forum News Service)

Dr. Miran Blanchard, a radiation oncologist with the Sanford Roger Maris Cancer Center, Fargo, shows the radiation plan to treat Meredith Staker's lung tumor. (Michael Vosburg / Forum News Service)

A mask, uniquely molded to a patient's face, holds them in place for the precision needed to irradiate a tumor with pinpoint accuracy. (Michael Vosburg / Forum News Service)

Dr. Miran Blanchard, a radiation oncologist with the Sanford Roger Maris Cancer Center, Fargo, seen Monday, Dec. 11, 2017. (Michael Vosburg / Forum News Service)

Meredith Staker of Fargo underwent treatment for brain cancer that included pinpoint beams of radiation. David Samson / The Forum

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