Wednesday, August 12, 2015

MD Anderson Cancer Center at Cooper - Debby: Breast Cancer and Pregnant

Her breast cancer “Dream Team” gave Debby a chance to live out her own dreams of motherhood. Debby was seven months pregnant when she discovered a lump in her breast. Within just a few days, Debby had appointments with the breast cancer experts at MD Anderson Cooper. Debby started aggressive chemotherapy treatments soon after the birth of her daughter and went on to have radiation treatment and surgery. Today Debby is cancer-free and enjoying her life and motherhood thanks to the hope, support and advanced cancer treatments she received at MD Anderson Cooper.


Tales of Triumph

South Jersey Magazine


Debby Madiraca
One week before her baby shower, Westmont’s Debby Madiraca felt a lump on her breast. She didn’t immediately become concerned, chalking it up to her changing body, but mentioned it at her next weekly OB appointment. She went for an ultrasound to have it checked, and when the doctor was called in to review it, she knew something wasn’t right.

“They told me to call my doctor immediately,” says Madiraca. “I asked her, ‘Is it bad?’ and she said, ‘It isn’t good.’” Her OB set up appointments with physicians from the MD Anderson Cancer Center at Cooper, including Dr. Kristin Brill, director of its breast program, and Dr. Generosa Grana, head of hematology and oncology and director of the MD Anderson Cancer Center at Cooper.

After Madiraca’s biopsy results were in, Brill confirmed the cancer in her breast. “When she told me, I started crying, but the nurse, Helen Nichter stayed in the room with me and told me she was a survivor. Seeing her standing there—alive—that was a game changer for me,” Madiraca says. “From that moment on, I only wanted to hear and read stories of hope and inspiration. They helped keep me going.”

She met with Grana to discuss treatment, but there was the matter of the baby to consider. Dr. Elyce Cardonick, who specializes in treating cancer in pregnant women, helped decide which options would be safest for mother and baby. “They felt I was far enough along in the pregnancy for Amelia to be delivered safely so I could start chemo right away,” says Madiraca. Amelia was born July 30, 2013.

With the baby out, Madiraca was able to have a PET-CT (PET scan) to get a better idea of what was going on. This testing revealed the cancer had spread to Madiraca’s liver, which meant she was now diagnosed as Stage IV.

Because of the limits on scans during pregnancy, Grana says they could not have known until after the baby was born that it had spread. The abnormality in the liver meant considering a new treatment plan. “If the cancer is limited to the breast and underarm we’re able to cure many of those … but if it spreads elsewhere, the bones, lungs, the liver, however, is not so common, the cure rates are less. It changes the playing field.”

There was a bit of good news, though. Special genetic testing revealed that Madiraca’s cancer was estrogen receptor positive (HER2). “If there is a good type of cancer, this is it,” says Grana. They were able to target the cancer with new drugs that have proven effective in those with the HER2-positive cancer.

Madiraca spent her maternity leave going to chemotherapy treatments, the first round lasting six months. “Having Amelia made me fight harder because it wasn’t about me, it was about her growing up with a mom,” she says.

After the first round, Madiraca had a lumpectomy to remove tissue where the tumor was. Soon after, she received news that her pathology test was clear—there were no signs of cancer.

“With chemotherapy your goal is a complete response and eventual complete disappearance,” says Grana. “When the disease is in the liver, you may only achieve complete disappearance in 20 to 30 percent, and for those who do achieve it, it’s not always permanent, but each scan gives us hope.”

Madiraca’s scans have been clear for nearly two years. She still receives drug treatment every three weeks, but she says it’s not a drag to be there because the whole team at the MD Anderson Cancer Center has become part of her family. “I’m not cured, I know it’s not guaranteed, but I know cancer won’t kill me,” Madiraca says, “… it’ll probably be the day my daughter starts driving.”

S.J. doctors: Gains made in breast cancer battle


October 5, 2014

Debby Madiraca of Haddon Township was diagnosed with metastatic breast cancer when she was 8 months pregnant with her daughter Amelia. She was a candidate for new medications which target the estrogen receptors that fed her kind of cancer tumors. Though she will be on expensive medication for the rest of her life, she is cancer free and she's not looking back. Thursday, October 2, 2014.(Photo: JOHN ZIOMEK/Courier-Post)

Eight months into her pregnancy, Debby Madiraca of Westmont figured the new lump in her breast was normal.

She mentioned it anyway at her next obstetrics appointment. Within days, Madiraca learned she had late-stage breast cancer that had already spread to her liver.

Her baby would need to arrive early, so the first-time mother could begin treatment.

Genetic testing showed her particular kind of tumors made her a candidate for a new regimen of chemotherapy drugs that included Perjeta, Herceptin and docetaxel.

After just three rounds, a second scan showed the estrogen-fed cancer was completely gone.

"I didn't know it was such a miraculous thing to happen like that," said Madiraca, who recently celebrated her 36th birthday.

"I'm learning now that everyone's not that fortunate."

Breast cancer detection and treatment are improving rapidly, South Jersey doctors say, catching tumors earlier and offering hope to patients with later-stage cancer who once had little chance of survival.

"Although early-stage breast cancers are where your successes are, because it's often highly curable, there's a lot of excitement in (the treatment of) advanced breast cancer," said Dr. Generosa Grana, director of the MD Anderson Center at Cooper and Madiraca's specialist.

"It's not the doom and gloom that it used to be."

Except for skin cancer, breast cancer is the most common among American women. About one in eight will develop invasive breast cancer during her lifetime, according to the American Cancer Society, and 40,000 people are expected to die this year from the disease.

Even so, a woman's chances of dying from breast cancer are just 3 percent.

Survival rates have improved by 50 percent in the past decade, said Dr. Arnold Baskies, chief science officer for the American Cancer Society and a medical director at Virtua. Rates are expected to improve another 34 percent in the next five years.

"We know that already," Baskies said. "The genetic code has been broken. We're able to identify women at high risk, and we're able to give targeted therapies to people based on the genetics of their individual breast cancer.

"That's made a huge difference."

Debby Madiraca (top and above) of the Westmont section of Haddon Township was diagnosed with metastatic breast cancer when she was 8 months pregnant with her daughter, Amelia. Today she is cancer free, thanks to new medications that targeted the estrogen receptors which fed her tumors. (Photo: Photos by John Ziomek/Courier-Post )

Madiraca is among the patients benefiting from Perjeta, a new chemotherapy drug produced by the Swiss pharmaceutical company Roche. Patients with aggressive HER2-positive breast cancer survived a median five years when given the new medication in combination with two others, Roche reported.

Grana has seen several patients with metastatic disease beat even those improved odds, still living seven years after their initial diagnosis without signs of cancer.

"How long will that remission last?" she mused. "We don't know.

"For many of these women, it may be permanent."

Jacqueline Timmons hopes to be among them. A year ago, the Bridgeton native noticed her right breast felt suddenly heavy and swollen. Between biopsies and her diagnosis, a golf ball-size lump quickly grew under her arm.

"I was praying, 'Lord, if this is what it is, this is nothing you and I can't get through together,' " recalled Timmons, who lives at the Joint Base McGuire-Dix-Lakehurst Air Force with her husband and two children, 12 and 17.

Tests revealed she had stage 3 breast cancer, the kind fed by estrogen. She had just celebrated her 41st birthday.

In the past year, Timmons has endured a regimen that included Perjeta, 28 rounds of radiation and a double mastectomy with newly constructed breasts made from her own belly tissue.

Though her body is stiff and sore, her nails and hair are growing back.

"Today, I feel really good," Timmons insisted. "I feel like every day is getting better."

Debby Madiraca of Haddon Township was diagnosed with metastatic breast cancer when she was 8 months pregnant with her daughter, Amelia. She was a candidate for new medications that have helped keep her cancer-free. (Photo: JOHN ZIOMEK/Courier-Post )

Fourteen months since giving birth to her daughter, Madiraca doesn't dwell on the tumor that once lived in her liver. To keep it at bay, she'll be on a regimen of cancer drugs for the rest of her life.

She lugs her laptop to her infusion appointments every three weeks, working through the three hours it takes to receive her medicine.

Though she misses her long hair, Madiraca counts herself blessed to be in remission.

"I don't have time for cancer," she noted. "I have too much going on.

"I think it picked the wrong person to mess with."

Reach Kim Mulford at (856) 486-2448 or Follow her on Twitter @CP_KimMulford

Debby's Blog "Boot Camp & Buttercream" - started June 2016

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