A year and a half ago, she considered herself one lucky lady.
It was Dec. 29, 2012, and Tabitha Morgan had given birth to daughter Sophia. The day was especially joyful for Morgan and husband Tim because it ended their seven-year struggle with infertility issues. Sophia was their “little miracle,” Tabitha said.
Five months later, physicians in the Morgans’ home state of Alaska diagnosed Tabitha with stage 4 lung cancer.
Worse, the cancer had metastasized to her bones and her brain. Imaging revealed the cruel progression of the disease: a golf ball-sized tumor behind her right eye, a half dozen more in the brain, and a large mass next to her pelvic bone, among other signs of invasion.
In a master stroke of understatement, a neurologist examining her said to Tabitha, “You are a very unlucky young lady.”
Blindsided. The crush of bad news caught Morgan unprepared. She’s a nonsmoker who had no symptoms until she had trouble catching her breath after carrying Sophia upstairs to bed. Tim, who works two weeks on and two weeks off as a foreman in the Alaskan oilfields for CH2M Hill, was away. What if she passed out and nobody was there to help? Tabitha worried. A visit with a physician assistant led to a CT scan that revealed fluid in her lungs. The diagnosis of cancer followed.
“I didn’t know what to think,” Tabitha said. “I’d fought so hard to have a baby, I didn’t know if I had any more fight in me.”
It turns out she had plenty – enough to endure a craniotomy to remove the brain tumors; surgeries to drain large amounts of fluid from her lungs; painful side effects from Tarceva, the medication she took initially to shrink the tumors; and constant difficulty breathing.
The challenges haven’t abated. A scan last April showed that her cancer, which had been under control, had returned. Tumors riddled her lungs, a spot appeared on her liver, and a new lesion showed up in her brain. Tarceva had stopped working.
Help from afar. But today the Morgans cling to a sliver of hope. With the help of an oncologist in Anchorage, they contacted a half-dozen medical centers, hoping to enroll Tabitha in a clinical trial. Stanford University Medical Center was among those that passed on her case, she said. Eventually, however, they received a remote second opinion from providers at the University of Colorado Cancer Center.
After reviewing Tabitha’s CT, MRI, and PET scans, Cancer Center medical oncologist Robert Doebele, MD, thought Tabitha could be a candidate for a phase 1 clinical trial of a new drug to treat patients with the epidermal growth factor receptor (EGFR) biomarker for non-small cell lung cancer. But Doebele needed additional tissue samples. The Morgans flew to Colorado, where surgeon Robert Meguid, MD, performed a pleurodesis procedure, eliminating the spaces between the membranes surrounding the lungs to prevent fluid build-up. During that procedure, Meguid obtained a good tissue sample – a better indicator of the presence of the rogue biomarker than lung fluid, Doebele said.
Tests confirmed the presence of the EGFR marker. That, coupled with her failed Tarceva treatment, made Tabitha eligible for the phase 1 trial of CO 1686, an oral drug which targets tumor cells with the EGFR mutation.
The treatment “is not curative,” Doebele said, “but the hope is that we can help patients live several years.” The new drug, he explained, is engineered in a way that targets tumor cells more aggressively while sparing healthy cells with the EGFR receptor in the skin and gut.
“There is less collateral damage,” he said.
Grueling journey. That’s welcome news for Tabitha, who endured painful rashes while she took Tarceva – an especially difficult problem for a mother with a six-month-old infant she wanted to cuddle constantly. Her skin burned and “peeled like a lizard.” She was also plagued by gastrointestinal problems.
In a phone interview in late June, Tabitha said she’d noticed no side effects from her CO 1686 regimen, which requires her to take six pills twice a day.
“Everything with the trial is going great,” she said.
But her cheerful attitude belies the physical, emotional, and financial challenges she’s faced in battling the disease that threatens to rob her of precious time with her daughter, husband, and extended family.
The first visit to University of Colorado Hospital in mid-May included a meeting with Doebele, Meguid, the clinical trial team, and Cancer Center social worker Joan Hart, LSW, OSW-C. The pleurodesis required a nine-day hospital stay, during which Tabitha celebrated her 35th birthday with the help of nurses who ordered a cake. Two days after she was discharged, however, she had to be readmitted because of breathing problems.
She also had to come back to UCH twice during the first 21 days of the trial, which meant paying for flights to Denver from Portland, where she stayed with a close friend who helped her with Sophia while Tim maintained his work schedule. She was back in Alaska June 26, staying with her mother and sister, but returned to UCH July 15 for another round of tests. The visits every three weeks figure to cost the Morgans about $15,000 in airfare alone in one year, Tabitha said.
Helping hands. The couple hasn’t gone it alone. The American Cancer Society paid for their lodging during their lengthy Denver stay in May. Hart has helped to secure day care for Sophia as well as gas and grocery cards to defray costs and housing during subsequent visits. The oldest of five kids, Tabitha has gotten plenty of support from her family, as well as neighbors in their tiny home community of Talkeetna, Alaska, population 876, who have raised more than $25,000 on her behalf.
The Morgans’ story also attracted the attention of CBS4 in Denver, which aired an interview with them after Tabitha’s July 15 visit with Doebele. Scans showed the new drug could be having a positive effect.
She is grateful to have found a measure of genuine hope through the Cancer Center. As Doebele pointed out, a remote second opinion helps to save patients like Tabitha the emotional devastation of making a long journey to a medical center only to find out there are no clinical trials or treatments to help them.
“It’s better if we can’t help them that we find that out in a one-hour phone conversation,” Doebele said. Tabitha, however, is among a growing number of lung cancer patients who are benefiting from the Cancer Center’s portfolio of clinical trials, he added.
For her part, Tabitha said she is confident she is getting good care from the Cancer Center and the hospital. She praises staff for keeping her informed about her progress and demonstrating their knowledge about her specific case each time she visits.
She still struggles with shortness of breath and pain. But she has no problem finding motivation.
“I can’t stay in bed and be upset about it,” Tabitha said. “Sophia gets me out of bed. Everything for her is new. I try to see things through her eyes – and the world is an amazing place.”
That attitude allows her to turn the conventional view of her disease upside down.
“Cancer isn’t easy for anybody,” she said. “I’m blessed to have the right kind of cancer. Traditional chemotherapy would wipe me out. I have no choice but to trust my physicians and do my best. I have a chance at another miracle.”