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First chance at new treatment means second chance at life 

 



Carol Ramnarine has accomplished a lot for someone who says she’s only 2 years old.

She’s married, has two grown children and retired as a public school administrator. Oh, and there’s the small matter of her cancer.

Diagnosed in 2004 with multiple myeloma, she later underwent a successful hematopoietic cell transplant paired with a new, targeted radiation technique using TomoTherapy developed at City of Hope.

“I have a new birthday — June 12, 2005, the date of my transplant,” Ramnarine said. “I’m now only 2 years old, because that’s how old my blood is.”

Ramnarine admits with a laugh that she’s actually 55, but she’s tackling life with the zeal of a toddler. And she’s sharing that enthusiasm with fellow cancer patients, survivors and caregivers to give them hope — and the knowledge that technology such as TomoTherapy may give them a second chance at living.

Ramnarine’s cancer story began after she noticed a strange bruise on her leg. When she sought medical help for it, the test results were stunning: She had early stage multiple myeloma, a cancer involving certain cells of the immune system. Unfortunately, it's notoriously tough to cure. About 16,000 Americans each year are diagnosed with the blood disease.

Undaunted, Ramnarine began treatment with Philip Chatham, M.D., a hematologic oncologist near her Newhall, Calif., home, who started her on medications that slowed down the aggressive cancer in her bone marrow. After about seven months, Chatham referred her to City of Hope for a consultation with Leslie Popplewell, M.D., assistant professor in the Division of Hematology & Hematopoeitic Cell Transplantation, and Jeffrey Wong, M.D., chair of the Division of Radiation Oncology.

A hematopoietic cell transplant, the team decided, was Ramnarine’s best hope at keeping the cancer at bay. But it would be no ordinary transplant: It would be part of a clinical trial using a total-marrow irradiation treatment designed by Wong and his City of Hope colleagues. And not only would Ramnarine become the first City of Hope patient to undergo the procedure — she became the first in the world.

First, the medical staff collected stem cells from her blood and stored them away. Then they provided high doses of chemotherapy to kill cancerous cells in her bone marrow.

Using the TomoTherapy Hi-Art system, Wong then targeted radiation “beamlets” directly to Ramnarine’s bones and bone marrow. Afterward, physicians reintroduced her stem cells back into her bloodstream. They took root in her marrow, kickstarting her brand-new immune system.

“TomoTherapy lets us aim these tiny beamlets where they need to go, 360 degrees around the patient,” Wong said. “Because the system works together with advanced, three-dimensional imaging, we can sculpt the radiation specifically where it’s most beneficial. We not only provide high doses to the marrow, but we can minimize exposure to other healthy organs. That translates to fewer side effects.”

Ramnarine can attest to that. “I didn’t feel the horrible side effects people talk about, other than some itchy skin,” she said. “I was amazed at the creation of the TomoTherapy Hi-Art system and the painless treatment I was receiving.”

On each of the five days of her radiation treatment, Ramnarine simply lay down on a platform. She was fixed in place using a customized mesh mask and was rolled into the machine. “I sort of fantasized I was riding a bobsled, while the machine made sounds like a washing machine or a marching band,” she said. “When I was done, the little red light would turn off, and off I went.”

Now she gets regular testing, but she’s returned to reading, exercising, gardening, painting and more. “I’m just getting back to being adventurous,” said Ramnarine, who recently returned from a trip to the Hawaiian island of Molokai.

She also stays connected to other cancer patients using the power of the Internet. Her patient “Care Page” shares her story with friends, while her Facebook and MySpace pages encourage other patients with chronic disease and caregivers nationwide and in countries from Korea to England. She also backs the Firefighters Cancer Support Network (her son Chad is a firefighter) and has been honored by TomoTherapy and the Radiate Hope Foundation.

It’s just her way of doing what matters. “I realize it’s not the length of your life that’s important,” she said. “It’s the quality of the way you live life.”

 

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