Medical Hero Spotlight: Allison Kuban, Pancreatic Cancer Clinical Trial Participant

allison kuban medical hero spotlight
Diagnosed with Pancreatic Cancer

In 2017, Allison Kuban had just returned from a week-long trip to France with her boyfriend when she started experiencing intense stomach pain, fatigue, and rapid weight loss.

After seeing several doctors, Allison was awaiting test results when her stomach pain became so severe that she went to the ER to be seen immediately. Doctors at the hospital initially suspected she had a form of endocrine cancer but weren’t sure. Two days later, on her 31st birthday, Allison found out she had Pancreatic cancer. 

Allison sought out a second opinion who confirmed this diagnosis and determined her cancer was stage-4, since it had metastasized to her liver. She began a regimen of chemotherapy immediately, going for treatment every two weeks that she received through a port in her chest. Allison stayed on chemo for seven months, struggling with the side effects from the drugs, which left her drained physically and too sick to continue.

“Chemo was keeping everything stable, but the side effects were so severe,” Allison says. “I realized the chemo might actually kill me before the cancer did. I wanted a higher quality of life instead of just trying to extend it. I was willing to try anything.”
Finding a Clinical Trial

One of Allison’s doctors suggested sending a biopsy of her tumor to a lab for genetic testing. If the tests could find the genetic mutation that was causing her cancer, Allison could then be matched with the right medication to target the mutation. During this time, Allison continued with her chemo treatments.

Luckily, Allison’s testing identified her specific genetic mutation. By fate, a relative of Allison’s was at a seminar for pancreatic cancer and met a doctor who knew of an opening in a trial for her mutation at MD Anderson.

“Treatment totally changed for me in a matter of days,” Allison recalls. “I had been on infusions, which were switched to two pills in the morning and two pills at night. After three months, I did a staging scan and my tumors had shrunk by 38%. As of today, they have shrunk over 70%.”

Allison started the clinical trial in 2018 and has remained on it for five years. She visits MD Anderson for regular bloodwork and scans to monitor her cancer. Although she lives about an hour away from the hospital, the pharmaceutical company running the clinical trial reimburses all her travel expenses.

“I didn’t think much about cancer before my diagnosis and knew nothing about clinical trials. At the time, I was so sick that I leaned on my caregivers for help researching and finding resources. If anything, caregivers for patients are the ones who should be made familiar with clinical research and the different treatments available. When you’re the actual patient, you just want to get through it and keep yourself alive,” Allison says.

In reflection, Allison wishes she had known about clinical trials when she was first diagnosed. “I likely would not have opted to do chemo if I knew there was an alternative option for me. Without my doctor, I likely wouldn’t have even done the genetic testing. Now, I tell everyone I know about it.”

Advocacy Work & Advice

After her initial diagnosis, Allison began getting involved with support groups through her hospital and other pancreatic cancer organizations. As an advocate for pancreatic cancer, she has also recently published a book about her experience and treatment, Like A Needle In A Haystack: My Survival from Stage-4 Pancreatic Cancer.

To other patients considering a clinical trial, Allison advises them to stay positive, and keep searching for a trial that is the right fit for them. Even if a study you participate in doesn’t work, your data is helping advance research to fight and cure diseases. “The traditional form of treatment with stage-4 cancer is chemotherapy, and doctors often don’t advise taking risks since you don’t have a lot of time,” Allison says. “For me that risk was worth it, and it could be for you too.”

Additional Resources:

https://pancan.org/
Read Allison’s book, available on Amazon here.

To search for medical conditions in a specific location, visit our Search Clinical Trials page.

To stay informed about clinical trials, visit our Resources page.

For volunteer opportunities with CISCRP, visit our Volunteer page.

Written by Lindsey Elliott, Marketing & Communications Manager, CISCRP | lelliott@ciscrp.org

Medical Hero Spotlight: Amy Gietzen, Scleroderma Patient Advocate

Scleroderma Symptoms

Amy Gietzen was 19 years old and in her second semester of nursing school at Trocaire College as a dietary supervisor when she started experiencing stiffness, swollen joints in her fingers and wrist, and sensitivity to cold and heat. Concerned, she underwent testing at her doctor’s office, which revealed she had systemic scleroderma, a rare degenerative autoimmune disease. “At that time, I had no idea what scleroderma was or even how to spell it,” Amy recalls. “I tried looking for more information online and resources were limited. My doctor told me to begin getting my affairs in order, this disease kills.”

Amy was devastated by her diagnosis and frustrated by the lack of care options in her city, which had no scleroderma specialists. Her doctors in Buffalo, NY, were only able to monitor her symptoms, which were progressing steadily. Amy started experiencing pulmonary fibrosis, Raynaud’s disease in her hands, trouble swallowing, and other complications.

“I wanted to be more proactive in my treatment, so I did some research and found a specialist in Pittsburgh, PA,” Amy says. “I felt so relieved and excited at my first appointment when everyone there knew about scleroderma and were incredibly informative and helpful.” Amy has been working closely with her care team in Pittsburgh ever since.

Starting Treatment

Researchers are still unsure what causes scleroderma to manifest, and there is no treatment that can cure or stop the overproduction of collagen that is characteristic of scleroderma. The condition affects the skin, vascular system, capillaries, blood vessels, and other organs like the heart and lungs. Each person living with scleroderma is affected differently, which makes it difficult to designate a standard of care treatment for all patients.

“When I was diagnosed 20 years ago, there was one medication that they gave everyone with scleroderma because there was evidence that it did help symptoms for some patients,” Amy says. “I was on that treatment for about 10 years before it became ineffective for me. Today, there are new medications and treatments for other comorbidities.”

After stopping the first treatment, Amy tried a form of chemotherapy that, for a time, helped improve her skin elasticity and her breathing issues. She then stayed on a treatment that was administered monthly by IV for seven years. Today, Amy takes a biologic medication which has helped increase her flexibility and mobility. Through these treatments, symptoms of scleroderma that affect Amy’s skin have remained under control. With her care team in Pittsburgh and her rheumatologist in Buffalo, Amy has been able to coordinate treatment plans that can be done at home.

Advocacy Work & Clinical Research Participation

Amy’s advocacy work began with her own independent research for resources. On Facebook and Myspace, she found other patients and support groups on the local and national level. She began attending meetings, but soon felt isolated when she realized there was no programming geared towards young adults with scleroderma. This experience inspired Amy to start her own Facebook group, Scleroderma Superstarz. “After starting the group online, I started accepting speaking engagements and talking about my journey with others. Through the National Scleroderma Foundation, I started the young adult virtual group, SYNC,” Amy shares.

SYNC meets every other month via Zoom and is designed for patients ages 18-40, with young adult panel sessions that focus on relevant topics like dating, working, and navigating social gathering with scleroderma. “I’ve recently handed the program over to two younger leaders, but I’m very proud of my work with the program,” Amy says.

Amy is passionate about clinical research and does what she can to participate. “At this point in my disease, I am not eligible for most clinical trials. I have applied for several but was not accepted because I’ve been living with scleroderma for so long,” Amy notes. “I do think it’s important that patients participate in clinical research when they can, but they should also understand what they participate in.”

Despite her ineligibility for clinical trials that involve medications, Amy has submitted x-rays of her lungs, as well as blood and urine samples for research. Amy is an advocate for finding an easier way to disseminate research results so patients have access and can understand them. In addition to her advocacy work, Amy completes research surveys detailing her disease symptoms, joins focus groups for research organizations, and serves on several patient advisory boards to help make clinical research more accessible to patients.

Amy also shares from her learned experience the importance of improving communication between patients and research teams during a clinical trial. “Patients need more opportunities to communicate their experiences and ask questions to those who are developing and conducting the study.”

“One of my greatest accomplishments as an advocate has been my work with the Steffens Scleroderma Foundation in Albany, NY,” Amy shares. For the last five years, Amy has served as a keynote speaker at an educational event where medical students from partnering colleges attend and meet scleroderma patients. This event teaches students how to practice collaborative care and gives upcoming healthcare professionals first-hand knowledge of scleroderma, something critically needed for improving the diagnosis and treatment of scleroderma patients.

“One of the biggest challenges the scleroderma community faces is building awareness and making it a household name. If we could get the notoriety that other diseases have, that would be a big help for research funding.”
The Waiting Room Entertainment Group

A current initiative Amy is working on is the formation of a group with other advocates in the scleroderma community, with the aim to share resources and bridge gaps currently existing for scleroderma patients. Alongside her co-founders, Amy has helped bring The Waiting Room Entertainment to life. The group has launched several initiatives, including a YouTube channel that interviews other organizations that provide disease-specific resources and answers complex questions patients may be facing like how to fill out adult disability forms, how to transition from pediatric to adult care, or how to advocate to your doctors. Additionally, Amy and the other co-founders have started a social club where patients can meet, connect, and network with each other. Jacob’s Hugs, another service the Waiting Room Entertainment provides, was coined after a close friend and prominent advocate in the scleroderma community passed away. The Waiting Room Entertainment developed a registry where patients can list two next of kin contacts who can then notify the group if a patient’s medical status changes or they pass away so the community can mourn and honor their life. “It’s a community-based end-of-life service where we work to honor scleroderma patients,” Amy says. Newly founded, The Waiting Room Entertainment has various initiatives planned to keep an eye on.

The Future of Healthcare

In years to come, Amy hopes to see major changes in the healthcare industry that will improve outcomes for patients living with rare diseases like herself. Better access to care, diversified healthcare services, clinical trial program improvements, and potential cures for rare diseases like scleroderma are all a possibility.

“The medical universe is vast and complex with moving parts of all shapes and sizes. The one thing that is constant is that without clinical trials and the participation of patients, proper treatments for diseases would be nonexistent,” Amy reflects. “Building a bridge to oversee both is the way to achieve success, and brick by brick we are laying the foundation for a solid pathway to medical breakthroughs!”

Additional Resources:

https://www.youtube.com/@thewaitingroomentertainment
https://scleroderma.org/
Amy’s Instagram: @sclerostarz

To search for medical conditions in a specific location, visit our Search Clinical Trials page.

To stay informed about clinical trials, visit our Resources page.

For volunteer opportunities with CISCRP, visit our Volunteer page.

Written by Lindsey Elliott, Marketing & Communications Manager, CISCRP | lelliott@ciscrp.org

Medical Hero Spotlight: Shira Kaplan-Walker, Lupus Patient Advocate

Finding a Diagnosis

The night before the birth of her third child, Shira remembers feeling like something was not right. The epidural she received in the hospital didn’t relieve the pain as they had in her previous births. After the birth, Shira suffered from horrible headaches and was so fatigued that she couldn’t move her head off the pillow. “I realize now I was experiencing a lupus flare but didn’t know it at the time.”

Shira visited the ER several days after leaving the hospital, assuming her headaches were caused by the epidural. Doctors in the ER were skeptical of her symptoms, making Shira feel isolated and confused. For the next 2.5 years, Shira went to many specialists trying to get answers for her condition. She recalls feeling like “It was a living hell”. Reflecting on her experience, Shira believes that there were so many missed opportunities to be diagnosed earlier. “If I had been treated sooner, there would have been far less damage to my body. It’s incredibly frustrating.”

Shira’s various symptoms included numbing in both of her hands below the wrist, random shooting aches and pains, extreme fatigue, headaches, and her face swelling. She had to cope with managing these symptoms while struggling to find the necessary medical treatment.

 “Lupus can cause ‘brain fog’ and it is very hard to navigate the healthcare system while in the middle of an intense flare-up unable to think straight. Being in so much pain and having doctors not believe me at every appointment made me start to question if my symptoms were in my own head.” Shira started seeing a psychiatrist after being led to believe that her symptoms were psychosomatic.

As months past, Shira’s symptoms continued to increase, and her health continued to decline. On Thanksgiving, two years after her son was born, Shira was so drained she could barely make it up the stairs in her parent’s home and had no appetite for the food that she had waited all year to enjoy. On December 3, 2013, Shira’s symptoms came to a head. “I walked my daughter to her school carpool and came back inside feeling awful and not breathing well. The last thing I remember is getting into an ambulance.”

Shira spent 10 days in the ICU and over a month in the hospital. Her kidneys had shut down and doctors made the decision to intubate her. When she woke up, Shira’s mother and her care team told her they believed she had lupus. “That moment was such a relief for me. I finally had answers and my doctors finally believed me.”

Living With Lupus

Shira began treatment for lupus while in the hospital. She was started on a high dose of steroids, an immunosuppressant, and other medications to treat her lupus flare. Shira was seeing many doctors including a Rheumatologist, Nephrologist, Hematologist, Gastroenterologist and Neurologist. She continued her treatment in an acute rehab and then sub-acute rehab facility for a month where she had to regain her strength and relearn skills she had lost during her hospital stay, like walking and other physical activities. This was a difficult experience for her family, including her children who at that time were 2.5, 5, and 7 years old. 

“We needed a lot of help to ensure my children would be able to maintain their daily routines and function physically and emotionally during my treatments. I’m so lucky I had such a strong support system and the encouragement of my family and community during this difficult time.”

After being released from rehab, Shira began readjusting to her daily life while living with lupus. She continued to see Dr. Anca Askanase, the head of the Lupus Center at Columbia Presbyterian and her attending doctor from when she had been hospitalized. She spent the next year attending doctors appointments, outpatient occupational and physical therapy, and trying to find the right combination of medications to keep her symptoms under control. Since her diagnosis, Shira has faced additional complications and hospitalizations. In 2017, Shira was hospitalized for a week with a medication-induced liver injury, which was incredibly unusual considering the combination of medications she was taking. Out of an abundance of caution, her doctor switched her immunosuppressant to avoid further damage to her liver. In 2018, she was again hospitalized when she suffered a seizure and her husband found her unresponsive. Doctors added a seizure medication to her regimen. Over the next year, Shira tried three different seizure medications until finding the right one. At the same time, she began suffering from neurocognitive deficits far beyond her typical lupus brain fog. “I couldn’t understand what people were saying to me anymore, it was scary. I knew I had to advocate for myself because I knew something wasn’t right.” Shira recalls. After requesting to switch her immunosuppressant back to her original medication, her neurocognitive difficulties improved significantly within two weeks. Since her diagnosis, Shira has endured many tests and procedures including a kidney biopsy, two liver biopsies, a spinal tap, EEGs, and numerous MRIs and CT scans.

Shira feels incredibly blessed to have Dr. Anca Askanase as her rheumatologist who trusts that Shira knows her body best and spends time addressing whatever health issues arise.

Drawn to Advocacy

Shira chose to use her experience to become an advocate for lupus patients. “I grew up in a family of activists and attended many political and social protests and rallies. Becoming a lupus advocate was natural for me,” Shira says. She started her advocacy work after seeing a Facebook ad for a lupus summit in Washington D.C. Her experience at this summit was positive, allowing her the opportunity to speak with other lupus patients, share their daily struggles, support each other, and meet with elected officials.

After the summit, Shira became a community ambassador for lupus. She has been invited to multiple speaking engagements and has attended three advocacy conferences. In 2016, she became an annual speaker at Columbia Medical School for second-year medical students.

Clinical Trial Participation

From the very beginning, Shira’s doctors asked if she would be interested in participating in some ongoing clinical research studies related to lupus. These studies involved submitting bloodwork and filling out questionnaires about her health. In more recent years, Shira became more involved in clinical trials. “My doctor recommended I participate in an ongoing trial that was testing whether stimulation of the vagus nerve would reduce the inflammation in the body of someone with lupus. After asking questions and discussing it with my doctor and family, I agreed.” Since her first clinical trial, Shira has participated in several other studies, having very positive experiences with the care team in each study.

 

Shira was able to combine her passion for clinical research with her advocacy work when she joined PALS as an advocate. PALS is a patient-to-patient educational program that shares information about clinical trials and how to make an informed decision before deciding to participate in one. Along with other patients, Shira was trained by five leading rheumatologists in the field of lupus about the disease, how to answer common questions, and all aspects of the clinical trial process.

“It’s incredible being a part of this group and learning just how many clinical trials and organizations are working to save the lives of people like me.”

When it comes to participation in clinical trials, Shira is motivated to further promote the discovery of new medications and therapies for people living with lupus. She sums up her belief in self-advocacy and working to achieve better medicine for all with a quote from her faith that has guided her throughout her medical journey:

‘If I am not for myself, who will be for me? If I am only for myself, what am I? And if not now, when?’
– Rabbi Hillel

Additional Resources:

https://www.lupusresearch.org/

To search for medical conditions in a specific location, visit our Search Clinical Trials page.

To stay informed about clinical trials, visit our Resources page.

Volunteer opportunities with CISCRP, visit our Volunteer page.

Written by Lindsey Elliott, Marketing & Communications Manager, CISCRP | lelliott@ciscrp.org