Sunny side up
I'm proud of what I've done, and I'm looking forward to a full, healthy future."
- Brenda Taylor, breast cancer survivor
Reno food server tackles cancer treatment with a generous serving of smiles
When food server Brenda Taylor delivers a meal, she brings something extra to the table.
It's not a bottle of ketchup or Tabasco - though those are available on request.
"I'm always happy, always smiling," said Taylor, 47 and a server at Bordertown Casino and RV Resort, north of Reno. "Work helps, because I just love people, and I love talking to them." No topic is off limits.
In fact, many - even those who aren't regular customers - inquire about Taylor's signature pale pink hat with embroidered pink ribbon, recognizing the universal symbol for breast cancer.
"A lot of customers ask questions about the cancer," she said. "And I'm happy to talk to them. It's amazing how much support you can get from people you don't even know."
They are inquiring about the cancer. But what is evident after even a brief conversation with Taylor is that the real topic is not cancer, but recovery. Taylor has been focused on that idea ever since her diagnosis in September 2009.
"I knew I'd do whatever it takes to beat this thing," she said. "I'm a fighter, I had a lot going for me, and I wasn't about to let this disease win. Not a chance."
After receiving the stage II breast cancer diagnosis, which at the time was isolated to her left breast and lymph nodes, Taylor and her husband, Don, chose a double mastectomy and simultaneous reconstructive surgery. She consulted with many doctors, friends and customers - some she knew, some she didn't - about her options.
"I really didn't want to go through the whole process again if the cancer came back," she said. "The chance of developing cancer in the other breast was one in four, and that seemed too great."
She chose the preventive treatment option, utilizing the resources available at Renown Institute for Cancer to help her aggressively treat and monitor the disease.
She discovered after surgery that she was a candidate for a promising clinical trial, NSABP B-46-I, which was investigating the benefits of adding a drug called bevacizumab, also known as Avastin, to chemotherapy for early stage HER2-negative breast cancer treatment.
"This drug (bevacizumab) works by starving the tumor by blocking some of the vessels it uses to get nutrients and oxygen," said Sowjanya Reganti, MD, who is one of the principal investigators of the clinical trial locally.
"This drug, which has been approved by the FDA for the treatment of breast, colon, lung and brain tumors, has also been effective in treating different types of cancers that have spread to other organs. So now we're investigating this drug to see if it has long-term benefits in preventing the breast cancer from returning and if patients live longer."
The clinical trial has three treatment groups - called arms - into which patients are randomly assigned. The first and second arms provide six cycles of two different types of traditional chemotherapy treatments, which are administered every three weeks.
The third arm offers the addition of bevacizumab administered with traditional chemotherapy treatments. The bevacizumab treatments continue every three weeks past chemotherapy for up to a year.
Taylor notes that she and her husband were optimistic yet thorough when considering whether to participate in the clinical trial. The deciding factor for her was the level of post-treatment follow-up offered through taking part in the clinical trial.
"My husband and I met with Beth (Ahart-Valk, lead cancer protocol nurse for Renown's Institute for Cancer)," she said. "The level of monitoring is what really convinced us."
Participants in the clinical trial are tracked for 10 years after surgery.
"We know the drug (bevacizumab) works in stage IV cancers," she said. "I was stage II. I knew it couldn't hurt, and if they were going to monitor me for 10 years, what's the down side?"
Dr. Reganti acknowledges that the investigational drug has been used to treat metastatic cancers, those that have spread to other parts of the body, which means a more advanced form of cancer. Thus, this study is determining whether the drug also can be used before cancer spreads, extending life and preventing recurrence.
"The medications used in this study have been tried and found effective for other forms of cancer," she said.
"But there are still unanswered questions, and this trial can provide answers that may be helpful for patients in the future and ultimately may change the standard of care."
The ability to benefit from a new treatment that is found effective - even while a clinical trial is ongoing - is a significant benefit to participants.
"If a new agent is demonstrated to work before a study has concluded," Ahart-Valk said, "everyone in the study may be offered the agent, regardless of which treatment arm they're assigned to. We saw this happen in another trial recently. These clinical trials are intended to positively influence standards of care for cancer treatment."
Taylor says she is grateful to those who've supported her on her cancer recovery journey, her husband and Ahart-Valk among them.
"It was a little overwhelming for me," she said, referring to the diagnosis, surgery and discussion of treatment options. "I'm so grateful Don was there to talk with Beth and to help me make good decisions. Beth was just awesome."
Taylor and her family were surrounded by experts at every turn, including her primary oncologist, who encourages patients to learn about access to clinical trials.
"These are leading-edge treatment options available right here in our own community," she said. "There's no need to travel to get treated. Patients can sleep in their own beds, be surrounded by the people they love. It's a wonderful thing that these trials are available right here."
Every three weeks since December, Taylor has spent a few hours undergoing chemotherapy treatments, followed by an intravenous administration of the test agent, bevacizumab.
"If I continue on track, if all continues to go well, I'll have my last chemo on the day before my birthday," she said. "I'm really looking forward to that."
She spends chemo sessions "chit-chatting" with her brother and sister-in-law, sometimes enjoying lunch together.
"I really feel great," she said. "I know a lot of people hear stories about how sick you can be from chemo, but I think we just need to remain positive. Everyone is different in how they handle it."
And now that she's on the mend, Taylor's Bordertown customers typically receive more than they ordered: a healthy serving of her positive attitude.
"I have so much going for me," she said. "My customers are awesome - they even took up a collection while I wasn't working, which I never expected. My boss has been great. They're OK with me wearing a hat, a scarf, a wig or just going bald."
But for Taylor, the hat serves as a visual reminder that she has come a long way in a very short time.
"I'm proud of what I've done, and I'm looking forward to a full, healthy future," she said.
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