Tag Archives: Lexington Oncology

Breast Cancer Genetics: Three Sisters, Two Genes, One Goal

Bridgett Mitchell of Lexington was diagnosed with breast cancer at Lexington Medical Center in January at just 40 years old. Doctors discovered four suspicious spots during a routine mammogram. Bridgett is a mother of four – her youngest child is in preschool.

Hope and Bridgett

Women’s Imaging Center wanted me to come back the next day for a biopsy; I got the call three days later that it was cancer,” Bridgett said. “Everything moved rather quickly from there.”
Breast cancer is no stranger to Bridgett’s family. Her older sister Iris was diagnosed with the disease in 2008 at age 41.

With two sisters diagnosed with breast cancer at a young age, the family decided to have genetic testing.
The Genes
Researchers have been able to test for genetic factors on the BRCA1 and BRCA2 genes that indicate a higher risk of breast and ovarian cancers. These gene mutations can be inherited from a person’s mother or father, and are the strongest inherited risk factor known for cancer risk in women.

The family’s genetic testing results raised even more questions. Bridgett tested positive for the BRCA2 gene. Iris tested negative. And then there was their sister Hope.


Hope, age 47, has never been diagnosed with breast cancer. But her genetic testing results revealed her odds of getting breast or ovarian cancer before age 70 were more than four times greater than women in the general population.

Steven A. Madden, MD, of Lexington Oncology, a Lexington Medical Center physician practice, is Bridgett’s doctor. He said the sisters’ story provides a valuable lesson.

“Even if you test negative, if you also have a strong family history of cancer, it’s a good reason to be more diligent in your ongoing screening.”

According to Dr. Madden, having a gene mutation is a very strong indicator of elevated breast cancer risk. So much, that many patients choose preventive surgery.
Bridgett’s diagnosis and positive genetic test results led Dr. Madden to advise her to have a double mastectomy.

“He said there’s an increased chance I would have breast cancer again if I didn’t,” Bridgett said. “We also found that two of my lymph nodes were positive, so it was spreading.”

In addition to the surgery, Bridgett opted for chemotherapy and radiation, plus a hysterectomy to eliminate the risk of ovarian cancer.

“Simply because of the mutation, he recommended a more aggressive treatment,” she said.

Steven A. Madden, MD

According to Bridgett, learning she had a BRCA mutation was helpful. “I consider it to be knowledge, and knowledge is power,” she said. “It makes you more mindful of what you’re doing and helps you stay on the right track. You try to make the best choices that you can, and then pray about the rest.”
Bridgett said she hopes her 7-year-old daughter will have genetic testing when she turns 18 so she will have the information she needs to make the right decisions.
While Iris does not have the BRCA mutation, her cancer diagnosis has led her to change her diet and exercise habits. Genetic testing did provide some relief.

“I have a daughter, and I was concerned about passing it on to her. The test resolved that stress,” she said.
Without a gene mutation and because Iris’ doctor was able to surgically remove all the cancer, her risk of recurrence was estimated at about 7 percent.

“Genetic testing can help you be proactive in finding the best approach to treatment. It may save your life.”
Although Hope never had cancer, her positive genetic testing spurred action. With the recommendations of her doctor and a genetic counselor, Hope underwent surgery to remove all of her breast tissue and a hysterectomy, which will greatly decrease her risk of cancer.

“My gynecologist and my family doctor both thought it would be in my best interest to go that route,” said Hope, a mother of five who also lives in Lexington. Hope’s daughter has tested negative for the breast cancer genes.

Hope also began eating more fruit and vegetables, cut back on bread and pasta in her diet and started walking three to five miles almost daily.

“Cancer can occur in different parts of your body, whether I had a mastectomy or not. I believe I’m doing all the things I need to do to prevent that.”

Finding Friendship While Fighting Cancer

Daniel Stevanus faces adversity with a level head. So when doctors diagnosed him with testicular cancer in March 2016, one day before his 30th birthday, his first thought was, “OK. What’s next?”

“That’s how I tried to face each day during my treatment. What do I have to do today? What is next in my journey?”

Testicular cancer can affect men ages 18 to 30, and it is very curable.

Daniel’s treatment started quickly after his diagnosis. He had surgery to remove the tumor a week after having his first sonogram and started chemotherapy at Lexington Oncology, a Lexington Medical Center physician practice, four weeks later. It was during chemotherapy that Daniel found a friend in John Ezekiel, PharmD.

John is the infusion oncology pharmacist at Lexington Oncology. He is also a member of Mt. Horeb United Methodist Church in Lexington, where Daniel serves as a youth pastor.

“Mt. Horeb is such a large church, and my kids are not quite middle-school age, so I hadn’t had the opportunity to meet Daniel. When he arrived at Lexington Oncology, I introduced myself, and we had an instant connection. Today, we see each other at church and always share a fist bump or a hug,” said John.

Daniel had four rounds of chemotherapy in three months. Every time he was at the hospital for treatment, John made sure to check on him. They talked about their church, soccer games, medicine and cancer.

“John was incredibly helpful throughout my treatment. He would explain what the medicines were doing, how they were affecting my body and what I could expect. He told me how chemo was like a crew of bulldozers, moving and shifting things inside of me, and how my body would feel the effects from the previous week,” said Daniel. “Our conversations were the best part of my days. I like knowing how things work and understanding the ‘why’ behind decisions, and John provided those answers for me.”

As an infusion oncology pharmacist, John manages the compounding or personalization of chemotherapies. Although he primarily provides behind-the-scenes patient care, John enjoys interacting with patients.

“As more therapies become available orally, pharmacists are able to have more patient-counseling opportunities,” said John.

Lexington Oncology will open an on-site retail pharmacy in 2018 to dispense oral oncology medications and other medicines patients may need during treatment, giving John and other oncology pharmacists the opportunity to be more involved in direct patient care.

“The men and women at Lexington Medical Cancer Center are incredible folks – from the receptionists learning my name to the interactions with the nurses, my doctor and his assistants. In my experience, the road to recovery was long and not fun. Having people come alongside me made it just a little bit easier,” said Daniel.

He also found support from his community.

“I found so much strength and encouragement from my church. They checked on me weekly and prayed for me the whole time. They also gave me rides to the hospital. Most of the time, I had someone new driving me to my appointments. The nurses and receptionists would even tease me about having someone new with me at almost every visit,” said Daniel.

As a cancer survivor himself, John admires how Daniel put his faith into practice throughout his diagnosis, treatment and recovery.

“Receiving a cancer diagnosis is incredibly difficult to process when you are the one who has cancer. Daniel chose to fight with his faith and not bear the burden of a cancer diagnosis on his shoulders,” he said.

“I believe that God is the source of my strength, so I trusted in Him,” said Daniel. “When I didn’t feel as though I had enough trust in the moment, I would pray and ask Him to provide for me and help me through the situation. And He was with me every step of the way.”

Every patient chooses to fight cancer in his or her own way. John thinks of fighting cancer like running a marathon. Patients may start the race with a lot of support and motivation, but they may also feel alone at times.

“We all have what I call a ‘Mile 17’ in life, and we have to choose to keep running or quit. We have to remind ourselves that life is worth the fight, especially when you are near the finish line and hear the loud cheers of those in your corner. I like to think that the Lexington Medical Cancer Center team will always be the loudest cheering section.”

An Update on Daniel
In March 2017, almost a year to the date of his original diagnosis, doctors discovered an enlarged lymph node during a routine CT scan. A biopsy detected traces of different cancer cells. This summer, Daniel had retroperitoneal lymph node dissection surgery at the Medical University of South Carolina in Charleston. His most recent CT scan showed nothing abnormal in the affected area, but his doctors will be monitoring a lung nodule during the next few months. Read more about Daniel’s fight against cancer on his blog at DanielStevanus.com.

And Then There Were Three!

Lexington Medical Center’s commitment to meeting the health care needs of its community continues with the completion of Lexington Medical Park 3. Located at 155 North Hospital Drive, this five-story, 175,460-sq-ft medical office building on the hospital’s main campus opened in August. It will be the new home of Lexington Brain and Spine Institute, Lexington Women’s Care and Lexington Oncology.

Lexington Brain and Spine Institute occupies suites 100 and 200, which make up half the building’s first floor and all its second floor. The new office features digital X-ray, four procedure rooms, a physical therapy gym and private physical therapy rooms. Lexington Brain and Spine Institute moved into its new location August 15.

Lexington Medical 3 building.

“Our new office space has nearly 40,000 square feet that will allow us to provide comprehensive and multidisciplinary care from day one of a patient’s symptoms to resolution. We have physical therapy, imaging, physiatry, pain management and neurosurgical services all within one office, providing both convenience and high quality medical and surgical care. We look forward to showing our new office to our existing and future patients,” said C. Philip Toussaint, MD, FAANS, neurosurgeon at Lexington Brain and Spine Institute.

Lexington Women’s Care moves into its new office on September 18. The practice, located in Suite 300, feature four labs, four ultrasound rooms, education and Centering™ rooms, and two procedure rooms. Suite 300 occupies the entire third floor of Lexington Medical Park 3.

Lexington Medical 3 building.

Lexington Oncology plans to move to the fourth and fifth floors (suites 400 and 500) of the new medical park in March 2018. With more than 60,000 square feet, the practice will be able to expand its infusion area from 40 infusion chairs to 68 infusion chairs, add another chemotherapy hood and an additional non-chemotherapy hood to the IV pharmacy and provide oral chemotherapy and support medications to patients through an in-office retail pharmacy.

Lexington Oncology will also add a 64-slice CT scanner and a five-ring PET/CT scanner, and expand its laboratory to accommodate future equipment for hematology, chemistry and genetic tumor marker testing. 

“Lexington Oncology is the only nationally certified Quality Oncology Practice Initiative® practice and Duke Medicine affiliate in the Midlands. These expansions will allow us to provide a multitude of enhanced and new services under one roof to better meet the needs of our growing patient population,” said Jon Bridges, MHA, CMPE, practice administrator for Lexington Oncology and Lexington Radiation Oncology.