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From healer to healing

Trauma ICU nurse fights breast cancer during COVID-19

When COVID-19 cases began spiking in early 2020, Liz De Macedo, RN, stood alongside her fellow nurses to care for the critically ill patients inundating Houston hospitals. A Navy veteran and trauma ICU nurse, Liz had always worked to help people, no matter the circumstances. Grappling with the mental and physical strain of the pandemic and her job, Liz put off her routine health care so she could continue providing care for her patients.

"You never expect anything bad at an annual wellness exam—you just expect another regular checkup,” she says. “Unfortunately, I waited a few months because we were facing so many challenges due to COVID-19.”

In September 2020, Liz managed to squeeze in an appointment with her gynecologist. What started out as a routine exam turned upside down when her physician found a lump in Liz’s breast. After receiving an MRI and biopsy, Liz got the news: She had breast cancer.

“My mind started drifting to all the worst-case scenarios,” she recalls. “Even though I work in health care and knew I had good chances for survival, we were living in a pandemic. Would I be able to get treatment in time? Would clinics close again?”

With no family history of cancer—and negative genetic tests for known breast cancer genes—Liz’s shock at receiving a cancer diagnosis quickly shifted into a plan of action.

To remove the growing tumor in her breast, she needed surgery. With the resources of the Texas Medical Center at her fingertips, Liz wanted to find the best surgeon available, so she turned to her colleagues for recommendations. In conversations with physicians and nurses in the ICU, one name kept coming up.

“Everyone told me to go see Dr. Robinson at UTHealth,” she says. “When so many amazing health care workers are telling you how great a surgeon is, you have to listen.”

When Liz met Emily K. Robinson, MD, her worries about treatment options were quickly addressed. Expecting radical surgery like a double mastectomy, Liz learned about new surgical techniques that improve patient outcomes without removing the full breast.

“I’m an ICU nurse, so I knew just enough about breast cancer to really worry,” Liz says. “But Dr. Robinson’s tremendous calm when describing my surgical treatment options and prognosis put me at ease.”

“Thanks to a routine wellness exam, we caught Liz’s cancer early,” Robinson says. “As a result, I was able to recommend breast-conserving surgery to remove her tumor, followed by radiation therapy to ensure no cancer cells remained.”

Just over a month after being diagnosed with cancer, Liz underwent surgery. Robinson and her team successfully removed the tumor on October 30, 2020, and biopsied one of Liz’s lymph nodes to ensure the cancer had not spread to other parts of her body. With a cancer-free biopsy result and an easy recovery, Liz began receiving regular radiation treatments in November 2020.

“Dr. Robinson and her team did an amazing job,” she says. “My scar looks great, and I experienced minimal discomfort during the healing process.”

While less intensive than some other cancer treatment options, surgery and radiation can still take a heavy toll. For Liz, who spends her days caring for the sickest patients in the ICU, her medical team encouraged her to take leave from work.

“It has been very challenging to sit at home while I see so many people needing help during the pandemic,” she says. “I’ve had to focus on healing and helping myself instead, which doesn’t come naturally to me.”

Liz has also spent the last year focused on finding joy: She and her partner of 12 years, Kenan Acar, got married in early October 2020.

“This year has shown us how precious and fragile life can be,” Liz says. “We decided to make a reason to celebrate despite everything that’s going on around the world.”

Liz finished her last radiation treatment during the final days of 2020 and celebrated the new year cancer-free. With overwhelming support from her friends and family, she soon returned to work in the ICU.

“For so many people in the medical profession—like my coworkers and Dr. Robinson—helping others is a true calling,” she says. “That holds true for me too, and I am so thankful to continue doing what I love.”

A new tool to spot pediatric cancer symptoms

From learning to ride a bike to making new friends, childhood is filled with endless possibilities. But for more than 300,000 children around the world, a cancer diagnosis will limit their activities this year. Rather than playing sports or going to school, they will spend time in hospitals undergoing cancer treatments that can bring debilitating side effects.

“How we report and manage cancer symptoms and treatment side effects impacts a child’s quality of life,” says Stacey Crane, PhD, RN, a certified pediatric oncology nurse. “But communicating a child’s symptoms to physicians can be a complicated process.”

Patient-reported outcome tools—systems in which patients or their families directly report symptoms to their health care team—have advanced how health professionals manage cancer treatments. However, many of these tools are complex, involving countless questions about symptoms that many patients may never experience. For a family caring for a child with cancer, it can be too much.

“My goal is to develop a straightforward symptom reporting tool that does not overlook anything a child with cancer may experience,” says Crane. “There is no single journey for young cancer patients, so we have to be creative in our approach.”

With the support of a grant from St. Baldrick’s Foundation—the foundation’s first award to a nurse-scientist—Crane is working to develop a platform for reporting pediatric cancer symptoms. By creating a visually engaging app called the Smart Pediatric Oncology Tracker of Symptoms (SPOTS), Crane hopes to make symptom reporting accessible to patients of all ages.

“On the SPOTS app, children will be able to report symptoms to their physicians by simply pointing to areas of the body or identifying activities where they are having difficulties,” says Crane. “Children often use a different vocabulary than adults, especially for things like body parts, so we have also included a comprehensive search function.”

Crane hopes that the new system will give physicians a better understanding of pediatric cancer symptoms, helping to improve the quality of life for children battling cancer.

“Pediatric cancer is considered a rare disease, so federal funding for research like this remains quite limited,” says Crane. “Philanthropy provides the resources we need to give children with cancer the best possible outcomes.”

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From healer to healing
From healer to healing