Navigating brain cancer treatment with skill and compassion

The brain is extremely delicate, and treating cancers of the brain requires exceptional skill. When faced with a diagnosis of stage 4 lung cancer with brain and bone metastases in 2019, Francine Maigue turned to her medical team at Sharp HealthCare.

Francine had been responsive to targeted oral therapy and radiation. However, with the development of leptomeningeal disease — when cancer spreads to the fluid meant to protect the brain and spinal cord — she had surgery to implant the Ommaya reservoir at Sharp Memorial Hospital.

The Ommaya reservoir is a device placed under the scalp and connected to a catheter inserted through center of the brain. It’s used as part of treatment for patients with certain types of brain cancer. The reservoir can be used to withdraw cerebrospinal fluid to test for cancer cells, as well as deliver chemotherapy directly to the cancer source.

Francine is the first patient to receive treatment through an Ommaya reservoir at the Douglas & Nancy Barnhart Cancer Center at Sharp Chula Vista Medical Center, where she goes twice a week for chemotherapy treatment and testing.

“Francine had been having headaches, which is how I knew there was something different about her diagnosis,” says Dr. Mariela Macias, hematologist-oncologist at Sharp Rees-Stealy Medical Centers. “We identified a mutation in the EGFR gene, which was causing her cancer to grow. Having this knowledge allowed us to put together a very specific and targeted treatment plan. One component is the Ommaya reservoir, which allows chemotherapy medications to be delivered directly to the cancer source (called intrathecal chemotherapy, or IT chemo), versus oral or intravenous medication, which can’t get through the brain’s protective layers as easily.”

Nurses partner with colleagues to prepare for treatment
Francine’s nurses at the Outpatient Infusion Center at Sharp Chula Vista wanted to be fully prepared to support her through her treatment, so they received mentoring from their fellow nurses at Sharp.

“It helped us tremendously partnering with the nurses at Sharp Memorial Hospital,” says Maria Theresa Hermosura, RN, lead clinical nurse at the Outpatient Infusion Center. “When a patient comes to Sharp, they know they have a team working hard for them and with them, and that includes across hospitals. We received excellent training and were ready when Francine arrived for her first treatment.”

“In addition to the clinical care we provide, we know how important it is to give emotional support to our patients and their loved ones,” adds Jennice Tolentino, MSN, RN, lead clinical nurse on the 5T PCU Oncology unit at Sharp Chula Vista. “We call chemotherapy ‘little bags of hope.’ Patients should feel that hope and know there are plans, that this is a battle, and we are with them every step of the way.”

Cancer care that’s more than just clinical
For Francine, coming to the Outpatient Infusion Center at Sharp Chula Vista feels like being with family. She is close with the nurses, and has given snacks and goodie bags to thank them.

Francine is also close with her fellow patients, for whom she always wants to show support. When the new expansion of the infusion center opened, Francine donated fairy bears to be hung on the IV poles and added an inspiring poem she personally wrote for her fellow warriors to read while receiving treatment. On her milestone 40th birthday last year, Francine donated care packages complete with letters for each recipient.

“We’ve become pen pals! We have to celebrate every day and find sources of hope and meaning in each of the days that we’re gifted,” Francine says. “I gave my fellow warriors care packages with tools to help with common side effects, like ginger tea for nausea, moisturizer for dry skin, journals to release thoughts or jot down appointment notes, and other items to help them feel good, empowered and connected. Cancer can be isolating, especially during a pandemic. It’s important that our circle of warriors be reminded that there are people who really understand what they’re going through and are fighting alongside them in every way on this challenging journey.”

This was the first time Francine had heard of an Ommaya reservoir. It was important to her that others in the community be educated on this option for testing and treatment, especially when it’s available close to home for patients in the South Bay at Sharp Chula Vista.

“I got emotional the first time I saw them draw the fluid from my head so easily, through the Ommaya,” Francine adds. “I had six lumbar punctures prior for draws of cerebrospinal fluid and to receive chemotherapy. While I am grateful for every treatment and every patient is eligible for different options, having an Ommaya has been a game changer for me. When my health care heroes care for me like family, all options for treatment are presented to me, and my fellow warriors have become friends, I don’t feel alone or hopeless. No cancer warrior should.”

“Francine fights really hard, and she’s educated about her disease. We’re a team in this,” says Dr. Macias. “It’s special that we’re able to bring the Ommaya reservoir and intrathecal chemotherapy to patients in the South Bay to give them the care they need close to home.”

June is National Cancer Survivor Month. Every current patient with cancer is also considered a survivor. Francine wishes every cancer warrior, their support systems and medical teams the very best this month and beyond.