Latest news with #biopsy
CNA
a day ago
- Health
- CNA
She's not a designer – but this public servant leads the charge to put Singapore design on the world stage
Long before she became the head of Singapore's national agency for design, DesignSingapore Council's Dawn Lim already experienced the cost of bad design – during the two decades she spent as a caregiver to her late parents. In a local hospital just last year, Lim had to collect a biopsy sample taken from her father. A biopsy is a medical procedure where a tiny portion of body tissue is taken to be examined in a lab. It's often used to check for diseases like cancer or better understand abnormal growths and conditions. The process, in theory, sounded simple: Go to the clinic, get the forms signed by his doctor, then let the hospital take over. In reality, the doctor told her to take the forms to the medical records office. 'I asked, 'Well, why can't you just send it over?' To me, that was the logical assumption, as (the staff) should know the hospital better than me,' the 43-year-old recalled. The response was clear: She'd requested for the biopsy, so she had to bring the forms to the office herself. After a bout of 'challenging' wayfinding through the hospital, she found the office in the basement – only to be asked which type of slide the biopsy sample should be placed on. 'I said, 'I have no clue because the doctor ordered it, and it's going to the lab for a test, right?'' Lim said. 'And the staff replied, 'Yeah, but I need to know which slides you want.'' Lim asked if they could call the clinic to check – and was told, again, that she had to make the call herself as the requester. But the hospital being a public one, the phone lines were near impossible to get through. She had no choice but to choose a slide herself, picking from what made more sense. She was also told to expect a call to 'collect the slides' eventually. The biopsy sample, or body tissue, is placed on glass slides before being sent to a pathologist who examines the cells for diseases. 'So I asked, 'Why am I collecting them? Shouldn't they be sent to the lab?' I also tried asking them to call the clinic instead. Both times, they told me: 'You are the requester.'' Now able to laugh about her situation, Lim told CNA Women: 'And what was I supposed to do with the biopsy slides then? Put them in my fridge?' The executive director of DesignSingapore Council since May 2022, she now recognises the design-related pain points in her experience. The agency is a subsidiary under the Singapore Economic Development Board (EDB), which is itself a statutory board under the Ministry of Trade and Industry. DesignSingapore has what she calls both 'social and economic mandates'. The first looks at the urban environment – how people live and interact in public and private spaces, how social organisation works, for instance. The latter is about how design can make businesses more competitive and innovative. Though Lim isn't aware if the hospital's process has changed since, she believes it was likely designed for 'optimal efficiency' within the institution by allowing the requester, usually the patient or caregiver, to take full ownership of their request – but overlooked the very same patient or caregiver's journey. In the end, she got through to the clinic and they sorted it out. She didn't have to collect the slides – but the experience stuck with her. 'Generally with sickness, it's already a very stressful situation. To navigate an institution's bureaucracy adds even more stress. I'm English-speaking so I can ask the right questions and try to manoeuvre around – but what if somebody else isn't?' she said. 'That informed a lot of my personal conviction about why good design is so important to us as a society, especially with an increasingly ageing population.' THE GOOD AND BAD OF EVERYDAY DESIGN Good design targets decision making and removes 'cognitive load', Lim believes. It should make 'everyday lived experiences' feel easy and seamless. And perhaps it begins with first noticing what doesn't work and why. Bad design is 'very easy to spot', she said – such as in the inconvenience and frustration she suffered navigating a hospital's system as her late father's caregiver. One of her pet peeves is locked wheelchair-accessible toilets in shopping malls. It's a practice driven by a fear of misuse, which she understands, but it ends up excluding those who need it the most. 'If someone with incontinence cannot wait 10 minutes (for the mall's staff to unlock the toilets), it becomes an embarrassing situation for them. It removes their dignity in a really challenging situation that they may face daily,' she said. Another instance of lacking design is the bustling intersection of Orchard Road and Scotts Road, which she often frames in a thought experiment: How might an able-bodied person cross from Wheelock Place to Tang Plaza? And how would, say, a wheelchair user or a parent with a pram do the same? An able-bodied person may take the escalator from the ground floor of Wheelock Place to its basement – it links to Orchard MRT station, which has an exit leading up to Tang Plaza. For a wheelchair user or parent pushing a pram, however, 'it's not so straightforward', she said. They may have difficulty even locating the lift in Wheelock Place to start. 'This is just a small example of how we don't always realise many things that are in our everyday places and spaces are not fully inclusive or accessible.' Good design, on the other hand, is often invisible 'because you almost live through it smoothly', Lim said. 'We don't always notice or appreciate it.' The app – a 'genius idea' – that allows drivers to pay for parking with a mobile device is her personal favourite. 'If I'm (held up), I don't have to leave where I am to walk back to my car to put another coupon. I just go onto the app and extend (my parking duration),' she said. 'It makes it easier for the user to get on with life.' And she often points to Changi Airport's unparalleled efficiency – the fact that you could spend less than 10 minutes from plane to cab – as a tangible example to educate others that good design is everywhere. 'Then, people get it. Raising awareness of our daily lived experience and how design shows up in the most innocuous ways tells a lot of the story itself,' she said. More recently, Singaporean designers showcased a spectrum of possible everyday design applications at Milan Design Week in April from furniture to medical technology, she added. A highlight was the 'digital twin' – a virtual replica of a real-world entity – of Changi General Hospital's (CGH) emergency department. It was designed by CGH and Singaporean companies, multi-disciplinary design agency Farm and cross-technology company Vouse, to enable the hospital to rethink operations and improve patient experience. Through simulations, the hospital would be able to see how people move around, how staff make decisions and how to deploy resources, among other scenarios. This makes it easier to find better ways to deliver care. 'Many people have the misconception that design equates to nice things, but nice things also need to work nicely. You can have both – it is not mutually exclusive,' Lim said. 'Let Singapore surprise you. We have more to offer than you would expect.' TAKING SINGAPORE DESIGN GLOBAL Unlike three of her four predecessors who were architects, and the fourth who worked briefly in a global design consultancy, Lim had no formal background in design. What she had was over a decade of experience in EDB – DesignSingapore's parent organisation and the lead government agency responsible for enhancing Singapore's position as a global business centre. While her role at DesignSingapore now requires her to dive deep into design knowledge, her prior stint at EDB taught her complementary skills by thinking about innovation 'very broadly'. This included how design was applied across research and development, product, and service areas among other functions. Her scope at EDB, including overseeing the independent execution of the agency's strategy and operations in Europe, taught to see the big picture to ensure Singapore was always 'internationally competitive'. 'That mindset is probably something quite embedded that I took with me into this role: What is Singapore design's competitive edge in the world? And what can we stand out for?' she said. FINDING THE COURAGE TO BE CREATIVE Putting Singapore design on the global stage, however, requires a fundamental mindset change involving creative confidence, competence and courage. 'Many people like to say Singaporeans are not creative … but we are very competent creatively. The fact that this country makes so many things work is creative,' Lim said. Singaporeans do have 'small 'c' creativity', she added. 'It's actually there every day. You look at these ground-up initiatives like Repair Kopitiam.' The community-driven programme encourages repair culture by getting people to first consider fixing their broken item before throwing it away. As for 'big 'C' creativity', she pointed to the NEWater process, which recycles Singapore's treated used water into ultra-clean, high-grade reclaimed water. 'So we have both ends of the spectrum of creativity. It's not that we're not creative, but we also must know how to recognise it exists in many different forms.' This starts with understanding what we mean when we talk about 'creativity', Lim noted. On one hand, there is the 'Silicon Valley type, where every day there's a startup that's invented and you hope that one of them becomes the next Facebook or Google'. On the other, there is 'creativity in terms of making changes to the everyday', she added. 'And I think there's space for both.' The issue is that Singaporeans often 'don't have enough courage to try', she believes. 'But the very definition of creativity means you must try and take risks. And when you don't practise it, you cannot build confidence. Then it becomes a cycle.' So she's convinced the 'crux of creativity' lies in not knowing the outcome but trying anyway – and knowing it is okay to get it wrong many times before finally getting it right. Importantly, this mindset shift starts from as early as primary school. The organisation's Learning By Design initiative brings together students, educators and sometimes parents to tackle a challenge within the school or wider community. In 2023, St Joseph's Institution students noticed 'quite a lot of elderly men lounging by themselves alone at kopitiams (coffee shops)' in Toa Payoh, and set out to create a 'community space' to address their social isolation. As with any discipline, there are professional qualifications and training in design, but there's also the aspect that's about encouraging 'a mindset of creative thinking that everybody can exercise', Lim explained. For when it works, good design makes all the difference. In healthcare, for example, it would involve training practitioners to deliver the human touch at critical points in the caregiver's journey, she added, speaking from experience. Eighteen months into her late father's treatment, she was referred to a palliative care institution. The first thing the chief medical officer asked: 'How are you doing as a caregiver?' 'Nobody in the entire journey of 18 months had ever asked how I – as the primary caregiver – was doing. And wow, that just changed the entire conversation,' she said. 'It wasn't about providing information. It was just someone acknowledging, 'Actually, it's hard on you, we know. We'll take care of you. We'll take care of your father.''
The Sun
4 days ago
- Health
- The Sun
Thousands of Brits had ‘organs removed unnecessarily' while cancers were missed in major hospital errors, NHS says
THOUSANDS of breast cancer patients may have had unnecessary mastectomies or had their cancer missed, a major investigation into a hospital trust has found. The County Durham and Darlington NHS Foundation Trust said it was "truly sorry" after it was revealed that some women under its care had "more extensive surgery than was clinically necessary at the time". 4 4 The probe also found that some patients' tumours were missed after they received the wrong kind of biopsy. Others weren't offered chemotherapy or had lymph nodes removed when it wasn't clinically necessary. The review has so far identified 200 cases where errors in care might have occurred. But the trust said thousands of cases dating back to 2019 could come to light and that a number of deaths were also being looked into, according to the BBC. Patients affected mainly received care at the University Hospital of North Durham, one of the hospitals the trust operates. Kathryn Burn, executive director of nursing, said: 'We know that some patients have not received the standard of care that we would want for them, or that they deserve. "We have identified areas where improvement was needed – including how surgical decisions were made, how our multidisciplinary teams worked and where some outdated practices were still in use. 'For some patients, this may have resulted in more extensive surgery than was clinically necessary at the time. "We fully recognise how distressing this is to hear, and we are truly sorry." Kathryn said changes were already being made to improve breast cancer care in the trust's hospitals. Jessie J breaks down in tears in heartbreaking hospital video as she has surgery after breast cancer diagnosis This includes appointing two new consultant breast surgeons and investing in more modern equipment. County Durham and Darlington NHS Foundation Trust launched a review into its breast cancer care services in February 2025 after "a patient safety incident", it said in a statement published on its website. It also commissioned an external review conducted by the Royal College of Surgeons (RCS). This followed a Northern Cancer Alliance peer review completed between April and June 2024, which suggested the trust was "an outlier in some aspects of breast care delivery". 4 The RCS team visited hospitals in January this year and published their report in April. It revealed that some patients had mastectomies that may not have been necessary. Some received the wrong kind of biopsy - procedures that check if a tumour is cancerous. In one case, RCS said clinical records showed this led to "a small breast cancer" being missed and "subsequent delays in diagnosis and treatment". The report also identified incidents where chemotherapy should have been offered to patients when it should have and "there was no documented reasons in the surgical or multidisciplinary team notes as to why it was not received". In addition, some patients had surgery to remove lymph nodes when not clinically necessary. The RCS made 21 recommendations for improvements in its report. The trust also conducted its own "look back exercise" into breast cancer care at its hospitals, which is still ongoing. What are the signs of breast cancer? BREAST cancer is the most common type of cancer in the UK. The majority of women who get it are over 50, but younger women and, in rare cases, men can also get breast cancer. If it's treated early enough, breast cancer can be prevented from spreading to other parts of the body. Breast cancer can have a number of symptoms, but the first noticeable symptom is usually a lump or area of thickened breast tissue. Most breast lumps aren't cancerous, but it's always best to have them checked by your doctor. You should also speak to your GP if you notice any of the following: a change in the size or shape of one or both breasts discharge from either of your nipples (which may be streaked with blood) a lump or swelling in either of your armpits dimpling on the skin of your breasts a rash on or around your nipple a change in the appearance of your nipple, such as becoming sunken into your breast Source: NHS It found "two cases in which patients were initially discharged from the service following a diagnostic test but later re-represented with cancer that was missed on the first occasion". It also flagged instances of "excessive surgery, unnecessary invasive surgery and a failure to consider all options, including breast reconstruction". Areas where improvements were needed included how surgical decisions were made and ending the use of outdated practices, the trust said. Kathryn said: 'Over the past four months, we have been reviewing the care of patients who had surgery through the breast service in 2024. "Where we have concerns about the care a patient received, we are contacting them directly and personally about this. "Patients whose care has been reviewed and found to be appropriate are also being contacted to provide reassurance. "Since February, we have reviewed – with the support of external experts – 123 individual cases of care. "We have spoken with more than 80 patients to openly discuss elements which could have been done differently and been improved. 'This work is not yet complete, and we continue to review patient notes. "We have also set up a patient call line and email address where any patients who have questions or concerns about their care can get in touch with us to share their experience.' 4 Kathryn told the BBC that the trust was looking at the investigation"from a clinical urgency perspective" and it had made "a lot of improvements". "We are looking back systematically through clinical priority where we feel there might be more risk to our patients," she said. She added: 'We are incredibly grateful to the patients who have taken the time to speak with us, to share their experiences and to raise concerns. "Listening to these experiences has been a vital part of learning and improving. 'The review is still ongoing and we remain committed to speaking directly with any patient whose care warrants follow-up.
Medscape
21-07-2025
- Health
- Medscape
Breast Growth: Cancer or Coincidence in 42-Year-Old?
A 42-year-old woman presented with an atypical enlarging breast mass over the course, which initially raised suspicion of a serious condition but resolved spontaneously. Initial physical examination revealed skin ulcerations and nipple retraction, raising suspicion for inflammatory breast cancer. Biopsy revealed acute and chronic inflammation, granulation-type tissue, and focal granuloma with suppuration, but no evidence of malignancy. With the diagnosis still unclear, the patient was asked to return within 1 month. However, upon her return, the breast mass and positive axillary lymph node had decreased in size significantly, with ulcerated areas showing signs of healing. The case reported by Junisha Martin, a medical student at Ross University School of Medicine in Miami, highlighted the importance of considering a wide range of potential diagnoses. The Patient and Her History The patient with no significant past medical history presented with an enlarging 4.5 cm mass over 2.5 months in the right breast. The patient disclosed that 2 years ago, she had experienced a lemon-sized lump in her right breast that had persisted for approximately 2 months. The mass was accompanied by small superficial ulcerations on the overlying skin and occasional discomfort. The mass completely resolved during that time, and no medical treatment was sought. Six months later, the mass returned to the same location and increased in size, with ulcerations in the areolar region. The patient declined to undergo mammography during that time because of the discomfort of the areolar lesion. The past surgical history consisted of three prior caesarean sections. The patient denied any allergies, smoking, recent travel, pets at home, or use of topical creams and ointments on the affected area. The patient denied any significant family or social history. Findings and Diagnosis On admission, patient vitals were obtained and reported normal: temperature 36.8 °C, blood pressure 132/88 mm Hg, heart rate 84 beats/min, respiratory rate 19 breaths/min, and oxygen saturation 99% on room air. She was alert and in no acute distress on physical examination. Physical examination revealed that the large right breast mass had decreased in size significantly. The mass now measured 3 cm from 4.5 cm and was non-tender, with minimal nipple retraction and healing ulcerations and scars with improving skin discoloration. The patient was scheduled for an ultrasound-guided core biopsy of the right breast and right axillary lymph node due to a high suspicion of malignancy, instead of fine-needle aspiration cytology. A core biopsy of the right breast at 12:00 revealed acute and chronic inflammation, granulation-type tissue, and focal granuloma with suppuration. Immunohistochemical tests were negative for carcinoma. A right axillary lymph node biopsy revealed sinus histiocytosis and acute non-specific lymphadenitis but no evidence of malignancy. During the follow-up visit after 1 week, the patient reported feeling well, with mild soreness at the biopsy site. Repeated physical examinations were consistent with an enlarging areolar breast mass with skin ulcerations and nipple retraction. The right breast was moderately tender on palpation. Due to the discordance between the pathology report and physical examination, a repeat ultrasound-guided biopsy was recommended for further management. No medications were prescribed to the patient, and conservative measures were taken because the final diagnosis was not confirmed. Upon repeat biopsy, physical examination revealed that the large right breast mass had decreased in size significantly. The decreasing size of the lesion (mass effect), decreasing size of the lymph node, and the nature of the ulcer now healing ruled out inflammatory breast cancer, and the physician suspected an idiopathic aetiology, instead of an inflammatory or infectious cause of this patient's presentation. A multidisciplinary approach was established for the patient, with a primary care physician and surgeon for further management if there were signs of disease progression. Discussion 'This case illustrates the diagnostic challenges of inflammatory breast lesions with overlapping clinical presentations. While initial findings suggested inflammatory breast cancer, biopsy results were negative for malignancy, pointing towards a benign inflammatory or infectious aetiology, such as idiopathic granulomatous mastitis or cat scratch disease. The spontaneous improvement after conservative management provided further evidence against a malignant process. This case reinforces the need for interdisciplinary collaboration, and further research into inflammatory breast pathologies is vital. Maintaining an open perspective and integrating all available data are essential when evaluating breast masses, facilitating timely diagnosis, and preventing unnecessary aggressive treatments. This case concluded without a definitive diagnosis, highlighting the importance of flexible management guided by clinical improvement in complex presentations,' the authors wrote.
Yahoo
19-07-2025
- Health
- Yahoo
Woman thought she had a pulled muscle working out. It was a rare cancer.
Jennifer Frederick was in the best shape of her life in 2023, so when she felt a small lump in her groin area after a week of workouts. She thought it was just a pulled muscle, but a month later, the lump was still there. Four months later, the lump was growing. Frederick went to a dermatologist and testing found more lumps in her leg. She scheduled a biopsy. On December 14, surgeons cut into her leg and removed the largest lumps. A week later, she had a diagnosis: Metastatic malignant melanoma. The disease is usually heralded by a mole on the skin, but Frederick never had one. More tests showed the cancer wasn't just in her leg. One scan found four lesions on her lungs. Another found five lesions on her brain. The results were shocking, Frederick said. "I never had a migraine, headache, blurry vision, never had problems breathing, never had a cough," Frederick, 50, said. "I never felt off at all." What is metastatic malignant melanoma? Melanoma is the deadliest form of skin cancer. Metastatic melanoma is any time of cancerous melanoma that has spread from one location to another, said Dr. Michael Postow, a medical oncologist at Memorial Sloan Kettering, who was not involved in Frederick's treatment. Metastatic malignant melanoma refers to late-stage metastatic melanoma. "Melanoma is a kind of cancer that can spread pretty widely throughout the body," Postow said. "It's one of the cancers that frequently involves the brain, so spread from melanoma to the brain ... can be quite a common occurrence. The lung is also a common site of metastatic melanoma." Typically, melanoma is recognized by a brown or black mole on the skin. Postow said it's unusual but not unheard of for a patient to have no mole or a "microscopic" one. He said that in addition to keeping an eye out for a new mole or an existing mole that changes color, size or texture, people should watch for lumps under the skin like the one Frederick had. Any concerns should be brought to a dermatologist, Postow said. The five-year survival rate for patients with advanced metastatic melanoma is about 35%, according to the American Cancer Society. Postow said clinical trials show that for patients who receive certain immunotherapy treatments, that number rises to 50%. Just a decade ago, the five-year survival rate was closer to 10%, he said. Immunotherapy was what Frederick's doctor, Cleveland Clinic medical oncologist Dr. Lucy Boyce Kennedy, recommended. The two talked over the options and decided to go with an intensive treatment that would combine gamma knife radiation and two immunotherapy drugs. Kennedy described the treatment protocol as "fairly high risk" and warned it could lead to the immune system attacking other organs. Frederick was undeterred. "She explained what this was going to look like. And I looked at her and I said, 'I don't care what it is. If it's the most aggressive treatment, I'm willing to do whatever it is,'" Frederick said. "I just wanted to be my healthy Jen Frederick again so I can get back to a normal life." A difficult treatment Frederick underwent gamma knife radiotherapy on January 7. The treatment uses precise gamma rays to target cancer tumors. Frederick said that it went well, but when she started receiving the biweekly immunotherapy medications on January 17, she began feeling "bad side effects," including "flu-like symptoms, rash, nausea," and high fevers. As she continued the treatment, the side effects expanded to include vomiting, chills and problems with her stomach and eyes. She was using the bathroom "25 plus times a day," Frederick said. She was hospitalized and spent a month in and out of the hospital. There was significant inflammation in her colon. She weighed only 95 pounds. "They would release me. I would go home. I'd be home 24 hours, and have to go back because I would just start vomiting again. I couldn't hold any food down," Frederick said. She had to take two months off from the immunotherapy to take steroids, antibiotics and other medications to treat the side effects. After recovering, she resumed treatment. When Frederick underwent her first PET scan since starting treatment, it showed "major, major improvement," she said. That made the months of pain, discomfort and illness worth it. A second scan several weeks later showed things were continuing to move "in the right direction," Frederick said. The immunotherapy was reduced to every three weeks, then every four weeks as she continued to improve. "My doctor said that I'm a Stage IV miracle," Frederick said. "Cancer does not have me" After 18 months of treatment, Frederick has not seen any progression of her cancer and continues to improve, her care team said. Kennedy believes that she has "a really excellent chance of having really long-term survival." Clinical trial patients who received the same treatment Frederick did are still doing well 10 years after the study, according to a recent update, Kennedy said. She believes Frederick will have a similar journey. "I only use the 10-year number because that's just as old as the drugs are. I think those patients will have responses that last beyond that, potentially indefinitely," Kennedy said. Frederick will continue her treatment until December 2025, Kennedy said. Then, she will start undergoing regular screening scans to make sure her cancer is not returning. Frederick said that once she is done with active treatment, she wants to share her story and make sure people know the importance of early screening. She has begun mentoring other cancer patients through the Cleveland Clinic's 4th Angel program. "I want people to know it gets harder before it's easier," Frederick said. "My saying has always been 'I may have cancer, but cancer does not have me.' And I want people to feel that way, because it isn't a death sentence." Wall Street Journal reports Trump sent "bawdy" birthday letter to Epstein, Trump threatens to sue Medical expert on Trump's chronic venous insufficiency diagnosis Americans on whether the U.S. should return to the moon, travel to Mars Solve the daily Crossword
CBS News
19-07-2025
- Health
- CBS News
Woman thought she had pulled a muscle working out. It was a rare cancer that had spread to her brain.
Jennifer Frederick was in the best shape of her life in 2023, so when she felt a small lump in her groin area after a week of workouts. She thought it was just a pulled muscle, but a month later, the lump was still there. Four months later, the lump was growing. Frederick went to a dermatologist and testing found more lumps in her leg. She scheduled a biopsy. On December 14, surgeons cut into her leg and removed the largest lumps. A week later, she had a diagnosis: Metastatic malignant melanoma. The disease is usually heralded by a mole on the skin, but Frederick never had one. More tests showed the cancer wasn't just in her leg. One scan found four lesions on her lungs. Another found five lesions on her brain. The results were shocking, Frederick said. "I never had a migraine, headache, blurry vision, never had problems breathing, never had a cough," Frederick, 50, said. "I never felt off at all." Melanoma is the deadliest form of skin cancer. Metastatic melanoma is any time of cancerous melanoma that has spread from one location to another, said Dr. Michael Postow, a medical oncologist at Memorial Sloan Kettering, who was not involved in Frederick's treatment. Metastatic malignant melanoma refers to late-stage metastatic melanoma. "Melanoma is a kind of cancer that can spread pretty widely throughout the body," Postow said. "It's one of the cancers that frequently involves the brain, so spread from melanoma to the brain ... can be quite a common occurrence. The lung is also a common site of metastatic melanoma." Typically, melanoma is recognized by a brown or black mole on the skin. Postow said it's unusual but not unheard of for a patient to have no mole or a "microscopic" one. He said that in addition to keeping an eye out for a new mole or an existing mole that changes color, size or texture, people should watch for lumps under the skin like the one Frederick had. Any concerns should be brought to a dermatologist, Postow said. The five-year survival rate for patients with advanced metastatic melanoma is about 35%, according to the American Cancer Society. Postow said clinical trials show that for patients who receive certain immunotherapy treatments, that number rises to 50%. Just a decade ago, the five-year survival rate was closer to 10%, he said. Immunotherapy was what Frederick's doctor, Cleveland Clinic medical oncologist Dr. Lucy Boyce Kennedy, recommended. The two talked over the options and decided to go with an intensive treatment that would combine gamma knife radiation and two immunotherapy drugs. Kennedy described the treatment protocol as "fairly high risk" and warned it could lead to the immune system attacking other organs. Frederick was undeterred. "She explained what this was going to look like. And I looked at her and I said, 'I don't care what it is. If it's the most aggressive treatment, I'm willing to do whatever it is,'" Frederick said. "I just wanted to be my healthy Jen Frederick again so I can get back to a normal life." Frederick underwent gamma knife radiotherapy on January 7. The treatment uses precise gamma rays to target cancer tumors. Frederick said that it went well, but when she started receiving the biweekly immunotherapy medications on January 17, she began feeling "bad side effects," including "flu-like symptoms, rash, nausea," and high fevers. As she continued the treatment, the side effects expanded to include vomiting, chills and problems with her stomach and eyes. She was using the bathroom "25 plus times a day," Frederick said. She was hospitalized and spent a month in and out of the hospital. There was significant inflammation in her colon. She weighed only 95 pounds. "They would release me. I would go home. I'd be home 24 hours, and have to go back because I would just start vomiting again. I couldn't hold any food down," Frederick said. She had to take two months off from the immunotherapy to take steroids, antibiotics and other medications to treat the side effects. After recovering, she resumed treatment. When Frederick underwent her first PET scan since starting treatment, it showed "major, major improvement," she said. That made the months of pain, discomfort and illness worth it. A second scan several weeks later showed things were continuing to move "in the right direction," Frederick said. The immunotherapy was reduced to every three weeks, then every four weeks as she continued to improve. "My doctor said that I'm a Stage IV miracle," Frederick said. After 18 months of treatment, Frederick has not seen any progression of her cancer and continues to improve, her care team said. Kennedy believes that she has "a really excellent chance of having really long-term survival." Clinical trial patients who received the same treatment Frederick did are still doing well 10 years after the study, according to a recent update, Kennedy said. She believes Frederick will have a similar journey. "I only use the 10-year number because that's just as old as the drugs are. I think those patients will have responses that last beyond that, potentially indefinitely," Kennedy said. Frederick will continue her treatment until December 2025, Kennedy said. Then, she will start undergoing regular screening scans to make sure her cancer is not returning. Frederick said that once she is done with active treatment, she wants to share her story and make sure people know the importance of early screening. She has begun mentoring other cancer patients through the Cleveland Clinic's 4th Angel program. "I want people to know it gets harder before it's easier," Frederick said. "My saying has always been 'I may have cancer, but cancer does not have me.' And I want people to feel that way, because it isn't a death sentence."
