In this time of increasing uncertainty, one thing is indisputable, “Cancer is a f@&$#€” exclaims Narda Hunt, Collingwood mother of two. In the midst of the COVID-19 pandemic, Narda heads to Toronto’s Sunnybrook Hospital to undergo radiation therapy to blast the cancer that has metastasized to her bones.

In 2011, on her 30th birthday and while still breast feeding her youngest daughter, Narda was diagnosed with breast cancer. Subsequently, she learned she carries a BRCA2 mutation which runs in her family. Following a double mastectomy and punishing rounds of chemotherapy, Narda assumed she was disease free.

Breast cancer is the most common cancer in Canadian women. One in eight women will develop breast cancer during her lifetime. BRCA1 and BRCA2 mutations account for the majority of cases. BRCA proteins function as tumor suppressors and the hereditary mutations in these genes disrupt normal function. Mutant BRCA2 carriers often experience high frequency of metastasis including liver, bone and central nervous system.

While the five-year survival rate for breast cancer is high, once it becomes metastatic it is largely untreatable. In 2017, a CAT scan after a ski accident confirmed a tumor on Narda’s liver. “You could literally see it,” she said. Narda was diagnosed with stage IV metastatic cancer, an aggressive subtype of the disease, and was told to prepare for the worst. “My oncologist told me that I had weeks to live and set me up with palliative care” Narda recalls. Over the spring and into the summer of 2017, Narda underwent multiple rounds of chemotherapy but the tumor was refractory to treatment and doubled in size. Her doctors maintained, “There is nothing we can do”.

Living on a permanent intravenous drip in palliative care and close to liver failure, Narda was losing hope and decided to explore alternatives to provincially available treatments. She learned of a technique used in Germany called regional chemotherapy: anti-cancer drugs are pumped through an artery directly into the tumor, rather than the body as a whole. Regional chemotherapy is used for certain cancers in Canada, such as pancreatic and abdominal cancers and melanomas, but is not approved for metastatic breast cancer in our country.

Narda reached out to Dr. Karl Aigner in Germany, an oncologist with 35 years’ clinical experience with regional chemotherapy who established that she was a candidate. With the help of family and friends, Narda raised the $200,000 required to travel from Collingwood to Germany to undergo regional chemotherapy. Following treatment in September 2017, her tumour shrunk considerably. In the ensuing months, Narda “felt normal” and was able to get back to doing things like mountain biking. “There is minimal sign of disease on the liver,” Narda claimed nearly a year later.

Although the trip to Germany was a success, the cancer persisted with its own agenda. Out of nowhere, Narda lost the ability to speak and was rushed to emergency at St. Mike’s Hospital in Toronto. The doctors diagnosed a brain bleed, and following an MRI, a golf ball size tumor was observed in her brain. In January 2020, Narda began a biweekly treatment of precision radiation therapy with Gamma Knife Icon, the newest and most advanced stereotactic radiosurgery system (SRS) used at Sunnybrook Odette Cancer Centre. SRS minimizes side effects associated with whole-brain radiation, such as damage to memory and cognitive functioning.

Now, Narda has pain in her upper arm and a recent bone scan revealed a tumor in the humorous. Facing an uncertain future, Narda maintains it is important to have a positive outlook and establish a strong believe system. Amidst all the turmoil in her life, Narda and her family are making masks to protect health care workers from COVID-19 exposure. Narda writes on Facebook to her friends, “My strongest belief is in prayer. I hold onto hope, for God is forever faithful. Every day is a gift.”

Submitted by: Dr. Oliver Kent, Scientific Associate and cancer researcher at the Princess Margaret Cancer Centre.

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