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  1. University of Arkansas for Medical Sciences
  2. Winthrop P. Rockefeller Cancer Institute
  3. kent mckelvey

kent mckelvey

El Dorado Artist Melinda Cameron-Godsey Donates Original Painting to UAMS Cancer Institute

El Dorado artist Melinda Cameron-Godsey (fourth from right) celebrated the installation of her painting titled

El Dorado artist Melinda Cameron-Godsey (fourth from right) celebrated the installation of her painting titled “Hope” at the UAMS Winthrop P. Rockefeller Cancer Institute. She is joined by Liudmila Schafer, M.D. (third from right); daughter Courtney Cassinelli (far left); friend Carla Emanuel (front row far left); and nurses from Infusion Clinic 1.

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El Dorado Artist Melinda Cameron-Godsey Donates Original Painting to UAMS Cancer Institute

By Susan Van Dusen

May 24, 2018 | May 24, 2018 |El Dorado artist, interior designer and cancer survivor Melinda Cameron-Godsey has donated an original piece of art to the Winthrop P. Rockefeller Cancer Institute at the University of Arkansas for Medical Sciences (UAMS).

Titled “Hope,” the large, colorful acrylic painting of monarch butterflies can be viewed on the first floor near Infusion Clinic 1 and is a permanent addition to the Cancer Institute’s collection of art created by Arkansans.

“The monarch butterfly has been used a symbol of the Cancer Institute for many years and represents hope for all patients who come seeking hope and healing,” Cameron-Godsey said.

It was given in honor of the doctors and nurses who provide compassionate care for Cameron-Godsey’s ongoing cancer treatment. To celebrate the painting’s installation, she was joined by her physician, Liudmila Schafer, M.D., medical oncologist and assistant professor in the UAMS College of Medicine Department of Internal Medicine; her daughter, Courtney Cassinelli; friends; and oncology nurses.

The painting also honors Kent McKelvey, M.D., director of Cancer and Adult Genetic Services and associate professor of family medicine and genetics in the UAMS College of Medicine, who was unable to attend.

In 2015, Cameron-Godsey was diagnosed with stage 4 linitis plastica, a rare stomach cancer that spreads to the muscles of the stomach wall, causing it to harden and become rigid. She remains under the care of Schafer and travels to the Cancer Institute in Little Rock for regular treatment.

Filed Under: Cancer Featured Stories Tagged With: Infusion Clinic 1, kent mckelvey, linitis plastica, Liudmila Schafer, Melinda Cameron-Godsey, stomach cancer

Family with Rare Cancer Syndrome Finds Hope at UAMS

By Susan Van Dusen

Aug. 7, 2017 | It was a normal day visiting her family in Little Rock when Melinda Godsey started to feel sick. “I thought I had a stomach virus,” she said. Not wanting to infect her grandchildren, she got up the next morning and started the drive back to her home in El Dorado.

Feeling weaker and weaker as the two-hour trip progressed, Godsey, an interior designer and artist, recalls the frightening moment when she passed out behind the wheel. “It was quick. I just faded in and out. Thankfully I didn’t cross any lanes of traffic,” she said.

Her weakness continued to progress over the next three days, getting to the point where she could not shower or speak. After being admitted to the hospital, doctors found what looked to be the cause of her weakness: Severe bleeding ulcers in her stomach had resulted in a significant loss of blood.

However, that was not the end of their findings. Tests also revealed that the ulcers were merely a symptom of a much larger problem that had likely been growing for months. Godsey was told that she was living with linitis plastica, a rare stomach cancer that spreads to the muscles of the stomach wall, causing it to harden and become rigid. While this aggressive cancer starts in the stomach, it quickly spreads to other organs, making treatment options limited and complex.

While this diagnosis was about to change Godsey’s life, she did not yet know the impact it would have on her loved ones as well.

Representing from 5 percent to 10 percent of all gastric cancers, a slight increase in cases of linitis plastic has been observed over the past few years. This may be attributed to improved diagnostic tools, said Luidmila Schafer, M.D., a medical oncologist and assistant professor in the UAMS College of Medicine Department of Internal Medicine.

“Our knowledge and ability to diagnose rare cancers has improved significantly in recent years, so conditions such as linitis plastica may not have been diagnosed with such precision in the past,” she said.

Godsey was referred by her physician in El Dorado to a cancer center out of state, where she immediately went for evaluation. After confirming her diagnosis, she was given the news that the cancer had already spread to her abdomen and the preferred surgical treatment was no longer an option. However, she was a candidate for aggressive chemotherapy.

Because her out-of-state physician received his fellowship training in the UAMS Hematology/Oncology Fellowship program, he was aware of the UAMS Winthrop P. Rockefeller Cancer Institute and its comprehensive treatment programs. He told Godsey that she could return to Arkansas and receive chemo at the Cancer Institute close to home.

Referrals were made and Godsey arrived for her first appointment at UAMS in June, about one month after her diagnosis. Unfortunately, good news did not await her. Godsey had developed sepsis as the result of an infection, resulting in a week-long hospitalization and postponement of the start of chemotherapy.

“It was a tough start,” said Godsey’s daughter, Courtney Cassinelli, adding that after the infection cleared, her mom was able to begin two types of chemo given simultaneously under Schafer’s supervision.

While the treatment has been tough, Godsey is thankful for her good days and the time she’s been given.

“I could have lived for only a short time, but I’ve made it two years thanks to Dr. Schafer’s care. What she has done for me has been remarkable,” she said.

A Family Connection

At about the same time Godsey was coming to terms with her diagnosis of stage 4 stomach cancer in 2015, her first cousin, Anita Meek, was getting the news that she had been diagnosed with lobular breast cancer. This form of breast cancer makes up only about 10 percent of invasive breast cancers and typically doesn’t form a lump, making it less likely to be detected on a mammogram.

Having lost a young son to cancer, Meek, who lives in Harrison, decided to undergo genetic testing to see if there might be an inherited genetic component to their conditions. Schafer also had recommended that Godsey undergo genetic testing at the UAMS Cancer Genetics Clinic, due to the rarity of her cancer and the known link between linitis plastica and the CDH1 gene mutation.

“As the only cancer genetics clinic in Arkansas, we see people with rare cancers, early-onset cancers or unusual presentations of cancer from across the state and region,” said Kent McKelvey, M.D., director of Cancer and Adult Genetic Services and associate professor of family medicine and genetics in the UAMS College of Medicine.

UAMS has the only board-certified geneticists who diagnose, manage and treat complex cancer syndromes, of which there are more than 50. Cancer genetics counselors work with the geneticist and are a vital part of the team to help families understand their genome and its implications in cancer prevention.

Although any doctor can order genetic testing — which is conducted using a blood or saliva sample — the process can be daunting. Abnormal results must be put into context for a specific patient and family in this rapidly changing field, and no two cases are the same.

When both Godsey and Meek were found to have the CDH1 gene mutation it only took minutes for McKelvey to conclude it was passed to them by their fathers, who were brothers.

“A person doesn’t inherit cancer from their parents. However, they can inherit the predisposition to cancer. That’s what happened in this family. The CDH1 gene mutation that Mrs. Godsey and Mrs. Meek have increases their risk of developing linitis plastica by about 80 percent and lobular breast cancer by about 40 percent,” McKelvey said.

There also is, to a lesser extent, an increased risk of colon cancer associated with CDH1.

Moving Forward

Armed with this information, Meek underwent a double mastectomy at a hospital near her Northwest Arkansas home and continues to be followed twice yearly at Highlands Oncology Group (HOG). The UAMS Cancer Institute and HOG formed a partnership in 2013 that provides expanded access to clinical trials and advanced treatment options to residents of Northwest Arkansas.

Because Godsey and Meek now knew they carried the CDH1 mutation, they also knew their adult children could choose to undergo genetic testing to determine if they had inherited it as well. When someone carries a gene mutation, they have a 50-50 chance of passing that mutation along to each of their children.

“My sister and I were both tested at UAMS. My test came back negative, but hers was positive,” said Cassinelli. Because Cassinelli does not carry the gene mutation, there is no need to test her children. Once the line is broken, it does not reappear in subsequent generations.

As for Kelly Cameron, Godsey’s eldest daughter, the positive result set in motion a series of completely unexpected and life-changing decisions.

Because there is no screening method for stomach cancer, it is often found in its late stages after it has already spread to other organs, which was the case with Godsey. The only way to prevent a person with the CDH1 gene mutation from developing stomach cancer is to undergo a procedure called total gastrectomy, which involves removing the stomach and extending the small intestine up to meet the esophagus. With time, the small intestine makes a small pouch mimicking the stomach.

Because food now passes directly into the small intestine when it is consumed, side effects such as bloating, nausea, vomiting, cramps and diarrhea following total gastrectomy are common in the first few months.

“Although it is possible to adjust to the new diet and small meals required following total gastrectomy, the surgery also has an impact on a person’s physical, social and emotional health,” Schafer said.

Due to her young age and the high likelihood that she would develop this rare cancer in her lifetime, the 41-year-old Cameron decided that, regardless of the side effects, total gastrectomy was her best option.

While it has been a challenging transition since her surgery in February 2016, each month has become a little bit easier for Cameron.

“The first year is traumatic to your body. Your stomach is a major player and suddenly it’s gone. You can’t fully understand what that’s like unless you experience it yourself,” she said.

Ultimately, however, the body adapts to its new situation and the symptoms subside.

“It’s a new normal,” Cameron said, adding that she has essentially relearned how and what to eat, in addition to taking vitamin supplements that ensure she meets her daily nutritional needs.

Although Meek also is at risk of developing linitis plastica, she elected to forego total gastrectomy for now.

“If I were younger, I may have chosen that path as well. Instead, I’m seeing my doctor regularly and hoping that any signs of cancer will be found early,” she said.

Additional Prevention

While still adjusting to her total gastrectomy, Cameron also chose in December 2016 to undergo a bilateral prophylactic mastectomy by having both breasts removed before there was any evidence of cancer.

According to the National Cancer Institute, this surgery will reduce her risk of developing breast cancer by at least 95 percent. The surgery was performed in December 2016 by V. Suzanne Klimberg, M.D., who was then director of the UAMS Breast Cancer Program.

She will soon finish the breast reconstruction process led by plastic surgeon Eric Wright, M.D., associate professor in the UAMS College of Medicine Division of Plastic and Reconstructive Surgery.

Cameron is thankful the surgical options were presented to her by McKelvey after completing her genetic test.

“He was a straight shooter. He told me exactly what I needed to do if I wanted to eliminate the chance of developing these cancers,” she said.

She also is thankful to have gone ahead with the surgeries at a young age, as the total gastrectomy revealed stage 1 cancer already formed in the lining of her stomach, as well as precancerous cells in one breast.

“If not for that genetic test and Dr. McKelvey’s guidance, I would have had a much earlier onset of disease than my mom did. Knowing my genetic makeup saved my life,” she said.

Next Steps

Now that her surgeries are complete, next on Cameron’s list is yearly colonoscopies at UAMS to screen for early signs of colon cancer. “Thankfully there is a successful screening method for colon cancer, so no preventative surgery is needed there,” she said.

Then, after her son turns 18, he will have the opportunity to undergo genetic testing at UAMS for the CDH1 gene mutation and make his own decisions based on those findings. Some of Godsey’s siblings and other relatives also have agreed to undergo testing to see if they carry the gene and may have passed it to their children.

In addition to providing individuals with knowledge about their personal health risks, genetic tests also assist researchers in better understanding cancer syndromes in the future.

“Our ability to diagnose and understand cancer and other genetic syndromes is changing on a weekly basis. Because of this, we need the ability to bank and store individual genomes and tumor samples that can be compared and analyzed for a better understanding of how these syndromes work. As more samples are documented, our knowledge will continue to grow,” said McKelvey.

Godsey and Cameron agree they found the right place to address their complex medical needs.

“The Cancer Institute at UAMS has been wonderful. They’ve treated me not only like a patient, but more like a friend. Members of the staff have even called to check on me at home. I would never go anywhere but UAMS,” Cameron said.

A portion of the net proceeds for the Winthrop P. Rockefeller Cancer Institute’s 2017 Gala for Life will benefit the UAMS Cancer Genetics Program. To learn more, visit TheGalaforLife.com.

Filed Under: Cancer Featured Stories, UAMS News Tagged With: cancer genetics, kent mckelvey, linitis plastica, lobular breast cancer, Luidmila Schafer, Melinda Godsey, UAMS, Winthrop P. Rockefeller Cancer Institute

Inherited Cancer Risk Leads Travel Blogger to Choose Mastectomy

April 14, 2017 | Lesley Murphy is accustomed to waking up in exotic locations. From snow-covered Finland to the beaches of Bali, this 29-year-old professional blogger spends more than 300 days a year documenting her travels to vacation destinations around the world.

“My number one goal is inspiring travel and showing people that if they get out of their comfort zones, they can make the world a better place,” she said.

Recently, however, the Arkansas native took a detour from her globetrotting lifestyle to focus on a very different subject — her future health. About three years ago, Lesley was living in Argentina when she received the call that her mother, Martha Murphy, was diagnosed with breast cancer. With no history of breast cancer in her family, the diagnosis came as a shock.

“It was my first year living abroad, and I felt so far away,” Lesley said. “It was a wash of emotions. You never want to hear the words ‘mom’ and ‘cancer’ in the same sentence.”

Martha Murphy, who was living in Fort Smith at the time, felt a lump in her breast before scheduling a mammogram in early March 2014. After it was confirmed she had stage 1 breast cancer, Martha immediately sought the advice of her next-door neighbor, who happened to be an oncologist. He recommended genetic testing to determine if she might have a mutation of one of the BRCA genes, commonly known as the breast cancer genes.

While every person is born with the BRCA1 and BRCA2 genes, women who inherit mutations of the genes have up to an 80 percent chance of developing breast cancer by age 70. If Martha tested positive for a gene mutation, it would mean her three adult daughters had the potential for it as well.

“My doctor in Fort Smith ordered the genetic test on the same day I was diagnosed, but it took a few days to receive the results,” Martha said.

The morning after her diagnosis, Martha decided she wanted to seek a second opinion at UAMS, Arkansas’ only academic health sciences center. After a reassuring visit on March 21 with breast surgeon V. Suzanne Klimberg, M.D., director of the Breast Cancer Program at the UAMS Winthrop P. Rockefeller Cancer Institute, Martha scheduled a double mastectomy for 10 days later.

Her breast reconstruction surgery was completed at UAMS in August, followed by an oophorectomy to remove her ovaries in September. A BRCA gene mutation also can increase a woman’s risk of developing ovarian cancer.

“When I look back, this experience was just a blip on my radar. While it was happening, I was in the midst of helping my eldest daughter plan her wedding. I didn’t have time to focus on myself, so I’m terribly blessed that I didn’t have any complications or need any chemo or radiation,” Martha said.

Klimberg also is a professor of surgery and pathology in the UAMS College of Medicine and director of the Division of Breast Surgical Oncology.

Martha received the results of her genetic test prior to her visit with Klimberg and was surprised to discover she did indeed carry the BRCA2 gene mutation. She immediately knew that she wanted her daughters to be tested as well.

“I told them, this is what we’re going to do. They needed to know if they had the gene mutation, so they could make informed decisions about their future,” Martha said.

Each child of a parent — mother or father — who carries a mutation in one of the BRCA genes has a 50 percent chance of inheriting the mutation.

Martha’s eldest daughter, Lauren, and youngest, Jordan, both underwent testing at the UAMS Cancer Genetics Clinic and received mixed results.

“After Jordan’s test came back negative, we were hopeful they all would,” Martha said.

That would not be the case, as Lauren’s results were soon found to be positive for her mom’s BRCA2 mutation. The UAMS Cancer Institute is home to the only clinical cancer genetics team in Arkansas. Although any doctor can order genetic testing — which is conducted using a blood or saliva sample — UAMS has the only board-certified geneticists and genetic counselors in the state who can diagnose rare syndromes and manage complex cancer syndromes, of which there are more than 50.

As for Lesley, finding time for the genetic screening was a challenge in itself. Because she was living in South America, did not have domestic insurance, and was launching her career as a travel blogger, the sense of urgency wasn’t strong.

“I would be in Arkansas for two days and then gone for a month, so there was never any time to schedule it. Two years went by before I was home for an extended time. That’s when Mom encouraged me to get it done,” said Lesley, who initially gained fame as a contestant on season 17 of ABC’s “The Bachelor.”

When her genetic test came back positive for the BRCA2 gene mutation, Lesley knew she had some choices to make. She looked to Kent McKelvey, M.D., director of Cancer and Adult Genetics Services, and the UAMS Cancer Genetics Clinic staff for guidance.

“Each person ultimately has to make the choices that are best for themselves and their families. We are here to help people understand the evidence and options and guide them to make the best informed decisions,” said McKelvey, who also is associate professor in the UAMS College of Medicine Division of Genetics.

For Lesley, those choices were to undergo breast cancer screenings every six months in an attempt to catch any tumors in their earliest stages or have a preventive double mastectomy, followed by reconstruction. With her travel career in full swing, Lesley said the choice was clear.

“Because of my schedule, I didn’t foresee the twice-yearly screenings as a realistic option. While it may sound drastic to some people, having the surgery was definitely the best option for me,” she said.

The fact that Lesley was able to learn about her gene mutation and make the best choice for herself provides a sense of freedom and empowerment, McKelvey said.

“Given her active career and the fact that she gave this decision serious consideration, her choice to have elective surgery makes perfect sense,” he said.

Following the double mastectomy with UAMS breast surgeon Daniela Ochoa, M.D., Lesley’s risk of developing breast cancer will be reduced by about 95 percent. Nothing can eliminate the risk entirely, McKelvey said, however, surgery is the most effective strategy to dramatically reduce her risk of breast cancer and eliminate any future need for screenings. Ochoa is a professor of surgery in the UAMS College of Medicine Division of Breast Surgical Oncology.

Because of her public image and large social media following, Lesley chose to document her experience on social media channels including Instagram, Facebook, Twitter and Snapchat.

“I saw this as a way to educate people and encourage them to be more knowledgeable about their own personal health decisions,” she said.

After a four-week break from traveling following her April mastectomy, Lesley will hit the road again in May, this time with Mom by her side.

“The doctors think I’ll be fine to travel by then, but she’ll be there for support if I need it,” Lesley said.

She will return to UAMS in late summer to complete her breast reconstruction process under the direction of plastic surgeon Eric J. Wright, M.D., associate professor in the UAMS College of Medicine Division of Plastic and Reconstructive Surgery.

Then, it’s back on a plane to her next destination. “I will always travel. I don’t know what my career will eventually evolve into, but travel is definitely what I’m passionate about and what makes me happy,” Lesley said.

Filed Under: Cancer Featured Stories, UAMS News Tagged With: arkansas, BRCA1, BRCA2, breast cancer, cancer, Daniela Ochoa, Eric Wright, genetics, kent mckelvey, Lesley Murphy, mastectomy, Suzanne Klimberg, The Road Les Traveled, UAMS, Winthrop P. Rockefeller Cancer Institute

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