Siteman employee, wife share story

By Patty Johnson and Mary Williams of BJC TODAY

July 2, 2012 – Kent Zimmerman, business manager at the Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, smiles as he shares a picture of his 10-month-old twins, Zachary and Zoey.

“They’ve brought so much joy to our lives,” he says. “And after the year that we’ve been through, it is just a blessing from heaven to have them. When they look at you, you forget about everything else.”

Today, the twins are healthy – and so is their mother, Stephanie, who faced breast cancer during her pregnancy. But at this time last year, all three faced an uncertain future, as did Kent, who listened helplessly as his wife, then seven months pregnant with their twins, received a devastating diagnosis.

One of the happiest times of their lives

Kent and Stephanie got married later in life. They weren’t sure they would be able to have children at all. But then, to their delight, Stephanie became pregnant. The couple soon found out they were having twins – a boy and a girl.

Stephanie’s pregnancy progressed smoothly. “Stephanie was so healthy,” says Kent. “She took such great care of herself, eating right, exercising, resting, keeping all of her medical appointments. She did everything she was supposed to do.”

It was one of the happiest times in their lives, Kent says.

Then one day in early June 2011, Stephanie felt a lump on her left breast during a routine breast self-exam. From there, things moved quickly. Since Stephanie had an appointment scheduled with her obstetrician just days after finding the lump, she mentioned it during the visit.

Her doctor, Jennifer Smith, MD, quickly scheduled an ultrasound at the Breast Health Center at Barnes-Jewish Hospital. Catherine Appleton, MD, who read the ultrasound, immediately scheduled a biopsy.

The next day, the Zimmermans sat in the office of breast surgeon Timothy Eberlein, MD, Siteman director. That’s where they found out the lump Stephanie had discovered was an aggressive, fast-growing tumor.

“I felt so many different emotions,” Stephanie says. “It all seemed very surreal because everything had been going great with the pregnancy, and we were so excited about that. It was very scary and overwhelming. My initial concern was how everything would affect our unborn babies and if they would be at risk at all.”

“Both of us immediately were worried about the babies,” adds Kent. “But we realized we didn’t have a choice. It was a very aggressive cancer.”

Stephanie says Eberlein and her medical oncologist,Michael Naughton, MD, not only had a treatment plan in place immediately, but they also did their best to alleviate the couple’s fears.

“When I received my diagnosis and treatment plan, Drs. Eberlein and Naughton were so kind and compassionate,” she says. “They reassured us that I would make it through this and that our twins wouldn’t be harmed during the treatments.”

“As prospective parents, and me worrying about my wife, it was a frightening experience in our lives that was made less frightening because of the people who treated Stephanie,” adds Kent. “They projected such confidence, took a personal interest in us and went out of their way to make sure Stephanie was taken care of.”

Treatment tailored to her needs

Because performing surgery could have caused Stephanie to go into preterm labor, her doctors reversed the order of her treatment. Her surgery was postponed until after the babies were born, and Stephanie began chemotherapy almost immediately.

Medical oncologist Naughton, says that aside from the chemotherapy taking place before the surgery, Stephanie’s treatment was just slightly different than what would have occurred had she not been pregnant.

He says one component of the chemotherapy drugs typically used couldn’t be given to Stephanie while she was pregnant, but that drug was given to her once the babies were born. He adds that the chemotherapy regimen she was on before the babies were born has been used successfully in pregnant women for years.

“We’ve had a good track record using these drugs during pregnancy,” Naughton says.

“We’ve had good breast cancer outcomes, and the safety overall has been good, with no severe complications for the babies.”

Naughton says he has treated about a dozen pregnant women in the past decade. And given the complexity of Stephanie’s situation, her treatment went smoothly.

“The positive message is we can very effectively treat breast cancer during pregnancy and have positive outcomes for both moms and babies,” he adds.

During the last two months of her pregnancy, Stephanie underwent three rounds of chemotherapy. Just five days after her third chemotherapy treatment, the babies were born — on Aug. 2, 2011.

Zachary weighed 6 pounds, 6 ounces, and Zoey weighed 5 pounds, 8 ounces. Neither had to go to the newborn intensive care unit.

“Fortunately, Stephanie was able to get through all of her treatments without any setbacks,” Kent says. “But we were on an emotional roller-coaster until the babies were born and we knew they were OK.

“It’s almost hard to believe the babies were born so healthy, with everything Stephanie was going through,” he adds. “I just can’t imagine how she did it. She was so determined to get to that 38th week, and the babies were fully developed at that point.”

Kent credits family, friends, co-workers and members of the couple’s church for helping them get through the months following the babies’ birth. “Family and friends pitched in to do whatever needed to be done. I thank God that we had Stephanie’s mom and dad to help,” Kent says. “Now Stephanie is fully independent and able to take care of the babies on her own, and she is just a fantastic mom. But it was a team effort for a few months.”

Key to recovery

Kent says taking care of the babies played a key role in Stephanie’s recovery. “Even though she was going through some awful stuff, she was focused on them every day,” he says. “That has been such a blessing for us. Having those babies around was a major component of her healing process.”

Stephanie had her eighth and last chemotherapy treatment on Dec. 1, 2011. In January, she had a double mastectomy and reconstruction with Eberlein and Keith Brandt, MD, a plastic and reconstructive surgeon at Siteman. She started radiation the following month and finished her 28th round of radiation during the first week of April. In July, she’ll have her final reconstructive surgery with Brandt, and she’ll be on preventative medication for the next five years.

It also was recommended that Stephanie have genetic testing. She tested positive for the BRCA2 mutation, which puts her at a much higher risk than the general population to get breast cancer, as well as ovarian cancer. She’ll have her ovaries removed in the fall.

“The worst part is over,” says Kent. “The chemo and surgery were the hardest on Stephanie physically. But she was a trooper through it all. She stayed on track with what she needed to do.

“It’s a testament to her and the fantastic care she got and all of the help we got from family and friends,” he adds. “That really lifted us up. We knew we weren’t going through this alone.”

Adds Stephanie, “I’m looking forward to raising our twins and spending more quality time with my family and friends. And I’m very grateful for my amazing treatment team. Throughout each step of this experience, my doctors and all the fantastic nurses and staff have been wonderful. Not only are they concerned with how I’m doing, but they always want to know how the babies are doing. That has meant the world to Kent and me.

“From my initial diagnosis and throughout my treatment, their expertise and caring has been so comforting,” she adds. “I also definitely couldn’t have made it through this without the unconditional love and help from my husband and parents. And the support and prayers I have received from so many people is such a blessing. I’ll never be able to thank everyone enough for all they have done and continue to do for me and my family. My faith and all these things have lifted me up and helped make this difficult journey much easier.”

Kent says he is inspired by his wife’s unwavering strength and determination, and he hopes her story will inspire others. “To make it through all of this, as she did, is inspiring,” he says. “And if her story inspires someone to get a mammogram, then telling it will have been worth it. Early detection is so important.

“Stephanie is doing remarkably well with everything that she’s been through medically.

I attribute that to her will and to those babies,” he says. “It all comes back to the babies. We want to be around them a long time to watch them grow up.