Tricia's story: Surviving brain metastasis

Located on Tricia's right thigh, the mole had an irregular shape but was smaller than the eraser at the end of a pencil. For years it was not a problem. Then, one day, it was.

A biopsy revealed melanoma, an aggressive form of skin cancer. A surgical oncologist removed the lesion, but eventually cancer cells broke away from the original site and traveled through Tricia's bloodstream.

Tricia was preparing for a marathon when she noticed a swollen node, small and very blue, that had popped up under the skin on her chest. Scans revealed that the melanoma cancer had spread to her groin, breast, chest, and brain.

"It went from nothing to something very quickly," Tricia says. "Fortunately, it showed up on my chest where I could see it, because I had no symptoms at all. I ran a marathon in 100-degree temperatures with metastatic brain cancer."

A one-two punch from radiosurgery + immunotherapy

Three years later, Tricia is still running, working, and enjoying life as a mother and new grandmother because of excellent cancer care, including Gamma Knife® radiosurgery overseen by Ronald Warnick, MD, a neurosurgeon with Mayfield Brain & Spine and Co-Director of the Gamma Knife Center at The Jewish Hospital – Mercy Health.

Within a week of her diagnosis of metastatic brain cancer, Tricia found herself in Dr. Warnick's office. A few days later, she underwent Gamma Knife radiosurgery. With Tricia's head immobilized in a frame, hundreds of low-dose beams of radiation came together to kill the cancer cells in two small brain tumors the size of blueberries. The radiation beams, while precisely targeting the cancer cells, avoided damage to nearby healthy cells.

"In the past, patients with multiple metastatic brain tumors would have been treated with whole brain radiotherapy, which can cause significant side effects, including cognitive decline," Dr. Warnick says. "Today, we are using a much more precise technique to pinpoint each tumor, reduce radiation to the normal brain, and avoid the side effects of whole brain radiation. Gamma Knife is outpatient, minimally invasive, and can be combined with other therapies."

Equally significant is the synergistic impact of radiosurgery combined with immunotherapy, which Tricia received as an IV infusion of the drug Keytruda® (pembrolizumab). She continues to receive infusions every 21 days.

"Tricia has had a great response to her treatments," Dr. Warnick says. "The combination of Gamma Knife and immunotherapy resulted in the disappearance of her brain tumors and a favorable long-term outcome. Recent studies have confirmed the positive synergy between radiosurgery and immune system therapy. Melanoma is a challenging tumor, but it responds well to this one-two punch."

Meanwhile, Tricia was stunned by the convenience of Gamma Knife. "It seemed like everything went really quick," she says. "The Gamma Knife was outpatient. I went home and I took a nap and was able to walk several miles with my dog. And the next day I went running with my friends. That's why the procedure is so amazing. It's painless, it's easy. It doesn't interrupt your life much."

In addition to regular immunotherapy treatments, Tricia undergoes a brain MRI twice a year. She continues to run half-marathons.

"When I was first diagnosed it was very overwhelming," Tricia says. "I remember praying that I'd still be able to run." And because at the time she wasn't a grandmother – and because she is someone who loves "simple things, like grandbabies," she prayed for a grandchild.

For Tricia, who says that relationships "are the only things that matter in life," good things came to pass. Among them was the care she received from Dr. Warnick.

"I tell Dr. Warnick, 'You'll be a blessing no matter what my day may bring.' And all I can say is that Jesus has a plan, and I'll work the plan. Let me be gracious. If my diagnosis should change, I want to do it graciously. I don't want to be a crotchety patient."

And how could she be? Her second prayer – to become a grandmother – was answered by sweet baby Junie.

~ Cindy Starr

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"The Gamma Knife was outpatient. I went home and I took a nap and was able to walk several miles with my dog. And the next day I went running with my friends. That's why the procedure is so amazing. It's painless, it's easy. It doesn't interrupt your life much."
~ Tricia

Tricia with her granddaughter