Latest Treatments, Local Care

Collaboration and cutting-edge technology help local doctors treat challenging cases close to home

Dr. Phillip Manno and patient Brenda Cadieux (right) visit at NCCC Manchester. (photo by Mark Washburn)

When a tumor wrapped around her heart didn't respond to treatment, Dr. Philip Manno drew on the technology and the experience of colleagues at Norris Cotton Cancer Center to find new approaches for his patient's Hodgkin lymphoma. Now she's cancer free.

In December of 2012, Brenda Cadieux noticed that her face was swollen when she woke in the morning. She chalked it up to the long shifts she'd been putting in at the new restaurant she'd opened just months before, and hoped a few days of rest after the holidays would help.

"I worked a double shift on Christmas Eve, and the day after Christmas I was on my deathbed," she said. A visit to the emergency room had revealed a tumor wrapped around her heart. It was a cancerous tumor—Hodgkin lymphoma— and it was preventing blood from draining from her head. "I lay in my hospital bed and felt totally overwhelmed," she said. "I'd just sunk everything I had into this new business, and there I was in Lebanon, NH, away from the restaurant, my community, and my friends' support. Both of my parents had died of cancer, so I was sure I was going to die."

Hodgkin lymphoma didn’t respond to standard treatments

Cadieux’s physician, Dr. Phillip J. Manno, who is clinical director, NCCC Manchester Hematology/Oncology, and a clinical associate professor at the Geisel School of Medicine at Dartmouth, brought her back to NCCC’s Manchester center for chemotherapy. Because the side effects were so bad after she had received just nine of the standard 12 treatments, they both wondered if the negatives outweighed any positive gain.

"This is a standard treatment that nearly always works for Hodgkin Lymphoma, but it didn’t for me," said Cadieux.

When radiation treatment also failed, Dr. Manno decided a different approach was needed.

Comprehensive Cancer Center resources support NCCC physician’s creative problem-solving

"I like to think creatively and to problem solve," said Dr. Manno, "Because we are part of an NCI-designated Comprehensive Cancer Center I have unlimited access to the latest technology and to clinical trials of emerging treatments when planning patient care."

He regularly attends tumor boards, where doctors from all of the NCCC centers pool their experience, training, and resources to review patient test results and treatment plans. He consulted with Elizabeth M. Bengtson, MD and arranged for Cadieux to have a stem cell transplant at NCCC in Lebanon, NH. After three and a half weeks in Lebanon, she returned to Dr. Manno’s care in Manchester, so she could have her follow-up treatment at home near friends in Goffstown, NH.

The best and latest treatment options close to home

"Because we are all part of the same cancer center I can consult and collaborate with specialists throughout the system," said Dr. Manno. "The process is seamless for the patient—the paperwork and processes are the same in all our locations. My patients can take advantage of the latest technology and cutting edge treatment options in Lebanon and still receive their follow up care here in Manchester, with the physicians and staff they know here near their home."

Today, it's all pretty straightforward for Cadieux. "Dr. Manno saved my life," she stated simply on a recent visit to NCCC Manchester. She beamed as she distributed flyers around the infusion suite, inviting those who had cared for her to join an upcoming celebration party at her restaurant. "I just had my 100 day check-in: I’m cancer free!"

For the second year in a row Norris Cotton Cancer Center has won the Union Leader Readers' Choice Award for Cancer Care in New Hampshire. Union Leader readers voted for their favorite New Hampshire business in 18 main categories and 180 subcategories. NCCC received top honor in Cancer Care for 2014.

August 18, 2014