By Darby Kendall
Margot Rocha is no stranger to the OHSU Knight Cancer Institute. For the past five years, her son, Flavio Rocha, M.D., FACS, FSSO, Hugh Hedinger and Georgeina Hedinger Chair of Surgical Oncology, has served as its physician-in-chief. But she never imagined that she’d one day receive treatment there.
A Chicago resident and former Brazilian diplomat, Margot has always lived an active life, even after she began experiencing worrying headaches a few years ago. After bringing them up to her doctor, she was diagnosed with a meningioma and decided to have it removed by a local neurosurgeon. Meningiomas are tumors in the central nervous system that are typically benign — however, that was not the case for Margot.
“When they saw the meningioma had a specific mutation that made it high grade, I got scared because that was something I had not experienced, not even imagined,” Margot said. “Flavio was following up and in contact with my surgeon over there, and they said, ‘You have to go under radiotherapy at this point.’ Flavio asked me, ‘Mom, why don’t you come here to my hospital?’”
Margot gladly took her son up on his offer and flew across the country to Portland last January, where she began receiving radiation treatment at the Knight Cancer Institute through their recently established comprehensive multidisciplinary neuro-oncology service. She was set up with radiation oncologist Josh Walker, M.D., Ph.D., and neuro-oncologist Huan Vo, M.D., and completed 35 sessions of radiation to treat any remaining meningioma tumor.
“I got to know Dr. Vo and Dr. Walker. They were so kind, so nice and helped me feel relaxed. I had the best experience. They answered all of my questions, and that made me feel secure,” Margot said. “The daily radiation treatment for six weeks is a terrible time to go through, but I knew that there were people that I could count on around me. I didn’t have to have doubts.”
While Margot was receiving her treatment at OHSU, Vo contacted Flavio about a hunch he had regarding her meningioma. Vo’s intuition, combined with Flavio and Walker’s willingness to follow it, ended up saving Margot’s life from being taken by another form of cancer hiding in the shadows.
“Dr. Vo said, ‘This meningioma, it’s got these bad features. Let’s get some more staging,’” Flavio explained. “He ordered a special form of PET called a dotatate scan that goes through the whole body to see if there are tumors anywhere else. Sure enough, this test picked up a bunch of lesions in her lungs. While typically this would mean the meningioma had spread to the lungs, we all said, ‘You know what? It’s a little unusual; let’s get a biopsy, just to be 100% sure.’”
OHSU has a dedicated interventional pulmonologist, Peter Lee, M.D., M.H.S., who specializes in obtaining lung biopsies from small nodules using a robotic device guided in the airways. The biopsy revealed those lesions were a newly diagnosed lung cancer, previously undiscovered by other physicians who had been consulted about her meningioma. Because the Knight Cancer Institute is integrated with so many specialists in different fields and focused on early detection and precision oncology, Margot’s lung cancer was discovered quickly, and a specific mutation was found on genetic profiling leading her to start a new, personalized treatment right away.
“I think part of the issue when folks get a new cancer diagnosis is navigating the system and having to speak with multiple providers in different places,” Flavio said. “It’s great to have the expertise all concentrated in one place where there’s a seamless journey and transition between specialists.”
Instead of standard intravenous chemotherapy, Margot started a targeted therapy pill combination at the multidisciplinary lung clinic within the Knight Cancer Institute and was able to return home to Chicago last February, where she’s continued to receive the same targeted treatment ever since without the typical side effects.
“She really loved the experience that she had here with everybody. I believe in the care that we give here, so I brought my mother here to experience it,” Flavio said. “She got such special care here that they actually diagnosed something else that other providers were not quite aware of. I really appreciate it, and she does too.”
Flavio and Margot are hopeful that her experience at OHSU can be translated to all cancer patients, allowing the Knight Cancer Institute to be an essential one-stop shop for diagnoses, treatment and care with an attention to coordination and timeliness.
Now, Margot is back to traveling the world with her husband and attending social events, grateful for the second chance at life given to her by all her medical providers.
“I was not expecting to have cancer, because the only symptom that I had was fatigue,” Margot said. “I’ve always been a strong person and my first reaction was, ‘It’s over. Now let me see, what should I do? Let me plan my life. Should I move to a house that has no stairs and make a will?’ But at a certain point I said, ‘Oh, my God, I don’t really want to leave the party before the party is over. I want to stay longer. Let’s see what can be done.’ And I’m still here!”
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