Bone Marrow Transplants: Greater Cincinnati Patients Receive World Class Care at OHC
Photography by Brian Ambs
At one time, the perception among medical consumers was that a patient had to leave Cincinnati to receive top-notch care when a bone marrow transplant was needed.
West side native Janie Oka was one of those who traveled for a second opinion after she was diagnosed with non-Hodgkin’s lymphoma and learned a bone marrow transplant would be needed. She went to the University of Nebraska Medical Center, which specializes in lymphoma.
“After they looked at all of our records they assured us we could get the same expert treatment here,” Oka says. “It was a no-brainer. I didn’t want to be in Nebraska in the middle of winter with my two-and-a-half-year-old son. I needed to be near my family.”
That was in 2000. Fifteen years later, Oka is cancer-free thanks to treatment she received from OHC (Oncology Hematology Care, Inc.), the independent, physician-owned cancer practice. OHC is the largest group of adult cancer and blood disorder specialists in the region with nearly 60 doctors supported by 24 nurse practitioners and 450 employees at 17 locations.
OHC, which is known for its blood cancer treatment expertise, has operated the Blood Cancer Center at Jewish Hospital – Mercy Health for more than 20 years. The BCC is the only accredited adult bone marrow transplant program in the Tri-State that offers autologous and allogeneic bone marrow transplant options.
You might call OHC’s world-class track record in bone marrow transplants a well-kept secret locally, at least among the general public. Of course, a lot of people aren’t aware of this treatment until they are faced with a life-changing diagnosis.
“Very few people need to go out of town for treatment. We have a very extensive program,” says James Essell, MD, OHC medical oncologist and medical director of the The Jewish Hospital – Mercy Health Blood Cancer Center. “A patient is served by board certified oncologists seven days a week, 365 days a year. We’ve done over 1,850 transplants since I’ve been here (starting in 1993).”
“I don’t know how it could have gone any better,” Oka says about her treatment. She laughs when asked why people think they might need to leave town for such treatment, speculating “maybe it’s a
‘Cincinnati thing,’ that we somehow feel the city is not with it. But I know my treatment couldn’t have gone better.”
It was a similar story for Pam Donnelly when she was diagnosed with acute myeloid leukemia in 2010. She too had heard of people going to Lexington or Columbus for treatment at the university hospitals in those cities. But when she asked around, the retired elementary art teacher found she could have peace of mind and excellent care in Cincinnati.
“I had a physician friend and value his opinion. He was the second call I made after I told my husband,” says Donnelly. “He told me Dr. Essell and the OHC team was the one to go to. I knew there were other options in other cities, but who does that? I needed to be near my family and friends.”
For bone marrow transplants, being out of town can add an especially difficult burden, since the procedure requires an initial 30-day hospital stay, then up to 100 days with almost daily visits.
“You have a new immune system,” says Essell. “Your body is saying, ‘This isn’t my body, I’m rejecting it.’ We can moderate that risk. And that requires very skilled, close follow-up, to fine tune the immune suppression treatment.”
If a patient has a high-risk blood cancer, or a recurrence, the physician may recommend a bone marrow transplant. Chemotherapy and sometimes radiation destroy the cancer cells and also the normal blood forming stem cell. The transplant replaces the damaged cells and is delivered into the body like a blood transfusion, settling into the marrow to begin growing healthy blood cells. The healthy cells come from a donor, and the best donors are usually a patient’s sibling. For Donnelly and Oka, their sister and brother, respectively, were perfect matches.
“We call that match a miracle,” says Donnelly. “She answered our prayers.”
A timely diagnosis is crucial in treating blood cancers. Both Oka and Donnelly say they found out about their cancers after routine blood tests showed anomalies.
“My diagnosis was a total shock,” Donnelly says. “I had no symptoms. It was just days (between) when I had a biopsy and was in Jewish Hospital for five weeks.”
Essell says what sets OHC apart is its four blood cancer physicians and pathology team are open for business every day of the year. Treatment is rapid, as it needs to be.
“At some hospitals, if you want to do a biopsy at 4 a.m. on Friday, the resources are not available,” he says. “We could have a patient admitted on Saturday for a biopsy, diagnosed on Sunday and entered into a national clinical trial for treatment by Monday. If I call our team on Christmas morning to do a bone marrow, they will come here and do it. That is better efficiency and patient focused care than anywhere in the region.”
That efficiency is enhanced by a team approach to the point where a patient practically inherits an extended family of caregivers. More than a dozen healthcare workers can make up a transplant team, including physicians, nurse clinician, floor nurse, social worker, psychologist, pharmacist, clinical trial coordinator, dietitian and financial navigator. “Even housekeepers have to be part of the team, trained differently because infection can be such an issue,” says Essell.
“The OHC team is so integrated,” Donnelly says. “They seem to work with a cohesiveness within the whole, even though they have their own unique roles to play.”
Patients also appreciate the fact that their doctor actually has an office within the blood cancer treatment facility, which has its own ICU dedicated to transplant patients.
“My office is five steps to the transfer center and the ICU,” Essell says. “If something goes bad, I’m there in 30 seconds.”
That teamwork has paid off. OHC reports excellent outcomes from its blood cancer program, based on metrics gathered by a federal database. “We are equivalent or better than anyone in the country with our outcomes,” Essell says.
The doctor says several changes have increased survival of blood cancer patients in the 25 years he has practiced. Among them are growth factors that stimulate cells to grow faster, better ways to harness the immune system and the vastly improved ability to type donors.
Advances in donor typing have opened the door for anonymous donors so patients don’t always need to rely on siblings. There is now an international database of more than 25 million people willing to have their stem cells harvested for a transplant. (Donor information can be found at www.bethematch.org.) For example, OHC recently matched a German male donor with a Cincinnati patient.
Bone marrow transplants hold the possibility that a patient can actually use the word “cured.” As Essell points out, with a kidney transplant, for example, a patient is always going to be on immune suppression. “With a stem cell transplant we can taper them off all immune suppression and they can really be back to normal.”
Just ask Janie Oka. “I am cured. You bet I am,” says the woman who has had a clean bill of health for more than 10 years following her transplant.
Donnelly, 16 months removed from her operation, is cautiously optimistic, still regaining her strength and closely monitoring her blood counts. “Absolutely there are hurdles. I have to be careful about going out in crowds and things like that, because my immune system is compromised,” she says. “I am so grateful for this team. I’ve never seen any place like it, or so many people so consistently excellent in their field, so compassionate and caring. It is such a plus to have OHC in the same city you live.”
Take it one day at a time.
That is solid advice for any cancer patient, but especially for bone marrow transplant recipients faced with a long recovery period. This is echoed by Pam Donnelly and Janie Oka. The West Side natives are blood cancer survivors who had different types of cancers and have different personal approaches to handling the disease.
Oka embraced her treatment, gathering as much information as possible and enlisting in a cancer support group. Donnelly says she was cautious she could learn too much about blood cancer, feeling the information would overwhelm her causing her to focus on all the negative things.
“Look at a part of it, rather than the whole. Don’t focus on the whole journey. That will overwhelm you,” Oka advises. “If something comes along, you deal with it.”
Oka has been cancer-free for more than a decade and considers herself cured. Donnelly is on schedule in her recovery 16 months after her transplant.
Other advice from the two:
Believe your body can do amazing things. “I had to crawl on the floor to play with my 2-old son I was so weak,” Oka says. “But it was my motivation to get my life back with him”
Take all the support you can get. “If people offer dinner, or whatever, say ‘yes,’ ” Oka says. “And surround yourself with positive, loving people because that will get you through it.”
Choose to look at cancer treatment as a positive event, even a blessing. “I am more grateful than ever. Everything is sweeter,” Donnelly says. “When you are given this diagnosis I look at is as a gift to recognize this time is precious. There has been so much goodness that has come into my life, the thoughtfulness, the generosity and kindness of people is just amazing.”
“Positive things have happened because of my cancer,” Oka says. “I switched careers. I was able to spend time with my child (while recovering) otherwise he would have been in child care.”
For information call 1.800.710.4674 or visit www.ohcare.com.