By Robert Hood
Colette Chaney smiles as she recounts a milestone that one of her immunotherapy trial participants recently met. The patient, who entered the trial very ill with cancer, is now in remission and was able to attend her daughter’s graduation. The woman told Chaney she feels good about her health and the hard decision she made to sign up for the extra treatments and time necessary to be a clinical trial volunteer.
Chaney says that patient, and other immunotherapy trial participants she’s helped care for over the years, have helped her stay connected to what’s truly important.
“My patients teach me on a daily basis what I should value in life,” she said. “They keep me grounded.”
Chaney and Anna Marie DeVito are two of the clinical research nurses with the Fred Hutchinson Cancer Research Center immunotherapy research team, a group of researchers conducting clinical trials that test the power of the immune system to cure cancer. The trials are myriad, but most involve tweaking the body’s own T cells to seek out and destroy tumors.
Chaney and DeVito administer investigational immunotherapies to patients enrolled in the clinical trials, but their roles and relationships with the patients extend far beyond the moment where they hang a bag of T cells on the patient’s IV stand.
“The nurses are among the most dedicated, caring and wonderful employees we have at the Hutch,” said immunotherapy researcher Dr. Stanley Riddell. “They are very passionate about what they do.”
The nurses are the liaison between research and clinical teams, involved in all areas of patient contact for a given trial. They help design and implement the trials, and they help recruit and screen patients, explaining to potential trial participants all the risks and requirements of the trial to ensure the patients give fully informed consent to participate. They check that everyone who touches the patient adheres to the trial’s instructions. They hang those bags of precious cancer-fighting T cells. They track the patients closely for any signs of side effects. And they follow up with the patients after the treatment phase of the trial is complete, and the patients have returned home.
By Robert Hood
This last role means that the nurses may be in some of these participants’ lives for years to come, officially to request the necessary samples and updates on their health to inform the research team, unofficially as friends and touch points to their time spent at Fred Hutch.
“They leave their primary clinical team when their treatment is complete, but then they’re ours for up to 15 years,” said Chaney, who has worked with Fred Hutch trial participants for a decade.
The studies Chaney and DeVito work on recruit patients from all walks of life and with many different types of cancer, but because the current immunotherapy research trials at Fred Hutch are all in early phases, most participants have already gone through many different types of treatments for their cancer that have failed. They’re excited to have another option available in the novel immunotherapy, DeVito said, but they may also be wary.
“By the time they reach us, they are savvy consumers of health care,” Chaney said. “They have high expectations and it’s up to us to speak to them and educate them at that level.”
From education to receiving immunotherapy drugs to monitoring their health, Chaney and DeVito walk the road with their patients, whether the path is short or long.
“It’s a nice journey to take with the patients,” Chaney said. “We provide hope, realism, a sense of security and the knowledge that even though there are a lot of unknowns, there are a lot of people with you to travel that path.”
Whatever the outcome, the nurses help remind the patient volunteers that they are a crucial part of propelling Fred Hutch’s immunotherapy progress. The research teams learn from every volunteer they touch, and every trial result informs their next steps toward their ultimate goal of saving more lives. That unifying goal among physicians, nurses and lab assistants is one of DeVito’s favorite parts about her job.
“No matter what degree each member of the team has, we all have that in common,” she said.
Of course, the patients, and their struggles with cancer, are a big motivator too. DeVito learns something new every day, she said, and every day and every patient taps her for something different. Some days it’s explaining the therapy in detail to her patients, some days it’s sharing happy news, some days it’s just sitting and holding a hand.
“We do whatever it takes to make that patient’s journey easier,” DeVito said.
Their long-term relationships with many of their patients make their jobs different from those of most oncology nurses, many of whom might only see their patients during active treatment. Their patients become like family members, and Chaney finds that one of the most rewarding parts of her job.
And when an experimental therapy works to slow or halt a patient’s cancer, DeVito and Chaney celebrate those victories too.
“We share in that joy with the patient,” Chaney said, “and remind them that even if it might be temporary, to take advantage of this window of time.”
“That’s kind of true of life in general,” DeVito added.
Rachel Tompa is a former staff writer at Fred Hutchinson Cancer Research Center. She has a Ph.D. in molecular biology from the University of California, San Francisco and a certificate in science writing from the University of California, Santa Cruz. Follow her on Twitter @Rachel_Tompa.