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What Samantha “Sam” Edall heard on the phone was unimaginable.

A day after learning that she had breast cancer, Sam found out her heart was functioning at 30% of normal – she was in heart failure.

“The thought of going through cancer treatment after my body had essentially withered away just felt unimaginable,” the 34-year-old said.

Those two calls came six months after she gave birth to her first child, Lucy. The complex birth nearly killed her.

Understandably, Sam questioned how her body could handle anymore after her prolonged hospital stay. And that’s why it was so important for her to find a team of medical professionals who could seamlessly take care of both the cancer and her heart.  

Read more about Samantha at VCU Health

Describing visits with other hospitals, Sam said, “It was so disjointed. You would meet with the oncologist and then the radiation oncologist, but it just never felt like they were in communication.”

Fortunately, her cardiologist recommended checking out VCU Massey Comprehensive Cancer Center and the VCU Health Pauley Heart Center due to the cardio-oncology program that binds the two units. And while Sam explored treatment opportunities at other providers, ultimately, that cross-department communication brought her ease.

”At VCU, it definitely felt like it was all together in one place and that they were talking. So, it was a big difference in comparison to the other places that I had gone to,” Sam said.

How Massey’s Cancer Service Line is a gamechanger for complex cancer cases

At Massey, Sam met with Kandace McGuire, M.D., the chief of breast surgery and the interim senior vice president of the Cancer Service Line (CSL), along with Hetal Vachhani, M.D., a hematologist oncologist specializing in breast cancer treatment and research, among other members of the CSL team.

From the start, Sam noticed Massey’s approach to her care was very different from other hospitals. McGuire says what makes their center unique is the way the teams are structured.

“The CSL breaks our provider teams down into what we call cancer programs or tumor programs. By breaking it down by cancer type and cancer programs  rather than breaking it down by those traditional lines of surgery, medicine and radiation, we're able to work together much more smoothly to give that comprehensive level of care, no matter what kind of cancer we're talking about.”

In a single day, Sam met with several members of the CSL team. While it was intense, she says it was also reassuring.

“It was almost like a boot camp where you meet all of your doctors, back-to-back-to-back in one five-hour appointment, essentially,” she explained. “It was extremely intimidating, but it was so nice to see what my treatment would look like from the very beginning to the end, all the way through plastic surgery.”

Sam was diagnosed with a challenging type of bilateral breast cancer, meaning she had two different stages of cancer in her right and left breast. In her left breast, the cancer was more aggressive and more advanced, having metastasized to her lymph nodes in the chest wall.

A chemotherapy regimen was at the top of Sam’s treatment options. However, certain types of cancer treatment can increase the risk of heart disease. With Sam also in heart failure, the Massey team needed to be in constant contact with colleagues in Pauley Heart Center’s cardio-oncology program  to treat her without causing a recurrence of heart damage or further damaging it.

Read more about Samantha's Pauley Journey 

“Working with Sam and our Pauley colleagues, we were able to offer her an alternative chemo regimen that had equal efficacy to what she would have otherwise received. With that, there were less cardiac implications in terms of toxicity. So, [Sam] felt more comfortable with that treatment plan,” Vachhani said.

And since Sam’s cardio-oncologist, David Chuquin, MD, believed Sam’s heart was getting better, McGuire noted that the regimen was fairly standard. “If we had not had that input, we probably would have pulled our punches and used less chemo, which would have affected her cancer outcome.”

Cardio-oncology has its roots in the 1970s and 1980s, and VCU Health’s program started in 2013. As more people are surviving from cancer, there is also a greater need for lifelong heart care from the side effects of cancer treatment. 

“Cardio-oncology is a relatively new concept,” Vachhani said. “Fortunately, Massey offers this service to our patients, which has been a game changer for patients like Sam, because they can have a cardiologist who knows their heart physiology, who knows the management of cardiac disorders, but they can view this with the filter of what's going on with their cancer.” 

“I am in constant communication with the hematology-oncology teams at Massey,” Chuquin said. “We work together to come up with the best plan of treatment for our patients. There really isn’t any cancer therapy we’re not able to help risk-stratify and treat.”

Cardio-oncology at VCU Health is a ‘godsend’

Following 20 rounds of chemotherapy, Sam underwent a double mastectomy, where surgeons discovered that both of her cancers were completely gone. In Sam’s words, that diagnosis “took my breath away.”

To be safe, 33 radiation treatments followed her mastectomies to ensure that a remaining lymph node that could not be removed during surgery was not cancerous. And because Sam’s tumors were hormone-receptor positive, she is now taking medication to limit the amount of estrogen in her body. 

Sam finished her final breast reconstruction. Throughout this process, she has recommitted to living life every day, no matter the obstacle. As someone who loves to travel, she is back to visiting tropical locales like Costa Rica and Hawaii with her husband, Patrick, and now 2-year-old Lucy.

Recently, Sam finished her final breast reconstruction. Throughout this process, she has recommitted to living life every day, no matter the obstacle. As someone who loves to travel, she is back to visiting tropical locales like Costa Rica and Hawaii with her husband, Patrick, and now 2-year-old Lucy.

“It's like when you get older, and you start to realize how beautiful a sunset is,” Sam said. “But then imagine that times ten. Everything is the best that it has ever been in my mind. I'm excited to live the rest of my life with that, because I think a lot of people don't get that until they're older.

“And I truly don't know if you can ever get that feeling unless you've been to the brink of death and back. And while I wish I did not go through all of this at 33, 34, 35, I am almost grateful because it has amplified my life tenfold. It is unreal how I view life, and I just love it.”

For her cancer team, Sam serves as a shining example of Massey’s commitment to collaborative, comprehensive care.

“Having the cardio-oncology program at VCU has been a godsend,” Vachhani said. “I wish that across our nation, we could have more of these because this collaboration is invaluable. And Samantha is a poster child of this collaboration between VCU Massey Comprehensive Cancer Center and VCU Health Pauley Heart Center.”

Written by: Bill Potter