Alice Armstrong is no stranger to MetroHealth. A patient there since 2010, she’s had hip surgery, a procedure for atrial fibrillation (Afib) and even a trip to the Emergency Department for stitches. “I was so pleased with the care I received that I stayed, I felt that strongly about it,” said Alice, Regional Growth Manager for the law firm Thompson Hine’s Cleveland office, where she has worked for nearly 19 years. A self-proclaimed “Energizer bunny” who turned 73 last December, Alice always has been in good health, working out regularly and staying active. She also stays busy with volunteer and philanthropy work, including serving on the board of Hope Ignites Northeast Ohio (formerly Boys Hope Girls Hope). There, she’s known for homemade birthday cakes she makes for the scholars in the organization’s residential program. With Bruce Jacobson, MD, her partner of five years, Alice enjoys cooking and gardening. The two prepared dinner at his house for their second date, in May 2020. Since then, they’ve traveled the world together. They also enjoy hanging out with their combined 14 grandchildren (seven each). In late 2024, Alice’s busy life started to change. The first sign of something wrong was her stomach. Once flat, even after having three children, it gradually became distended. Alice didn’t dwell on it much. Then, she started needing to rest after going up a flight of stairs. She chalked up the occasional fatigue to her Afib or a too-hard workout at the gym. Then, Alice started to feel extreme pressure in her abdomen. When it got worse, she began to think it might be a bladder or gynecological issue. On January 15, during an internal exam, Alice told OB-GYN, Paula Hendryx, MD, “It feels like everything is falling out.” Dr. Hendryx ordered a battery of tests. One of the tests was the CA 125 blood test, which measures the amount of the CA 125 protein. Anything below 35 is considered irregular and prompts more tests to indicate the presence of certain cancers. Alice’s test was over 400. The results of all the tests came back one week later, on January 24: stage 4 uterine cancer. Within days, Alice was in an exam room with Kimberly Resnick, MD, Division Director of Gynecology Oncology at MetroHealth. Bruce, a retired ophthalmologist who completed a surgery rotation at MetroHealth during his training, had used his deep medical and community ties to informally vet Dr. Resnick, whom Dr. Hendryx had referred them to. They quickly found out she was highly regarded as a clinician and a person. During that first appointment, Alice asked Dr. Resnick to be as straightforward with her as possible. No sugarcoating. The cancer was treatable but not curable, Dr. Resnick said. A recurrence wouldn’t be a surprise. It was the honesty Alice had requested. Around 75% of uterine cancers are diagnosed at early stages when they are extremely curable, mainly because patients experience abnormal post-menopausal vaginal bleeding, an early warning sign. Alice’s cancer had spread throughout her pelvis. For the best and safest chance of removing the tumors without any cancer behind, Dr. Resnick chose to start first with chemotherapy to shrink the tumors as much as possible. If the treatment plan – chemo first, then surgery, more chemo, then radiation and maintenance therapy – went well, Alice could live another five years. “She was very kind, very strong,” Alice said of Dr. Resnick. “I felt very confident about her taking care of me, especially knowing that she believed in the mission of MetroHealth.” The diagnosis devastated Brooke Codney and Kyle and Bryce Pechak, Alice’s children. Still, they were a positive force for their mother, encouraging her to stay strong for them and the grandkids. After Alice had her first round of chemo on February 4, Dr. Resnick encouraged her to get a second outside opinion – something she often suggests to patients who can easily go to another health system. “I’m used to serving the underserved and I love doing it. That’s why I work at MetroHealth,” said Dr. Resnick. Alice didn’t fit that profile. Alice did get another opinion, mainly for more information about possible clinical trials and future options. She was told the care Dr. Resnick had prescribed was the gold standard treatment of care. “Dr. Resnick had told me right up front that if the treatment was not working, she would find an alternative to attempt, even if it wasn’t within the system,” Alice said. Alice’s infusions lasted nearly eight hours. They consisted of two chemo drugs and Keytruda, an immunotherapy drug first approved by the Food and Drug Administration in 2014 for advanced melanoma. “The timing for me was incredible,” Alice said. In June 2024, the FDA approved Keytruda for use with standard chemo for advanced endometrial cancers. “It’s been a miracle with so many cancers,” Dr. Resnick said. “We’re seeing amazing responses. The biggest breakthrough is an increase in the length of remission.” After the first chemo treatment, severe gastrointestinal side effects landed Alice landed in the Emergency Department overnight. After a few weeks of taking steroids, her GI issues began to subside. Throughout Alice’s treatment, Bruce served as a fierce advocate, often questioning her care team about some of the treatment’s side effects. Dr. Resnick says she’s appreciated that high level of engagement from Bruce and patients like Alice who’s been so engaged and curious. “We love when patients can be knowledgeable partners in their care – it’s almost like having a partner in crime,” she said. With incredible support and encouragement from her children, her and Bruce’s families, and their friends, Alice stayed strong and positive, and in the moment – not jumping to the future. Alice continued to work out at the gym. When her shoulder-length hair started coming out after the second chemo session, she had her stylist shave it all off. One day, the headscarf she was wearing in the gym got too hot. She took it off and immediately was touched by the support she received from the other regulars, coaches and staff at Results Fitness. “I had been concerned about making people comfortable,” she said. “When you walk into a room and you look different, people immediately freeze up.” After the fourth chemo treatment, Alice’s tumor was nearly gone, and other areas of metastasis had diminished. On May 8, Dr. Resnick performed a radical hysterectomy (including the removal of the cervix and the upper part of the vagina). After three nights in the hospital, Alice went home on Mother’s Day. That afternoon, her children and grandchildren visited. The second round of chemo started on June 3. Three weeks later, on June 24 – five months after her diagnosis – Alice rang the bell in the infusion center at MetroHealth Cleveland Heights Medical Center, signaling the end of chemotherapy. By then, the result of her CA 125 test was back in the normal range. On July 3, a CT scan showed no evidence of cancer. Four days before, Alice met with radiation oncologist Suzanne M. Russo, MD. Alice had responded so well to her treatment that Dr. Russo felt she would benefit even more with a course of targeted radiation therapy before starting maintenance therapy. After Alice’s insurance initially denied coverage for the radiation, Dr. Russo wrote an appeal stating why she thought Alice was a good candidate. The same day the CT scan results came back, Dr. Russo received approval from the insurance company to move forward with the radiation. Following three radiation treatments, Alice received her first maintenance immunotherapy treatment on August 5. She’ll receive maintenance therapy every six weeks for the next two years. Despite having an aggressive cancer and enduring a difficult treatment, Alice has remained strong and determined – and hopeful, Dr. Resnick said. Alice has handled everything “with a lot of bravery, confidence, and optimism with brief periods of reality-checking,” Bruce said. In between her ongoing treatment, Alice and Bruce continue to do the things they love. In August, they vacationed in Scotland. When they’re at home, Bruce tends to the greenhouse he assembled in the spring, with Alice supervising his care and feeding of her plants. Alice says she is grateful for the care she has received at MetroHealth from Dr. Resnick, her practice support specialist, Dawn Erdman, and her all-female surgical team; and from others in the MetroHealth Cancer Center, including Cindy Bindus, RN; Julie Damko, APRN-CNP; Meredith Shayeb, RN; Melissa Terwilliger, RN; Rachel Thelan, RN; and Dr. Russo, who she called a “get it done” kind of person. “My MetroHealth cancer team is incredible!” said Alice, who is determined to beat her long-term prognosis. “I kind of took it as a challenge to say, I’m going to get more than five years out of this,” she said. “If didn’t have my partner or children or grandchildren, maybe I wouldn’t be so optimistic. “Instead of crawling in a hole and staying there until treatment is over, hopefully you beat this disease as best you can.” (fb)

One of the country’s first Emergency Medical Service (EMS) divisions is celebrating a major milestone this weekend. Cleveland EMS will be celebrating 50 years of service in the City of Cleveland. With approximately 20,000 patients transported by Cleveland EMS to MetroHealth each year, Cleveland EMS is one of our most vital partners. For nearly three decades, MetroHealth has provided Medical Direction to the City of Cleveland Department of Public Safety which oversees the city's police, fire and EMS teams. Earlier this year, MetroHealth Emergency Medicine Attending Physician Jeremiah Escajeda, MD, FACEP, FAEMS, was named Medical Director for Cleveland EMS, following in the footsteps of Thomas E. Collins Jr., MD, FACEP, FAEMS, who faithfully served in the position for an incredible 26 years. Our close working relationship with Cleveland EMS has led to numerous innovations, including our recently announced partnership to train their paramedics in administering whole blood transfusions at trauma scenes, making Cleveland the first major city in Ohio to implement the life-saving practice. As Cleveland's most experienced trauma and burn center, our mission would not be possible without the dedicated work of Cleveland EMS. Join us in congratulating – and thanking – Cleveland EMS for their service to our great city. (fb)