For Patricia Latham, cancer was not something she expected to face in her 80s. It all began with a routine mammogram. When the test revealed something concerning, a biopsy soon confirmed the diagnosis: breast cancer. Unfortunately, it was right before Christmas, a difficult time to begin making treatment decisions.
"Trying to get a treatment plan in place during the holidays was less than ideal," she recalled.
Luckily, her doctors at MUSC Hollings Cancer Center quickly assembled a comprehensive care plan. By the end of January, she underwent a lumpectomy to remove the tumor. That was accompanied by a sentinel node biopsy. This procedure shows whether the cancer has spread by removing and biopsying the first lymph nodes – the ones "standing sentinel" – along the path that cancer cells would take. After surgery, she moved to chemotherapy, a grueling process over nine sessions.
"Chemotherapy is a hard road," she said. "Some days were better than others. Usually, I kept myself going. But other times, I was too tired to even get out of bed. And that's OK; I allowed myself to have those days."
Next came targeted treatment every three weeks to keep her HER2-positive cancer from recurring. This type of breast cancer results from an overabundance of HER2 receptors on cancer cells, and the medication that Latham was prescribed, trastuzumab, also known as Herceptin, specifically blocks those receptors.
Clinical trials to "right-size" care
When it came time to consider radiation, she was offered a new option: participation in a clinical trial. As a National Cancer Institute-designated cancer center, Hollings offers clinical trials as an important part of its mission to improve the prevention and treatment of cancer.
For Latham, the decision had personal resonance. Before retirement, she had worked in clinical research, making her uniquely aware of the role patients play in advancing science. Joining a clinical trial in her own cancer journey felt like coming full circle.
"I was interested right away," she said of joining the trial. "Having worked in research, I know how hard it can be to find participants who meet the criteria and are willing to take part. It felt like an opportunity."
The trial Latham participated in was a national trial, led at the Hollings site by radiation oncologist Jennifer Harper, M.D. The goal of the now-concluded study was to determine whether women with early-stage HER2-positive breast cancer might safely avoid radiation.
"These types of studies help us 'right-size' treatment, which is about finding the balance between doing enough to stop cancer while avoiding unnecessary toxicity."Jennifer Harper, M.D.
Traditionally, radiation therapy is the standard of care following surgery and chemotherapy. But doctors are increasingly asking whether radiation is necessary in cases where tumors are caught early and treated with highly targeted therapies.
"Patricia's trial was designed to de-escalate the intensity of treatment for women with her form of breast cancer," Harper explained. "These types of studies help us 'right-size' treatment, which is about finding the balance between doing enough to stop cancer while avoiding unnecessary toxicity."
Patients in the clinical trial were randomly assigned either to receive radiation or to be observed without it. Latham was placed in the observation group.
Despite her confidence in the value of clinical trials, the decision carried weight. Because radiation is the current standard of care, there was a risk in not receiving it. The trial meant trading a known risk – the difficult side effects of radiation – for an unknown: whether her cancer outcomes would be as strong without radiation.
"Did I have second thoughts? Sure, because I didn't get radiation. But that's exactly the question the study was trying to answer. I knew that. I also knew that a dedicated team would be watching my health closely."
"She went into it eyes wide open," Harper said. "We had preliminary data suggesting her outcomes would still be excellent, but we couldn't guarantee it. That's the purpose of clinical trials: to answer these critical questions with the highest level of evidence."
Finding strength in daily routines
Today, surrounded by her daughter and three beloved dogs, Latham can reflect on the courage it took to step into the unknown. Her decision was made easier knowing she had that support system waiting at home. Her daughter was a constant presence, and her dogs – (Maybe It's) Maybelline, Max (the Factor) and Clover – provided comfort without words. Maybelline even accompanied her to appointments.
"She's a certified therapy dog, and the staff were so welcoming to her," Latham said.
"She loves having a job, and it made a huge difference to me having her there."
Latham also stayed active by playing duplicate bridge several times a week. The game, with its competitive structure and devoted community, has been both a welcome distraction and a source of connection. She further prioritized her physical health by walking the dogs daily and working with a trainer to maintain strength and balance.
As she continues her follow-up care at Hollings, Latham is grateful for the expertise and coordination that supported her throughout her journey.
"Being part of the Hollings approach is a benefit. You have a team of people working together for your treatment to give you the best course of care. Not only are they collaborative, but everyone is also supportive, approachable and open to questions."
Latham's background in health care helped her to navigate the complexities of cancer care. Not only did she understand medical terminology, but she also knew the value of speaking up. That self-advocacy is something she encouraged all patients to embrace.
"The ultimate decision maker is you and your family," she stressed. "If something doesn't feel right, say something. Having the right care – and the right people around you – makes all the difference."
Latham also encouraged cancer patients to consider joining a clinical trial. As Harper put it, clinical trials have ripple effects far beyond one patient.
"Many people who join trials do it not only for themselves but to contribute to medical knowledge. They recognize that the treatments helping them today came from patients before them who were willing to take part."
