50 time October 14, 2019
metastatic breast cancer was no reason to change
their plans. Before long, she moved into his condo
and they picked up where they had left off.
Women who have breast cancer that has spread
to the brain often die within a year or two of the
diagnosis. To shrink the tumors inside Kraemer’s
brain, one oncologist recommended she undergo
what’s known as “whole brain radiation,” an ex-
treme but common procedure for patients with
multiple brain tumors. Such treatment can cause
debilitating fatigue and permanent cognitive dam-
age. Kraemer instead enrolled in a clinical trial
to test whether a relatively new drug called Ver-
zenio could beat back brain tumors in women with
estrogen-receptor- positive metastatic breast can-
cer. Kraemer went on the drug, and most of her tu-
mors stayed the same size for eight months, a good
sign. The largest even shrank. The drug also kicked
Kraemer into chemical menopause, which her on-
cologist thought might help cut off the supply of
estrogen her type of breast cancer was feeding on.
But the drug had side effects, including chronic
diarrhea that required Kraemer to get IV fluids to
prevent dehydration. Her oncologist decreased the
dose of the trial drug, which stopped the diarrhea but
also the menopause. Soon her tumors began growing
again. The clinical- trial protocol dictated that Krae-
mer had to stop taking Verzenio—if her cancer was
growing, the drug was not working. But a new on-
cologist had a different take. Nancy Lin, a metastatic
specialist at the Dana-Farber Cancer Institute in Bos-
ton, speculated that the drug actually was working
and that the estrogen produced by Kraemer’s ovaries
was canceling out its effects. The problem was that
the clinical- trial rules did not allow patients to start
hormone therapy in the middle of the study. “I said,
‘I don’t care what I have to sell or do, someone’s going
to get me that damn drug back,’ ” Kraemer told me.
Lin lobbied the drugmaker Eli Lilly to allow Krae-
mer to have Verzenio and begin hormone therapy.
Miraculously the company agreed to sponsor a new
trial with just one patient, Kraemer.
The treatment kept Kraemer’s brain tumors stable
for six months. But in January 2018, a scan showed
they were growing. Still worried about the cognitive
side effects of whole brain radiation, Kraemer began
specialized radiation treatment that would hit only
her largest tumor. Her brain tumors remained stable
for a few months, but eventually they started growing
again. Kraemer enrolled in yet another clinical trial,
this one testing whether a drug that has been shown
to work against certain types of liver and kidney can-
cer might help women with metastatic breast cancer.
In September 2018, I flew to Chicago to see Krae-
mer. I met her and Marintzer for breakfast the day
after I arrived and couldn’t help thinking they looked
entirely, astonishingly normal, their predicament
hidden inside a relationship they were trying hard
not to define by the fact that Kraemer was battling
a disease that would most likely cut her life short.
Later that day, I asked Kraemer how her disease
affects her everyday life. She said her largest tumor
in her brain had begun to impede her ability to use
her right hand. She could no longer hold chopsticks
or write legibly. She also had frequent migraines
and once burned herself on a hot pan because she
couldn’t feel that her hand was on it. She said ever
since her targeted brain radiation, she had had trou-
ble multitasking and struggled to have a conversa-
tion if music was playing in the background. I asked
if she felt like she was dying. “Yes and no,” she said.
She had a loving boyfriend, a tight-knit family and
a good life, but her symptoms were getting worse. “I
am in a decline,” she said.
Kraemer babysat in high school, worked as a
nanny in college and chose a career as a speech
pathologist for kids. “All I wanted to do was be a
mother,” she told me. After her early-stage diag-
nosis, Kraemer froze eggs harvested from her ova-
ries, and every three months, she pays to keep them
in storage. “I know I’m not going to use them, but
I can’t stop paying for them and just throw them
away,” she said.
In December 2017, Kraemer had told me that the
upcoming Christmas holiday would probably be her
last. But in December 2018, she and Marintzer went
shopping for a Christmas tree and picked out the big-
gest one they could find. It was so large, they had to
move most of their furniture out of their living room.
“We know that the number of Christmases Lianne
has are limited,” Marintzer told me. “Let’s do it up.”
A scan in January 2019 showed that several of
Kraemer’s tumors were growing again. In the months
since, she has been treated with multiple types of
chemotherapy and more specialized radiation. But
her symptoms are becoming more pronounced. Krae-
mer’s right hand and arm are now mostly useless. Her
right foot and leg are also not working properly, and
she walks with a noticeable limp. She is weighing
whether to allow a neurosurgeon to try to excise the
largest tumor inside her brain. The surgery would
be risky, so Kraemer and Marintzer decided to take
one more big vacation. In August, they traveled to the
Greek islands and stayed on the cliffs of Santorini.
“All things considered, I’m really lucky,” Krae-
mer, now 43, told me recently. It has been more than
three years since she was diagnosed with metastatic
breast cancer in her brain. She has survived longer
than most women like her, thanks to new drugs, clin-
ical trials and creative thinking by her doctors. Krae-
mer is proof that research and science can change the
fates of metastatic-breast-cancer patients. We just
need more of it.Excerpted from Radical: The Science, Culture, and
History of Breast Cancer in America‘HOW CAN
YOU HAVE A
MOON SHOT
TRYING TO
CURE CANCER
AND NOT
MENTION
PEOPLE DYING
OF CANCER?’
—DR. CYRUS GHAJAR,
cancer biologist at
the Fred Hutchinson
Cancer Research
Center in SeattleHealth