Innovative cancer treatment saves renal medullary carcinoma patient and her pregnancy

Every cancer patient’s situation is unique. But Heather Williams’ was exceptional. 

The ER nurse from North Carolina was only 24 when she was diagnosed with stage IV renal medullary carcinoma in early 2023. This rare and extremely aggressive kidney cancer is normally found only among young Black people who carry the sickle cell trait, an inherited blood mutation. It also typically requires chemotherapy first, because starting treatment with surgery can aggravate the disease and make it spread even faster. 

Yet Heather is Caucasian. She tested negative for the sickle cell trait. She’d already had surgery locally to remove both the tumor and her right kidney. And, she was developing flank pain because the cancer was spreading. On top of all that, she was seven weeks pregnant.

“I didn't know what to do,” recalls Heather, of those stressful early days. “My prognosis was horrible. When we saw a high-risk obstetrician, she told me the baby would never survive. So, I started researching.”

Research leads to MD Anderson — and hope

That research led Heather to Pavlos Msaouel, M.D., Ph.D., a medical oncologist at MD Anderson who specializes in genitourinary cancers, including the rare type of kidney cancer that Heather has.

“The first thing he said to me was, ‘I will do everything in my power to save your baby,’” Heather remembers. “That turned out to be one of the best days of my life. He was the first person to give me any hope.”

Research leads to novel treatment plan

Heather is believed to be the first pregnant patient to come to MD Anderson with stage IV renal medullary carcinoma. So, figuring out a viable treatment plan for her was a challenge. 

“If we’d used the standard approaches,” Msaouel notes, “she almost certainly would have lost the baby."

Msaouel consulted a colleague. In this case, that colleague was his wife, Bora Lim, M.D., a medical oncologist with years of experience in treating aggressive and difficult breast cancers, including those in pregnant patients.

“We discussed some of the most common chemotherapy regimens that could be used in this situation,” Msaouel explains. “Then, we debated which ones made the most sense for renal medullary carcinoma, based on research. We didn’t want to try anything new because then we wouldn’t have long-term data that it was safe. So, we chose drugs that had been around awhile and repurposed them.”

Once Msaouel and Lim had agreed upon a treatment plan, they provided it to Heather’s local care team in North Carolina, along with exquisitely detailed instructions on when and how to administer it. A few weeks after Heather started the protocol, her pain began to subside. The treatment was working. She safely delivered a healthy baby girl on Sept. 3, 2023.

“To do something that nobody else has ever thought of or done before, based on research, and it’s successful, that’s beautiful,” Msaouel adds. “It’s what motivates us.”

Research leads to life

Heather finished her last round of chemotherapy this past May and radiation therapy for one small nodule in her left lung on June 14. She is hopeful that upcoming scans will show no evidence of disease. And, she is grateful for both her own life and that of her now 10-month-old daughter, Indy.

“Without research, I wouldn’t be here,” Heather says. “My baby wouldn’t be here. It’s as simple as that. Other pregnant moms paved the way for us. And Dr. Msouael and Dr. Lim were absolutely brilliant. My daughter is completely healthy. She’s meeting all her milestones, and just said, ‘Mama,’ for the first time. That’s something I never thought I’d hear. So, I wake up every day and just thank God.”

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