Technology to help bridge communication gaps

As her tumor swells, new cancer intelligence platform brings Cynthia Herrera closer to her care team

SANTA MONICA — Despite a shocking cancer diagnosis in 2013 — a defining moment that signaled the start of countless doctors’ appointments and treatments — Cynthia Herrera has remained determined to keep her life and attitude intact.

For nearly a decade, Herrera has fought back a relentless sinonasal tumor, identified as olfactory neuroblastoma. Her care team at Providence Saint John’s Health Center and the Pacific Neuroscience Institute (PNI) have aided her on this journey, which has seen Herrera undergo a myriad of procedures like open-brain surgery and several endoscopic endonasal biopsies. But, despite enduring years of illness, the La Habra resident and former educator has refused to let her cancer diminish her upbeat disposition at home or work.

“At one point, I had lost all my hair from the chemotherapy, so I used to enjoy visiting schools with different-colored wigs,” quipped Herrera, who routinely treks some 40 miles west to the Santa Monica-based health center for treatment. “I had a wig for every occasion. My colleagues would always make remarks about what wig I would show up with. I had a lot of fun with it.”

With the help of her family and colleagues, Herrera has gone to great lengths to preserve a sense of normalcy, no matter the physical toll. From pushing her fatigue aside to help her daughter move into her college apartment in Austin, Texas, to safely concealing chemotherapy needles in her arm before heading to work, Herrera has maintained her daily routines as much as her health will allow.

“I needed to keep things as normal as possible,” she said. “If I was just sitting around, I don’t think it would have been a positive thing for me.”

While her sense of humor and self-proclaimed stubbornness have remained unmarred, Herrera has experienced several setbacks since her initial diagnosis, which resulted in a drawn-out battle with cancer. Lurking behind every appointment, MRI and lab result has been the threat of bad news that could upend her progress — a reality she has lived with for the last nine years. 

Unfortunately, the tumor cannot be completely surgically removed without risking permanent damage to her vision because of its location, according to Akanksha Sharma, MD, Herrera’s neurooncologist at PNI. Because of this, Herrera’s care team has utilized a multi-pronged approach to treatment that must be adapted to address changes in Herrera’s health.

At one point, doctors told Herrera they believed her cancer had gone into remission. Now, though, they say her tumor is growing again, moving from the left orbit of her brain to the right.

With the tumor swelling, Herrera benefited from a new, leading-edge cancer intelligence platform recently deployed at Providence Saint John’s. Developed by Project Ronin, a Larry Ellison-funded company, the platform enables cancer patients and their clinical teams to manage treatment symptoms better, prevent avoidable emergency department visits, raise the standard of care and improve patient outcomes.

For the last three weeks, Herrera had the opportunity to take advantage of the platform’s symptom-monitoring mobile app, connecting her with her physicians in real time. She says it has facilitated better communication and understanding between her and her caregivers. Ronin’s cancer intelligence platform is comprised of: a patient engagement system, a treatment insights and triage dashboard for clinicians and predictive data analytics that enhance notifications and support the decision-making process.

Three times a week, the mobile app prompts patients to track their symptoms through a symptom survey. It alerts the patient’s care team if their symptoms require medical follow-up. In the few weeks since the platform’s official launch, 52 patients have downloaded the app.

“This platform has given us unfettered insight into how Cynthia is feeling from day to day,” Dr. Sharma said. “The continual reporting, at her own convenience, not only helps us keep track of the types and intensity of symptoms, but also helps us learn what is considered normal for the patient and allows us to quickly identify any pattern changes that could be alarming.”

According to Dr. Sharma, the app has already proven effective.

Since her latest biopsy, Herrera has experienced discomfort in the eye the tumor sits behind. The app, Herrera said, allows her to provide her care team with daily updates that have resulted in a couple medical check-ups.

“I’ve always had really good communication here, but this app is just so practical. It’s so easy to open up and write how I’m feeling,” she said. “It’s a great reminder to me that even though I may think I’m fine, I need to pay attention to my symptoms.”

Since downloading the app, The Ronin platform has brought Herrera closer to her care team and allowed her to report issues that she may have not otherwise brought up.

“I think (the app) came along at a good time,” Herrera said. “If it’s a bad day, if I’ve been vomiting or feel ill, they respond right away and that’s been super helpful.”

In her journey to health, Herrera will continue to look for ways to live life to the fullest. This time, however, she’ll have a new tool to help her overcome challenges she may face.