In May 2008, as she was preparing for her oldest daughter’s high school graduation, Pam Schnettler had a seizure. Doctors searched for what caused the seizure in the otherwise healthy woman. It wasn’t long before they had an answer — Pam had brain cancer.
Nearly 10 years later, countless medications have kept Pam alive and provided her with an overall good quality of life, but the medications have also caused many side effects.
“I would describe myself as very sensitive to drugs,” Pam, now 56-years-old, said.
After Pam’s seizure and diagnosis, she was prescribed a seizure medication that made it impossible for her to keep weight on and that made her feel “sick, dizzy, and shaky all the time.”
Seeing how ill the medication made Pam, her doctors opted for a different one. Her side effects improved after the prescription change, but Pam’s issues with medications didn’t end there. Soon after she was diagnosed with cancer, Pam started suffering from anxiety, something that is common among people with cancer. Her doctor prescribed an anxiety medication, fluoxetine (Prozac).
“When I started taking Prozac, it was horrible. I wanted to crawl out of my skin,” Pam reflected.
Doctors eventually found a better anxiety medication for Pam, but only through trial-and-error — first prescribing a medication, waiting to see its effects, and changing it again when it didn’t work. This timely trial-and-error process, which was accompanied by side effects, only added to the anxiety Pam was already experiencing.
Then, after two separate surgeries, Pam learned that she also struggled with anesthesia and pain medications. After one of the surgeries it took hours for Pam to wake up. After both surgeries, the pain medications caused her agonizing nausea.
“It was like gambling each time I had to take a new drug. How I would feel after taking a new drug was such an unknown,” Pam said.
“It was like gambling each time I had to take a new drug. How I would feel after taking a new drug was such an unknown.”
In early 2017, Pam’s doctors told her she needed brain surgery. She thought back to her past surgeries, remembered the debilitating side effects of the pain medications, and knew she didn’t want to go through them again.
Fortunately, from the time she was diagnosed in 2008 to the time when she needed brain surgery in 2017, a new field in medicine, pharmacogenomics, had emerged. Pharmacogenomic testing analyzes a person’s DNA to predict how he or she is likely to respond to a medication.
Pam learned about pharmacogenomic testing from her daughter, Erica. Inspired by her mom’s diagnosis, Erica went on to earn a Ph.D. in pharmacology with a focus in oncology. Today Erica works at OneOme and is passionate about how the RightMed® comprehensive test can help people, particularly cancer patients like her mom.
The RightMed test analyzes a person’s genes to predict how he or she will respond to hundreds of medications, including several that Pam had taken and struggled with over the years. The RightMed test held the potential to help Pam’s doctors understand which medications, and at what dose, may work best for her without causing the debilitating side effects she had become so accustomed to — all based on Pam’s DNA and how her body processes the drugs.
“I feel like I’ve been given too high of dosages so many times. That’s why when I heard about the test, it sounded like something that would be extremely helpful for me, given how sensitive I am to drugs.”
Erica encouraged her mom to bring information about the RightMed test to her doctor so that Pam’s doctors would have a resource available when making prescription decisions for her brain surgery, recovery, and future treatment. Pam brought OneOme’s patient toolkit (and her daughter) to her doctor’s appointment, and her doctor chose to order the RightMed test.
“When I heard about the test, it sounded like something that would be extremely helpful for me, given how sensitive I am to drugs.”
The test results were eye-opening for Pam and Erica. All of the medications that had made Pam so sick — the seizure medication, the anxiety medication, the pain medicines, etc. — were all marked as drugs that doctors should use caution with when prescribing them to Pam. This is because of how some of Pam’s genes affect how her body metabolizes (or processes) the drugs. In Pam’s case, the drugs likely were making her sick because she was processing the medications at a slower rate than normal, resulting in a buildup of too much medication in her system.
Pam brought the test results to her anesthesiologists, and they used the results to guide how they prescribed her pain and nausea medications for her brain surgery.
“This time, anesthesia was a breeze. I had no nausea or vomiting.”
The results also provided reassurance about Pam’s chemotherapy medication. The medicine, vincristine, showed up “in the green”1 with a recommendation for doctors to use it as directed. This served as a comforting confirmation that Pam was on a chemotherapy regimen that was processed normally by her body.
“The test results, for me, mean that I don’t have to be anxious or scared going into a procedure now that I know my doctors have information to guide their prescription decisions. Having the test results gives me a sense of calm and relief. I feel like I can now get the medical benefit of medications without dealing with all of the side effects.”
“The test results, for me, mean that I don’t have to be anxious or scared going into a procedure now that I know my doctors have information to guide their prescription decisions.”
Pam’s daughter, Erica, has been an invaluable resource for Pam in her cancer treatment. Pam feels lucky that her daughter guided her to the RightMed test and that she has such a knowledgeable caregiver. She wishes that everyone knew about the test.
Erica believes her mom’s story provides further validation for the work she does every day at OneOme.
“We don’t know which medication she’s going to be on next, but we do know she will have to go on more medications. People live longer with cancer today. It’s partially because they’re being supported by palliative medications and more targeted chemotherapies. If you have cancer, you’ll likely be on medications for life. It’s important to get them right,” said Erica.
“As a caregiver, it’s incredibly helpful to have this information and encourage the doctors to double check the report before prescribing my mom more medications. We wish we had the test results sooner, but knowing my mom will need more medications in the future, the results are such a valuable resource to have now.”2