The prognosis was dire when Cheryl Grantham learned she had multiple myeloma, a rare form of cancer, in March 1999.
"I thought I'd be dead by Christmas," she said.
The best treatment to extend her life was a round of specialty high-dose chemotherapy, a course more potent than the normal chemotherapy prescribed to combat more common cancers.
Multiple myeloma is cancer of the plasma cells and the high-dose chemotherapy treatments fight it by destroying the cancerous cells in the bone marrow, where plasma originates. The treatments are intense enough that it can kill a patient. But it's one of the most effective ways to treat the cancer.
So doctors a few decades ago created a workaround using stem cells, extracting them from the patient's blood before administering the high-dose chemotherapy and then transplanting them back in to repair the damaged bone marrow after the chemo has been given.
Stem cells are given back to the patient like a blood transfusion, said Brock Whittenberger, Grantham's doctor at Billings Clinic.
Billings Clinic has been using this stem cell approach with its myeloma cancer treatments for years, and Whittenberger has been the one performing procedure.
"What it's allowed us to do is successfully treat the cancer," he said. "There's a fairly rapid recovery."
Billings Clinic was recently accredited by the Foundation for the Accreditation of Cellular Therapy for its stem cell treatment. With the FACT accreditation, those treatments will be more accessible.
The accreditation also will make it easier for insurance companies to approve the procedure and will allow Billings Clinic to conduct trials on the stem cell treatment.
Billings Clinic is currently the only FACT-accredited center in Montana.
Grantham, who was an infusion nurse at the time of her diganosis, elected to have the treatment and has outlived her initial prognosis by almost two decades.
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"I've been fine," she said. "I've been alive for 18 years."
Unexpectedly, the treatments helped her become a better nurse.
"It made me more empathetic," she said.
The stem cell treatment eradicates certain forms of lymphoma but it won't cure Grantham's cancer. At some point the multiple myeloma will return.
Until then, she visits with her doctor every three months for blood work and works to keep her focus on the now.
"With a diagnosis like that you have short-term goals," she said.
Her youngest son was in high school in 1999, and she was still working full time as a nurse. As much as she wanted to crawl under her covers and not face the reality of her cancer diagnosis, she had no choice but to move forward.
"It made me be normal," she said.
And it helped her focus on what was important in the moment. The Christmas before she began her treatments, she took her three sons to the Cayman Islands for the holidays.
"Because everything was going to change," she said. "You just do it."
And it's an attitude she still carries. Her youngest son, long graduated from high school, is now married. These days, she's hopeful he'll give her a grandchild.
"That's my goal now," she said, smiling.