Near the end of 2021, Lisa Hocking developed symptoms of head congestion, sinus pressure and headaches. After taking antibiotics for what was thought to be sinusitis didn't ease her symptoms, she underwent a CT. The CT revealed a mass that extended from her sinuses through the base of her skull adjacent to her brain. 

With the revelation of this complex diagnosis, Lisa realized that she needed an advanced care center to guide her. After witnessing previous family members experience coordinated care at Mayo Clinic, Lisa understood the importance of a health care team that would partner with her to make informed decisions regarding her health care journey.

Lisa worked with her local doctor to obtain a referral to Mayo Clinic in Rochester, Minnesota. She and her husband, Charles, were referred to Rhinologist and Skull Base Surgeon Dr. Garret Choby from the Department of Otolaryngology and Head and Neck Surgery. From there, things moved quickly. 

Dr. Choby met with her in a video visit from her home in Virginia. After the video visit and review of Lisa's scans, Dr. Choby recommended an in-person visit that same week to obtain a biopsy and determine next steps in care.

Before ending the telemedicine visit, Lisa communicated her enthusiastic expectations with Dr. Choby for a partnered care approach, noting "I need you to crack the door, and I will kick it down."

Charles and Lisa arrived in Rochester and met with Dr. Choby. Lisa underwent an endoscopic biopsy the following day. The biopsy results returned as sinonasal undifferentiated carcinoma, or SNUC,a rare cancer arising in the sinuses and base of the brain.

"A SNUC is a type of sinonasal cancer that is aggressive. As a high-volume referral center, we see quite a few patients with this particular tumor. Although many sinonasal cancers are best treated by upfront surgical therapy, we now understand that most SNUCs are best approached by upfront chemotherapy, referred to as "induction chemotherapy," and often followed by radiation therapy. This treatment approach has greatly improved treatment of this aggressive tumor," says Dr. Choby. 

After discussing treatment options with a multidisciplinary group of physicians, including Medical Oncologist Dr. Harry Fuentes Bayne, Radiation Oncologist Dr. Mauricio Gamez and Skull Base Neurosurgeon Dr. Jamie Van Gompel, the recommendation for induction chemotherapy and proton beam radiotherapy was discussed with Lisa.

Charles and Lisa note: "We were given unprecedented comprehensive care. We were never given false hope, and we were told exactly how it was. And there were never statements during consultation that did not provide perspective. We are forever changed by what we were given. We were given a shot. They listened to us, and they understood what we wanted."

Given Lisa's unshakable outlook and perspective, she refused to be defined by her aggressive tumor. She began induction chemotherapy and had an excellent response after three cycles. Then she moved on to combined chemotherapy and proton radiation therapy for seven weeks. She tolerated the therapy well. 

She wants others to know: "It is most important to note that I am living. My most recent scans show no evidence of disease, and Mayo Clinic gave that to me. I want to pay it forward and share my story as a way to offer hope for others so they, too, can find their partners for their needed health care journey. I also want to thank the hundreds of people at Mayo who got me to this point. Those who provided direct care and those who were behind the scenes. You saved my life."

"Taking care of Lisa has been a joy," says Dr. Choby. "We were able to work in a physician-patient partnership to tackle this cancer. A coordinated team of expert physicians working together with the patient that is in front of us — to me, that is what Mayo Clinic is all about." 

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