The Duke Fencing men's and women's teams in their fencing whites at Northwestern University, Feb. 1, 2020. Team manager Elizabeth Beguinet (center in grey) is flanked by team captains Eoin Grooningsater (to her right) and Lindsay Sapienza (to her left) who have organized a fundraiser — Fence4TheFight against breast cancer — in Elizabeth's honor. (photo courtesy of Duke Fencing, Duke Athletics)
Keep Calm and Parry On
Published
From the Duke Cancer Institute archives. Content may be out of date.
Duke Fencing's Elizabeth Beguinet comes to the Oncology Treatment Center at Duke Cancer Center Durham for a chemotherapy infusion every 21 days. On this day, January 8, 2020, she's feeling good. (photo by Julie Poucher Harbin)
In September 2016, beloved long-time director of administration and recruiting for Duke Fencing, Elizabeth Beguinet, was diagnosed with breast cancer. Shortly thereafter, she learned that the cancer had spread to her bones.
Shock, and no small amount of fear, rippled through her tight knit family — from her husband, Duke Fencing head coach Alex Beguinet, to their daughter Heather, a Duke alum, to Elizabeth’s sisters and extended family — all of them recognizing that, with stage 4 cancer, she was in the bout of her life.
Scans scheduled ahead of her first chemotherapy treatment revealed several metastases in her hip (in the ilia of the pelvis) and on her spine, which spurred Elizabeth’s oncologist Kimberly Blackwell, MD, to revise the original chemotherapy drugs to ones more in line with the now stage 4 diagnosis.
Two days after her first chemotherapy, Elizabeth and her daughter flew to Hawaii for a long-planned vacation to Hawaii with her sisters. Warned that the chemotherapy would cause her to lose her waist-long hair, she cut it to shoulder-length before the trip. While there, it began falling out.
Elizabeth and Alex waited several weeks — until the fencing season was over — to tell colleagues and the fencing program students and parents about Elizabeth’s cancer. When they did go public with the news, they were touched by a flood of cards, e-mails and phone calls of support.
After a year of chemotherapy, the sudden growth of one of the tumors necessitated a revised plan to include lumpectomies and removal of several nearby lymph nodes, followed by six weeks of radiation to the lumpectomy and node-removal sites.
Some of the student-athletes came to sit with her during intravenous chemotherapy treatments — the roles temporarily reversed for the “team mom,” as they called her, who was so accustomed to being their cheerleader and shoulder to cry on.
A special video tribute created for Duke Athletics at the end of 2017 — The Spirit of Beguinet — had Elizabeth tearfully reliving her first year of treatment, with Alex by her side. Alex said, proudly, that she “took the bull by the horns.” He admired her strength and positivity. He couldn’t be sure that he’d have handled it quite the same if cancer had happened to him.
Where did the time go?
Elizabeth Beguinet was born in Winnipeg, Canada, north of the Dakotas. Her parents, both originally from Holland, moved the family west to Portland, Oregon, when she was sixteen.
While in her mid-20s, she made a life-changing decision. She enrolled at Mt Hood College in Portland and selected fencing as her PE class. The school’s fencing team coach, Alex Beguinet, from Toulouse, France, was the instructor. They were about the same age, had much in common with their European backgrounds, and they hit it off.
When the semester was over, they started dating. In 1983, they married. Two years later, Alex was recruited to coach fencing at Duke University. Before Elizabeth could complete her degree, they were headed cross-country with their daughter.
Elizabeth had been a volunteer program manager for the Duke Fencing team from the start. Still staying involved with the program, Elizabeth earned her Bachelor’s degree in 2002,in Interdisciplinary Studies (Mathematics, Sociology and Women Studies)from the University of North Carolina at Chapel Hill as a part time college student over ten years. Once she had earned her degree, she was able to devote all of her time as volunteer manager with Duke Fencing.
Career highlights included serving, in 1991, as a manager at the Olympic Festival in Los Angeles, being team co-manager for the 2006 Junior/Cadet World Championship Team in Taebaek, Korea, and being team co-manager for the 2006 Senior World Championships in Turin, Italy.
A New Year
The sun is flooding through the window of Infusion Room 50 on the fourth floor of Duke Cancer Center Durham. It’s mid-afternoon on Wednesday, January 8, 2020.
“Cancer,” explains Elizabeth, “is just the thing I have, the thing I live with.”
She’s managed to work her infusions (every 21 days) into her busy schedule of recruiting trips, competitions and team functions. Her hair has grown back to shoulder-length since that 2017 video.
“I just had a haircut recently and this could actually be the same dress that I was wearing in that video interview; that would be very funny,” she says, happily agreeing to have a new photo taken.
As what Elizabeth calls her “beloved poisons” cycle through her veins, she speaks frankly about what she calls her “chronic disease.”
She recounts how last August several new tumors appeared on her spine. Radiation therapy quickly took care of it. But an insurance glitch left her with no follow-on treatment at all for three-months.
“During those months, I was scared to death,” Elizabeth shares. “I didn’t know what the November scans were going to show. That was hard. To just keep living… It was overwhelming.”
Adding to the stress, she traveled back and forth twice to the west coast to help her sister after a death in the family.
In November, she was relieved to learn, thanks to “a little bit of luck,” that there was no active cancer anywhere. She resumed treatment. The holidays, spent with family, were quiet.
“We’d just had a loss and everybody was wondering (aloud), “Are you next?”” says Elizabeth. “And I said, “Could be, could be, love me while you got me.””
Beguinet says that fencing skills are good life skills and good coping-with-cancer skills.
“Be in the moment. If your opponent beats you and you are coming off the strip, you can’t dwell on that loss because that next opponent is waiting for you,” she says. “And if you come in wearing the defeat that you just encountered, then you are coming in defeated. You just have to experience what happened, process it, then let it go because in that next moment, you have to be there and be ready to go… especially when you’re in the midst of the fight. From one day to the next, there’s always some new thing that’s being presented to you.”
There’s a sign at the gym that reads “Keep Calm and Parry On.”
“Parry” is a fencing blade-work maneuver intended to deflect or block an incoming attack. If the next incoming is another tumor, she, her family, her Duke oncologist, Paul Kelly Marcom, MD, and her fencing students will do their best to parry on.
Fence4TheFight
Elizabeth’s fencing students are asking donors to partner with the team and Duke Cancer Institute to Fence4TheFight against breast cancer in Elizabeth's honor.
Duke seniors Eoin Grooningsater (captain of the men's fencing team) and Lindsay Sapienza (captain of the women's fencing team) co-founded the fundraiser.
"She's not just our recruiting coordinator, or travel coordinator, or seamstress for our uniforms," said Grooningsater. "She’s been our confidant, our coach, our on-campus mom, and our family for 35 years. And when a member of our family fights, we all fight."
She's not just our recruiting coordinator, or travel coordinator, or seamstress for our uniforms," said Grooningsater. "She’s been our confidant, our coach, our on-campus mom, and our family for 35 years. And when a member of our family fights, we all fight."
Patient Update (January 11, 2023)
The Duke fencing team, in partnership with the Duke Cancer Institute, announced the Fence for the Fight campaign would relaunch for the 2023 season in memoriam of Elizabeth Beguinet who passed away after a long battle with breast cancer on Dec. 17, 2022. The goal is "to raise enough money to name a room after Elizabeth in the Duke Cancer Institute so her memory and her fight will continue to inspire others just as she's inspired us."
For decades, a diagnosis of metastatic breast cancer has carried a clear message: while treatments can help control the disease and extend life, the disease is generally considered incurable. As a result, treatment strategies have traditionally focused on managing cancer and maintaining quality of life rather than pursuing a cure.New advances in breast cancer therapies are changing that conversation. Research led by Duke Cancer Institute breast surgical oncologist Jennifer Plichta, MD, suggests that some patients with limited metastatic breast cancer may benefit from a more aggressive treatment approach than has traditionally been offered. The findings, published in JAMA Surgery, add to growing evidence that metastatic breast cancer is not the same for every patient and that treatment decisions may need to become more personalized.Plichta's research builds on years of work focused on improving how physicians classify and predict outcomes for patients with breast cancer. Historically, a diagnosis of metastatic, or stage IV, breast cancer, was associated with poor survival. However, the development of targeted therapies and other advances in systemic treatment have dramatically improved outcomes for many patients."Many women with metastatic breast cancer are now living for years and sometimes even a decade after diagnosis," Plichta said. "We've come a long way in terms of treatment options and survival."At the same time, researchers have discovered significant variation among patients with metastatic disease. Some experience aggressive cancer that progresses quickly, while others have relatively limited disease that remains controlled for long periods.This variability led Plichta and her colleagues to ask an important question: Are there certain patients with metastatic breast cancer who could benefit from treatment strategies typically reserved for patients with earlier-stage disease?The study focused on patients with what is known as oligometastatic breast cancer, a form of metastatic disease in which cancer has spread to only a limited number of sites. Researchers believe this group may represent a distinct subset of patients whose disease behaves differently than widespread metastatic cancer.Using data from the National Cancer Database, which captures information on many newly diagnosed breast cancers in the U.S., the team analyzed outcomes among patients with limited metastatic disease. They examined whether patients received treatment directed at the primary breast tumor, treatment directed at metastatic sites, both treatments, or neither.The goal was to determine whether a treatment approach that more closely resembles care for stage III breast cancer—combining systemic therapy with aggressive local treatment—might improve outcomes for selected patients."What stood out was that removing the primary breast tumor seemed to be the factor most strongly associated with improved survival," Plichta said. "Treating the distant sites did not appear to offer the same survival advantage on its own."While previous studies have explored surgery for patients with metastatic breast cancer, results have been mixed. Plichta believes one reason may be that metastatic breast cancer is often treated as a single category, even though patients can have vastly different disease characteristics and prognoses.One of the most significant implications of this research is how clinicians think about treatment goals. Patients with stage III breast cancer are typically treated with curative intent, meaning doctors use every appropriate therapy available, including chemotherapy, surgery, and radiation, in an effort to eliminate the disease. Patients with metastatic breast cancer, by contrast, are usually treated with palliative intent, focusing on disease control rather than cure.But as outcomes improve, the line between those groups may not be as clear as it once was."We're seeing some patients with metastatic disease living longer than patients with locally advanced breast cancer," Plichta said. "That raises important questions about whether some patients with limited metastatic disease should be approached differently."Because the study was retrospective, the results point to an important association that warrants further study. Several clinical trials are now being developed to investigate curative-intent treatment strategies in specific subgroups of metastatic breast cancer patients, including those with HER2-positive disease. Duke hopes to participate in these multi-institutional studies as the field continues to evolve.As breast cancer treatments continue to improve, researchers are gaining a more nuanced understanding of metastatic disease. For Plichta, the study represents an important step toward that goal."I hope this work encourages further research into which patients may benefit from a curative-intent approach," she said. "The ultimate goal is to find the right treatment strategy for the right patient."
For decades, a diagnosis of metastatic breast cancer has carried a clear message: while treatments can help control the disease and extend life, the disease is generally considered incurable. As a result, treatment strategies have traditionally focused on managing cancer and maintaining quality of life rather than pursuing a cure.New advances in breast cancer therapies are changing that conversation. Research led by Duke Cancer Institute breast surgical oncologist Jennifer Plichta, MD, suggests that some patients with limited metastatic breast cancer may benefit from a more aggressive treatment approach than has traditionally been offered. The findings, published in JAMA Surgery, add to growing evidence that metastatic breast cancer is not the same for every patient and that treatment decisions may need to become more personalized.Plichta's research builds on years of work focused on improving how physicians classify and predict outcomes for patients with breast cancer. Historically, a diagnosis of metastatic, or stage IV, breast cancer, was associated with poor survival. However, the development of targeted therapies and other advances in systemic treatment have dramatically improved outcomes for many patients."Many women with metastatic breast cancer are now living for years and sometimes even a decade after diagnosis," Plichta said. "We've come a long way in terms of treatment options and survival."At the same time, researchers have discovered significant variation among patients with metastatic disease. Some experience aggressive cancer that progresses quickly, while others have relatively limited disease that remains controlled for long periods.This variability led Plichta and her colleagues to ask an important question: Are there certain patients with metastatic breast cancer who could benefit from treatment strategies typically reserved for patients with earlier-stage disease?The study focused on patients with what is known as oligometastatic breast cancer, a form of metastatic disease in which cancer has spread to only a limited number of sites. Researchers believe this group may represent a distinct subset of patients whose disease behaves differently than widespread metastatic cancer.Using data from the National Cancer Database, which captures information on many newly diagnosed breast cancers in the U.S., the team analyzed outcomes among patients with limited metastatic disease. They examined whether patients received treatment directed at the primary breast tumor, treatment directed at metastatic sites, both treatments, or neither.The goal was to determine whether a treatment approach that more closely resembles care for stage III breast cancer—combining systemic therapy with aggressive local treatment—might improve outcomes for selected patients."What stood out was that removing the primary breast tumor seemed to be the factor most strongly associated with improved survival," Plichta said. "Treating the distant sites did not appear to offer the same survival advantage on its own."While previous studies have explored surgery for patients with metastatic breast cancer, results have been mixed. Plichta believes one reason may be that metastatic breast cancer is often treated as a single category, even though patients can have vastly different disease characteristics and prognoses.One of the most significant implications of this research is how clinicians think about treatment goals. Patients with stage III breast cancer are typically treated with curative intent, meaning doctors use every appropriate therapy available, including chemotherapy, surgery, and radiation, in an effort to eliminate the disease. Patients with metastatic breast cancer, by contrast, are usually treated with palliative intent, focusing on disease control rather than cure.But as outcomes improve, the line between those groups may not be as clear as it once was."We're seeing some patients with metastatic disease living longer than patients with locally advanced breast cancer," Plichta said. "That raises important questions about whether some patients with limited metastatic disease should be approached differently."Because the study was retrospective, the results point to an important association that warrants further study. Several clinical trials are now being developed to investigate curative-intent treatment strategies in specific subgroups of metastatic breast cancer patients, including those with HER2-positive disease. Duke hopes to participate in these multi-institutional studies as the field continues to evolve.As breast cancer treatments continue to improve, researchers are gaining a more nuanced understanding of metastatic disease. For Plichta, the study represents an important step toward that goal."I hope this work encourages further research into which patients may benefit from a curative-intent approach," she said. "The ultimate goal is to find the right treatment strategy for the right patient."
