At the end of those six months, Siple again got bad news. The cancer was now in her liver.
Wary, but willingSiple learned about the Hopkins vaccine through an early participant who appeared cancer-free. Still wary of fully embracing traditional medicine, she saw the vaccine as the next best thing to alternative medicine, something that would harness the body's healing power to go after cancer's mutant cells without the side effects of most cancer drugs.
Spending so much time in Baltimore, Siple wasn't content to just go from appointment to appointment. In her downtime, she would hop on the subway or the light rail, against the advice of the friends of friends she was staying with who warned her it might not be safe.
Right away, the other passengers could tell she wasn't from around here. And they were happy to chat with this outgoing woman they encountered. She would mention why she was in town, cancer and all. They would ask how she stayed so positive. She loved when they asked her that. It gave her an opening to preach about God and her "awesome hope" and how when she dies she will wake up in Paradise. It allowed her the face time with strangers that she relishes as a Jehovah's Witness, the faith that keeps her so up even when circumstances don't call for it.
Three months of waitingFor three months, Siple has been waiting to find out whether the vaccine is working. Now she waits some more, as Emens answers a page about another patient. She talks to her husband, Cory, by cell phone, setting up its speaker so he can listen in to whatever the doctor has to say. After what seems like an eternity, Emens is ready to let her patient know the score.
"The news isn't perfect," Emens begins, "but it's not terrible."
The tumors in her liver - there are four of them, two the size of walnuts, two the size of limes - have grown a bit. But there are no new ones.
Had there been more growth, Siple would be kicked off the trial, sent off to find another treatment. Instead, Emens schedules Siple to return in August, three months from now. Then they will take a new set of pictures and, if the cancer hasn't spread, she can get her fourth and final round of vaccines.
Siple is sure the last doses will kick-start her recovery. "It just seemed like I reacted really quickly to the last vaccine," she tells Emens. "I felt like something had changed in my body."
Looking for something positive to hold on to, Siple asks Emens how the others have fared: Have they seen their tumors grow only to shrink later on? Emens doesn't have an answer. So few women have gotten the vaccine. She doesn't have enough experience to draw on.
"Sometimes with immune therapy," Emens offers, "you can have a kind of delayed response." The limited literature suggests it is possible.
That is exactly what Siple wants to hear.
She starts making plans - to go to the North Carolina mountains and to take that Colorado hiking vacation she has been dreaming of. Maybe she'll spend some time with her sons. She'll go back to serving the tourists at Disney's Animal Kingdom, as long as she has the energy for it.
This summer could be her last. She's going to live as if it is. "I'm just being realistic," she says as she heads away from Hopkins on a bright spring afternoon. "There's no next time in my life anymore."
more on the seriesTomorrow in The Baltimore Sun: How a student of science came to devote her life to developing a vaccine for breast cancer, the disease that killed her mother.
On the web: Watch a video of Dr. Leisha Emens discussing her quest to develop a breast cancer vaccine at baltimoresun.com/vaccine
Monday on WJZ: Watch one woman's personal story as she battles breast cancer. Can this study save her life? See the interview at 11 p.m. Monday on WJZ Maryland's News Station