Early detection, excellent medical oversight, and 25 TomoTherapy treatments at the Precision Radiotherapy Center have enabled Sandy to attack breast cancer without missing a step. Her story is a model of what can happen when best practices and best available technologies intersect.
Sandy did her part by scheduling regular mammograms. Her radiologist did his part when, after studying micro-calcifications on an inclusive mammogram in May 2008, he advised Sandy to return for another in four months. He did his part again when, after studying the new, but still indefinite, mammogram, he recommended a biopsy just to be safe. Sandy’s breast surgeon did her part when, after learning that the biopsy contained “atypical cells,” she recommended removing them via a lumpectomy.
The surgeon did her part again when, upon finding signs of cancer in the breast, she prescribed radiotherapy, which Sandy elected to have at the Precision Radiotherapy Center in West Chester, Ohio. And Sandy’s radiation oncologist, did her part by overseeing the state-of-the-art delivery of precisely targeted radiation to the area where Sandy’s cancer was located.
“I’m a very, very fortunate person, because my cancer was found so early, about as early as you could find it,” Sandy says, “and because I had such exceptional care.”
She also feels fortunate to have had access to the Precision Radiotherapy Center. “I always called it the Precision Radiotherapy Spa,” she says, with a laugh. “I said, ‘While I’m in here, could you do a little tanning while I’m getting my radiation?’”
Sandy, an artist who works in mosaics, was struck first by the center’s comfort and ambiance. “They had a beautiful piece of artwork on the ceiling, so when I was lying down, I could look up at a beautiful photograph of fall leaves,” she says. “It was very pleasant. The facility was beautiful and soothing and peaceful. And the people were amazing. It became a part of my routine, a regular part of my life. The last day I was there I said to them, ‘I'm really going to mis s you. I'm going to miss coming here. Is that a weird thing to say?’ And they said, ‘No, a lot of people say that.’”
The actual radiotherapy treatments, she says, were painless and unthreatening. The radiation was delivered in highly targeted beams, shaped precisely to the contour of the target area, and in low doses over multiple days, by a technology called TomoTherapy. The radiation was not delivered straight-on, but rather in a helical format, with beams streaming into the targeted area from all angles.
The TomoTherapy machine uses an onboard CT scanner to precisely align the patient for image-guided treatment. As the tumor shrinks during the many days of treatment, or if it shifts, the beams of radiation can be adjusted to accommodate the change.
During Sandy’s first visit, which was the most time-consuming, technicians took a battery of x-rays and built a mold for her to recline in. The mold aligned her so that radiation could be delivered to the prescribed spot every time.
“Each time I came in they would do a scan to make sure I was in the exact, correct position,” Sandy says. “Then I would lie down with my arms up. That was the only discomfort – having to hold my arms up and having to be still while the radiation was being delivered. Once you’re in the mold properly, they slide you back into the TomoTherapy machine, which is very high-tech and something like an MRI. I called it “Tom” -- short for TomoTherapy. Tom was good. A little cold, perhaps, but he is a machine, after all. So we got to know each other well after 25 visits.”
“I don’t want to get teary,” Sandy says, pausing, “but I actually would use that time to pray. I found it to be a good, quiet time, and it was good to occupy my thoughts. It wasn’t in any way painful. It didn’t hurt; it wasn’t scary. It was actually over pretty quickly. After the first three or four sessions it just started to feel very natural: go in, lie down, click the scan, then give the radiation. The next thing I knew, 11 minutes were up and I was done.”
Sandy’s only side-effect from the TomoTherapy was a bumpy, itchy, red rash, which was easily treated with a cream. She suffered no fatigue.
Sandy’s cancer was found to be hormone-receptive positive, which means that hormones played a role in its development. To combat a recurrence, she will follow a maintenance regimen by taking a hormone blocker, tamoxifen, for five years, while visiting her oncologist every three months.
But less than six months after her ordeal began, there is no outward evidence that it ever happened. Her active treatment behind her, the mosaic artist can look back at a fine mosaic of a different sort: an assemblage of people and technologies, mortared together to preserve her life.
According to the American Cancer Society, breast cancer is the most common cancer among American women, except for skin cancers. About 1 in 8 (12%) women in the US will develop invasive breast cancer during their lifetime. The American Cancer Society's estimates for breast cancer in the United States for 2013 are:
At this time there are more than 2.8 million breast cancer survivors in the United States. (This includes women still being treated and those who have completed treatment.)
'Sandy's Story' is about one patient's health-care experience. Please bear in mind that because every patient is unique, individual patients may respond to treatment in different ways. Results are influenced by many factors and may vary from patient to patient.