New Treatment for Breast Cancer Could Help Some Women Avoid Surgery

Most women diagnosed with early stage breast cancer typically have surgery to remove the tumor, followed by three to six weeks of radiation. But there’s an exciting new development in breast cancer treatment – a first-of-its kind radiation therapy system for early stage cancers that may cut the number of treatments to only a few days.

And, one day, the inventors say, it might even eliminate the need for surgery altogether for some patients.

It’s called the GammaPod, invented by scientists at the University of Maryland School of Medicine. The U.S. Food and Drug Administration (FDA) recently cleared the way for the GammaPod to be used to treat patients with early stage breast cancer, along with surgery to remove the tumor.

A treatment machine that looks like a pod and uses gamma radiation, it has the power to hit a tumor with higher doses of radiation than standard radiation therapy and the precision to avoid damaging the rest of the breast and important organs such as the heart and lungs.

“The GammaPod has the potential to significantly shorten the treatment time to a few sessions or possibly even one treatment,” says inventor Cedric X. Yu, DSc, a physicist who is a clinical professor of radiation oncology. “We envision that one day we’ll be able to neutralize a tumor with a high dose of focused radiation instead of removing it with a scalpel.

“This approach would spare patients the negative side effects of surgery and prolonged radiation treatments, significantly improving their quality of life.” Dr. Yu says.

With advances in imaging and better screening, most breast cancers are diagnosed at an early stage, when the tumor is confined to the breast or nearby lymph nodes but has not spread to distant parts of the body.

A few interesting facts about the GammaPod:

  • It targets a tumor with thousands of precisely focused beams of radiation from 36 rotating sources
  • The patient is treated lying on her stomach with her breast in a vacuum-assisted cup, which is attached to the treatment couch during treatment
  • The couch moves during treatment as radiation “paints” the tumor
  • Treatments take five minutes to 40 minutes

The GammaPod will be available to patients at the University of Maryland Medical Center in Baltimore, Md., in the spring of 2018 and at several other locations in the United States and Canada within a year.

Cancer Dietitian Talks Food, Patient Care and More

By Mindy Athas, RD, CSO, LDN
UMGCC Outpatient Oncology Nutritionist

What Does a Cancer Dietitian Do?
Hang out and eat bonbons all day? Nah (I wish!). An oncology nutritionist, also a registered dietitian (RD), in the outpatient setting at the Greenebaum Cancer Center does many things. Primarily, we are available as needed to see patients in the three major oncology treatment areas: clinic, infusion and radiation. This means you may see me running from one end of the building to another; hopefully, with time to catch a hot tea in between. Patients may also be contacted by phone or seen in the waiting areas or other ambulatory units in and around the hospital. I have also been known to catch up with patients on my cell phone while at the food store; less ideal but nonetheless still helpful.

Patient contact usually involves discussion of the nutrition issues or concerns, current food intake and tolerance, ability to take in nourishment and digest it, and nutrition support options. I also communicate the plan of care to the team(s) involved with each patient. And patients receive nutrition education handouts, references and resources. I do like to talk (can you tell?), so I got that goin’ for me, which is nice.

What Do You Talk About?
The most common nutrition issues affecting cancer patients include nausea, vomiting, diarrhea, constipation, swallow dysfunction, lack of appetite, loss of taste, sore mouth and throat, and the need for small portions. Many patients also need nutrition support, often in the form of tube feeding, but some even need intravenous nutrition. Food, however, is much more interesting to talk about than canned tube feeds. Alas, I try to make Osmolite (a tube feed formula) enticing! Complications of cancer treatment, past medical history and co-morbidities (such as diabetes, heart issues or kidney disease) also need attention.

One of the most difficult aspects of nutrition therapy involves prioritization of issues: Do we focus on the blood sugar and carbohydrate intake, the need for increased calories (much of which come from carbs) or both? The proof is in the pudding. Finding high-calorie, low-carbohydrate foods may be the answer. The most challenging is discovering which foods the patient likes, will eat and tolerate, which also meet the nutrition needs and fit into the plan of care. Like rocket science (not really).

Beyond Food
As part of the Clinical Nutrition Services Department, we all contribute to departmental and hospital-wide goals. This includes sitting on committees, attending meetings, helping peers and staff, educating the public, coordinating events, reviewing (and often revising) education materials, and developing resources for both patients, visitors and staff. Makes me sound smart, huh? One of my favorite things to do is design and develop nutrition education handouts. I also love to lecture and present information (as you can see) and my ultimate goal is to write a book (hopefully that will land me on Oprah’s couch!)

A Plan of Action
The outpatient nutrition plan of care needs to cover all the areas surrounding cancer treatment: Before, during and after. Patients often lose weight prior to starting treatment, then have tolerance problems during treatment, and pain issues afterward — all of which compound their nutrition troubles. Talk about life giving you lemons! And mud! Luckily, I have a very nice lemon-meringue mud-pie recipe. Cancer treatment may include chemotherapy, radiation therapy, hormone treatments, surgery, or a combination of these. Side effects from these treatments may impact the patient’s ability to eat normally, digest, and metabolize both food and nutrients. Stress, fatigue, pain, fear, and anxiety, as well as family and economic and social issues may all further exacerbate the poor nutrition picture. Makes you want to take a vacation!

Getting Down and Dirty
The outpatient oncology dietitian is able to take the time to discuss various options with patients and their families to troubleshoot nutrition concerns and help find a variety of answers. Nutrition handouts, references and resources are ways we provide ideas and solutions to numerous nutrition-related issues. For example, if you are feeling full quickly after eating a small portion only once daily, of something like chicken broth (a low-calorie food), this may be due to multiple factors. These may include:

  • Poor appetite
  • Sore throat
  • Slow gastrointestinal (GI) tract (from pain medications)
  • Fatigue (from treatment, stress and lack of sleep)
  • Heavy mucus/phlegm build-up
  • Constipation
  • Mouth ulcers

The nutritionist may suggest these options:

  1. Take a walk outside (to perk up your appetite, relieve stress and fatigue)
  2. Sit down with your comrade (someone you like to eat with), and
  3. Snack on some homemade Mac-n-cheese (high-calorie, easy-to-swallow food) or creamed soup with added heavy cream
  4. In a 4-ounce cup (small portion)
  5. Surrounded by a nice setting (pretty tablecloth or window view)
  6. And repeated every 2 to 3 hours (small but frequent eating)

Fix It
The RD may suggest discussing your medications with your health care team: pain meds may increase constipation by slowing down the GI tract, so you may need a laxative. Constipation can also affect your desire and ability to eat well. Medications can cause or help treat nutrition troubles. It is important to tell your team about all your medications and how they interact with you, your food and digestion, and each other. Don’t be shy about alerting your team to your problems! We may not work at Lowe’s but we can still build something together: a healthier YOU!

Eat Like a Kid (Seriously!)
Generally, eating smaller, more frequent meals and snacks is the best option. Choosing high-calorie, high-protein food gives you more bang for your buck. Think kid-friendly foods, which are often high-density (calorie/protein-rich) items in a small package. Remember Aladdin’s genie: All the power of the universe in a teeny little living space. Choose foods and drinks based on this premise. Read labels and compare. Think like a kid: eat small and often, but you don’t have to watch iCarly or Spongebob (unless you want to: they’re both really funny!)

Some Kid Favorites:

  • Peanut butter and jelly
  • Tuna salad with real mayo
  • Cheese omelets
  • Drinkable yogurt
  • Ice cream with bananas, chocolate syrup, caramel and sprinkles
  • Fruit topped with honey and whipped cream (yum!)

Other High-Calorie Ideas:

  • Juice — especially nectars
  • Creamy dressings (Ranch & Caesar)
  • Dried fruit
  • Nuts & seeds
  • Chocolate
  • Oils
  • Butter
  • Cheese
  • Bananas
  • Avocado (and guacamole-ole?!)
  • Milkshakes
  • Fruit Smoothies

For Nutrition handouts, contact me at or 410-328-5462.