Taking Treatment & a Half Marathon, Together, One Step at A Time

The relationship between a cancer patient and their care provider is a special one.  Between radiation therapy appointments, hours of chemotherapy, and even sometimes surgery and recovery, there’s not much that can strengthen this bond, besides running a half marathon.

Dana and Tiffani

But Tiffani Tyer, a nurse practitioner in Radiation Oncology at the University of Maryland Greenebaum Comprehensive Cancer Center (UMGCCC), and Dana Deighton’s journey started long before this year’s Maryland Half Marathon & 5K.

About 3 years ago Dana was diagnosed with stage IV esophageal cancer.  At 43 years old with 3 young children, it was, in Dana’s words, “unfathomable.” She traveled up and down the East Coast looking for a treatment plan that would give her the most hope. Many acted like she was naïve and unrealistic for even seeking out treatments beyond palliative chemotherapy.

After much deliberation, Dana settled on a plan of 8 cycles of chemotherapy at one local hospital. During this treatment, a friend introduced Dana to Mohan Suntha, MD, a radiation oncologist at UMGCCC.

Within an hour of getting Dana’s information, Dr. Suntha gave her a call. While he agreed the appropriate preliminary step was chemotherapy, he did not close the door on her like many others.  Dr. Suntha and Dana continued to check in with each other throughout her chemotherapy treatments to see how things were going.

In December 2013, after Dana finished chemotherapy, she learned she would not be considered for radiation or surgery by the hospital where she was initially treated. She was told that the data did not support it. She was devastated. Dana returned to UMGCCC, where Dr. Suntha and Tiffani were always willing to reassess her situation and provide guidance when obstacles seemed insurmountable.  Knowing that every case is different, he agreed to reevaluate her.

tiffani dana and dr sunthaAfter careful consideration and determining that her distant disease had indeed resolved, he offered her local treatment with chemotherapy and radiation targeting the primary site in her esophagus.  While the local treatment helped, the primary site still showed evidence of persistent disease at the end of her treatment.  To try to avoid major thoracic surgery, an endoscopic mucosal resection was attempted, but was unfortunately unsuccessful. Dana was again devastated. She felt like it was just another blow to her journey to health and she was running out of options.

Dr. Suntha and Tiffani encouraged Dana to stay hopeful. They agreed along with many other providers that indeed she was in a difficult position. After many tumor board discussions and repeat imaging studies to confirm her extent of local disease thoracic surgeon Whitney Burrows, MD, was consulted. He discussed surgical salvage to address her only site of cancer.  Albeit risky, with no guarantee of a survival benefit, it was her only remaining local treatment option.  Recognized as a long shot with a real possibility of acute complications related to such a long and complicated surgery, she willingly consented to undergo the esophagectomy. From Dana’s view the benefit far outweighed the risk. She believed in her team and her surgeon, whose expertise is well established in post chemoradiation patients. It proved to be a good choice and offered a huge reward.  Dana recovered well and was cancer free and feeling great–until July 2015.

It was then that a routine interval scan revealed a new lymph node mass in her Axilla (near the armpit) was biopsied and confirmed to be recurrent esophageal cancer.  Dana had resigned herself to more draining rounds of chemotherapy after another surgery could not remove all of the cancer.  But again, Dr. Suntha, Tiffani, and medical oncologist, Dan Zandberg, MD, always made sure all options were presented and considered.

tiffani zandberg and sunthaDana’s case was represented to  their colleagues at a tumor board meeting on the Friday before she was supposed to start chemotherapy.  Drs. Suntha and  Zandberg called her that evening to  recommend  immunotherapy, which harnesses the power of a  patient’s immune system to fight cancer.  After a sleepless night, Dana agreed.   She now receives treatments of Nivolumab every 2 weeks for at least a year.

Dr. Suntha has always recognized that there’s something unusual about Dana’s case, and has often asked, “Is there something different about her biology? We don’t know.”

Dr. Suntha, he also believes that Dana’s strong will and clear ability to advocate for herself has facilitated part of the success of her care.

dana and tiffaniThroughout these three years, Dana describes herself as lucky enough to continue her usual regimen of walking, running, and exercising consistently.  She donated money to the Maryland Half Marathon & 5K to fund cancer research in the past, but feeling much healthier and up to a new challenge, she promised to run it in 2016. She has always ran 10 milers in her hometown of Alexandria, Virginia, but knew those 3 extra miles of hills in the Half Marathon would be challenging.
Despite her reservations, in a partnership with Tiffani, the Radiation Oncology Greene Street Dream Team was born. On May 14th, Tiffani and Dana ran the entire race together (even though, according to Dana, Tiffani could’ve run circles around her).  To date, they’ve raised more than $10,000. They’ve taken every step together in cancer treatment and every step in the half marathon & 5K – a true bond that will continue.

Fundraising for the Maryland Half Marathon and 5K that supports this Radiation Oncology Dream Team and their patients continues until June 30th.

You can donate to Tiffani & Dana’s team here.

Ringing in Hope for Cancer Patients

For David Taylor, ringing the bell on the wall in the main waiting area of the Department of Radiation Oncology at the University of Maryland Marlene and Stewart Greenebaum Cancer Center marked the end of 42 days of radiation treatments for prostate cancer – and the beginning of a new chapter in his life.

The Department of Radiation Oncology treats nearly 1,000 patients at the cancer center each year. Several times a day, the waiting area erupts in cheers and applause as patients, joined by family members and radiation oncology staff, ring the bell to celebrate their final day of radiation treatment.

Read the entire story here

Radiation Therapy and Patient Safety

By William F. Regine, M.D.
Chief of Radiation Oncology

Editor’s Note: In response to an article in the New York Times on January 24, 2010, about radiation injuries to patients, Dr. William F. Regine provided the following comment. Dr. Regine is chief of radiation oncology at the University of Maryland Marlene and Stewart Greenebaum Cancer Center and professor and Isadore and Fannie Schneider Foxman chair of radiation oncology at the University of Maryland School of Medicine.

An article in the New York Times highlights several cases of radiation over-exposure in cancer patients in several New York hospitals in 2005. We are concerned that the article could make some patients fearful of receiving radiation therapy. This would be disastrous, since radiation therapy is by far one of the safest and most effective forms of cancer treatment.

We want to reassure all of our patients that their safety is our number one priority. In fact, our hospital has been recognized as one of the nation’s best hospitals for patient safety and quality of care for the past four years in a row by the Leapfrog Group, a national public assessment of hospital safety and quality performance. We strictly follow the highest standards of quality assurance in providing radiation therapy to patients.

Radiation therapy actually has an extremely low rate of errors, due to the many checks currently in place to ensure patient safety. As noted in the article, an estimated 35 million treatments were administered last year on equipment made by Varian Medical Systems alone, with about 70 instances of mistakes that affected or nearly affected patient care. While this is a very low rate, even assuming significant under-reporting, even one such mistake is too many.

The errors described in the article were associated with the lack of quality assurance processes. At our center, we strictly follow a comprehensive set of safety rules. These include: 1) machine-related QA checks, including a daily check of the beam output and monthly physics checks of all equipment; 2) secondary calculations to verify the accuracy of the radiation dose calculated by our treatment planning systems; 3) a review of all treatment plans by medical physicists; 4) quality assurance checks of Intensity Modulated Radiation Therapy (IMRT) plans prior to treatment; 5) review by the therapist staff to verify agreement between the radiation dose in the treatment plan and the treatment console; and 6) verification of the physician’s written directive, the prescribed dose and the patient’s identity.

Since 2005, when the events described in the New York Times article occurred, two national-level professional meetings have taken place to specifically address errors in radiation therapy. A member of our faculty in the Department of Radiation Oncology was selected to serve on a special task force launched by the American Association of Physicists in
Medicine (AAPM)
to study safety processes in radiation oncology. Both the AAPM and the American Society for Radiation Oncology (ASTRO) continuously work to strengthen training, quality assurance and safety in radiation oncology.

All treatments pose risks, and patients should discuss them with their doctors. Our staff is committed to the very highest standards in the delivery of radiation therapy to our patients. Please feel free to discuss your treatment plan and our quality assurance processes with your radiation oncologist or with any member of our staff.