Over the past five years, advances in the field of oncology have changed the face of cancer. New treatments and clinical trials begin almost daily, offering patients longer lives and improved quality of life. In a word, these advances give new hope, and the
majority of treatments can be accessed right here in Cumberland. At the UPMC Western Maryland Schwab Family Cancer Center, we offer cutting-edge technology, along with the compassion and personal care of local providers, while taking advantage of our relationship with the world-class research of the UPMC Hillman Cancer Center.
In a recent interview with Dr. Lawrence Shombert, radiation oncologist here at UPMC Western Maryland, we talked about just how far the field has come. Early in his career, he chose to pursue radiation therapy over chemotherapy, as it offered the most curative potential for patients at the time. He remembers hearing one of his professors share that the average lifespan for chemo patients was one year.
That is far from the case today. “As we get better at screening and diagnostic methods and earlier detection, we’re finding smaller tumors,” he says. “Consequently, we don’t need to treat with the same amount of radiation as before.” Of course, early detection
equates to smaller volumes of radiation, less invasive treatment, and higher survival rates. “Imaging has changed the way we treat,” he says. With the advent of the PET scan, doctors can pinpoint the exact location of the tumor and its size, as well as detect cancer in the lymph nodes.
But not all cancers can be treated alike. While there is significant crossover today, combining highly sophisticated radiation therapy and targeted medications for chemo-
therapy, the prognosis still determines what course of treatment is most effective. Shombert says that the greatest challenge today is not eradicating the tumor but limiting the side effects of treatment. “The interesting thing is that doctors were curing tumors as early as the 1920s,” says Dr. Shombert. “They just had a lot of side effects. We knew how to remove the tumor; we just hadn’t mastered doing so without harming the organs around it.”
How do we balance getting a dose of radiation to the tumor without affecting normal tissue? “That’s been a lot of our struggle, really, over the past four decades.” The Deep Inspiration Breath Hold (DIBH) treatment, a newer, more advanced technology, does just that. By delivering radiation only to targeted points during the patient’s breathing cycle, DIBH reduces exposure to the heart and lungs, especially for women with left breast cancer, where the cancer is closest to the heart. The equipment is programmed to start sending a radiation beam while the chest is expanded, suspended in a breath hold, which moves the heart and lung away from the treatment field. Then, as the patient takes a breath, her breathing rhythm prompts the machine to pause the radiation. The equipment will allow UPMC Western Maryland to treat virtually every left-sided breast cancer and provide a treatment pathway for women whose heart is too close to the chest wall. Without the equipment, the dose of radiation to the heart can cause damage to the heart muscle. Since the heart has a very limited ability to repair itself, exposure can result in permanent cardiac issues, which show up later on.
The WMHS Foundation is investing in the DIBH technology right here in Western Maryland, at a cost of about $145,000. Dr. Shombert – alongside Drs. Mavromatis and Zaman, medical oncologists – felt this next step was a vital link toward advancing treatment options for their breast cancer patients. Through the generosity of our donors, the Foundation raised the funds at our annual Golf Classic to secure this equipment. The balance of proceeds from the tournament will be applied to cancer patient assistance, for those in need (see article below).
“There is hope today. People are living longer and living better following cancer treatment,” says Dr. Shombert.
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