Optimism, a trusted oncologist and a cancer treatment method that she has called “a miracle” have given Pamela Girsh a clean bill of health and a desire to share her story with others.
The Redmond resident is one of about 100 women who’ve successfully undergone MammoSite 5-Day Targeted Radiation Therapy at Overlake Hospital in Bellevue.
After a routine mammogram last February, Girsh was diagnosed with breast cancer. And like any woman receiving that news, she was frightened. But this wasn’t Girsh’s first experience with cancer.
In 2003, she was diagnosed with non-Hodgkin’s lymphoma. And four years after beating that disease, she was diagnosed with a gynecological cancer.
In both cases, she underwent several rounds of chemotherapy and radiation which left her so nauseous and exhausted that she could barely function.
When Girsh learned she had breast cancer, she once again turned to Dr. James Pelton at Overlake’s cancer center, who’d seen her through her other battles with cancer. Pelton had hopeful news for her.
An increase in early detection of tumors has enabled a growing number of breast cancer patients to choose breast conservation therapy, which relies on excising the tumor through a lumpectomy, rather than a mastectomy. That is usually followed with five to seven weeks of radiation, to reduce the likelihood of recurrence.
MammoSite 5-Day Targeted Radiation Therapy, which was approved by the U.S. Food and Drug Administration (FDA) in May 2002, delivers a full course of radiation in just five days, directly to the tissue surrounding the original tumor. As such, it minimizes radiation exposure to the rest of the breast, skin, ribs, lungs and heart.
“I am really lucky we caught this in the early stage,” said Girsh. “I was told that I could try MammoSite versus seven weeks of daily radiation. I came in twice a day for five days, with no side effects. There was no pain, no redness, no rash. It was nothing like my previous experiences.”
We asked her if she felt at all hesitant when Pelton first offered this treatment method, since it hasn’t been widely publicized.
Girsh, who works as a mortgage banker, replied, “I look at things in percentages. I was told I had a slightly better chance (the cancer) wouldn’t come back with MammoSite.”
But also, “I had done this two times already — the radiation and the fatigue. It was also the time spent, the cost of commuting back and forth, how this interfered with daily life,” she said.
So how does it work?
Pelton described MammoSite as being “like an implantable balloon.”
The little balloon is inserted into the breast’s lumpectomy cavity and inflated with saline. A hollow tube remains outside the breast and connects to a wire which brings a radioactive “seed” into the inflated balloon.
The balloon remains inflated in place over the twice-daily, five-day course of treatment. Each session takes about 10 minutes, “just long enough to listen to a couple of songs,” said Girsh.
Patients leave sessions with a dressing over the catheter exit site and a sports bra to hold it in place. When the therapy is over, the balloon is deflated and removed.
“Ten of these treatments equal 35 daily treatments,” of conventional radiation therapy, Pelton noted.
And no special measures were needed afterward, said Girsh. She was able to shower and dress normally without discomfort.
Not everyone is a candidate for MammoSite. At Overlake and other hospitals which are successfully using this treatment, criteria include that the women are 40 or older, with a tumor of two centimeters or less in diameter, a clean surgical margin and negative lymph notes.
Some of it also comes down to “geometry,” said Pelton. If the cancerous growth is at the top of the breast, there isn’t enough room to properly insert the balloon. It works best when implanted deep within the breast.
A five-year, follow-up study, based on more than 38,000 women who’ve had MammoSite treatment, revealed that there were no local recurrences of cancer. Eighty-three percent of the women reported good to excellent cosmetic outcomes. One hundred percent said they would use the therapy again, if necessary, and would recommend it to a friend or family member with breast cancer.
But why don’t more people know about this?
Pelton explained, “The center has to be capable — there’s an investment in the technology. And the biggest plus in Overlake is the team approach. All of the surgeons took the training course and we’ve had many months of telling how to consult, how to explain this treatment to patients. The surgeons have to work differently, it’s a different type of incision and we do this soon after the lumpectomy, before the cavity closes. Lots of centers aren’t willing to make those adaptations. … We’ve been told that Overlake is a model site within the country.”
Girsh agreed, “The coordination here is amazing. … It’s a huge comfort to the patient.”
She suggested that those considering MammoSite should check out the “Voices of MammoSite” section on their Web site, “which gives great stories from real people.”
For information, visit www.mammosite.com.