Spotlight: Dr. Bethany Anderson, Radiation Oncologist
Radiation oncologist Bethany Anderson, MD, believes that treating patients compassionately is the most important part of her job.
"I'm all about my family – my husband and I have four children under the age of 8," Anderson said. "The approach I take as a provider is to treat each person that I meet in the way that I would want my family to be taken care of."
Anderson, an assistant professor of human oncology at the UW Carbone Cancer Center, plans and administers radiation therapy mostly to breast cancer patients, with a smaller focus on gynecological cancers and general radiation therapy. She recently updated us on advances in technology and personalized care in breast cancer radiation therapy.
Innovations in Treatment
Breast radiation oncology at the Carbone Cancer Center has long been at the forefront of treatment and technology, and Anderson highlighted some ways she and her colleagues strive to provide the best care possible.
The first two are relatively simple changes in treatment plans. Sometimes all that needs to be adjusted is the position in which a patient receives treatment. For example, studies have shown that some women may be best treated in the face down, or prone position, with the treated breast falling through a hole. Also, traditionally breast cancer patients are treated with 6 weeks of radiation therapy, but Anderson said "for the right person" that course can be compressed into 3-4 weeks, reducing skin reactions and fatigue.
Technological advances include the addition of MRI-guided radiation therapy and brachytherapy, or partial breast irradiation.
"For each patient, we always do a treatment planning image that includes a CT scan and sometimes an MRI," Anderson said. "We have the second MRI-guided radiation machine in the world, called ViewRay, that allows us to visualize with MRI the area we're treating before and during treatment to make sure we're targeting the area accurately."
In breast brachytherapy, radiation oncologists treat just the portion of breast tissue adjacent to the cancer site from the inside using plastic tubes, or catheters, as opposed to an external radiation beam. Brachytherapy treatment occurs twice a day and lasts only four to five days, then the catheters are removed. Anderson said that UW has historically been a leader in the development of breast brachytherapy, and continues to do so.
"One of our brachytherapy physicists, Dr. Rupak Das, developed the most recently-introduced catheter that combines the best features of the previous ones," Anderson said. "Also, I completed a brachytherapy fellowship in Paris, because there are certain areas of Europe where the therapy has advanced faster than in the US."
Individualized Treatment Plans
"When it comes to treatment options for breast cancer, we're really fortunate to have a huge variety of the most modern technologies available in radiation oncology," Anderson said. "We personalize the experience and we're not pigeon-holed into treating all women on the same machine or in the same way."
With the multitude of different options, such as those mentioned above, Anderson and other radiation oncologists can look at several factors and develop recommendations for each patient.
"In some cases, there’s one treatment option that is clearly most appropriate for a particular woman, so we spend most of our time focusing on that,” Anderson said. “Many times, however, radiation treatment plans are really influenced by patient preference: I'll meet a woman, talk about the side effects, the length of treatment, and the expected outcomes and see what she says.”
Carbone Cancer Center radiation oncologists also go to great lengths to limit radiation dose to the heart in women with left-sided breast cancer. CT-guided treatment planning to visualize the heart and special breathing techniques during treatment can be very helpful. Tomotherapy is another treatment option, in which Anderson says "the radiation lines are curved, not straight, so it's a heart-sparing technology that is useful in some women."