Winning the battle with cervical cancer: Local care and localized treatment with brachytherapy

When you have cancer, living a normal life can be a challenge. Treatment can take you away from your home and distance you from your loved ones. With the new addition of HDR brachytherapy, Durham Region residents who have cervical cancer receive every form of treatment they need close to home and in the same location – Lakeridge Health’s R. S. McLaughlin Durham Regional Cancer Centre (RSMDRCC).

Used in conjunction with chemotherapy and external radiation, brachytherapy allows high doses of radiation to be applied internally and directly to a cancer source, limiting exposure of the rest of the body to otherwise harmful radiation. One session of this therapy is an eight-hour long process involving members from across the interprofessional team.

“If our patients didn’t have this form of treatment available to them here, they would have to uproot their lives to Toronto or Kingston for eight or nine weeks for radiation, chemotherapy and brachytherapy,” says Christine Black, Manager of Radiation Therapy. “Patients who have cancer shouldn’t need to worry about being away from their family or making travel arrangements. Care close to home will allow them to truly focus on getting better.”

Brachytherapy is a form of cancer treatment rarely offered by young cancer centres such as RSMDRCC, yet possible for centres located in full-service hospitals like Lakeridge Health Oshawa. RSMDRCC provides oncology patients with a continuum of care that is personal, state-of-the-art and dignified. The Centre sees approximately 450 patients a day and maintains radiation wait times that are below the provincial average.

Amanda Visser, a 27-year-old single mom, has lived in Oshawa her entire life. After months of visits to the ER, gynaecologists and her family physician, Visser was diagnosed with a rare form of Stage 2B cervical cancer. Visser makes the short, 10 minute trip to the RSMDRCC and receives chemotherapy, radiation, and brachytherapy. She returns home every afternoon.

“I’m so glad we have a Cancer Centre here in Oshawa . . . I can’t imagine going to Toronto or Kingston for this treatment,” says Visser. “You’re very tired afterwards. It’s nice to come here in the morning and then go home to my bed, my family and my son.”

Visser wasn’t scared of the treatment – she was scared of not qualifying for it. She knew brachytherapy was life-saving and had a very high success rate. In mid-October, she became the twelfth patient treated for cervical cancer via brachytherapy at RSMDRCC.

When a patient receives brachytherapy for cervical cancer, they go through a process similar to day surgery that requires an interprofessional team consisting of anaesthetists, physicists, radiation therapists, registered nurses and radiation oncologists. When receiving brachytherapy, a patient goes through the extensive process of getting an applicator inserted into their cervix in the operating room, resting in Post Anesthetic Care Unit (PACU), and then receiving a high dose of radiation after planning of the treatment is complete. The patient, who can become exhausted throughout the process, must stay completely still for several hours and has a registered nurse to assist them with any discomfort.

One unique aspect of the RSMDRCC is the use of imaging technology to localize the treatment. “Brachytherapy is a very old treatment that has been offered for almost 100 years, and it’s probably one of the best treatment options available to patients,” says Dr. Behzad Banihashemi, a radiation oncologist at RSMDRCC.

Dr. Banihashemi works alongside Dr. Audrey Li to provide cervical cancer patients with treatment. “What we are doing now is image-guided brachytherapy that uses ultrasound, CT scans and MRI images to sculpt the radiation dose and minimize exposure to the normal, non-cancerous structures. Not many hospitals in Canada are doing this.”

With treatments like brachytherapy, cervical cancer is 70 to 90 per cent curable in Stage I and II cervical cancer and 50 to 60 per cent curable in Stage III cervical cancer. This means patients like Visser can feel confident in their future.  “I can’t wait until I’m better; I’m confident that I will get better,” says Visser. “I’m planning to travel and take my son to Europe. It will be a great experience for us.”