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RAPID ASSESSMENT

About Amy Umble:
Amy Umble is health reporter for The Free Lance-Star

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For brain cancer patients, surgery can be an outpatient procedure

Stereotactic radiosurgery, or SRS, is the region’s newest cancer treatment. It arrived at the Regional Cancer Center at Mary Washington Hospital in January. Since then, about 40 people have received the treatment, including Dana Jacobs of Remington.

Jacobs underwent the procedure over four days last month. She and officials at the hospital agreed to let a reporter and photographer for The Free Lance-Star observe the treatments and write about it for the paper. That story, with photos by Suzanne Rossi, will appear this Sunday.

Here is a preview of that story. In addition to Jacobs, the cast of characters mentioned here includes Dianne Jennings and Susan Haley, radiation therapists, and Dr. Jeffrey Poffenbarger, neurosurgeon.

“Are you ready?” asked Jennings.

Jacobs nodded yes and climbed onto the treatment table. She was at the cancer center for Day Two of her treatment. She rested on her back, a pillow beneath her legs. Above her was the gantry or treatment head of the linear accelerator.

The machine is used for conventional radiation and for SRS. During SRS, the power is increased, and the X-ray beams are narrowed. When Jacobs had whole brain radiation in 2011, no portion of her brain was untouched. This time the dosage was similar but concentrated. More than 99 percent of her brain was spared.

To treat the tumors, the team at the cancer center, including medical physicist Changan Xie, studied images of Jacobs’ tumors. With special computer software, Xie designed a four-part assault. The larger of the two tumors would be treated for three days. The smaller one would get one day.

The plan was to move the accelerator and the treatment table in combination to strike the tumor from different angles. The X-ray beams would pass through her brain on their way to the tumor, but they would be lethal only in combination, when they met at the tumor. The technique recalls a scene from an old Western where the townsfolk ambush the bad guys, firing at them from the rooftops. In Jacobs’ case, the tumors were the bad guys.

For this to work, however,Jacobs had to be immobilized, day after day, in the same spot on the treatment table. To achieve this, the team molded a tight-fitting plastic mask.

“You let us know if it feels too tight,” Jennings said, as she and Haley slipped the mask over Jacobs’ face and snapped it to the table.

Jacobs replied with a thumbs-up gesture.

Poffenbarger ran his finger beneath the mask to check the fit.

“It’s a little tight, but the tighter the better for accuracy,” he told Jacobs.

Poffenbarger asked Jacobs to wiggle her face, but she couldn’t.

“OK, we’re ready to go here,” he said.

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