Diagnosis: Breast Cancer
Treatment: Radiation oncology with respiratory gating
Breast cancer had always been in the back of Paula Chiles’ mind because her mother had been diagnosed at age 46.
But that still didn’t prepare her to hear that diagnosis for herself, especially at age 35.
“I went numb,” she recalls. “It took my breath away.”
Thankfully, the Halvorson Cancer Center at EvergreenHealth has the experts – and the expertise – to give young women such as Paula the best chance for a healthy outcome and a long, healthy life.
It began with the diagnosis.
“The radiologist explained everything and had already lined up doctors’ appointments for the following day,” Paula says. “Thank goodness they do that, because I was overwhelmed and wouldn’t have known where to start. It was such a comfort to know they’d taken care of the first steps for me.”
Given Paula’s young age and the location of the cancer in her left breast, her EvergreenHealth cancer team went to work to make sure her treatment not only addressed the cancer but took care not to impact her long-term heart health.
Dr. Marion Johnson, who performed Paula’s lumpectomy, says the approach to treatment is the key.
“When you’ve got a very young woman like Paula and you anticipate years ahead of them and a healthy active life, you can’t afford to decrease their cardiac function even a little bit.”
Medical oncologist Dr. Aimee Kohn tailored Paula’s chemotherapy to her age and the location of the cancer.
“The standard drug, anthracycline, can have potential long-term impact on the heart,” Dr. Kohn explains. “So we went with a different regimen to minimize the cardiac complications for what should be a curable cancer.”
Minimizing cardiac complications also meant a truly “breathtaking” approach to the radiation treatments that followed Paula Chiles’ chemotherapy.
Standard treatment plans, no matter how customized, could have put her heart in the path of the radiation beams, increasing her risk for coronary artery disease in 15 to 20 years.
Instead, Dr. Eric Taylor, the director of radiation oncology at EvergreenHealth, used respiratory gating, a breakthrough in the treatment of breast cancer that times the radiation beams with the patient’s own breathing.
“During respiratory gating, Paula would hold her breath, which moved her heart back into her chest cavity and out of the way of the radiation beams,” Dr. Taylor explains. “The beams were then cycled on and off to coincide with her breathing pattern – on, when she was holding her breath; off, when she was breathing normally.”
Respiratory gating is a treatment technique that EvergreenHealth helped to pioneer in Washington state.
“We always prioritize patient safety and try to cause no harm,” Dr. Taylor states. “Respiratory gating allows us to do that.”
It also allowed Paula to take an active role in her treatment.
“Working with the radiation technologists to time my breathing made me feel like I had a little more control over my cancer,” she says. “It was scientific and fascinating, and very empowering.”
The preschool teacher and active mother of three gives credit to her EvergreenHealth cancer team.
“I got great care from the best team I could possibly have had,” Paula says enthusiastically.
“Our team aspect is so important in doing what’s best and right for each patient,” explains Dr. Kohn. “Everyone involved is onboard and communicating with one another – from day one.”
Dr. Johnson agrees. “I’m not just the breast surgeon. I’m working in concert with the oncologist and the radiologist to make sure women who are diagnosed with breast cancer have the best chance for a long and healthy and active life.”