Gaining Ground

Written by Bakersfield Magazine

The first reaction is usually fear. Fear of pain; fear of financial burden; fear of death. All typical responses from someone diagnosed with cancer. It’s the only six-letter word that can do considerable emotional damage to even people with the most cavalier of attitudes toward illness.

While cancer certainly isn’t the foe it once was, when medical technology was in its infancy, it is perhaps the fear of the unknown surrounding cancer that continually leaves people ill at ease. The undetermined outcomes from treatments, the unanswerable questions about lasting effects; they’re present in the mind of a cancer patient as well as in the minds of his or her family.

Just a few short years ago, certain cancers had oncologists and researchers playing the guessing game. There was still so much to learn about our bodies’ cells without the added strain of cancer. Patients were told to have hope while physicians were running to catch up.

Today, however, cancer doesn’t have nearly the head-start it once did. Doctors, armed with more knowledge and more treatment options for patients, are gaining ground. As science continues to delve into the depths of cancer cells, more people are surviving aggressive forms of the disease that were once considered incurable.

And fortunately for people living in Bakersfield, many of these advances are in arm’s reach in part because of the Comprehensive Blood and Cancer Center (CBCC) and the progressive research done within this integrated cancer facility.

According to Dr. Ravi Patel, CBCC’s founding physician, this coming year will see even more research into the inner workings of cancer cells—something that will greatly help scientists and oncologists when developing treatment plans for cancer patients.

“We have been working closely with UCLA on some exciting new research,” Dr. Patel explained. “They have discovered several newer molecules that are being used for cancer treatment. At this point, however, the molecules are just at a ‘code name’ stage.”

This microscopic research is being done to accompany a new trend in cancer care: personalized medicine.

“These molecules are targeted toward specific genes in a cell. So what happens,” he elaborated, “is that we can test the genetic makeup of the tumor for a particular gene. Once we have identified that gene, we know that we can use a certain molecule developed to treat that cancer; that this molecule will be successful in treating the cancer.”

As Dr. Patel explained, this will make treatments much more bearable for patients. It will be so much more refined and geared toward that particular cancer patient’s genetic material. Broad-range treatments like chemotherapy and radiation, which are still highly successful today, will not need to be used in all cases. Treatment can be much less invasive.

“We know that by using this particular molecule in a patient with a particular gene, they will have a 60 to 70 percent chance of survival in aggressive forms of cancer.”

These molecules have been developed over the past year. However, CBCC helped pioneer another type of cancer treatment—MammoSite.

“MammoSite treatments began here roughly six years ago, at which point we were the first to utilize MammoSite in Kern County. It is absolutely precise radiation for breast cancer,” Dr. Patel continued.

“We introduce a small balloon of radiation directly into the tumor for treatment. This procedure reduces radiation time from six weeks all the way down to five to seven days. And it’s all outpatient.”

The benefit to the patient is enormous.

Along these lines, CBCC will be introducing another less-invasive, high-tech way of treating other forms of isolated tumors. It’s called HDR brachytherapy. The HDR stands for high-dose rate. Similar to MammoSite, this treatment will administer radiation therapy to a precise location within the body through the use of a small balloon. Dissimilar to traditional radiation, HDR minimizes the discomfort caused by skin irritation. It can be used for prostate, pancreatic, and lung cancers.

“This type of treatment has never been available before in the community and we will begin doing procedures in the next few months,” he said.

Last year, CBCC was gearing up for the arrival of the CyberKnife, a robotic radiosurgery system which can target a tumor from 180 different directions for ultimate precision.

“We can provide a much more targeted treatment,” Dr. Patel explained of the equipment.

Many tumors will shift during treatment delivery. Using advanced robotic technology and continual image guidance, the CyberKnife System delivers unprecedented targeting accuracy with the unique ability to automatically correct for intra-fraction target motion—without interrupting the treatment or having to reposition the patient. It does this without the limitations of conventional respiratory gating and breath-holding techniques. It delivers beams that move precisely with tumor motion throughout the respiratory cycle and through this process provides unparalleled healthy tissue preservation.

Already, CBCC has treated over 100 patients with the CyberKnife at their facility, one of only 150 in the entire world.

“Over the past year we have seen tremendous success with this machine. The precision is sub-millimeter, so we’re able to perform treatment on patients with types of tumors that are unreachable by conventional surgeries or radiation therapies,” Dr. Patel explained.

Technology and medical science are a big part of the innovation taking place within the walls of CBCC, but Dr. Patel insists that’s not all this freestanding cancer facility has been developing over the past year.

“We take a team approach for cancer care,” he said. “The emotional trauma is significant during treatment, so we have created several options for patients.”

Namely, CBCC created a Mind and Body Program which runs throughout the year and is free for all patients.

“We teach them a variety of relaxation techniques through yoga or meditation. We use music therapy and laughter therapy. We’ve called in speakers to help encourage patients to laugh. Additionally, we teach them breathing techniques and how to create a life plan.

“Sometimes when you are given an unpleasant prognosis, the only thing you think of is death. We will help these patients create a daily plan, which can include going out to be in your garden, going for a walk, and other fulfilling activities.”

This type of guidance can be very beneficial to cancer patients who feel a loss of control in their life.

Interestingly, much of the research Dr. Patel and colleagues are focused on currently is the correlation between the mind and the body.

“This coming year, we’ll be conducting a study on how the use of mind-body techniques, like relaxation, can bring about genetic transformation of cells.”

A telomere is a part of your DNA, located at the end of a chromosome, which protects that particular chromosome from destruction. The telomere in a cancer cell causes that particular cell to age slower so that the cancer can continue to grow and spread.

“We want to discover if we can change the size of the telomere through mind-body techniques. If so, the telomere would make the cell age faster or slower. This discovery could potentially cure certain illnesses.”

In relation to cancer, the mind and body techniques would be used to change the size of the telomere in a cancer cell, causing the cell to age much faster, and giving the cancer less chance to grow. This would ultimately give doctors and the patient more time to fight.

So whether it be research on the genetic level or helping patients cope mentally with the emotional impact and fear of the diagnosis, all of the new procedures being brought to Kern County have two overarching goals: to stop cancer in its tracks and to remove fear of the unknown.

Article appeared in our 26-5 Issue - December 2009