IT'S A DIAGNOSIS NO OF US WANT TO HEAR.
CANCER.
WHETHER IT'S YOU, A FAMILY MEMBER, OR A FRIEND.
IT DOES NOT DISCRIMINATE.
AND ON THIS SHOW, WE'RE ALWAYS LOOKING FOR WAYS TO EASE THAT BURDEN EITHER THROUGH SUPPORT
GROUPS OR TREATMENT.
TODAY, OUR GUEST IS HERE TO SHED SOME LIGHT ON GYNECOLOGICAL CANCERS AND WAYS TO TREAT
IT.
PLEASE WELCOME DR.
MATTHEW BIAGIOLI BACK TO THE BALANCING ACT.
GOOD MORNING.
THANKS FOR HAVING ME BACK.
OH, GREAT TO SEE YOU AGAIN.
DOCTOR, GYNECOLOGICAL CANCERS, NOW WHEN I HEAR THAT, TO ME, THAT JUST FALLS UNDER A
HUGE UMBRELLA.
SO BREAK IT DOWN FOR ME.
WHAT FALLS UNDER THAT?
OK.
GYNECOLOGICAL CANCERS ARE BASICALLY 5 DIFFERENT TYPES OF CANCERS.
SO, THIS INCLUDES OVARIAN CANCER, UTERAN CANCER, CERVICAL CANCER, VAGINAL CANCER AND VOLVAR
CANCER.
AND ARE ALL WOMEN AT RISK?
ALL WOMEN ARE AT RISK.
YOU'RE RISK INCREASES WITH AGE HOWEVER, YOU CAN, THERE ARE THINGS YOU CAN DO TO REDUCE
THAT RISK.
AND WITH GYNECOLOGICAL CANCERS LIKE A LOT OF OTHER CANCERS, YOU KNOW, EARLY DETECTION
AND EARLY TREATMENT MEANS HIGHER LIKELY HOOD OF CURE.
LET'S TALK ABOUT CERVICAL CANCER SPECIFICALLY.
HOW CAN WE LOWER THAT RISK?
IT USED TO ACCOUNT FOR ONE OF THE HIGHEST MORTALITY RATES.
REALLY?
AMONGST CANCERS HERE IN THE US.
NOW FORTUNATELY WITH THE INTRODUCTION OF THE PAP SMEAR TEST AND NOW THE HPV DETECTION OR
HUMAN PAPOLOMA VIRUS DETECTION, AND ALSO WITH THE HPV VACCINE THOSE RATES HAVE SIGNIFICANTLY
BEEN REDUCES.
CERVICAL CANCER IS ONE OF THE MOST PREVENTABLE FORMS OF CANCER THAT ARE OUT THERE.
AND THE AMERICAN CANCER SOCIETY RECOMMENDS THAT WOMEN AGED 21 AND OLDER UNDER GO ROUTINE
SCREENING WITH REGULAR PAP SMEARS.
AND WHAT WE'VE FOUND IS THAT WOMEN THAT ARE DIAGNOSED WITH INVASIVE CANCER OR ADVANCED
CANCERS TYPICALLY HAVE EITHER FORGONE ROUTINE SCREENING OR THEY HAVEN'T DONE IT WITH ANY
REGULARITY.
NOW, WHEN YOU UNFORTUNATELY GET BACK A SAY, AN ABNORMAL PAP SMEAR.
OR YOU HEAR THE NEWS THAT YOU HAVE CANCER.
WHICH IS OBVIOUSLY VERY DEVASTATING, VERY EMOTIONAL, EXTREMELY STRESSFUL FOR A WOMAN.
WHAT IS THE NEXT STEP?
SO, YOU REALLY KIND OF NEED TO DISCUSS THAT WITH YOU DOCTOR.
LET THEM GUIDE YOU THROUGH WHAT YOUR OPTIONS ARE.
WITH CERVICAL CANCER, IT'S VERY STAGE DEPENDENT, DEPENDING ON HOW ADVANCED THAT CANCER IS,
IS GOING TO KIND OF DICTATE WHAT TREATMENTS ARE BEST FOR YOU.
SO, IF YOU ARE REALLY ADVANCES YOU'VE GOT TO BE REALLY AGGRESSIVE?
EXACTLY.
SO, WHAT ARE SOME OF THOSE TREATMENT OPTIONS?
SURGERY?
YOU REALLY KIND OF NEED TO DISCUSS IT WITH YOUR ENTIRE HEALTH CARE TEAM TO SEE WHAT SPECIFIC
TREATMENTS ARE GOING TO BE THE BEST FOR YOU AND YOUR SPECIFIC CANCER.
AND THERE ARE A NUMBER OF DIFFERENT TREATMENT OPTIONS AND SOME OF THEM YOU MAY ONLY NEED
ONE OPTION AND SOMETIMES THEY MAY BE DONE IN COMBINATION WITH EACH OTHER.
BUT EXACTLY WHAT YOU SAID, SURGERY IS DEFINITELY AN OPTION.
A HYSTERECTOMY.
EXACTLY.
SO, IT'S A HYSTERECTOMY WHICH MEANS THEY ARE GOING TO TAKE OUT YOUR OVARIES, THEY ARE GOING
TO TAKE OUT YOUR UTERUS, THEY ARE GOING TO TAKE OUT THE CERVIX, AND THEY MAY TAKE OUT
SOME OF THE LYMPH NODES.
OTHER OPTIONS INCLUDE CHEMOTHERAPY, WHICH ARE BASICALLY GIVING YOU DRUGS.
OR RADIATION THERAPY SPECIFICALLY BRACHYTHERAPY.
LET'S TALK ABOUT BRACHYTHERAPY.
WE'VE TALKED ABOUT IT BEFORE.
I KNOW IT'S NOT NEW, BUT A LOT OF VIEWERS DON'T KNOW WHAT IT IS.
TELL ME WHAT IT IS DOCTOR.
OK, SO THERE IS RADIATION THERAPY.
RADIATION THERAPY BASICALLY CAUSES DAMAGE TO THE DNA OF THOSE CANCER CELLS AND CAUSES
THOSE CANCER CELLS TO DIE.
AND THERE ARE TWO FORMS OF RADIATION THERAPY.
THERE'S EXTERNAL RADIATION THERAPY, AND THE WAY TO THINK OF THAT IS YOU ARE TREATING FROM
THE OUTSIDE IN.
SO, THERE ARE USING THESE HIGH ENERGY RADIATION BEAMS THAT ARE DIRECTED FROM THE OUTSIDE TOWARDS
THAT TUMOR IN YOUR CERVIX TO KILL THOSE TUMOR CELLS.
NOW, TYPICALLY WITH EXTERNAL BEAM RADIATION THERAPY, THEY GIVE LOW DOSES OF RADIATION
THERAPY AND THAT MEANS ONCE A DAY TREATMENT OVER THE COURSE OF MANY WEEKS.
ALTERNATIVELY, WITH BRACHYTHERAPY, OR BRACHYTHERAPY, YOU'RE GIVING THE RADIATION FROM INSIDE OUT.
SO, YOU ARE PUTTING THE RADIATION EITHER DIRECTLY INSIDE THE TUMOR OR ADJACENT TO THE TUMOR
SO YOU CAN GET VERY HIGH DOSES OF RADIATION TO THE CANCER CELLS AND KILL THOSE CANCER
CELLS WHILE LEAVING THE REST OF THE NORMAL TISSUE RELATIVELY UNTOUCHED.
AND BECAUSE YOU ARE GIVING HIGH DOSES OF RADIATION, IT MEANS FEWER TREATMENTS.
USUALLY IN TERMS OF BETWEEN TWO TO FIVE TREATMENTS.
AND NOW BRACHYTHERAPY MAY BE DONE BY ITSELD BUT MORE TYPICALLY IT'S DONE IN COMBINATION
AT LEAST FOR PATIENTS WITH ADVANCED CANCERS AFTER EXTERNAL RADIATION AND USUALLY IN COMBINATION
OF SOME FORM OF CHEMOTHERAPY.
GREAT INFORMATION.
STAY RIGHT THERE DOCTOR BECAUSE I HAVE A FEW MORE QUESTIONS REGARDING BRACHYTHERAPY.
WE HAVE TO TAKE A QUICK BREAK BUT WHEN WE RETURN WE ARE GOING TO DISCUSS THE BENEFITS
OF BRACHYTHERAPY SO STAY RIGHT THERE.
(MUSIC) (COMMERCIAL BREAK)
(MUSIC) WELCOME BACK EVERYONE.
BEFORE THE BREAK WE WERE DISCUSSING THE ADVANCED CANCER TREATMENT BRACHYTHERAPY.
WITH US ONCE AGAIN IS DR.
MATTHEW BIAGIOLI WHO SPECIALIZES IN RADIATION ONCOLOGY AND IS HERE TO HELP US LEARN SOME
MORE.
DOCTOR, I KNOW WE TALKED A LITTLE BIT ABOUT BRACHYTHERAPY BUT I'M FASCINATED ABOUT HOW
YOU DESCRIBED FROM THE INSIDE OUT.
TELL ME ABOUT THAT AGAIN.
YEAH, SO TRADITIONAL RADIATION THERAPY WORKS BY RADIATION GOING FROM THE OUTSIDE IN ---
RIGHT.
--- WHICH MEANS IT HAS TO GO THROUGH SOME NORMAL TISSUE TO GET THERE.
WIHT BRACHYTHERAPY IT'S BASICALLY PLACING THE RADIATION INSIDE THE CANCER SO YOU ARE
RADIATING FROM THE INSIDE OUT.
YOU'RE PROTECTING THAT NORMAL ORGAN.
AND WHAT ARE THE BENEFITS OF BRACHYTHERAPY?
SO, THERE ARE A LOT OF BENEFITS OF BRACHYTHERAPY.
FIRST OF ALL, IT'S A VERY EFFECTIVE AND COST EFFECTIVE WAY OF TREATING CANCER.
OK.
IT'S BEEN SHOWN TO BE HIGHLY EFFECTIVE IN THE TREATMENT OF CERVICAL CANCER AND LONG
TERM STUDIES HAVE SHOWN THAT WOMEN THAT UNDERGO BRACHYTHERAPY AS PART OF THEIR CERVICAL CANCER
TREATMENT, HAVE BETTER CANCER FREE SURVIVORS.
REALLY?
ADDITIONALLY, BECAUSE IT'S BEING DELIVERED FROM THE INSIDE, IT MEANS THAT THERE ARE LOWER
TOXICITY.
AND IT'S STATE OF THE ART.
EVEN THOUGH IT'S BEEN AROUND FOR YEARS, THE BRACHYTHERAPY THAT WE DO TODAY IS VERY DIFFERENT
THAN WHAT WE DID EVEN 5, 10 YEARS AGO.
AND NOT ONLY EFFECTIVE, BUT I CAN IMAGINE HERE CONVENIENCE AS WELL BECAUSE IT'S DONE
DIFFERENTLY.
EXACTLY.
BECAUSE THE RADIATION DOSE IS SO HIGH, AND SO FOCUSED, IT MEAN FEWER TREATMENTS WHICH
MEANS SHORTER DURATION OF TREATMENT, WHICH IN CERVICAL CANCER IS ACTUALLY VERY IMPORTANT.
IT IS.
WE KNOW IF WE CAN SHORTEN THOSE TREATMENT TIMES, THAT THE LIKELY HOOD OF CURE IS BETTER.
NOW SOMETHING THAT IS VERY IMPORTANT HERE IS SIDE EFFECTS.
YES.
SO WITH ALL TREATMENTS OF CERVICAL CANCER, THERE ARE SOME FORM OF SIDE EFFECTS.
WITH BRACHYTHERAPY, IF YOU THINK ABOUT IT, THE CERVIX IS KIND OF WEDGED RIGHT IN BETWEEN
THE RECTUM AND THE BLADDER.
SO, IT'S POSSIBLE THAT YOU MIGHT DEVELOP SIDE EFFECTS LIKE YOU FEEL LIKE YOU HAVE A G.I.
BUG OR EVEN POSSIBLY LIKE YOU HAVE A URINARY TRACT INFECTION OR AN OVER ACTIVE BLADDER.
NOW, YOU MENTIONED EARLIER AND WE TOUCHED UPON THIS REGARDING BRACHYTHERAPY.
TREATING CANCERS OF DIFFERENT BODY SITES, SO, WHAT DO THEY INCLUDE?
I MEAN IS IT EVERY WHERE?
YES, SO ESSENTIALLY IT'S HEAD TO TOE.
OK!
SO, WE ARE TALKING LUNG CANCER, WE ARE TALKING ABOUT RECTAL CANCER, WE'RE TALKING ABOUT ESOPHAGEAL
CANCER.
WHAT ABOUT BREAST CANCER?
YOU GOT IT.
IT'S ONE OF THE MAIN USES FOR BRACHYTHERAPY IS ACTUALLY WITH IN BREAST CANCER.
AND HOW DOES IT WORK THERE?
WITH WOMEN THAT ARE UNDERGOING TREATMENT FOR BREAST CANCER, THERE ARE TWO MAIN SURGICAL
OPTIONS.
SO, THERE IS ONE, WHICH IS WHERE THEY HAVE TO REMOVE THE ENTIRE BREAST.
BUT ALTERNATIVELY, YOU CAN PRESERVE THE WOMAN'S BREAST AND WITH A DIFFERENT TYPE OF SURGICAL
PROCEDURE CALLED A LUMPECTOMY.
AND WHAT THAT INVOLVES IS JUST REMOVAL OF THE TUMOR AND THEN THE NORMAL BREAST TISSUE
JUST SLIGHTLY AROUND THE TUMOR.
NOW, IF YOU UNDERGO A LUMPECTOMY, YOU NEED SOME FORM OF RADIATION AND TO REDUCE THE LIKELY
HOOD OF THAT CANCER COMES BACK.
TRADITIONALLY THAT'S BEEN WITH EXTERNAL RADIATION WHICH REQUIRES 5-6 WEEKS OF TREATMENT.
OR ALTERNATIVELY, IT CAN BE DONE WITH BRACHYTHERAPY AND WHICH MAY ONLY REQUIRE ONE TREATMENT.
WOW.
OR AS FEW AS 5 TREATMENTS.
WHAT A GREAT OPTION THEN.
AT THE END OF THE DAY HERE, IT'S ALL ABOUT EDUCATION AND GETTING WOMEN THAT OTHER OPTION
BECAUSE IT'S BEEN AROUND.
EVEN THOUGH IT'S BEEN AROUND FOR 35 YEARS, IT'S EVER EVOLVING AND THE TECHNOLOGY THAT
THEY USE TODAY FOR BRACHYTHERAPY IS STATE OF THE ART AND IS CUTTING EDGE AS MANY OF
THE OTHER TECHNOLOGIES WE USE TO TREAT CANCER.
THANK YOU SO MUCH.
COME BACK AGAIN ANYTIME TO TALK MORE ABOUT BRACHYTHERAPY.
AND IF YOU'D LIKE MORE INFORMATION ON BRACHYTHERAPY AGAIN IT'S
BRACHYTHERAPY.
IT'S AFFORDABLE.
IT'S AN EFFECTIVE TREATMENT OPTION TO TREAT CANCER.
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