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Kathleen Merlino's story: Facing breast cancer

Bookmark and Share Kathleen Merlino is starting over. After being laid off from her job of 28 years, she did something she hadn't done in years — went to school. Merlino enrolled as a full-time student at Camden County College. "I never thought I'd be in college at this stage in my life," says Merlino. "Luckily, my son also is a student there, and we are facing the challenges of college together." During her first semester, however, Merlino was diagnosed with early stage breast cancer. "Typically, patients diagnosed with early stage breast cancer are treated with a lumpectomy, removal of a cancerous lump, followed by six to eight weeks of radiation therapy," says Michele Fantazzio, MD, breast surgeon at Virtua Health. While Merlino was shocked by the diagnosis, her biggest concern was not being able to attend school while undergoing treatment. A few days after the diagnosis, Merlino had a lumpectomy. After recovering from the procedure, she went to a radiation oncologist to plan her radiation treatment. That's when the doctor told her about a new type of radiation therapy called MammoSite that was being offered as part of a clinical trial. What is MammoSite?
Unlike standard radiation therapy that treats the whole breast, MammoSite is an alternative therapy that delivers radiation from within the space where the tumor was removed. "This reduces the amount of radiation that reaches healthy tissue," says Deborah Butzbach, MD, radiation oncologist at Virtua Health. How it works
In a separate procedure after the lumpectomy, a thin, flexible tube with a balloon on the end is inserted into the area where the tumor was removed. The balloon is filled with saline until it fills up the entire space where the tumor once was. This holds the balloon and tube in place for the entire length of treatment. Patients receive outpatient radiation treatments twice a day for five days. During treatment, a small radioactive seed travels from a machine, through the tube and into the balloon in the breast. "Patients are in the office for one hour, twice a day, although the actual treatment only takes about ten minutes," says Dr. Butzbach. After each treatment session, patients are able to go home and go about their daily activities. "I felt great the whole time. Between treatments I was able to go shopping, meet up with my friends and go to the movies," says Merlino. History of breast cancer treatment
Not long ago, patients diagnosed with early stage breast cancer had two treatment options — a mastectomy, removal of the entire breast, or a lumpectomy followed by six to eight weeks of radiation treatment. "A lumpectomy involved removing the breast lump and surrounding tissue. The lump was tested to determine if it was cancerous. If it was and cancerous cells were present in the surrounding tissue, the patient would undergo another procedure to remove more tissue. This process would be repeated until all the cancer cells were removed," says Dr. Fantazzio. But, treatment didn't end there. Patients then received radiation once a day for six to eight weeks to help prevent cancer from recurring in that area. Looking to the future
"It's important that we explore new techniques for detecting and treating breast cancer," says Maureen Kling, MD, breast surgeon at Virtua Memorial Hospital. New technology and less invasive techniques have enabled doctors to determine if a lump is cancerous before performing a lumpectomy. Almost 80% of lumps are not cancerous and do not need to be removed. "If it's determined that the lump needs to be removed, we can attain a better result in just one procedure," says Dr. Kling. Facing the challenges ahead
It's almost a month since Merlino completed treatment and, once again, she's a full-time student. "It's great to be at school and moving on with my life. I hope my experience helps other women see how new treatments can make a positive impact on their lives," says Merlino. With her son by her side, she's facing college head-on. In fact, they're both scheduled to graduate in the spring of 2007. Targeted radition and imaging now available
Patients can receive the most advanced radiation oncology services without traveling over the bridge or far from home at the Fox Chase Virtua Health Cancer Treatment Center. "The Center has the latest imaging equipment that allows us to get a clear picture of tumors and a computer-support system that targets radiation with pinpoint accuracy," says Lemuel Ariaratnam, MD, radiation oncologist. The new facility is located on the Virtua Voorhees campus and offers convenient access to the comprehensive oncology services through the Fox Chase Virtua Health Cancer Program. The new facility features:
  • All new, state-of-the-art Varian clinic iX linear accelerator with GE CT simulator delivers the most targeted radiation
  • Innovative networking capabilities to support all-digital image-archiving system, 3D treatment planning system and image-fusion software for the most detailed, high-resolution images
  • Easy access and transfer to departments within Virtua Voorhees
  • Comprehensive continuum of care throughout Virtua Health
  • Intensity modulated radiation therapy (IMRT) delivers precise radiation doses directly to the tumor while sparing the surrounding healthy tissue
  • Image-guided radiation therapy (IGRT) technology will be available in the beginning of 2007 and provides a high-resolution x-ray image of the tumor and pinpoints the treatment area

For more information, please call 1-888-Virtua-3 (1-888-847-8823). Physician profile
Lemuel Ariaratnam, MD, is a board-certified radiation oncologist and chief of radiation oncology for the Fox Chase Virtua Health Cancer Program and medical director of the Fox Chase Virtua Health Cancer Treatment Center. Dr. Ariaratnam earned his medical degree from the University of Ceylon in Sri Lanka and served as a surgical house officer at General Hospital in Ceylon. He completed his internship in radiation oncology at Maimondes Medical Center in Brooklyn, New York. He then completed his residency in radiation oncology at Montefiore Medical Center in Bronx, New York. Deborah Butzbach, MD, is a board-certified radiation oncologist with the Fox Chase Virtua Health Cancer Program. She earned her medical degree from Hahnemann University School of Medicine. Dr. Butzbach completed an internship in internal medicine at Abington Memorial Hospital and a residency in radiation oncology at Thomas Jefferson University Hospital. Michele Fantazzio, MD, is a board-certified breast surgeon. She earned her medical degree from Jefferson Medical College. Dr. Fantazzio completed an internship and residency in general surgery at Lankenau Hospital. Maureen Kling, MD, is a board-certified breast surgeon at Virtua Memorial Hospital. She earned her medical degree from the Medical College of Pennsylvania. Dr. Kling completed her internship and residency in general surgery at the University of Massachusetts Medical Center.