A Targeted Approach to Cancer Care

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Audrey Hansen

During a routine medical checkup three years ago, Audrey Hansen, then 74, mentioned that she was having some minor bladder problems.

Alert to the possibilities, her doctor suggested an ultrasound. When the diagnosis came back, Audrey was stunned: She had uterine cancer. Once she overcame the initial shock, Audrey took the news in stride. “It seemed that we’d caught it early, so I felt rather lucky,” she says. It didn’t take long for her to decide where to go for treatment. “I knew that Long Beach Memorial was a leader in cancer care, so that’s where I wanted to go,” says the retired administrative assistant. In fact, when it comes to gynecologic cancers, of which uterine is the most common, Long Beach Memorial’s Todd Cancer Institute treats four times as many patients as the average California hospital.

Uterine cancer often starts in the lining of the uterus, called the endometrium. Surgery is usually the most effective way to treat the disease. After a comprehensive diagnostic workup, Audrey underwent a hysterectomy, including the removal of the uterus, cervix, fallopian tubes and ovaries.

Multidisciplinary Care

During the operation, doctors also performed biopsies on adjacent lymph nodes to determine if the disease had spread beyond the uterus. Fortunately, it hadn’t. Still, the medical team didn’t want to take any chances. “Historically, treatment for uterine cancer relies on surgery only,” says Ajmel Puthawala, M.D., associate director of radiation oncology at the Todd Cancer Institute. “Newer approaches combine surgery and other therapies such as advanced radiation treatments to increase the chance of a cure.”

In certain instances, patients’ cases may be presented to the hospital’s tumor board. Composed of nationally recognized cancer specialists, this multidisciplinary group meets regularly to help design the best course of action.

That Extra Mile

The Todd Cancer Institute is enrolled in many clinical trials, allowing patients access to the newest drugs. There’s also a wide range of other cancer treatments, including image-guided external beam radiotherapy (IGRT). “This technology uses a built-in CT scanner and computer-designed radiation doses to match the exact contour and depth of a tumor, sparing normal tissue. Another innovative treatment is internal radiation therapy, also called brachytherapy. “This method kills cancer cells using precisely targeted, high-intensity radioactive pellets,” Dr. Puthawala explains. “They’re placed in a thin, sealed tube, which is positioned in or near tumors for a few minutes using CT guidance, then withdrawn. The great advantage is that we can administer intense doses of radiation to the tumor or area in question while reducing radiation exposure to surrounding healthy tissue.” Because the treatment is so localized, other side effects are also minimized.

After surgery, Audrey completed five weeks of standard radiation therapy, followed by high-dose rate (HDR) brachytherapy. Today, she’s cancer-free and has returned to her part-time job working at the Long Beach Convention Center. She even got around to painting the outside of her house this past summer. “That was a bigger job than I thought, but it felt good,” she laughs.

Audrey credits the Todd Cancer Institute, Dr. Puthawala, and the rest of the team for her positive outcome. “They could have just done a hysterectomy and stopped there,” she says. “But Dr. Puthawala is wonderful and so meticulous. He and the team really went the extra mile to make sure that the cancer was totally gone, and that I received the best treatment possible.”

Ajmel A. Puthawala, MD
Featured physician:

Ajmel A. Puthawala, MD, FACR, FACRO, FASTRO

Medical Director of Radiation Oncology, MemorialCare Cancer Institute at Orange Coast Memorial
  • Radiation Oncology, Radiation Oncology - Pediatric, Radiology