Beating the odds: New technology helps Whiting woman fight cancer
February 18, 2008
By Piet Levy Post-Tribune staff writer
Pamela Downs-Angotti was told she had had four to eight months to live.
She had long been a smoker, but when they found malignant tumors, she didn't want to believe it. Following an urgent call from her doctor, the Whiting woman just took a trip to the grocery store as if all was normal. She didn't even tell her husband, Ron, until the day of her first tests.
Downs-Angotti was supposed to be dead nearly four years ago.
But thanks in large part to a new technology at The Methodist Hospitals in Merrillville -- stereotactic body radiosurgery -- Downs-Angotti is still alive and for the past 2.5 years has been cancer-free.
"I was determined that I was going to do everything I was supposed to do," she said. "It's been my attitude the whole time."
She underwent surgery -- waking up to the sensation of pain slicing down her back. All of that, and only one of three tumors was gone. Then came chemotherapy, and she lost her long locks of hair, and the energy to tend to her garden and venture out to Chicago shows.
But after the stereotactic body radiosurgery, there were no side effects. No pain. No exhaustion. And most importantly, the two other tumors on her lungs were completely eradicated.
Perhaps in 10 years, body radiosurgery may replace standard operations used to treat lung and liver cancer, just as the gamma knife is now the primary method physicians use to treat brain tumors. But patients from as far away as California are coming to Northwest Indiana to try out this treatment now.
In 2004, The Methodist Hospitals in Merrillville was the first in the region to acquire an Elekta Stereotactic Body Frame. Downs-Angotti read about the procedure on her own, and after approaching Methodist Hospitals, became one of its first body radiosurgery patients.
"With multiple tumors, it was impossible to do surgery on her," said Dr. Robert Woodburn, a radiation oncologist who oversaw the Whiting woman's procedure. "She wouldn't have any lung left."
After being "tattooed," to create reference points for Woodburn and his staff to treat the tumors, Downs-Angotti had to lie still with her hands behind her head while a machine generating highly concentrated radiation beams fired at the tumors from multiple angles.
She underwent three 45-minute sessions for each tumor. Then, they were gone, without a single incision.
Dr. Brian Kavanagh, co-editor of the medical book, "Stereotactic Body Radiation Therapy" and a professor of radiation oncology at the University of Colorado Denver, said body radiosurgery represents a new way of thinking about cancer treatment.
But the technology, a spin-off from the gamma knife concept, is still young, especially compared to surgery, which has been the gold standard for 40 years.
"It will be important for all of us in the radiation oncology community to follow patients carefully to make sure the long-term results from this treatment hold up as well as the short-term results would seem so far," Kavanagh said.
St. Catherine's alternative
St. Catherine in East Chicago has its own first-in-the-region stereotactic body radiosurgery machine -- the $5 million CyberKnife.
Where Methodist's machine tries to restrict the patient's movement, St. Catherine's machine allows for more flexibility.
"If the patient sneezes, moves, twitches, it will stay on target," said Dr. Andrej Zajac, Medical director of the Department of Radiation Oncology for St. Catherine and Community Hospital in Munster.
The Cyberknife is guided by a flexible robotic arm that even accounts for tumor movement based on the patient's breathing. As a result, sessions on average take twice as long as Methodist's machine and can span up to five treatments. But where Methodist's machine is used primarily to eradicate liver and lung tumors, the Cyberknife also can be used on the brain and spine.
Medicare covers stereotactic body radiosurgery as do many insurance providers. Zajac said the average Medicare cost for Cyberknife, which can vary widely from patient to patient, is about $12,000 for up to five treatments. Methodist spokeswoman Evelyn Morrison wouldn't provide approximate costs for their machine. Downs-Angotti said her husband's insurance provider covered 80 percent, leaving about $6,000 for the couple to pay out of pocket.
Woodburn estimates about 35 people a year have been treated by Methodist's machine, while St. Catherine has treated about 500 people since going online with the Cyberknife in May 2005. Woodburn said body radiosurgery has a 90 percent to 95 percent success rate in eradicating tumors. However, that doesn't equate to a cure rate. Even after body radiosurgery, regression can happen, and despite a few years in the clear,
Downs-Angotti knows the disease can come back. But she's grateful for the years of life she may not have had without the treatment.
"It's a second chance," she said. "You've got to live it to the fullest."
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