Northwest Indiana oncologists offer the latest in cancer treatment - September 13, 2017

Courtesy of NWI Times

Written by Giles Bruce

Five years ago, Nilda Seuberling said she had to talk herself into getting out of bed in the morning.

The Lake Station woman was tired all the time. Bruises covered her body. She couldn’t muster the energy to continue caring for her sick parents.

Her diagnosis: chronic myeloid leukemia.

Her doctor recommended target therapies, designed for her specific form of cancer. She tried a couple of medications before she found one without unpleasant side effects.

Now, the 64-year-old retiree’s cancer is in remission. She can once again care for her mother (her father has since died).

“I now use my treadmill, do Pilates — stuff I couldn’t do before,” she said. “I feel more energized, more able to get up and do things.”

Seuberling is one of a number of Northwest Indiana residents who have benefited from local advances in cancer treatments in recent years. Oncologists say the cancer care in the Region often rivals that offered at university hospitals in Chicago.

“Twenty years ago, chronic myeloid leukemia used to kill everyone who had it within five years,” said Seuberling’s oncologist, Dr. B.H. Barai, medical director of the Methodist Hospitals Oncology Institute. “Now more than 90 percent survive a natural lifetime.”

As in Seuberling’s case, cancer treatment has become much more targeted and, in turn, the side effects have lessened.

“In cancer, we know what cells we want to kill,” Barai said. “But how do we differentiate between normal cells that we don’t want to harm and cancer cells we want to kill?”

Traditional chemotherapy and radiation often kill the good cells along with the bad ones, leading to ill effects, including early death.

The new approach, Barai said, is more like a “GPS guided bomb.” “You want to hit the particular building while causing minimal or no collateral damage,” he said. The new drugs are also much more lethal. Using another war analogy, Barai compared them to missiles with nuclear warheads.

Older drugs couldn’t be as lethal specifically because they weren’t as targeted, he said.

He expects cancer treatment to become more targeted, in the form of genomic editing, where immune cells would be genetically edited to kill cancer cells. He predicts the treatment will be in wide use in 20 years, transforming cancer care.

Immunotherapy, technology advance care

Another promising advancement in cancer treatment is immunotherapy, where drugs stimulate the patient’s immune system to fight the cancer.

Dr. Janet Retseck, a medical oncologist with the Porter Physician Group, explained that cancer cells put the brakes on healthy immune functioning.

“What these drugs do is take these brakes off and allow the immune system to recognize cancer cells as something foreign or bad and destroy them,” she said.

She said immunotherapy has been most effective against melanoma and renal cell cancer but is expanding into breast, prostate, bladder, head and neck cancers.

“We’re all very excited about immunotherapy,” she said. “I’ve heard stories of people who had been ready for hospice, at the end, taking immunotherapy, and the cancer vanishing, being able to go back to regular daily activities. That’s why we do this.”

Cancer screening is also becoming more accurate. One advancement is 3-D mammograms.

“Those are good at unveiling cancers in breasts with dense tissue,” said Dr. Chadwick Mills, a diagnostic radiologist with Franciscan Health hospital in Crown Point.

He expects the diagnostics to continue to advance.

“Just in the time since I started medical school, I’ve seen the technology rapidly improve,” he said. “Do I think there’ll be a new technology that will replace mammography? I do.”

He predicts the next forefront in diagnostics will be molecular imaging, which provides detailed pictures at the molecular and cellular levels.

Increased customization

Cancer treatment is increasingly being customized to each patient.

Dr. Mohamad Kassar, an oncologist with Community Healthcare System, brought up the case of a middle-age woman with an aggressive form of breast cancer that had spread to her liver.

“She was very disturbed about her diagnosis,” he said.

She got a second opinion at a hospital that recommended palliative chemotherapy, predicting that she had no chance of living past a couple of years.

She went back to Kassar, who chose to be aggressive with dose-dense chemotherapy, which delivers chemo in shorter intervals than the traditional version, as well as beam-directed radiation. She is now in remission.

“We are getting smarter now in the way we treat cancer,” he said. “We are not going to provide the same recipe to everyone with cancer.”