Aiming to Heal with Advanced Radiotherapy in Western North Carolina

Boone is a small, vibrant community in the Blue Ridge Mountains and known as part of the ‘High Country’ of western North Carolina. Melanie shares that her interest in medicine developed as a result of her father’s involvement in emergency management services and the local fire department. “My dad was always rushing off to help people when they needed it most. I guess in my own way I wanted to follow in his footsteps.”

After high school, Melanie went to a community college in Asheville, NC to study radiology, where she met a radiation therapist who inspired her to pursue a career in radiation oncology. From there she went on to complete her radiation therapy training which required an onsite clinical rotation. The rotation at Seby B. Jones Regional Cancer Center turned out to be more of a working job interview than a school requirement. After graduation, she was hired by the Cancer Center and is now approaching her 18th year of service.

As the clinical lead for the radiation oncology department, Melanie works closely with the cancer care team and focuses on the well-being of each patient. For example, at the conclusion of each patient’s six to eight weeks of radiation treatment, the therapy team celebrates the momentous occasion in a unique way. “We all gather around the patient and cheer as they strike the Cancer Center’s ceremonial gong to signal the end of their treatment.”

Advanced radiotherapy elevates cancer care: C-RAD’s Catalyst+HD with Elekta Synergy for left breast cancer treatments

“At our center, we use the Elekta Synergy linear accelerator with Agility and C-RAD’s Catalyst⁺HD. We love our Elekta linac and their customer service—the system is very user-friendly. In the summer of 2022, we added C-RAD’s Catalyst⁺HD to advance our radiotherapy capabilities. It especially helps in treating people with breast cancer. Breast cancer patients make up around 37% of our patients.

With the C-RAD system, we like the way the room lights change colors as an indicator for the patient—versus the glasses that some other centers use—that need to be cleaned between each treatment. It’s just an easy visual indicator for everyone, and that’s worked out well for us. Interoperability between our technologies is key for seamless workflow and we found that with Elekta and C-RAD. Our new C-RAD support person is very helpful and responds quickly which is greatly appreciated.”

Treating breast cancer, protecting the heart

“With our previous breath technique, we had to go in and out of the room for patient setup, which added time to our workflow and patient treatment. We were not feeling confident monitoring the patient’s breath-hold during treatment—even if the patient said they were holding their breath—because we couldn’t tell if they were within the window they needed to be.

The treatment is now much quicker with C-RAD’s Catalyst⁺HD. More importantly, just making sure that the patient is in the treatment parameters that are set, and of course, minimizing the radiation dose to the heart because that’s always a big concern. I think that makes patients more comfortable when we’re able to tell them that we do protect their hearts because some patients do come in and ask—they do a lot of research—and that’s something we’re proud to offer. If our center couldn’t block radiation dose to the heart without using breath-hold, the patient may have had to go somewhere else for their treatment.”

For left breast treatments, deep inspiration breath hold (DIBH) treatment is a proven method for minimizing the dose delivered to the heart muscle while maximizing the dose to the treatment volume. In contrast with most other gating systems, the system will monitor the respiratory motion without requiring any markers or fiducials to be placed on the patient. General patient motion is also monitored in parallel, thus ensuring maximum patient safety.

Melanie and the radiotherapy team love to coach their patients through the tough times, encourage them when they struggle and celebrate their successes—whether they’re big or small.