Alberta Cancer Foundation

In Treatment: Brachytherapy

Photograph of Lorna and Roger Smith at the Tom Baker Cancer Centre.

After being cancer-free for over a year, Lorna Smith went on a family vacation with her husband, Roger. But after they returned to Calgary on March 17, 2020, she experienced a resurgence of symptoms.

Lorna was diagnosed with uterine cancer in January 2018, and underwent a radical hysterectomy that March. She was declared cancer-free a month after surgery, only to be told that it returned in 2020. The tumour was too close to her surrounding organs for surgery, so her oncology team at the Tom Baker Cancer Centre recommended a mixed treatment of external radiation and brachytherapy. Brachytherapy treats cancer by directly delivering radiation to a tumour through needles, catheters or applicators inside the body to avoid damaging other healthy tissues.

The treatment, led by Dr. Tien Phan and Dr. Kevin Martell, was successful, and Lorna was declared to be in clinical remission in March 2021. Since witnessing the life-saving capabilities of this treatment first-hand, Lorna and Roger have donated $16,000 to the brachytherapy program at the Tom Baker in the hopes other lives will be changed, too.

Here, Roger and Lorna reflect on the experience:

LS: “One day, we were on the Cayman Islands with our niece and nephew and their family. I was swimming and walking on the beach. I felt no pain. So, when we got home and I noticed I was bleeding, I was shocked.

“It was also the day the lockdown began in Alberta, so that was an unfortunate coincidence. I had to quarantine for 14 days before they could do any tests. I was diagnosed with cancer again in April, and the tumour was large: six centimetres by six cm by six cm, and it was lodged between my bladder and my bowel.

I was in shock. I’m a stoic person, though, so I just said, ‘All right.’ You just roll up your sleeves and get after it. And I had a lot of confidence in the doctors I was dealing with.”

RS: “They did a series of CAT scans and MRIs on Lorna to make certain that it hadn’t gone anywhere else, and the indication was that it hadn’t. That was all good news. Then they realized, radiation therapy could really work.”

LS: “I got a call from my doctors, who explained they wanted to do this treatment. They were going to combine 25 treatments of external radiation for 25 straight days, and then do brachytherapy. They determined this plan, and I was relieved it wasn’t chemo, but honestly, I didn’t even know what brachytherapy was.”

RS: “Treatment started on June 8, so that was radiation five days a week for five weeks.”

LS: “By the time we finished external radiation, the tumour shrunk to less than two cm, which the doctors were very pleased about. I was really lucky.”

RS: “But, as the tumour shrinks, the rest of the tissues move into the space where it’s shrinking. So radiation, which was focused exclusively on the tumour initially, tends to reach some of the adjacent tissues. So that’s when the brachytherapy started.”

LS: “Brachytherapy was three procedures, where they inserted 14 needles into the tumour so they could transmit live radiation into it. This way, it’s not passing through your skin and organs; the radiation goes directly through these needles. By the end of July 2020, the tumour was less than one cm — less than the crest of a fingernail. “

And even before we were told of the successful results, we really wanted to donate something to the Tom Baker in appreciation.”

RS: “We had a combination of so many exceptional doctors. And to the extent that they can localize and focus radiation on a tumour to minimize the impact on adjacent organs — and do that effectively — is exciting.”