We Are The Pioneers of Breast Brachytherapy
Critics likened Dr. Kuske’s PBI research to a salmon swimming upstream to spawn. Over the last 18 years, the journey has been long and arduous past dams (obstructions in the progression of clinical research), past Grizzly bears (hungry opponents trying to devour the entire project), and potential wrong turns up blind streams. But the reward at the end has been the spawning of countless individual studies, methods, and the birth of a potential paradigm shift in the very way that breast cancer should be treated.
Over the last two decades, PBI research represents the ideal of how medical research should progress. A single patient presented a challenge to two physicians, who sought to solve her particular problems and cure her cancer while taking quality of life, her family, her work, and her life preferences into consideration (read about Rosario’s story by clicking here.) With brachytherapy, this patient could be successfully treated in four days instead of 6 weeks, and she was quickly back home with her family and returning to work. This single patient inspired the original New Orleans brachytherapy trial, and institutional review-board approved study. Two years later, doctors in Royal Oak Michigan started their own trial, validating the New Orleans favorable outcomes. Four years later, Dr. Kuske proposed a national phase II clinical trial to be sponsored by the National Cancer Institute. Six years later in 1997, the trial opened and became the most successful and rapidly accruing breast cancer trial in the history of the Radiation Therapy Oncology Group.
Throughout this PBI history, Dr. Kuske has been the unquestioned voice and leader in this research. He has advanced the techniques and technology, and championed the research bringing us to where we are today. He has remained totally committed to his patients, who let him know in no uncertain terms that they wanted a shorter more convenient alternative with less radiation exposure to surrounding normal tissues.
Gregory Maggass, MD, is the fourth physician in ABCs and AROs. He has practiced in the East Valley for more than 20 years.
Dr. Maggass is an established leader and pioneer in prostate brachytherapy and has treated thousands of men over the years in Arizona. He has learned PBI techniques from Drs. Kuske and Quiet, and brings special expertise to the Gilbert, Mesa, Chandler, and East Valley region. With his reputation, experience, and vision, Dr. Maggass will help ABCs expand our ability to offer all PBI options to a large number of women in the Valley.
With four outstanding physicians who wish to advance breast cancer care for Valley women, Arizona should continue to be the world-wide pioneers in this rapidly changing field of medicine.
We Are The Most Experienced Practitioners of Breast Brachytherapy In The World
Between the six radiation oncology physicians, Dr. Robert Kuske, Dr. Coral Quiet, Dr. Scott Tannehill, Dr. Gregory Maggass, Dr. Farley Yang, and Dr. Luci Chen, more than 1600 women have been treated with PBI over the last 18 years. No other practice in the world comes close to this record. As noted above, we have entered more patients onto clinical trials than the top academic institutions in the USA. Patients are sent to us for advanced breast brachytherapy from many of these institutions when simpler techniques will not suffice for their patients.
We expect 1/3 of our patients to come from out-of state or out-of-country because of the special expertise and experience that ABCs offers. In many cities, their leading hospital may have performed 5 or 10 PBI procedures, with doctors who may or may not have been to our lectures or courses in this technique. For a $250 airfare, why not be treated by the teacher rather than the student? Like surgery, with APBI, experience and skill matters! Remember, you must live with the radiation dose you have received for the rest of your life!!
We Teach Others Breast Brachytherapy
To handle this demand, we are asking doctors to come to Arizona with their nurses, therapists, dosimetrists, and physicists. The entire team, one institution at a time, comes for a 2.5 day “crash course” in PBI, during which they will observe 2 or 3 live cases (with the patient’s permission!), lectures, and workshops.
You might ask: What if I need traditional whole breast or post-mastectomy chest wall and nodal irradiation? Answer: You are better off with us than a general radiation oncologist who also treats lung, prostate, rectal, and other cancers. There is an advantage to going to a physician totally focused on one disease! Do you go to a general surgeon or breast surgeon? Do you go to a general radiation oncologist or a breast radiation oncologist? With external beam techniques, the volume of lung, heart, and other normal tissues exposed to radiation varies tremendously from one radiation oncologist to the next. Dr. Kuske has published the The Kuske 5-field Technique of Comprehensive chest Wall and Nodal Irradiation that teaches how to wrap dose around the lungs and heart and minimizing collateral damage to internal organs. His educational videotape about this technique has been distributed around the world. Text-book chapters are devoted to it.
Our doctors will continue to lecture at national and international meetings. We have been asked to direct the international breast course in 2010 (www.tbc.com). We plan to bring this course to Scottsdale, Arizona, after previous annual meetings in Nice, France, Quebec City, Canada, and Key Largo, USA. We run the interstitial breast brachytherapy workshop at the annual meeting of the American Brachytherapy Society.
Recently, the American College of Surgeons and the USC Norris Cancer Center convened a “think tank” of the 17 leading minds in breast cancer treatment today. One of our physicians had the great honor of participating, and was on the writing committee. The final document, “State of the Art Diagnosis and Treatment of Image-Detected Breast Cancer,” has rapidly been accepted for publication in a peer-reviewed journal.