Radiating Hope 2019

Radiating Hope Annual newsletter from the radiation oncology service at the NC State Veterinary Hospital www.go.ncsu.edu/RadiatingHope

INSIDE Familiar Faces p. 2 Seeing Better Treatments p. 3 All In It Together p.4

CONTACT NC State Veterinary Hospital

Radiation Oncology 1052 William Moore Dr. Raleigh, NC 27607 919-513-6690

Hours:

Monday-Friday 7:30AM-4:30PM

Surviving a Deadly Brain Tumor At 5 years old, boxer Nick developed anxiety. He seemed confused, unaware of his surroundings, and started walking funny – goose-stepping.

An otherwise energetic young dog, he was quickly referred to the NC State neurology service, where he had an MRI. The scan showed a large tumor compressing his brain.

If left untreated, Nick would likely have succumbed to the tumor within a few short months. But he and his family are fighters. They weren’t going to give up easily.

In June, our neurosurgeons removed as much of the tumor as possible. Nick then began a monthlong course of radiation therapy, under the care and supervision of Tracy Geiger, Associate Clinical Professor of Oncology.

While we don’t yet know if he’s been cured, Nick is now celebrating his 1 year anniversary of his initial diagnosis. In short, he’s doing great.

We’re not only excited for Nick, we’re thrilled to see all of the fun in-store for him in the future.

Treating patients with brain tumors is tricky business, but our highly skilled treatment team, including Beth Piojda, Kirsten Cromly and Tammy Hawkes, were up to the challenge. They helped Nick and his family through a month of radiation treatments without any worries.

We’re also incredibly thankful to the Petco Foundation, who made Nick’s treatments possible through a multiyear grant that provides financial support to eligible families whose pets are undergoing cancer care at NC State. For that, his family and our team are forever grateful.

Familiar Faces: Greetings, Farewells and Kudos •

Connie Meneses is our newest team member.

She practiced as a veterinary anesthesiologist in Chile, before moving to the U.S. earlier this year to pursue a Ph.D., with mentorship from faculty Mike Nolan and Duncan Lascelles.

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Leanne Magestro completed her radiation oncology residency in June 2018. She passed her certifying examination and is now a board-certified specialist in radiation oncology. Leanne moved to East Lansing and is now on faculty at Michigan State University as an Assistant Professor of Oncology.

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It’s not often that somebody decides to specialize twice. But James Elliott is doing just that. He is a European board-certified medical oncologist and joined our team as a radiation oncology resident this past July. We’re excited for our patients to gain from his unique perspectives on cancer care.

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Katherine Sweet, our current second-year resident, gave an award-winning lecture at a national symposium. With mentorship from Assistant Professor of Oncology Hiroto Yoshikawa, Katherine spoke about an innovative treatment for rare cancers of the canine skull.

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This year, we bid adieu to Janelle Burnette, who provided our patients with excellent nursing care for several years. She moved on to pursue a new career in social work.

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For their service to the College and state, both

Kristen Price, veterinary technician, and Ryan Hutchinson, client services specialist, were nominated to receive the prestigious NC State University Awards of Excellence. Wish them luck!

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Mike Nolan was nominated for the College of Veterinary Medicine’s Huffman Leadership Award, which is granted to a faculty member who demonstrates outstanding leadership skills.

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Tracy Gieger is actively serving as President of the American College of Veterinary Radiology’s subspecialty of Radiation Oncology. This position is like having a second full-time job. Having volunteered to serve in this capacity is just another reflection of how committed she is to ensuring that specialists in our college hold themselves to the highest standards possible.

You Help Us See Better Cancer Treatments Did you know that the process of planning a radiation treatment for a single patient often takes more than 4 hours and involves at least 3 different people?

Much like using a spotlight to illuminate dancers on an otherwise dark stage, our job when treating cancer is to carefully shine the radiation beam onto the tumor – and only the tumor. Doing this with precision is important, because misdirected radiation can be really damaging to the patient.

To accomplish a safe and effective treatment, we start by outlining the tumor on medical scans like x-rays, CAT scans, and MRI’s. Next, we use fancy mathematics and modeling to help shape the radiation beam.

Our treatment plans then undergo quality control checks, which are performed by our medical physicist, Dr. Don Roback.

Once this is complete, we subject our work to peer review. Our radiation oncologists gather each week for “Physics Rounds” and review each patient’s radiation treatment plan.

The goal is to detect errors before they happen and

optimize outcomes for patients, by minimizing side effects and maximizing tumor control.

Until recently, we would have 5-6 doctors packed around a single small computer screen to review each of the critical details of these treatment plans.

Thanks to generous donors like you, we have upgraded by investing in a large electronic white board.

This big screen makes it seem like we’re reviewing the radiation plans on a movie theater screen. Not only are the images bigger, but we can also write directly on the screen with a digital marker. This makes it easier to ask questions, demonstrate important concepts, clarify treatment plans, and teach.

The upgrade has already transformed the quality of our rounds, which is undoubtedly improving the quality of care we provide to patients.

It wouldn’t have been possible without your support.

Thank you!

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NC State Veterinary Medicine NC Veterinary Medical Foundation 1060 William Moore Drive Raleigh, NC 27607 cvm.ncsu.edu Support us: Clients may choose to give to the general radiation oncology fund which provides financial support for the service and their greatest needs. Give online at go.ncsu.edu/support-radiation-oncology Contact us: Giving Office: 919-513-6660 cvmfoundations@ncsu.edu

We’re All In It Together Head and neck cancers are problematic. They interfere with breathing and eating, and can be quite painful.

These cancers are also difficult to treat, frequently requiring intensive combinations of surgery, chemotherapy, and radiotherapy. Treatments are expensive, and sometimes cause unpleasant side effects.

The situation is particularly dire for cats with oral cancer: their prognosis rarely exceeds a few months.

With generous funding from the Winn Feline Foundation, the Paul and Lea Levine Foundation, and a number of private donors, Mike Nolan, Associate Professor of Oncology, and graduate student and veterinarian Yen-Hao (Erik) Lai, with expert assistance from Karen Marcus, are testing a new approach to feline oral cancer.

This treatment involves injecting ethanol, similar to potent drinking alcohol, directly into the tumor. The ethanol was modified so it forms a gel and sticks to the tumor.

Once stuck, the ethanol kills the surrounding tumor tissue.

Our early data are encouraging. However, just as exciting, are the new ways we’ve discovered to precisely measure oral cancer pain in cats. This is important because having a way to measure pain makes it easier for us to treat pain.

Armed with better ways to treat the pain, we may also be able to control the cancer’s growth more easily, allowing patients to live with less pain and less cancer.

We are really early in this work and are still looking for ways to support larger and more complete studies, but we are onto something that may benefit cats, dogs, and people with cancer.

So stay tuned, and we’ll share more as we learn!