Cancer Women's health

Patient story: the MR-Brachytherapy Suite’s first outpatient

stylised drawing of surgeon in operating room

After not having a Pap test for about 25 years, Urszula Waryan-Jasinska’s new family doctor encouraged her to do a Pap test earlier this year.

Urszula put it off for a few more months, and then finally relented.

Her doctor did the Pap to check for abnormal cells, along with a manual exam.

“Immediately, she said she felt something unusual during the exam, and referred me to a gynecologist,” Urszula, 61, recalled. “Both my family doctor and the gynecologist were upfront at that point that this could be cancer.”

When the colposcopy and biopsy results came back, Urszula was upset but not surprised.

“I had known that something was wrong,” she said. “When I looked at myself in the mirror, I didn’t think I looked well. So when they said cancer, I wasn’t too shocked. It was the location of the cancer that I didn’t ever imagine.”

There is a history of colon cancer in Urszula’s family, and she’s always been vigilant with colon cancer screening. Pap screening tests are done to screen for cervical cancer but can sometimes find vaginal cancer cells as well.

Urszula was diagnosed with vaginal cancer and put on a course of radiation and chemotherapy.

“I really didn’t know what to expect with cancer treatment,” Urszula said. “I just took it as it came.”

Her oncologist told her of a procedure available at Sunnybrook and she was referred.

In August, Urszula became the first patient in Sunnybrook’s MR-Brachytherapy Suite to receive electromagnetically guided interstitial brachytherapy — and go home the same day.

Brachytherapy strikes tumours with high doses of radiation and is used in the treatment of prostate, breast and gynecological cancers. For interstitial brachytherapy for gynecological cancers, a cylinder and applicators that look like needles are inserted into the tumour, around the vagina, cervix or uterus. The applicators are attached to a treatment unit that moves a radiation source precisely through the applicators to destroy the tumour while avoiding harm to the patient’s normal tissues

Currently, for most gynecological interstitial brachytherapy, an MR image is taken about a week before the procedure. The radiation oncology team uses the MRI to plan the placement of the needles in relation to the cylinder that is placed into the vagina.

Previously, the full procedure could take up to 48 hours, with an overnight stay.

Sunnybrook’s MR-Brachytherapy Suite, which is made up of an operating room, radiation bunker and MRI machine for imaging, allows for a much more streamlined approach.

“Having the suite allows us to image MR in real time for optimal applicator placement, planning and even treatment. The patient doesn’t have to be awake with the applicator in place and instead can have the treatment all done while under anesthesia,” Dr. Eric Leung, radiation oncologist, explained.

Prior to the suite, patients would have to wait for a few hours — awake — with the applicator inserted, which many found to uncomfortable or painful. They were also awake for the applicator removal.

In addition, Sunnybrook is testing electromagnet technology that helps guide the needle placement for increased precision during the procedure.

“Our brachytherapy team is excited by this leap forward in the evolution of our program,” said Ananth Ravi, PhD. “The efforts of our team, the introduction of innovative technologies and our MR-Brachytherapy Suite working in concert enable us to deliver not just effective, but truly compassionate, patient-centred care.”

Sunnybrook is working to adopt this workflow as a standard of care for gynecological interstitial brachytherapy patients moving forward.

For Urszula, she says she appreciates the care and treatment she received from Dr. Leung and the entire team. And, the convenience of having the entire procedure while under anesthetic and then going home the same day is welcomed.

But, she hopes other women don’t ever need to experience it.

“I have avoided a Pap Test for years; that’s proven not to be wise,” she said. “I am told there is a Pap Awareness Week, [October 21-25], thus a very good reason to think about getting one, along with the subsequent gynecological exams, to avoid illness or at least catch it early.”

To learn more about Sunnybrook’s MR-Brachytherapy Suite, visit sunnybrook.ca/cat

 

End note:

Put your health first and call your doctor or nurse practitioner to book your Pap test today. To learn more this screening test, typically used to help detect cancerous or pre-cancerous cells in the cervix, visit Cancer Care Ontario

  • People who do not have a healthcare provider can get screened at some public health units, sexual health clinics and walk-in-clinics, or by finding a healthcare provider through the Ministry of Health and Long-Term Care’s Health Care Connect program. Register for Health Care Connect online at https://hcc3.hcc.moh.gov.on.ca/HCCWeb/faces/layoutHCCSplash.jsp or by phone at 1-800-445-1822.

To use Health Care Connect, you must:

  • not currently have a family health care provider
  • have a valid Ontario health card
  • have an up-to-date mailing address associated with your health card

About the author

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Alexis Dobranowski

Alexis Dobranowski is a Communications Advisor at Sunnybrook.

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