Finding Joy

The holidays can take on special meaning to those fighting serious illness. Reuniting with family, quiet conversations, and savoring simple joys are the best part of the holidays, says one cancer survivor. Her advice to us during this holiday season is measured in common sense, spirituality, and the love of those around her.

This holiday season consider stepping back and reevaluating choices: big meals or small informal ones? Shopping for gifts or finding small personal ways to gift? Baking dozens of cookies for family and friends or baking a few for the joy of it? If it isn’t joyous, pass on it for now and don’t feel guilty for the choices you make. Instead enjoy feeling peaceful and grateful for the chance to choose.

Thousands of our patients have traveled this same path over the years. Many have shared that slowing the pace of the holidays was a great gift that they took along into recovery. It seems they felt closer to the true spirit of the holidays.

Palliative Care is Rising

Palliative care is increasing in acceptance throughout the country. Heart disease, kidney disease, dementia, and of course cancer treatment are serious illnesses where palliative care has proven its worth. Though difficult to access in some smaller communities, 72% of hospitals in the U.S. now provide it, up from just 7% in 2001. "High quality palliative care has been shown to improve patient and family quality of life, improve patients' and families' healthcare experiences, and in certain diseases, prolong life," says Dr. R. Sean Morrison, director of the National Palliative Care Research Center. The center estimates that 12 million adults suffer from serious illness nationally. Treating pain can be as important as treating disease. Palliative care can transform the lives of people with serious, life-threatening conditions, we witness it every day at Turville Bay Radiation Oncology Center.

Palliative care provides relief from the symptoms and stress of illness. At Turville Bay we use radiation therapy palliatively to relieve pain. Further, our physicians and staff listen carefully to patients and their families, answer questions and strive to meet their concerns regarding anxiety and fatigue, which can be problematic for those with cancer. A simple but powerful question we ask our palliative care patients is, “What matters to you?” says Shagun Saggar, MD, HMDC Chief, Palliative Care Medicine at SSM-Health-Wisconsin.

The need for palliative care at all stages of illness is clear, and the field is rising. Turville Bay’s philosophy of patient centered care delivers because every patient deserves the best possible experience.

It’s All About You: Individualized Breast Cancer Care

Doctors at Turville Bay SSM Health

As Turville Bay Radiation Oncology Center formalizes its ties with SSM Health we’ve strengthened our relationships with those physicians that form our cancer care teams. I’m happy to introduce Dr. Dana Henkel, a surgeon that works closely with breast cancer patients. Here, Dr. Henkel speaks to our individualized care at SSM Health. Dr. Michelle Mackay, Radiation Oncologist at Turville Bay, a member of SSM Health

“In 2019, around 268,600 U.S. women will be diagnosed with invasive breast cancer, according to American Cancer Society. But even though breast cancer is a common disease, each patient’s situation is unique. What works well for one patient, may not work as well for another.

That’s why at SSM Health, we’re focused on individualized treatment and recovery plans. I’m part of the breast cancer care team, which includes all the specialties needed for comprehensive breast cancer care: surgeons, medical oncologists, pathologists, radiation oncologists, genetic counselors and a nurse navigator. We work together to develop and deliver a personalized treatment plan that is right for each patient.

When surgery is a part of the treatment plan, I get to know what’s important to my patients and what concerns they may have, before recommending a surgical approach. We use an array of innovative surgical technologies depending on the patient’s specific needs, including technologies that enable precise surgical navigation when removing cancerous tissue.

At SSM Health, we offer comprehensive breast cancer care that is individualized for each patient. Our team of breast cancer care specialists diagnose and treat over 150 new breast cancers per year, each with an individualized treatment plan.”  Dr. Dana Henkel, SSM Health Surgeon 

Turville Bay is Now a Member of SSM Health

Dr Michelle Mackay Turville Bay

Founded in 1986 by Madison’s 2 community hospitals, Turville Bay is south central Wisconsin’s radiation oncology center for the treatment of cancer and other serious illnesses. In the years since the center opened its doors, our relationship with SSM Health strengthened. Now as a member of SSM Health we renew our efforts: together, we fight cancer. 

This October we’re shining a light on the SSM Health breast care team. It all starts with the patient: Self-care. Regular screening by a physician and mammograms. And if that patient is diagnosed with breast cancer our breast cancer team steps in. Turville Bay’s radiation oncologists work intensively with SSM Health’s medical oncologists, surgeons, infusion teams and comprehensive genetics.  Through this team of healthcare professionals, the patient receives continual personalized care. Together we bring hope and healing to the 1 in 8 women that develop this challenging disease. Together we heal.

Turville Bay’s Technology Delivers

Dr June Kim Turville Bay

A remarkable piece of science and technology, Turville Bay’s TrueBeam linear accelerator is one of the pieces of equipment that delivers the power and flexibility we need to fight cancer. So, we bought another one and it’s just come online here at Turville Bay Radiation Oncology Center. Investment in this technology is just part of our dedication to patient-centered care.

From the patient’s first visit we use state of the art science and technology to better understand their body and how the disease is affecting it. We use it to craft a highly personalized treatment plan that will carry them through weeks of therapy. And during treatment, we direct its power to shrink tumors and destroy their DNA so they can no longer harm the patient.

At the helm of this science and technology is a team of healthcare providers, medical physicists, radiation oncology physicians and nurses, imaging specialists, dosimetrists that calculate dosage, treatment therapists, and support staff that patients never meet but have worked for weeks to help them heal.

In the center of this team and technology is the patient, struggling with a disease that seems mysterious and all consuming. Appointments, tests, technology they’ve never seen, healthcare providers they’ve never met, and a language of terms they’ve never heard. At this intersection we meet the patient following a referral from another care team. We build a relationship with that patient, learning about them, their family and close friends. We listen, we share information, and we keep their preferences in the forefront of each decision.

Healing is about people, and keeping their humanity, as we draw on the power of technology and science. We’re grateful to work with each patient, restoring their health and wellbeing.  It’s an everyday wonder we never take for granted.

Patient Centered Cancer Care? Its More than Checking the Boxes

Dr Michelle Mackay Turville Bay

At Turville Bay we practice patient centered care. Visualize this: the patient is central to their own care. They share information with their doctor and in turn the physician shares information with the patient. This mutual sharing of detail provides that patient with the tools to make decisions that are right for their own healthcare. Dr. June Kim, a radiation oncologist at Turville Bay, says that decision-making power is powerful medicine, and I agree. A cancer diagnosis can be a terribly humbling time for some people as treatment and technology become the focus of their lives. Suddenly thrust into a part of healthcare they may never have faced personally; the learning curve can be steep. Separating fact from fiction is important to every patient. In open discussions with patients we do a lot more than check the boxes of steps that they must take.  As patients are referred to Turville Bay Radiation Oncology Center for radiation therapy as part of their cancer care they share their state of mind and their health concerns. That helps us provide their patient centered care.

In the weeks following a patient’s first visit to Turville Bay, they receive daily treatment. During this time, they build bonds with their radiation therapists, nurses and physicians that often surprise the patient. We provide healthcare, and many patients tell us, a sense of wellbeing through those daily interactions. The therapies are state-of-the-art, the technology is incredible, but it’s the human connection that makes the journey a little easier.

Stereotactic Radiosurgery: a Primer for Patients

Dr Michelle Mackay Turville Bay

As patients are referred to Turville Bay Radiation Oncology Center for stereotactic radiosurgery, an overview of their surgical experience can be meaningful. The technology employed to perform incision-free treatment is quite specialized. The physicians and healthcare teams that do this work are not typically known to most of today’s healthcare patients. Every patient has questions and some may be anxious. What will this “surgery” be like? How will I feel? What will my recovery be like? Will it work?

Though complex planning precedes the day of treatment, the patient sees little of this. Typically, stereotactic radiosurgery consists of one to five treatments. This surgery effectively kills the tumor while seemingly decreasing potential side effects. During the procedure we focus scores of radiation beamlets from multiple angles on the tumor (or other target) with submillimeter accuracy. Each beam has very little effect on the brain tissue it passes through, but when these tiny beams meet, a strong dose of radiation is delivered. Rather than surgically removing the tumor, we destroy the DNA of tumor cells to ablate the tumor. As a result, these cells lose their ability to reproduce and die.

The patient’s experience is straight forward compared to traditional surgery. The time needed to complete a stereotactic treatment is approximately one hour, depending on the size and shape of the target. As the patient reclines on the machine’s treatment couch, a stabilizing mask is put in place. During the procedure:

  • You won't feel the radiation, it is painless.
  • You only hear a minimal hum from the machine.
  • You'll be able to interact appropriately with your treatment team.

After the procedure: 

  • The stabilizing mask will be removed.
  • You may experience fatigue and possibly headache.
  • You'll be able to eat and drink after the procedure.
  • We prescribe rest for a day or two.

Follow up appointments are scheduled. In the coming weeks the tumor will shrink and die because it’s DNA was destroyed, and the tumor is ablated in the surgical process.

Patient Centered Care

Dr Michelle Mackay Turville Bay

“Caring for the cancer patient’s health includes caring for their mental health. The evidence is pretty conclusive, an interdisciplinary approach to care maximizes the medical and technical gains we are making with cancer. Patient-doctor research has focused on patient satisfaction, comprehension, and the patient’s ability to adjust to their life with cancer. How does patient centered care actually work?

We’ve found that clear and continuing communications strengthen the patient-provider relationship. This in turn plays a critical role in the patient adapting to health-enhancing lifestyle changes. We know that, for example, smoking cessation can be a critical step for a cancer patient’s recovery. But, where mental health is concerned, will the patient deal with uncertainty while maintaining hope and following protocols? To achieve patient centered care, patients have to communicate with us, expressing their needs, preferences, and expectations as well as their concerns throughout treatment. Having a patient share power by offering meaningful involvement in choices related to treatment is characterized by mutual trust, respect, and commitment to their own health and to the protocols we ask them to follow. Patient effort can wane when fatigue swamps them and depression can become an issue. It is in these critical periods that patient centered care is most valuable. We can uncover a flagging spirit by discussing those difficult topics candidly during these periods of treatment.

Trust. The process of building trust takes time, but we’ve found it to be invaluable. We align our goals with the patient as those vary from person to person. We do our best to adapt to their needs throughout treatment. And above all, we communicate with the patient and their care team. Patient centered care is our core belief that together with the patient we’ll provide the best possible care.”

Celebrate Survivors & Thrivers

Dr Michelle Mackay Turville Bay

Once you’ve heard the words “you have cancer” your life is changed. Surviving the disease is just one part of this journey. Patients quickly learn a lexicon of medical terms, face myriad appointments, sort through their own emotions along with those of their loved ones, they may deal with economic uncertainty, and more. Treatment plans are unique to each patient and their experience is just as unique. But each year we see more Americans surviving cancer, and more of us living with cancer. The 16.9 million survivors and thrivers among us are testament to how far we’ve come in this battle. And it’s something we celebrate the first Sunday in June every year.

We gather on a Sunday afternoon under big canopies. There’s music and ice cream, there’s dancing and laughter. After all we are part of a community we never sought to join that has the strong bonds formed of shared journey. Put us together in one place and it becomes a party! Women and men, young adults and seniors, those that are cancer free, currently in treatment, and those living with cancer, their families, kids, and caregivers celebrate how far we’ve come together. It’s an event that we look forward to each year, I hope you’ll join us.

If cancer has touched your life join us on Sunday, June 2 from 1-3 for Madison’s Cancer Survivors & Thrivers Ice Cream Social. The event is free to all. There’s plenty of Chocolate Shoppe’s ice cream. Live music and joy fill the air. We wouldn’t miss it.

Surgery Without a Knife

Dr. James Richardson Turville Bay Radiation Oncology Madison Wisconsin

It’s called stereotactic radiosurgery (SRS) but it’s not surgery in the traditional sense. There's no incision. One of the tools in our arsenal at Turville Bay is a non-surgical radiation therapy used to treat abnormalities and tumors of the brain. This surgery is far less invasive than neurosurgery which requires incisions to skin, skull and membranes surrounding the brain tissue itself. For the patient, SRS nearly eliminates surgical recovery time.

It begins with an incredible piece of technology, a linear accelerator called TrueBeam. Our team of radiation oncologists use our TrueBeam LINAC to deliver radiation therapy every day to patients from south-central Wisconsin.

But with stereotactic radiosurgery, Dr. Michelle Mackay teams with a neurosurgeon and a team of others using 3D imaging to target high doses of precisely-targeted radiation. The equipment is specialized, focusing many small beams of radiation on the tumor or other target. Each beam has very little effect on the tissue it passes through, but when all the beams intersect a powerful dose is delivered cutting off blood flow to the tumor and disrupting the DNA of tumor cells so they can no longer replicate. There are few side-effects usually limited to a headache. We recommend resting after the procedure.

Weeks of preparation and calculations go into preparing for the radiosurgery at Turville Bay. But to the patient the process is incredibly fast and life altering. In a single outpatient treatment appointment, the tumor begins to shrink rapidly. SRS is used to treat noncancerous (benign) and cancerous (malignant) brain tumors, including meningioma, paraganglioma, hemangioblastoma and craniopharyngioma. It may also be used to treat cancers that have spread to the brain from other parts of the body (brain metastases).

The success of Turville Bay’s stereotactic radiosurgery program is notable. An additional TrueBeam LINAC is currently being added at Turville Bay and will be in use by summer.