Radiation oncologists at Miami Cancer Institute are using a therapy first conceived of by the inventor of the telephone to now treat an ever wider range of cancers, including the cervical cancer that nearly took the life of a South Miami-Dade mother of six and grandmother of eight.
For Shallotte Mills, 49, a Miami native, life changed suddenly in 2018 when she was diagnosed with stage 4 cervical cancer while seeking treatment for excessive, abnormal bleeding at Baptist Health Emergency Care in West Kendall. She was referred to Jessika Contreras, M.D., a radiation oncologist at Miami Cancer Institute who specializes in the treatment of gynecologic cancer and breast cancer. After reviewing her case, Dr. Contreras recommended brachytherapy as part of Mrs. Mills’ treatment plan.
Brachytherapy, the oldest form of radiation therapy, was first conceived by Alexander Graham Bell, along with Pierre Curie, M.D., and Marie Curie – some of the leading scientific minds of their time. In 1901, several years after the discovery of radioactivity, they independently envisioned the possibility of taking a sealed miniature capsule containing a radioactive source and inserting it directly into a tumor. By directing a high dose of radiation to the tumor itself, they theorized, the tumor would shrink or even disappear while leaving surrounding organs largely unaffected.
Today, brachytherapy has advanced in many ways and is one of many weapons in Miami Cancer Institute’s arsenal of cancer-fighting therapies and technologies, according to Dr. Contreras. “For cervical cancers, brachytherapy should always be used with external beam radiation – it’s the only way to give the high doses of radiation that we really need in order to provide our patients with a cure for their disease,” she says.
Brachytherapy is commonly used in combination with external beam radiation therapy (EBRT) to treat cervical cancer, says Dr. Contreras, but it is also used at Miami Cancer Institute to treat other cancers, including cervical, prostate, breast, and skin cancer.
According to the American Cancer Society, nearly 14,500 new cases of invasive cervical cancer will be diagnosed in the U.S. this year, with a mortality rate of roughly 30 percent. The disease is most often diagnosed in women between the ages of 35 and 44, with the average age at diagnosis being 50, and it rarely develops in women younger than 20. The American Cancer Society warns that many older women don’t realize the risk of developing cervical cancer is still present as they age. More than 20 percent of cases of cervical cancer are found in women over 65.
Cervical cancer was once one of the most common causes of cancer death for American women but thanks to early screenings such as the Pap test and the introduction of the Human Papilloma Virus (HPV) vaccine in 2006, mortality rates have declined. If detected early, cervical cancer is actually one of the most treatable of all cancers.
To treat Mrs. Mills’ cancer, a five-week course of chemotherapy and external beam radiation was followed by two and a half weeks of intracavitary brachytherapy, in which the radiation source is placed inside an applicator in the vagina or cervix – precisely positioned to target only the tumor while limiting dose and maximally protecting the surrounding healthy tissue.
“Brachytherapy is such an important component of treating cervical cancer – it allows us to deliver up to twice the amount of radiation than with external beam radiation therapy (EBRT), while sparing the healthy surrounding structures such as the bladder and rectum,” Dr. Contreras says.
Brachytherapy is the best way to guarantee the best possible outcome, according to Dr. Contreras. “Studies show that women who get brachytherapy as part of their treatment plan experience significantly fewer side effects and are less likely to die from their disease,” she says. Because it’s so specialized, however, not every facility can offer the treatment, she adds.
Mrs. Mills says her brachytherapy was relatively easy, with minor side effects. “It was okay, a little uncomfortable,” she says. “No bad side effects.” Chemotherapy, however, wasn’t so easy. Facing weekly chemotherapy sessions along with a total of 25 external beam radiation treatments – one a day, Monday through Friday, for five weeks – she almost walked away after the first couple of treatments. “After the second one, I felt so sick and weak and dehydrated, I had to go to the hospital for a blood transfusion,” she recalls.
Feeling like she just couldn’t go on, Mrs. Mills told her six children, who range in age from 15 to 31, that she wanted to stop her treatment. “That night, my family and friends started calling and coming by and they told me they were going to fight this fight with me and be by my side every step of the way,” she says. “They really helped push me over the finish line.” And when Mrs. Mills eventually celebrated the end of her cancer treatment by ringing the bell at Miami Cancer Institute, one imagines another Bell beaming with pride to see yet another life saved by his idea.
Mrs. Mills gets scanned every six months and sees Dr. Contreras every three months. She says she’s not yet back to 100 percent but she’s feeling much better. “I think once you have cancer your body never adjusts back to what you once considered normal. I still have some neuropathy pain in my feet, and that’s been keeping me from my doing some of the things I enjoy.” For Mrs. Mills, that includes walking and shopping at the mall, as well as travel, with trips to Old San Juan and Dubai at the top of her list.
Her advice to others diagnosed with cervical cancer? “Have faith, don’t give up, and lean on your family and friends – they’re your support group.” Mrs. Mills says. “Get to all of your appointments. That’s real important.”
Getting screened – and getting to your appointments – isn’t always easy for many people.
Data shows that Hispanic women and African-American women in their fifties are more likely than White, non-Hispanic women to be diagnosed with cervical cancer. Yet, according to Dr. Contreras, they are also more likely to forego health screenings and medical appointments, for a variety of reasons.
“Minority women don’t always enjoy the same access to adequate health care – including routine screenings such as Pap smears – or health insurance,” Dr. Contreras explains. “There are also challenges inherent in taking time off from work and actually getting yourself to a cancer center that offers brachytherapy, as well as some deeply rooted social factors.”
Health disparities such as these present challenges for both patient and physician, but can be overcome by making regular health screenings available to all women – especially minorities, studies show. January is National Cervical Cancer Awareness Month, and you can learn more about cervical cancer, including screenings near you and treatments and therapies available at Miami Cancer Institute, here.