When physicians informed 47-year-old Patricia O'Rourke* that cancer had spread from the base of her skull to enclose a portion of her spine, the Los Angeles-area social worker knew that her spinal cord was being held a virtual hostage. Since injury to her spinal cord would leave her permanently paralyzed from the waist down, treatment of the tumor would have to be selected carefully.

The skull-base tumor had already been operated on twice, and her neurosurgeons recommended radiation therapy as the weapon to combat the newly detected tumor. Armed with a computer and the research experience brought by an earned master's degree, O'Rourke went on the Internet, searching medical journals and university research centers for information on the most effective form of radiation therapy.

Her research brought her to a common recommendation: an advanced form of radiation therapy called Intensity Modulated Radiation Therapy (IMRT). "I'm not a doctor, but this is my body and I am an expert on that. When my research indicated that IMRT would deliver highly focused radiation with out damaging other parts of my spine, I knew I had to talk to a specialist," O'Rourke said. "I knew I wanted IMRT, but I had to find someone who could,and would,do the procedure."

Armand Bouzaglou, M.D., medical director of St. Vincent Medical Center's Cancer Treatment Center, reached the identical initial conclusion. "Her clinical condition highlighted the inability of standard treatments such as surgery, radiation therapy and chemotherapy to treat this tumor while sparing her spinal cord," Dr. Bouzaglou said.

IMRT treatment computers evaluated more than 10,000 different treatment plans before a finalized version was chosen. Aided by three-dimensional technology and imaging, the team of physicians and physicists, guided by Dr. Bouzaglou, manipulated the intensity of each of the thousands of radiation beams that IMRT delivers to create a donut-shaped treatment beam. This technological feat allowed high doses of radiation to treat the tumor without affecting the spinal cord.

"My last spinal MRI indicated that the treatment was successful," O'Rourke said, who added that she had entered the Cancer Treatment Center unable to walk, and walked out under her own power. And while the Los Angeles resident voiced elation over the result of her treatment, she also lavished praise on the staff of the Cancer Treatment Center.

"No matter how much a center may know about technology, patients rely on the staff," she said. "As a social worker, I naturally observe people, and I noticed that everyone was so professional, from the transport staff to the nurses to Dr. Bouzaglou who always made himself available to answer all of my questions. I was always made to feel comfortable regardless of how anxious I was."

According to Dr. Bouzaglou, the treatment-molding capability of IMRT allows the Cancer Treatment Center to treat tumors in difficult-to-treat areas like the brain, lung, gastrointestinal region, prostate, and rectum, and even allows simultaneous treatment of multiple targets. Patients treated with IMRT typically receive 20 to 35 consecutive daily treatments.

The Cancer Treatment Center began treating patients with IMRT in January 2000, and now treats up to one patient every 30 minutes from 6 a.m. to as late as 8 p.m. A new machine, made possible by generous grants from the Daughters of Charity Foundation, has allowed the Center to work toward doubling the number of patients treated.

This article was provided by St. Vincent Medical Center.

(*The patient interviewed for this story requested that her real name not be used in order to preserve her privacy. No other details about her experience at St. Vincent Medical Center have been changed.)

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