Vim & Vigor - Summer 2019 - UVA - 51

She's a cancer surgeon.
He's a radiation oncologist.
This husband-and-wife
team work together to bring
radiation treatment to the
operating room for women
facing breast cancer.

BREAST CANCER
TRIAL
The husband-and-wife team of Drs. Shayna and Timothy
Showalter has been awarded more than $1.8 million
from the National Institutes of Health to evaluate the
effectiveness of a treatment for early-stage breast cancer. They are now enrolling women in a phase II trial
(IRB #18004) to evaluate whether their approach,
Precision Breast Intraoperative Radiation Therapy, will
produce improved outcomes in terms of quality of life,
effect on the immune system, and cosmetic appearance
of the breast following treatment. See more about their
work at uvahealth.com/showalter.

low dose of radiation over a long period
of time. A newer, high dose-rate version of brachytherapy is showing to be
another effective option for men with
prostate cancer that is considered to
be high risk. (With the high dose-rate
option, radioactive material is inserted
into the tumor for 15 to 45 minutes and
then removed rather than permanently
implanted.) Adding high dose-rate
brachytherapy treatment to external
beam radiation therapy has been shown
to improve patient outcomes, without
increasing unwanted side effects that
come with radiation treatment. "A big
landmark study showed that low doserate brachytherapy with seed implants
comes at the price of urinary frequency
and a weaker stream. The high dose-rate
version is being increasingly used, and
the evidence to date shows no difference
in rates of urinary frequency or weak
stream," Dr. Showalter says.
In another major development in prostate cancer treatment, the FDA approved

an injectable gel used to create 15 millimeters of space between the prostate
and rectum. "This gel is game-changing
technology," Dr. Showalter says. "When
someone is laying down, the prostate
gland literally rests on the rectum, which
can be easily damaged by radiation. The
gel takes 0 millimeters of space and creates 15 millimeters of space. When delivering radiation to cancer cells, we work
within 3- to 5-millimeter margins, so it's
amazing to have that much space," Dr.
Showalter says. With this breakthrough,
men no longer have to worry about experiencing urgent or frequent bowel movements as a side effect following treatment
for prostate cancer.

One-Time-Only
Breast Cancer Treatment

Dr. Showalter's enthusiasm for brachytherapy is clear when talking about a
clinical trial he and his wife, Shayna L.
Showalter, MD, a UVA breast cancer surgeon, have introduced for women with

early-stage breast cancer. Together, the
Showalters are investigating a procedure
that gives women a single high-dose
radiation treatment during breastpreserving surgery. This brings weeks of
daily radiation exposure to a one-time
exposure. And by using advanced image
guidance, the doctors can avoid exposing
healthy tissue, including the heart, lungs
and other organs, to radiation.
The Showalters, along with their
research colleagues, have already established the safety of Precision Breast
Intraoperative Radiation Therapy in a
small phase I clinical trial and are now
enrolling women in a larger phase II
trial (see above).
Dr. Shayna Showalter, serving as
the trial's principal investigator, says,
"We've had women travel from far away
to receive this individualized and novel
form of radiation therapy that is much
more convenient. It is so rewarding to be
able to advance the field through such a
patient-centered research program." ■
SUMME R 2019

http://www.uvahealth.com/showalter

Vim & Vigor - Summer 2019 - UVA

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