Treatment

Should a mammogram find cancer, the Breast Health Center's team approach to treatment means you don't have to start looking for a surgeon or an oncologist.

The center's dedicated cancer care coordinator is there to schedule any necessary appointments, and make sure that test results and images get to consulting specialists.

Treatment Planning

Treatment planning begins with the EvergreenHealth tumor board, where each patient's case is collectively reviewed by radiologists, pathologists, surgeons, radiation oncologists and medical oncologists. Together, they decide on the best course of treatment for each particular cancer.

In some cases, treatment may begin with surgery, followed by chemotherapy or radiation therapy to kill any remaining cancer cells. Other times, the best course of treatment may be using chemotherapy or radiation therapy to shrink a tumor's size, followed by surgery to remove it.

All treatment options are conveniently available at the Halvorson Cancer Center on the EvergreenHealth campus:

• Surgery
• Medical Oncology (Chemotherapy)
• Radiation Oncology

Our patients are also offered access to clinical trials through our partnership with Fred Hutchinson Cancer Center.

Having all of these services in close proximity allows for more collaboration among the cancer care providers at EvergreenHealth. It's great technology and great teamwork combining to save lives.

Surgery

Surgery is the oldest form of cancer treatment. Although it remains an important part of cancer treatment today, surgery is typically combined with other types of treatment such as radiation, chemotherapy and hormone therapy to achieve greater success.

The main types of breast cancer surgeries include:

• Lumpectomy - The surgeon removes the breast cancer and some normal tissue surrounding it.
• Breast Conserving Surgery - Breast conserving surgery is where the surgeon tries to spare and preserve as much breast tissue as possible.
• Mastectomy - Mastectomy is where the entire breast is removed.

Lymphedema

Lymphedema is a build-up of lymphatic fluid, causing swelling in the arm and hand, and occasionally in the chest/breast on the side of the surgery. When the lymphatic system is damaged, fluid collects in the tissue of the affected area, causing swelling.

EvergreenHealth Rehabilitation Services provides a specialized lymphedema program to reduce this discomfort. EvergreenHealth therapists have received training in massage techniques, bandaging and exercises and have specialized equipment to reduce the discomfort.

Talk with your health care provider about a referral to the lymphedema program, or call EvergreenHealth Rehabilitation Services directly at 425.899.1960.

Breast Reconstruction Surgery

This plastic surgery procedure rebuilds a breast that has been removed following a mastectomy. Breast reconstruction can be done at the time of the mastectomy, or at some point in time following a mastectomy.

There are two types of breast reconstruction:

• Breast reconstruction with natural tissue
• Breast reconstruction with implants

Radiation Therapy

EvergreenHealth's Radiation Oncology Center leads the nation with a 98% rate of women keeping their breast following a lumpectomy and radiation therapy.

Image Guided Radiation Therapy

While most linear accelerators have the ability to wrap the radiation beams around the tumor target, EvergreenHealth's technology brings even more precision to radiation treatment.

EvergreenHealth Radiation Oncology's two linear accelerators are both equipped wIth IGRT - Image Guided Radiation Therapy. This onboard imaging takes a high resolution scan of the patient prior to each treatment. If adjustments need to be made, the computer software auto-corrects the treatment table so the patient is in the correct position.

It gives EvergreenHealth the ability to deliver higher doses to the tumor while reducing the spillover to surrounding, healthy tissue.

The result is:

• The correct dose of radiation
• Exactly on target
• Every single time

4-Dimensional Respiratory Gating

Another advantage for breast cancer patients is respiratory gating - the ability of EvergreenHealth's new state-of-the-art Varian Trilogy ® linear accelerator to track the position of a breast tumor as the patient breathes. This enables us to choose the right moment to fire the radiation beams during the breathing sequence.

This is particularly important for breast tumors on the left side, because respiratory gating can spare the heart from any radiation during treatment.

Respiratory gating is made possible by using the Trilogy's onboard four-dimensional CT scanner to measure the patient's range of motion during breathing. It then customizes the treatment field to the patient.

During treatment, the radiation beam is continuously turning on and off to synchronize the delivery of radiation with the patient's breathing.

For more information, or to schedule an appointment, call 425.899.1860.

Cancer Care Commendations