Joey Wahler (Host): It's an inspiring story of a woman kicking cancer to the curb, so we're discussing CyberKnife radiation. Our guests, Dr. Kenyon Meadows, he's a radiation oncologist for the Cancer Care Center at Southeast Georgia Health System; and Lana Wright, she's a CyberKnife patient at the Cancer Care Center.

This is Health Matters from Southeast Georgia Health System. Thanks for joining us. I'm Joey Wahler. Hi there, Dr. Meadows, Lana. Welcome to both of you.

Kenyon M. Meadows, MD: Thanks for having me.

Lana Wright: Thank you.

Host: Absolutely. So first, Dr. Meadows, for you, how long have you been with Southeast Georgia Health System? And what would you say more than anything else drew you to both healthcare and specifically radiation oncology to begin with?

Kenyon M. Meadows, MD: I've been here since 2008. So a nice number of years, all but the first two of my career have been here, St. Simon's Island, Brunswick area. The thing that drew me here, honestly, was my wife. She wanted to stay generally in the Southeast region after I finished my training at University of Florida. She's a Jacksonville girl. And so, I wanted to stay in the general area. And she knew of this area, she'd come up here numerous times for various vacations and things of that nature. I'd never heard of Brunswick and St. Simon's. But when we came here to visit, I was hooked and been here about 18 years now.

Host: Lana, you're a longtime local resident with a family, grandmother. And I know that before switching careers, you spent about four decades in the same career. So, give people an idea of what that was and what was your life like overall before your cancer diagnosis. You were very active, right?

Lana Wright: I was. To begin with, I started working at Fort Stewart, Georgia in Hinesville in November of 1971. And my primary job there was to take care of the soldiers, to do whatever I needed to do. My father relocated us to Jesup, Georgia from Bismarck, North Dakota. Jesup was my home. So, I drove back and forth to Fort Stewart from Jesup for 39 years, and that's what I did.

Host: Wow. And that was as a civilian employee for the Army, right?

Lana Wright: That's correct. That is correct. So, Doctor Meadows, what exactly is CyberKnife and how is it different in a nutshell from traditional radiation treatments

Kenyon M. Meadows, MD: So, the CyberKnife is a specialized robotic delivery system that's tailor-made, delivering relatively large doses of radiation to small targets. And that's in contrast to the more conventional or traditional radiation where we're treating larger areas, say like a whole pelvis or a person's whole brain. And when you treat large volumes like that, you have to do it slowly over multiple weeks to do it safely. If you have a situation where the tumor is small enough, you can deliver much higher doses of radiation to that small volume. And the CyberKnife is a radiation platform that's just tailor-made for that type of delivery.

Host: And so, Lana, in 2023, you're diagnosed with breast cancer. How did you initially feel at the time and what led you to Southeast Georgia Health System for that CyberKnife treatment?

Lana Wright: When I was diagnosed, I'm probably not any different than most other females or people that are diagnosed with breast cancer. You first feel like, "Oh, what am I going to do? Not me. This can't be happening to me." However, because of annual screenings, because they're very important, I had my physical exam and went for my mammogram. And when I went, I got a call soon after from the hospital radiologist that said there was an abnormality in my mammogram, and asked to do a sonogram. So, I went back for a sonogram, or ultrasound I think is what they did, anyway, and they checked it because it was kind of small.

So when I got through with that, I asked him, "Should I be concerned?" And he said, his actual words to me was, "We like to find them the size of a pea instead of a golf ball." So, that settled the nerves a little bit. My diagnosis was much better than some friends I've had, so I feel blessed. So, I went to Brunswick, had the CyberKnife radiation, and I really did not know what to expect when I got in there. It was a little different.

Host: Well, Lana, I'm going to ask you more about your experience in a moment. But first, Dr. Meadows, what specific types of breast cancer patients benefit most from CyberKnife?

Kenyon M. Meadows, MD: So fortunately, Lana's story is fairly typical in that the vast majority of the breast cancer patients we see we catch them as a result of screening. And so, they're on the smaller side, which we would define generally as less than two centimeters or about the tip of your finger or an inch. And they don't have any involvement of the lymph nodes in the armpit, which is really the next place where breast cancer likes to spread. So, provided the cancer is small and there's no lymph node involvement. And Lana had the type of non-invasive breast cancer that we know particularly does not spread to the lymph nodes.

So, we've known for a long time that when you have a cancer like that, surgery to remove it, that's always the first step. And when you look at the recurrence pattern of those types of cancers, the vast majority reoccur within two centimeters or so of where the surgeon did the operation. So, many years ago now, we started investigating on can we treat just a part of the breast, as opposed to the traditional whole breasts, which we used to do for everybody, regardless of the size of their cancer or lymph node status, and we used to do it for multiple weeks.

And, you know, about a decade ago, the studies finally matured that said, "Hey, you can get away with treating part of the breast that's just around where the surgeon did the surgery," and that seems to work very well. And so, that was just a natural application of something like CyberKnife, which is the best way to treat smaller volumes.

Host: So Lana, what was your experience with the CyberKnife treatment in terms of the best part for you? And how about the recovery process as well? What was that like?

Lana Wright: Well, I had my first appointment at the hospital here in Brunswick. I didn't really know what to expect. I met with Dr. Meadows. He explained to me that I could need five to seven treatments. I think we wound up with only five, which was a good thing. When I came in, I felt welcomed. For us folks that get diagnosed with the C word, you have all kind of bad things running through your mind. I can tell you that the people in the cancer center here, when I walked in the door, they were so warm and comforting and made me feel so relaxed, because I got to tell you, it's a nervous thing.

But anyway, I came in the first time for my treatment. I went back in a room. Everyone was perfect. I can't say enough about the people that work there. They were comforting. They were, "Are you warm enough? What channel do you want the TV on?" And then, they lay you down in this little thing, this gigantic thing that looks like Lost In Space, okay? You guys are too young to remember Lost In Space. But anyway, it kind of circles over you and it's really amazing because you're laying there watching it. It's not noisy. I figured it'd be like a real noisy thing. It's not that noisy. It just moves around. It kind of flashes, light flashes at you, and it was no pain whatsoever. Afterwards, over a period of, I'd say about four days, I was a little fatigued. I'm not usually easily fatigued even though I'm 71. But I was a little fatigued, although Dr. Meadows did explain to me that I might be a little tired. But I had absolutely no effects, I would say serious effects, from the radiation and all. And it was smooth as glass.

Host: Smooth as glass. They even asked you what channel you wanted on the TV for crying out loud. You can't ask for more than that.

Lana Wright: Absolutely.

Host: Dr. Meadows, Lana led me beautifully into my next question here. She mentioned no side effects for her. Generally speaking though, how does CyberKnife compare to traditional radiation in terms of both recovery time and side effects?

Kenyon M. Meadows, MD: Well, specifically, we used to counsel patients when we were doing the more conventional radiation over multiple weeks. Almost universally, people would get some degree of a skin reaction. I told people that imagine going to the beach, no sunscreen, and being out there all day, but imagine that kind of skin reaction taking three to six weeks to occur slowly. That almost happened uniformly to folks that we did regular conventional radiation on.

With CyberKnife, both because of the smaller volume, and because we have a very specific limitation on the skin dose, it's really unheard of to have a skin reaction. Everything is planned out three dimensionally. So, we map in her skin, her heart, her lungs, her esophagus, and things of that nature, because we have very specific dose constraints to all of those things. And as long as you don't violate them, things can be smooth.

And, you know, one other point that's important to make, I think, Lana's like a lot of folks here in our community. They come to our center for treatment, and they're not in the immediate local area. You know, they're driving for some distance. And so, particularly in our locale, being able to offer patients this much fewer sessions of treatment, it really can make a big impact. She still works and everything, and was able to work while undergoing the treatment. And a lot of times when you are asking people to come in for multiple weeks at a time, you know, it's a lot more inconvenient. They wind up taking some time off. The side effects wind up being a little bit more significant. And so, there's all these other factors that come into play that really make CyberKnife, you know, a great choice if you're a good candidate for it.

Host: Great point, Doctor, because that's one of the things, that travel time things along those lines sometimes maybe doesn't get as much attention when we're talking about cancer patients and cancer treatment. So, let me ask you, Doc, besides breast cancer, what other cancers can CyberKnife effectively treat?

Kenyon M. Meadows, MD: Yeah. And just to be clear, in Lana's case, the radiation, it's kind of an add-on to surgery, or it's a complement to surgery. There are many instances where CyberKnife is the primary treatment where we're going to deal with the cancer right up front. Probably the biggest impact has been for small lung cancers. Now, lung cancer generally speaking is more deadly than breast cancer. So, we can catch a small lung cancer. We will oftentimes treat that, what we call definitively with CyberKnife, where you're looking at a lump of cancer that you can visibly see on a CAT scan. And the CyberKnife is the main thing that we're counting on to ablate or deliver enough dose to kill off that cancer. So, that's one.

It's frontline in many instances with brain metastasis, where you have a cancer in another part of the body and it spreads to the brain. Radiation can be very effective there, and has obviously some benefits over actual surgery in that setting. And another big area is prostate cancer. That's another very common one that we use primarily CyberKnife for, is to treat prostate cancer. So, that's just a few examples.

Host: You hear a lot about CyberKnife when it comes to prostate cancer, indeed. A few other things. Lana, what advice do you have for other women who may find themselves facing that breast cancer diagnosis?

Lana Wright: My first advice would be that there have been a lot of improvements made in the way breast cancer has been treated over the years. You know, you can tell people not to panic. You can tell people to think positive. But my biggest thing for them would be to continue to make sure that they keep their self-checks to take care of themselves, to make sure that they have their regular checkups by their doctors.

For me, if I have anything else happen, if I need CyberKnife, I'm going to trust my doctors to tell me that CyberKnife will work, and I hope that they would do the same. It is a great alternative. I mean, I've been around people that had to have the long-term radiation, as Dr. Meadows pointed out, and there are some significant side effects from that. So, I am excited that they even have the CyberKnife. I didn't even know they had CyberKnife radiation until I was found to be with breast cancer.

So, my biggest thing to the people out there, the females and males, I'm sure there are males out there with breast cancer, is to one step at a time, you know, it'll all work out, eventually. I'm thankful for Dr. Meadows, and I'm thankful for the CyberKnife.

Host: Great advice. So, Dr. Meadows, for those newly diagnosed, what resources would you recommend for finding support and next steps on their road to treatment?

Kenyon M. Meadows, MD: Well, you know, particularly when it comes to breast cancer, there's a lot of very robust resources. One that I think does a great job of both speaking to clinicians and to patients both on their site is breastcancer.org. I definitely would start there. They have a really, really robust set of patient information, clinical trials, data, handouts you can print out what to expect going through treatment. So, that's one resource that I would recommend, breastcancer.org.

Host: In summary here, first for you, Lana, you're now a bailiff for the Wayne County Sheriff. So, what's it like being back at work, back in the courtroom and having this whole experience hopefully behind you?

Lana Wright: I'm not a stay-at-home person. I like people. I like to enjoy being around people. And I get to share my story with some people because we have people that you run into every day that are faced with maybe not breast cancer, but other circumstances. So, I get to share my story with people and I certainly don't mind doing that. So, that's just me.

Host: That's great. That's great. And finally, for you, Dr. Meadows, emotionally speaking, when you have a success story, like the one sitting with us today in Lana, what's the most rewarding part of it for you? I bet it makes all those years of med school and everything that came after between then and now all well worth it.

Kenyon M. Meadows, MD: Oh, absolutely. You need success stories like Lana's to balance out some of the other experiences that people have. Cancer is a huge spectrum. We have lots of patients where the goal even upfront is just to alleviate some pain and some suffering. But the expectation's they're not going to be around for years. And so, for the folks that you do have the expectation, like I'm going to see Lana back three, four, five years down the road, good mammograms. And at some point, be able to say, "Hey, we're going to let you go from our clinic. We're not worried about the cancer anymore." Those are the best. And she's one of those kinds of folks that that's what we're looking forward to in her case.

Host: Well folks, we trust you're now more familiar with CyberKnife Radiation. Dr. Meadows, keep up all your great work. And Lana, thanks so much for sharing your story and continued good health to you.

Lana Wright: Thank you so much.

Kenyon M. Meadows, MD: Thank you.

Host: Absolutely. And for more information about CyberKnife and the services offered, please visit sghs.org/cyberknife. If you found this podcast helpful, please do share it on your social media. Thanks again for being part of Health Matters from Southeast Georgia Health System.