Tamara F The Power of Precision

An advanced type of radiation therapy helped one young woman beat a life-threatening brain cancer.

After finishing work one day in October 2017, Tamara Francis, a 32-year-old graduate student who was earning her master’s degree as a family nurse practitioner, went to get her purse so she could drive home. Suddenly, she became disoriented, forgetting where she was and what she was doing, and had a seizure that rendered her unconscious. A medical assistant found her convulsing on the floor, and an ambulance was called. By the time Tamara regained consciousness, she was at Robert Wood Johnson University Hospital (RWJUH) New Brunswick.

In short order, she was diagnosed with a rare form of cancer called anaplastic meningioma, which arises from the lining of the brain. In November 2017, she had a craniotomy at RWJUH New Brunswick to remove the tumor, which was occupying a quarter of her brain. After the surgery, her oncology team recommended radiation therapy. Tamara was concerned that traditional radiation therapy could cause collateral damage to other parts of her brain, so she researched other options. “I wanted a treatment that would have the fewest side effects,” says Tamara, who lives in Brooklyn, NY. “I didn’t want any cognitive changes.”

Finding a Safer Option

Tamara discovered the Laurie Proton Therapy Center at RWJUH New Brunswick, which uses energy from positively charged particles instead of X-rays to destroy cancer cells. Proton beams target tumor tissue more precisely and can be stopped at a certain depth. This technique destroys any microscopic cancerous cells while minimizing damage to healthy tissue near the tumor site. Another benefit is that proton therapy can be given a second time if the cancer returns. “When I was diagnosed, the doctors said it was an aggressive cancer and the chances of it coming back were high,” says Tamara.

“Tamara was a great candidate for proton therapy because of the cancer’s location—high, on the right side of the head and very superficial,” says Joseph P. Weiner, MD, Tamara’s radiation oncologist at Rutgers Cancer Institute of New Jersey and RWJUH New Brunswick. “Since we can reduce the dose to the opposite side of the brain and the hippocampus, where memory is processed, we can maximally protect her brain and function. We think it may lead to a better quality of life. ”

The Center, which opened in 2016, is unique. “We’re the only facility in New Jersey to use this technology in the setting of a National Cancer Institute-Designated Comprehensive Cancer Center,” says Rahul R. Parikh, MD, medical director of the Laurie Proton Therapy Center at RWJUH New Brunswick and Associate Professor of Radiation Oncology at Rutgers Cancer Institute of New Jersey and Rutgers Robert Wood Johnson Medical School.

A Painless Treatment

In December 2017, Tamara began having 30-minute sessions of proton therapy five days a week. She continued the protocol for six weeks. During the sessions, “I didn’t feel anything,” she says. “I just had to sit really still so the beam could target the same site every time.” In fact, she would wear a customized, immobilizing mask to prevent her from moving her head during the treatment sessions.

After a few weeks, Tamara began experiencing side effects, including nausea, vomiting and headaches. She completed the treatment in February 2018, and the side effects stopped over the summer.

Living Life to the Fullest

In the summer of 2018, Tamara graduated from her master’s degree program and took her board exams to become certified as a family nurse practitioner. She returns to RWJUH New Brunswick every three months for an MRI and a check-up. The plan is to space out these visits to every six months. “We’re cautiously optimistic,” says Dr. Weiner. “We don’t see any evidence of the tumor on repeated scans, but we have to be vigilant because it’s the most aggressive type of meningioma.”

In the meantime, Tamara works as a family nurse practitioner and travels as often as she can. She doesn’t have any restrictions on her lifestyle or take any medications. “I feel fortunate to have received the kind of treatment and care that I did,” says Tamara. “God forbid, if I get this again, I will go the same route.”

Best Candidates for Proton Therapy

Many patients who need radiation can benefit from proton therapy, but it’s especially useful for challenging cases, says Rahul R. Parikh, MD, medical director of the Laurie Proton Therapy Center at RWJUH New Brunswick and Associate Professor of Radiation Oncology at the Rutgers Cancer Institute of New Jersey and Rutgers Robert Wood Johnson Medical School. Patients with a tumor located near a critical brain structure or the heart or lungs stand to benefit because “the more refined beam of radiation enables us to spare neighboring healthy organs more than traditional X-ray radiation therapy,” he says. “We can control exactly where the beam is delivered, which is important because breathing can cause tumors in the chest and abdomen to move.”

To learn more about the Laurie Proton Therapy Center, call 732.253.3176 or visit www.rwjbh.org/rwjuhprotontherapy.