Research
Cancer Therapy on Target
When Eileen Fahrenkrug was diagnosed with an early-stage tumor in each of her breasts in November 2001, she had no idea that her treatment journey would lead to Madison. It was only after a Madison-area relative saw a television news story that the Saint Paul, Minnesota, woman made the trip.
The story was about brachytherapy, a promising breast-cancer treatment pioneered by Robert R. Kuske, a professor of human oncology at the UW Hospital and Clinics. The therapy allows patients to complete post-surgical treatments in about a week, compared to the standard six to seven weeks that breast radiotherapy requires.
"I just felt we were led to it," says Fahrenkrug, after completing treatments in ten days. "Now, I talk it up all the time. I just feel wonderful."
A growing number of women with early-stage breast cancer are opting for brachytherapy over traditional external-beam radiation. The convenience of the timesaving therapy is an obvious benefit, but Kuske notes there are other significant advantages. Brachytherapy treats only the breast tissue closest to the site of the surgically removed tumor, not the entire breast. As a result, radiation exposure of the underlying lung, heart, ribs, and muscle is markedly diminished, as is the dose to the skin.
The story was about brachytherapy, a promising breast-cancer treatment pioneered by Robert R. Kuske, a professor of human oncology at the UW Hospital and Clinics. The therapy allows patients to complete post-surgical treatments in about a week, compared to the standard six to seven weeks that breast radiotherapy requires.
"I just felt we were led to it," says Fahrenkrug, after completing treatments in ten days. "Now, I talk it up all the time. I just feel wonderful."
A growing number of women with early-stage breast cancer are opting for brachytherapy over traditional external-beam radiation. The convenience of the timesaving therapy is an obvious benefit, but Kuske notes there are other significant advantages. Brachytherapy treats only the breast tissue closest to the site of the surgically removed tumor, not the entire breast. As a result, radiation exposure of the underlying lung, heart, ribs, and muscle is markedly diminished, as is the dose to the skin.
Kuske started developing breast brachytherapy in 1991, while at the Ochsner Clinic in New Orleans. Initially better known in Europe, the therapy has caught on since Kuske's arrival in Madison two years ago. He says he currently treats about three patients a week.
"I have treated 278 women over eleven years," Kuske says. "In that time, there have been only two recurrences." Long-term results have been published in the American Journal of Surgery, and clinicians at the William Beaumont Hospital near Detroit have published similar results.
"Brachy" is Greek for "short distance," signifying how the therapy deploys radiation very close to the site of the removed tumor. The doses are delivered through radioactive seeds, about the size of a thin grain of rice, which are inserted using a series of catheters that encircle the lumpectomy site. An alternative method, recently approved by the FDA, uses a single catheter attached to a balloon, which is inflated in the lumpectomy cavity. The seed delivers radiation within one centimeter of the site, says Kuske, who was a principal investigator during development of the balloon technology, known as MammoSite. The entire procedure is completed on an outpatient basis, making it a good option for women who live far from treatment centers or who cannot spare time for radiation therapy. In fact, it was a patient who refused to relinquish the time necessary for conventional thearpy that led Kuske to develop the new technique.
"I have treated 278 women over eleven years," Kuske says. "In that time, there have been only two recurrences." Long-term results have been published in the American Journal of Surgery, and clinicians at the William Beaumont Hospital near Detroit have published similar results.
"Brachy" is Greek for "short distance," signifying how the therapy deploys radiation very close to the site of the removed tumor. The doses are delivered through radioactive seeds, about the size of a thin grain of rice, which are inserted using a series of catheters that encircle the lumpectomy site. An alternative method, recently approved by the FDA, uses a single catheter attached to a balloon, which is inflated in the lumpectomy cavity. The seed delivers radiation within one centimeter of the site, says Kuske, who was a principal investigator during development of the balloon technology, known as MammoSite. The entire procedure is completed on an outpatient basis, making it a good option for women who live far from treatment centers or who cannot spare time for radiation therapy. In fact, it was a patient who refused to relinquish the time necessary for conventional thearpy that led Kuske to develop the new technique.
To be a candidate for brachytherapy, a tumor must measure less than three centimeters, and patients must meet other selection criteria (see www.rkuske.com for details). Also, Kuske notes, the skill of inserting the catheter requires practice for doctors. "You need experienced and trained physicians to perform the procedure," he says.
—Michael Felber '87, MA'92
—Michael Felber '87, MA'92
A New Picture of Perception
Like beauty, anger may also be in the eye of the beholder. According to new research, experience can change how people perceive certain emotions.
Most psychologists have thought that people see emotions in the same way, regardless of their race, culture, or language. Show any two people the same picture of a face, it was commonly believed, and they'd see the same emotion.
But Seth Pollak disagrees. "Experience can shift where a person draws the boundary of a particular emotion, and this idea runs counter to claims that boundaries for emotions are innate," says the professor of psychology and psychiatry.
To prove this, Pollak studied how eight-to ten-year-old children perceive emotion in facial expressions. The children played a series of computer "games," which prompted them to pair emotions with a series of faces that flashed on a screen. In this case, the game had a trick. Most of the faces were designed to exhibit two emotions.
Most psychologists have thought that people see emotions in the same way, regardless of their race, culture, or language. Show any two people the same picture of a face, it was commonly believed, and they'd see the same emotion.
But Seth Pollak disagrees. "Experience can shift where a person draws the boundary of a particular emotion, and this idea runs counter to claims that boundaries for emotions are innate," says the professor of psychology and psychiatry.
To prove this, Pollak studied how eight-to ten-year-old children perceive emotion in facial expressions. The children played a series of computer "games," which prompted them to pair emotions with a series of faces that flashed on a screen. In this case, the game had a trick. Most of the faces were designed to exhibit two emotions.
Pollak digitally altered photographs of men and women showing one of four emotions - happiness, sadness, fear, or anger - so that each photo contained another emotion. He arranged the photos on a continuum, progressing, for example, from fully happy to fully sad, or completely angry to completely fearful.
If mainstream views had been correct, you would expect that children would generally agree with each other in their assessments, even for the tricky mixed faces. And in some cases they did, such as when faces were mostly happy, sad, or fearful. But when it came to anger, an interesting difference appeared.
Some of the children in the study had been physically abused in the past, which Pollak says offered the chance to learn how atypical experiences alter perception, as well as possibly to identify new treatments to help these children overcome their hardships. The abused children identified more faces as angry, even when the faces evinced more of another emotion.
"The abused children were more sensitive to anger," explains Pollak. "It may be the case that physically abused children develop a broader category of anger because it's adaptive for them to notice when adults are angry."
If mainstream views had been correct, you would expect that children would generally agree with each other in their assessments, even for the tricky mixed faces. And in some cases they did, such as when faces were mostly happy, sad, or fearful. But when it came to anger, an interesting difference appeared.
Some of the children in the study had been physically abused in the past, which Pollak says offered the chance to learn how atypical experiences alter perception, as well as possibly to identify new treatments to help these children overcome their hardships. The abused children identified more faces as angry, even when the faces evinced more of another emotion.
"The abused children were more sensitive to anger," explains Pollak. "It may be the case that physically abused children develop a broader category of anger because it's adaptive for them to notice when adults are angry."
But if sensing anger may actually be helpful when they're in threatening situations, Pollak says it's not useful and potentially harmful once they leave those environments. They might over-interpret an expression to be hostile when it's really not, he notes, and end up lashing out or running away. He hopes that the refined understanding of how these children perceive anger can help psychologists as they try to manage the behavioral problems that often result from childhood abuse.
— Emily Carlson
— Emily Carlson
Another UW Solution
More than a decade ago, UW surgeons created a chemical solution that became the gold standard for organ transplants, greatly increasing the amount of time that organs could be stored outside the body.
New improvements to the fluid, known as the UW Solution, could extend the life span of organs even further.
The original UW Solution, created in 1986, was the first synthetic solution to allow for longer storage of livers and kidneys, increasing the chance that they could get to patients awaiting transplants. But the solution also caused small injuries to organs, sometimes resulting in rejection once transplanted.
Now, another UW team has enriched the formula with proteins that stimulate growth and DNA repair. With the modified solution, kidneys can be kept alive for six days with little damage, says veterinary surgeon Jonathan McAnulty MS'89, PhD'94, who developed the new solution with veterinary ophthalmologist Christopher Murphy and Texas Tech University professor Ted Reid.
—Emily Carlson
New improvements to the fluid, known as the UW Solution, could extend the life span of organs even further.
The original UW Solution, created in 1986, was the first synthetic solution to allow for longer storage of livers and kidneys, increasing the chance that they could get to patients awaiting transplants. But the solution also caused small injuries to organs, sometimes resulting in rejection once transplanted.
Now, another UW team has enriched the formula with proteins that stimulate growth and DNA repair. With the modified solution, kidneys can be kept alive for six days with little damage, says veterinary surgeon Jonathan McAnulty MS'89, PhD'94, who developed the new solution with veterinary ophthalmologist Christopher Murphy and Texas Tech University professor Ted Reid.
—Emily Carlson
