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Liz’s story – MRIdian radiotherapy for inoperable pancreatic cancer

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Liz was a career minded woman, named IT Woman of the Year in Belfast, while looking after a young family. “Everything at work and home was going really well until a bombshell hit” in August 2020.

Liz had been experiencing digestive issues for three months but blood tests with her GP were inconclusive. A swollen and painful abdomen in August 2020 led her to visit A&E, where she underwent various tests, before a CT scan revealed a tumour, and a follow up MRI scan confirmed a diagnosis of pancreatic cancer.

Liz comments on the diagnosis: “While there were tell-tale signs for a while, you tell yourself it couldn’t be that, so the diagnosis was a shock. I don’t think there’s ever a good time to receive that news, but when things are going well, it’s just like your life explodes. It all felt a bit surreal from then.”

Liz began a treatment pathway with the NHS, and it was initially believed that the tumour was operable. However, on the operating table in October 2020, surgeons realised they couldn’t proceed as the tumour was wrapped around her portal vein, a main vein that drains the blood from the gastrointestinal tract. Liz comments: “It was a bit of a roller coaster – getting a diagnosis like that, to then be told you’re eligible for surgery, then going into surgery and finally finding out that your tumour is inoperable. Even though surgery is not always a cure, when you have a tumour in your body, you just want it out.”

In November 2020, Liz began a tough regime of chemotherapy in the hope that it would shrink the tumour enough for an operation to be safe. After 6 cycles of chemotherapy despite it keeping things stable it was evident there wasn’t a significant tumour response and in February 2021, she was advised by her surgeon that it was unlikely the tumour would ever be operable.

To receive such devastating news and that palliative care was the next step, Liz didn’t want to give up hope. In her professional life in cyber security Liz does a lot of research into new technologies and protocols, and just like at work, she spent time researching innovations into cancer treatment and treatment protocols. She read articles about a new technology being used by GenesisCare and spoke to her case manager at her private health care provider who connected her with Dr James Good, Clinical Director of Stereotactic Radiotherapy at GenesisCare in Oxford.

Within just two phone calls Liz was having a Zoom consultation with Dr Good, who explained about SABR radiotherapy treatment on the MRIdian Linac and the emerging results from across the globe. As quickly as that everything was in place for Liz, and her family, to travel to Oxford for treatment, which took place over two weeks in June 2021.

Liz was treated on the UK’s first MRIdian Linac at GenesisCare in Oxford, which uses innovative radiotherapy technology to treat tumours using live images, meaning clinicians can see in ‘real time’ as they treat. It combines live imagery and automated beam control to avoid healthy tissue being damaged during treatment. If a tumour moves, even slightly, the treatment will automatically pause until it comes back into position.

This greater accuracy allows a higher dose of radiation to be administered, without an increased risk of side effects.

Liz had just five sessions of radiotherapy, ranging from 45 minutes to an hour in length. With minimum disruption and side effects it meant she and her family were able to enjoy their time in Oxford. Liz comments: “For the day I was in treatment, I was able to go back to our apartment and rest and my husband would take the kids to the parks nearby. I took it easy but we were able to have a holiday, visiting London, Legoland and the Cotswold Country Park whilst we were there – we have really nice memories of our time there.”

But importantly, this course of treatment led to Liz’s tumour shrinking considerably, to the point that she was now, unexpectedly suitable for surgery and in December 2021 the tumour was successfully removed.

Liz comments: “It’s very rare that a surgeon opens up a person twice. I was planned to have a very risky operation where the surgeon would team up with a vascular surgeon to do a vascular resection in addition to the normal procedure, but it turned out that the tumour had come away from the vein. I don’t know what the future holds for me in terms of what the disease will do – nobody can predict that. However, I do genuinely believe that the treatment has given me more time with my family which is all anyone really wants. At the very least, the treatment has delayed the progression of the disease.”

The success of radiotherapy on the MRIdian in giving Liz more time with her family comes as a recent study of 148 patients found that this treatment doubles the median survival rate of patients with inoperable pancreatic cancer, when compared with historical outcomes from conventional treatment.

The findings of this are significant because, at diagnosis, only 20% of pancreatic patients are eligible for surgery and the prognosis for inoperable pancreatic cancer patients is especially poor.

Dr Good comments “MRIdian gives us the confidence to treat challenging tumours, like those in the pancreas, with the higher doses of radiation needed to achieve better outcomes for patients like Liz. The GenesisCare team is so proud to have been given the opportunity to help her in this way.”

Find out more about MRIdian radiotherapy for pancreatic cancer here.