At Penn Medicine’s Jordan Center for Gynecologic Cancers, radiation oncologist Neil Taunk cultivates a professional but friendly relationship with his patients.
Amid the hustle of the Abramson Cancer Center, Taunk, the director of Brachytherapy and Procedural Radiation and Radiation Oncology’s director of Imaging Sciences, wants patients to feel that they’re really seen, as humans, by the health care providers who will be treating them for years through initial treatment and follow-up visits.
Dalia Jakas, a retired research chemist in her 80s, arrived in Taunk’s office in 2017 seeking treatment for a rare recurrence of uterine cancer. Jakas’ case was unique in that her uterine cancer had returned 26 years later in a single, but different spot from the initial cancer. That rarely happens—to have a single recurrence this far removed from an initial diagnosis and in the location of her recurrence, Taunk says.
Jakas made clear she was seeking treatment that would not compromise her quality of life. She had withstood three rounds of chemotherapy at another cancer center, which left her, previously an active volunteer, churchgoer, traveler, and grandmother, completely debilitated after treatment. The soles of her feet burned and she was no longer able to drive, or walk without assistance. She left there and came to Penn seeking another option.
Taunk explained to Jakas how targeted proton radiation could be useful in her case. Proton therapy delivers a beam of proton particles that targets the tumor and minimizes the exposure of nearby organs to unintended lower-dose radiation. It’s typically used as the primary therapy for an initial diagnosis—not as frequently for recurrences of gynecologic cancer—but he believed it could work as a noninvasive treatment to maximize her quality of life goals and treat her recurrence.
Three weeks of daily proton radiation killed Jakas’ tumor without any noticeable side effects, an outcome Taunk never promises patients. Her particular cancer expressed the estrogen receptor—that is, it relied on estrogen to develop and grow—so she continues to take an oral estrogen blocker that has prevented her tumor from recurring or any new cancers from growing.
In appreciation for his team, Jakas established a fund to empower Taunk’s research into how treatment can be improved for uterine cancers like the one she experienced. Her support will allow Taunk to pursue clinical research on the use of positron-emission tomography (PET) scans to calculate estrogen-receptor levels in uterine tumors, building on estrogen PET research by Penn’s David A. Mankoff.
Having such a diagnostic tool would help clinicians predict which patients are most likely to respond to the estrogen blockers like the ones Jakas now takes, Taunk says. Using estrogen PET is well established for breast cancer, but uterine cancers are less well seen or understood at this level.
“Using anti-estrogen medication is a common regimen in patients with recurrent or metastatic uterine cancer, but there’s going to be a proportion of patients that will never benefit from it,” he says. “We don’t want to expose patients to a futile therapy, nor delay them from getting to a more appropriate therapy.”
This story is by Daphne Sashin. Read more at Penn Medicine News.
