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A Radiation Oncologist’s Role in Treating Breast Cancer

A Radiation Oncologist’s Role in Treating Breast CancerSince October is Breast Cancer Awareness Month, discovering more about Dr. Kristina Mirabeau-Beale, Board Certified Radiation Oncologist, should be an inspiration to all women and men alike. As a Radiation Oncologist for 21st Century Oncology in Collier County, her personal motivation, lead her to achieve her goals and graduate from Harvard with what is sometimes called “Preparation H:” impressive simultaneous degrees from Harvard college, medical school, and residency with honors. In her spare time, she is also mom to twin boys and married to a surgeon, Dr. Scott A Thompson. She is a champion for women and men’s health and a great asset to our community.

Dr. Kristina Mirabeau-Beale has a clinical interest in maintaining patient “quality of life” and improving long-term adjustment in cancer survivors after radiation therapy. She has published extensively on techniques to mitigate side effects from radiation and improve patient quality of life, including breast, colorectal and gynecologic cancers. She also studied clinical effectiveness and holds a masters degree in public health from the Harvard School of Public Health.

Having grown up in a diverse immigrant household, she has a keen understanding of how to communicate with and respect individuals of all backgrounds in a way, which sets her apart from many of her peers. Her patient testimonials speak volumes about her personal devotion, bedside manner, and style.

We had the distinct privilege of interviewing Dr. Mirabeau-Beale:

Q: Dr. Mirabeau-Beale, what made you want to go into medicine and pursue radiation oncology?
A: My undergraduate degree was in anthropology and women’s studies at Harvard. I’ve always been drawn

to helping people and especially the underserved. When I decided to pursue a medical career, I thought I wanted to focus on research, but then I had the opportunity to work on a project that allowed me to interview ovarian cancer survivors one-on-one. That project was intricate—I got to interview hundreds of cancer survivors, and each interview literally took over 4 hours. Getting to know these women through this study gave me perspective about the unique journey and experience of cancer patients, and made me realize that I wanted to work with cancer patients in my career.

Radiation Oncology is a unique field that integrates complex imaging, understanding of anatomy, and the ability to have intimate, long-term contribution to patient’s lives. You meet their family members, are part of their multidisciplinary care team and are able to significantly impact their well-being as you are part of their care. Plus I get to know them personally and create long-lasting relationships.

Along with the ovarian cancer study, I had key mentors that really helped facilitate my decision to go into radiation oncology specifically: Akila Viswanathan, M.D., M.P.H., Vice Chair at John’s Hopkins and an expert in gynecological cancers and Anthony D’Amico, M.D., Ph.D., a dean at Harvard Medical School who is a well-known scholar in prostate cancer. I had the privilege to work with Akila and Anthony as a medical school student and throughout my residency, and published research with them. We still keep in close contact today.

Q: Is there a reduction in breast cancer recurrence with radiation therapy?
A: Today we know a lot more about the biology of breast cancer, which has significant implications for prognosis and survival for our patients. Historically, we used to think that radiation only decreased local recurrence but did not improve survival. However, after more updated research including a large meta-
analysis, it is now established that radiation does help prevent cancer recurrences and helps women live longer. Radiation reduces the risk of any recurrence, local or distant by about 50% in many instances. “Local recurrence” is when cancer comes

back in the breast after a lumpectomy, while “distant disease” is when cancer spreads or appears in other organs or distant lymph nodes, which is significant.

Q: What can patients expect when diagnosed with breast cancer and they receive radiation therapy?
A: We use a specialized CT Scan called a simulation scan so that we can precisely preplan the radiation process. An immobilization device is created specifically to patient’s anatomy to position them appropriately for their treatment.

We perform radiation Mondays through Fridays, so patients have time to rest over the weekend, in the comfort of their home. For most patients, the timeline is anywhere from 4 to 6 weeks of therapy, but can sometimes be fewer or more based on the details of the disease.

We typically give patients a few weeks to heal at home after surgery to have their skin intact before beginning radiation. While they are on treatment, I will see my patients on a weekly basis. It’s at this time that I continue to monitor my patient’s healing and how they tolerate treatment. I will see them for regular intervals generally the first few years after therapy.

Q: What are the short-term and long-term effects of radiation for breast cancer?
A: Short-term: Patients may experience skin reactions that can vary from mild redness or slight tanning to more significant irritation, like that of a severe sunburn. Making the patient comfortable is always of the utmost importance, so I will prescribe various creams or over-the-counter topical ointments to relieve these symptoms as necessary. Some women feel fatigued during treatment, but usually, their routine and quality of life aren’t too disrupted.

Long-term: Textural changes to the breast can occur, such as firmness, changes in size of the breast or and some skin tanning. These are issues that I continue to monitor and treat during our follow-up visits.

We now have more advanced technology that helps us to better personalize our treatment plans and minimize radiation dose to other organs such as the heart or lungs, which allows me to prevent any subsequent heart or lung issues. With these cutting-edge methods, I can greatly decrease chances of toxicity or damage to the heart and lung tissues making these side effects very rare.

Q: Understanding that proper rest, maintaining a healthy diet and moderate exercise are essential to healing, how can patients benefit from these to reduce fatigue?
A: We have a nutritionist physically here at 21 C to help assist patients with healing and nutritional balance. I would never recommend any patient start an aggressive new physical fitness plan or diet during treatment, but maintaining exercise and fitness levels has been shown to help alleviate fatigue. Patients absolutely do need to rest after their treatment, but they can also benefit from some forms of low-intensity exercise to help them reduce stress and fatigue.

I’m a huge advocate for patients wanting to add additional healthy lifestyle modalities such as yoga, acupuncture, and physical therapy. These help both mentally and physically and have been shown to reduce anxiety and to promote the body’s natural healing process.

Q: After the typical 4-6 week radiation treatment, what should patients be aware of for proper healing?
A: It’s essential for patients to continue with their follow-up visits for six months to a year or longer depending on their particular case. I ask my breast cancer patients, to be self-aware and perform regular breast exams. It’s important to have a pre and post-baseline of what’s “normal” for them. There may be skin changes or perhaps new textures or firmness that form as the tissues heal from radiation, which is why post-
treatment mammograms are critical. I provide clinical exams and review mammogram algorithms for each of my patients specifically.

Q: What is the one thing that you would tell a woman that has just been diagnosed with breast cancer?
A: I’m here for you. I’m always here to field questions, comfort, give sound advice, and convey positivity. No one has a crystal ball, but I’m on this entire journey with my patients. Ideally, I’d like to follow them forever. My goal long-term is to do what I can to help cure their cancer and prevent it from coming back while helping them heal and subsequently stay as healthy as possible.

For me, communication is key. I enjoy when patients are a real active participant in their treatment. I want patients, no matter their circumstances to experience genuine, passionate, evidence-based, expert care.

I have always had a passion for women’s health, but I equally enjoy treating my male patients, and I love taking care of patients in our community. I grew up in Miami, and even though I did all my training in Boston, I always wanted to come back to Florida to serve my fellow Floridians. I love being able to work locally here in the Bonita Springs and Naples area, where I can literally run into my patients at Publix, at the park, or where I volunteer. It’s such a great community, and I’m so thrilled to be able to live and work here while serving our patients.

To find out more about Dr. Kristina Mirabeau-Beale, and to schedule your appointment, please visit www.21stCenturyOncology.com or call (239) 436-5520.

 

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