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Up to half of all men and one-third of all women will face a cancer diagnosis in their lifetime, according to the Nevada Cancer Coalition. Chances are, you or someone you care about has been affected by cancer and has witnessed the ultimate fight for life. More than likely, your loved one’s cancer journey involved radiation therapy – and in fact, more than half of cancer diagnoses are treated in whole or in part with radiation. At first glance, this treatment plan can sound scary to any person. With a cancer care journey, it takes a village, and at Renown Health, we have top-notch leaders of the village roads that lead to radiation.  Meet our Radiation Oncology team at the William N. Pennington Cancer Institute. From intake to inpatient, this department of passionate physicians, radiation therapists, registered nurses, medical assistants, intake coordinators, schedulers and more are here to help every patient dealing with the intimidating diagnosis of cancer. Any patient that needs radiation as a part of their treatment is in the best of hands with this team, who will stop at nothing to ensure each patient under their care knows that they have a village Fighting the Good Fight right alongside them.  Teamwork in Tackling Tumors One of the most common forms of cancer treatment, radiation therapy uses high-energy X-rays to minimize cancerous cells. But with Renown’s Radiation Oncology department, the impressive cancer care doesn’t stop there – this team leverages advanced technology right at their fingertips. In fact, our cancer institute has the most state-of-the-art radiation therapy system of its kind – the ultra-precise Varian TrueBeam radiation therapy system – and is the very first program holding American College of Radiology accreditation in the entire region.  Given the advanced nature of their jobs and the high standard of care their patients expect them to uphold, it’s no question that the days-in-the-life of each team member is complex and can continually change every day.  “There are many moving parts in radiation oncology on any given day,” said Sandra Bailey, Manager of Radiation Oncology Services. “The radiation oncologists consult newly diagnosed patients, follow up with previously treated patients and oversee daily treatments for patients actively receiving treatments. Nurses and medical assistants move around the clinic to support the physicians with patients and provide education and other supportive care.”  The physics and dosimetry teams work diligently alongside the physicians to design the most beneficial treatment plan for each patient. Once a patient begins their treatments, the radiation therapists administer the daily treatments with the utmost precision. Intake coordinators, schedulers and patient access representatives make surethe patients have their insurance authorization and are processed through the system appropriately. Like any well-oiled machine, each part is necessary for the other to function at peak performance to ensure our patients receive the quality care they deserve and expect. Like many other clinical departments at Renown, teamwork coupled with education is crucial to best serve radiation therapy patients. Our nurses on this team are experts at exactly that, serving as a reminder of the transformative power of care in the face of a daunting disease.  “Radiation oncology is a unique world,” said Kristen Reed, Registered Nurse. “We have many different team members that play a role in how we function as a department. We all work together in some aspect to provide care for our patients. As a nurse, I provide patient education to all my patients before starting treatment to go over potential side effects and expectations on their treatment. Daily, we see new patients and follow-ups, plan simulations to start patients for radiation treatments and provide radiation treatments, among many other daily tasks.”  The unique role of our radiation therapists, the team members who are on the frontlines of giving radiation treatments, helps this department stand out from the rest with their tireless dedication to fighting against cancer with compassion and expertise. Not only are they armed with technology, but they are also armed with hands that deliver healing rays of radiation.  “As a radiation therapist, our daily tasks can vary pretty widely,” said Casey Johnson, Radiation Therapist. “We rotate between three radiation treatment machines called linear accelerators – one of which we use for stereotactic radiosurgery, a minimally invasive form of surgical intervention. We also staff the CT simulation room where we construct all the patients' treatment devices and perform their ‘mapping’ scan. We then coordinate with the dosimetrists and physicians to determine the specifics of the patients’ course of treatment. The most important parts of our job are patient care and education. Even though our job is very technical and requires tremendous attention to detail, the critical part is remembering that our average workday could be a monumental day for a new patient.”  “Our day-in-the-life in Radiation Oncology is centered around patient care,” added Haley Longfield, Radiation Therapist. “Although we do not spend a ton of time with our patients, we see them every day. We are able to build a wonderful rapport with our patients that is top-notch. We set up the room with their treatment devices, get them set up appropriately and administer their radiation treatment. On average, our patients are here for about 15 minutes.”  The bottom line: our Radiation Oncology team’s unified commitment to both excellence and innovation promises a brighter future for those battling cancer. No one is ever alone in their fight, and this team makes sure of that, no matter what.  Radiating Excellence in Cancer Care The Pennington Cancer Institute boasts a stellar reputation in our community for offering best-in-class, evidence-based care and cutting-edge research, improving outcomes for patients battling cancer. This fact is what inspired many Radiation Oncology team members to take their talents to this department in the first place.   “I chose to work at the Cancer Institute because I believe we offer the best patient care experience, along with the most advanced radiation treatments in the area,” said Casey Johnson.  "I am a fifth generation Reno resident, and I am part of this community through and through,” added Haley Longfield. “I always knew that I wanted to work here.” The success of our cancer institute starts with our people – and many members of the Radiation Oncology team witnessed this firsthand upon their arrival in this department. “I was initially inspired to move across the country to work in the Cancer Institute by the vision of the senior leaders and the future growth plans for the entire institute; once I arrived, I quickly realized what a great team I am now leading,” said Sandra Bailey. “The compassion and care the Radiation Oncology team provides our patients is second to none. Medical errors are rare in our department, and this can be attributed to not only the processes in place to prevent them, but everyone working together to deliver radiation treatments safely. Each day I witness a patient relationship being nurtured and developed. I am truly honored to be part of this team.”  Inspired by Renown's integral role in the northern Nevada community, several team members were drawn to this department because of the opportunity to make a meaningful impact on patients' lives in a quiet healing environment.  “As a student nurse, I had clinical and practicum on the cancer nursing unit here at Renown; I noticed the quiet, healing environment and a patient population enduring some of life’s most challenging hurdles,” said Rachel Bales, Registered Nurse. “It is in these moments that you can really make a difference as a nurse. After pursuing critical care as a new grad and working in Interventional Radiology with cancer patients, I knew that I had to find my way back to oncology. I applied to Radiation Oncology, and I am working towards my third year in this department. I have always known that I enjoy helping others, and the fulfillment that comes from working with this patient population is unmatched.”  “Renown is a huge part of the community in northern Nevada, and I knew while I was in nursing school that I wanted to have a career here,” added Kristen Reed. “I ended up joining the Cancer Institute about two years ago. My patients are a huge part of why I stay. We really get to know these patients and their families well, especially because they come in from Monday through Friday for up to six weeks for treatments. Building connections and being able to support these patients during a difficult time in their life makes my job fulfilling.”  From the initial consultation to the administration of therapy, the staff's commitment to personalized care remains strong. Patients and their families develop profound connections with these team members as they navigate through the challenges of treatment.  “We have knowledgeable and caring staff that help guide our patients through treatment,” said Kristen Reed. “This starts on the day of their consultation and continues even after completion of treatment. The patients and families get to know the staff through their treatment, and having a familiar face can be reassuring to them. We also take time every week to see how they are doing physically and mentally while undergoing treatment and we give them a chance to check in with their doctor. Taking this time helps reassure patients and allows them to ask questions, and in turn, reduce some anxiety and worry.”

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Breast cancer screening has long been a cornerstone of women's healthcare. With 1 in 8 women diagnosed with breast cancer in their lifetime1, the United States Preventive Services Task Force (USPSTF) has developed screening recommendations to help detect early-stage cancer. Notably in 2023, the USPSTF revised the recommended age for biennial mammogram screenings for women with average risk to start at age 40 instead of 502, estimated to result in 19% more lives being saved3 by starting screening earlier. While initiating screening at an earlier age offers advantages to a wide demographic, concerns about the potential of over-screening prompted research into the feasibility of identifying women with lower breast cancer risk who could safely delay mammograms. While guidelines address high-risk individuals, a notable gap exists in providing recommendations tailored to those at lower risk. To gain insight into a patient's risk level, physicians are able to utilize genetic testing to understand an individual's genetic makeup, providing precise insights into their predisposition to various health conditions, including breast cancer. Armed with this genetic information, healthcare providers could craft tailored screening strategies that align with an individual’s specific risk profile. This genetic risk-based approach underscores the value of genetics in individualizing the onset of screening to help avoid over-screening and its associated costs. Surprisingly, genetic information is not currently being widely utilized to identify women at risk of breast cancer or other diseases in clinical practice, despite its potential to make a significant positive impact for patients. A recent retrospective analysis of 25,591 women from the Healthy Nevada Project4 sheds light on the potential benefits of this genetic risk-based approach. The study classified 2,338 (9.1%) of these women as having a low genetic risk for breast cancer. What's remarkable is that these women exhibited a significantly lower and later onset of breast cancer compared to their average or high-risk counterparts. This finding suggests that it might be safe for low-risk women to delay mammogram screening by 5 to 10 years without compromising their health.

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Early detection is a significant piece of the breast cancer puzzle. Susan Cox, Renown Health Director of Cancer Operations, discusses what you need to watch for and how the latest technology can help detect potential cancer sooner. When should women start getting breast exams? It depends on risk factors: Average-risk women: Most medical organizations recommend the first mammogram between 40 and 44. Higher-risk women: Dependent on their high risk, which will dictate when they start screening, but generally around the age of 30 and not before 25 years old.

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Breast cancer is the leading cause of cancer deaths in women in the U.S. That’s why early detection is so important. Dr. George Krakora, a radiologist with Renown Institute for Cancer, explains what to watch for and how new technology can lead to early detection. Most women know the importance of breast health and staying current with annual breast exams, but may not know that both screening guidelines and technology is evolving. So we asked George Krakora, MD, a radiologist for the Renown Institute for Cancer, what every woman should know about breast cancer detection and which screening method is right for them. First off, when should women start getting breast exams? Generally, women should start getting breast exams using mammography or ultrasound after they turn 40 years old. But we also want women ages 18 to 39 to talk to their primary care provider and ask for what’s called a formal risk assessment to see if screening is needed sooner. And you want to make sure your care provider is giving you a breast exam starting at age 25. It’s also a good idea to be familiar with how your breasts look and feel so you can report any changes to your care provider. What are the risk factors for breast cancer? Are there any preventive steps women can take? There a few risk factors you can’t control, like your age, family history of breast or other cancers, and if you have dense breast tissue. Your risk for breast cancer increases as you get older, and most breast cancers are diagnosed after age 50. Knowing your family history is important because a history of cancer and shared lifestyle can raise your risk. Your breast density can also increase your risk: Women with high breast density are four-to-five times more likely to get breast cancer than women with low breast density. But the good news is there are quite a few things you can do to prevent breast cancer, like not smoking, watching your alcohol intake, and maintaining a healthy weight with good diet and exercise. There are a lot of newer screenings out today. What is the difference between 2-D and 3-D mammography? In a 2-D mammogram, the tech takes X-rays of the breast. These pictures can show the radiologist if there are any lumps or tumors you might not be able to feel. In 3-D mammography, the process is largely the same but more X-rays are taken and it takes a few seconds longer for each image. This kind of exam detects 41 percent more cancers and reduces the number of false-positive results given to patients. This improvement in technology is great for both patients and their care providers. 3-D mammography provides better images of the breast, which allow doctors to more clearly diagnose and avoid false positives, especially in women with dense breast tissue. And what about a whole breast ultrasound. What is that? A whole breast ultrasound uses sound waves to detect cancerous tumors in the breast without using any radiation — it’s an ultrasound just like pregnant women get to check up on their baby. And the exam only takes about 20 minutes. We recommend these exams for patients whose mammograms have shown that they have dense breast tissue. Dense breast tissue can make it harder for doctors to see any abnormalities, lumps or tumors in a mammogram, so this technology ensures better early detection.

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