Radiology And You - Patient Testimonials

Living With Cancer
Targeted Radiation Therapies Offer Hope to Patients

Maggie Miller, Carcinoids Survivor
It took 56-year-old Maggie Miller nearly two years to convince doctors that she had a rare form of cancer called carcinoids. Miller, the assistant dean of nursing at UNC School of Nursing, knows cancer, as she worked for many years in hospital oncology units.

“It all started in January 2005 when I was struck with acute pain in the right side of my stomach,” described Miller. “My physicians did everything right by performing numerous tests, but there was nothing to diagnose my pain. It would recur every few weeks and was severe enough to send me to the emergency room or doctor’s office each time.”

Miller’s symptoms didn’t fit with a typical carcinoids patient. Carcinoid tumors are rare, slow-growing cancers that typically originate in the lining of the digestive tract or lungs. The tumor doesn’t produce symptoms at first since it is slower growing. In later stages of the disease, the tumors can release hormones, which result in patients having flushing of the face and upper chest, diarrhea, and difficulty breathing.

Finally in December 2006, her gastroenterologist ordered a CT scan of her liver and surrounding region.  It revealed multiple lesions in her liver, along with two large masses, one measuring 4.5 centimeters and another more than 2 centimeters.

Miller was referred to a medical oncologist who told her that it was not primary liver cancer, but metastatic cancer. He performed biopsies, expecting that the results would reveal an aggressive cancer. Instead the biopsy came back just as Miller had always suspected—carcinoids.

Miller then was given several options and was told that she had time, since carcinoids is a slower growing cancer. “I don’t think that patients are benefited by waiting, and I knew that I didn’t want to wait.” Miller’s medical oncologist referred her to Dr. Andrew Kennedy, a radiation oncologist at Wake Radiology Oncology Services.

“His approach was completely different,” explained Miller. “He immediately ordered several imaging studies to find the primary tumor, which was located in the ileum jejunum of the bowel. He was able to quantify my disease and recommended that I undergo surgery to remove the primary tumor and undergo liver brachytherapy afterwards to treat the liver lesions.

“I immediately underwent surgery at Duke to remove the visible cancers, and then six weeks later Dr. Kennedy performed the brachytherapy procedure at WakeMed.”

Liver brachytherapy, which was reintroduced in the United States by Dr. Kennedy in the early 2000s, places radioactive microscopic spheres into the liver, destroying cancerous cells while preserving adjacent healthy tissue.

“I had the treatment on March 7, and it was pretty much uneventful, with just some fatigue and nausea that lasted a few days. I even went back to work part time a month later.

“Six weeks later I went in for my follow-up MRI to see if the radiation microspheres were beginning to work, and I went from having too many tumors to count to fewer than ten tumors,” said Miller. “The treatment was working perfectly.”

Within another six weeks, tests showed that there was no visible sign of cancer in her liver. “Dr. Kennedy told me that even though carcinoids is a lifelong disease, it is gone from my liver. If it does reappear there, it will be from a new source.

“I’m under no illusion that I am disease free, but I have been given a wonderful gift. At this point, I feel like I am the luckiest person in the world,” commented Miller. “I don’t have any symptoms, thanks to the treatment and weekly Sandistatin injections that help keep carcinoids at bay.”

Recently, Miller and a friend completed a 56-mile bike ride in celebration of her 56th birthday. “I’m back to doing nearly everything I want to do with my life.”