UCSD doctor Mary Ann Rose fights cancer with technology

In 1963, when Mary Ann Rose was 10 years old, she watched her grandmother - who had been diagnosed with terminal lymphoma cancer - fight for her life.

“She came to Houston, Texas, where we were living, and was treated with an experimental drug at the [University of Texas] MD Anderson Cancer Center which was just getting started at the time - and she was cured, after being told in Georgia that she had only weeks to months to live,” Rose said.

Now, Rose, 55, is a physician and mother of three who has dedicated much of her life to combating and curing various cancers. Rose is a professor of radiation oncology at the UCSD School of Medicine and medical director of recently-opened UCSD Radiation Oncology in North County.

In October, the Department of Radiation Oncology at the Moores UCSD Cancer Center and the UC San Diego Medical Center opened the 7,500 square-foot satellite facility in Encinitas, offering area residents the same types of radiation therapy services and similar opportunities for participation in clinical trials that are available at the UC San Diego’s La Jolla campus.

The center’s 11-member staff is currently treating about 25 patients daily for a wide range of cancers including the breast, prostate, rectum, bladder, head and neck.

“And I’m on track to see about 250 new patients this year,” Rose said. “The new facility is an effort to make radiation treatments easier, more convenient and less expensive in terms of travel for many of our patients. When you’re getting radiation therapy, sometimes you’re coming every day for six or eight weeks, [and] you want to choose the closest spot, particularly if you are elderly.

“But patients do need to understand with radiation therapy that there’s a difference in the outcome based on the equipment that’s used and the expertise of the physician. It’s not just ‘Turn the beam on, turn the beam off and bingo, you’re done.’ It requires a huge team of people. In this particular facility, we have not only the state-of-the-art equipment, but also a dedicated, highly trained group of professionals who assist me in planning and delivering the treatment.”

In addition to Rose, the staff includes a board-certified medical physicist, a dosimetrist who calculates dosages, four radiation therapists, a registered nurse and office support staff.

The center’s state-of-art therapy device is a sophisticated Trilogy linear accelerator used to pinpoint and destroy tumors deep inside the body. The Trilogy conforms a radiation dose to the exact size and shape of a tumor in three dimensions, reducing the risk of toxicity while safely delivering higher doses than more conventional accelerators.

The facility is also equipped with a wide bore CAT scanner dedicated solely to radiation treatment planning, and a Varian Eclipse computerized treatment planning system that allows for the complex planning necessary for Intensity Modulated Radiation Therapy (IMRT) and stereotactic radiosurgery performed with the Trilogy accelerator.

IMRT uses multiple angled beams around a tumor while sparing normal tissue in front of and behind the cancer.

Stereotactic radiosurgery is a non-surgical procedure that uses precisely focused X-rays to treat brain and spine tumors as well as localized cancers in the lung and liver. It is capable of destroying small tumors with a dose of high radiation in one to four treatment sessions.

The success rate of radiation therapy, Rose said, is high, “but of course it depends on the disease and the stage of the disease.”

“For example,” she said, “with early stage breast cancer, we’re successful in preserving the breast 95 percent of the time. And we have similar statistics for early stage prostate cancer.

“Also,” she added, “for patients with painful bone metastases, we’re successful in providing pain relief nearly all the time.”

Rose was born in Augusta, Ga., and raised in Houston, Texas.

At Yale University, she fell in love with literature and majored in English, while taking pre-med science courses as well. “To become a physician,” she explained, “you don’t necessarily have to be a premed major. I thought it would be better to have some experience in other areas in the humanities because it’s helped me a lot. Reading great works of literature actually helps you understand people and human emotion. I think that’s always helpful to a physician.”

After graduating summa cum laude from Yale in 1975, she entered Baylor College of Medicine in Houston, Texas, where she earned her medical degree with honors in 1979, followed by an internship and residencies in internal medicine at Beth Israel Hospital in Boston.

Initially, she thought she would become a medical oncologist - a physician who gives chemotherapy - but a one-month elective in radiation oncology during her senior medical residency prompted her to change her specialization.

“Radiation therapy was just starting to become recognized as a way to cure cancer, apart from surgery and chemotherapy,” she said. “In those days, the late ’70s, early ’80s, chemotherapy, which is what I thought I wanted to do, was so incredibly toxic … It was really the dark ages of chemotherapy because you would basically give intravenous medications that would cause people to lose their hair and vomit. It wasn’t really specific-targeted therapy back at that time - whereas radiation therapy was just coming into its own.

“So the concept of breast preservation for women with early stage breast cancer was just coming to the forefront so women were being offered lumpectomy and radiation therapy as opposed to mastectomy; and patients with cancer of the throat and larynx were being offered curative radiation therapy instead of … procedures that left them with difficulty swallowing and speaking; and patients with early stage prostate cancer were being offered radiation therapy instead of having the prostate removed.”

Today, she said, chemotherapy has greatly improved. “We now have so many medications that counteract nausea … side effects. And most cancer patients have a combination of surgery, chemotherapy and radiation. For many cancers that offers the best chance of cure.

“The trend has been less surgery and more targeted chemotherapy and radiation therapy,” she said.

Rose served as a clinical fellow in medicine at Harvard Medical School and after completing an additional residency in radiation medicine at Massachusetts General Hospital in Boston in 1985, she focused her career on radiation oncology in Massachusetts and California as a specialist in hospitals and in private practice.

Rose and her family moved to Rancho Santa Fe in 1993. She served as medical director of the Palomar Medical Center in Escondido for nine years and medical director of radiation at the Vantage Oncology Centers in Temecula and Wildomar for four years.

In 2007, she joined the UCSD Moores Cancer Center.

“I’ve been in the field now for 24 years since finishing my residency and I’ve seen tremendous improvement in the ability to target the cancer,” she said. “So patients need not be afraid anymore. We still have patients who come in here and are fearful because they knew someone who was treated back in the dark ages, even 10 or 15 years ago, with cobalt therapy or older technologies and they’re fearful.

“My main message would be that cancer is going to affect one out of four Americans and people no longer need to be afraid of the treatments and the side effects.

“Hopefully the future is prevention. That’s the future.”

Arthur Lightbourn is a writer for the Rancho Santa Fe Review, where this story originally appeared.

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