To hear the two discuss Jean's rehabilitation, you might assume they are talking about a sprained ankle. In fact, at the age of 91, She is making a strong recovery from a high tech, non-invasive type of lung cancer surgery.
Stuetzle, who has lived in Mountain View with her husband for more than 16 years, was diagnosed with cancer in April and treated in June. And while the cancer was discovered at a fairly late stage, especially for someone her age, she is currently getting around fine with a little help from her cane and Al's surprisingly strong 92-year-old arms. A stack of papers rests in the seat of the wheelchair, which is gathering dust in the corner of the Stuetzle's home.
The Stuetzles have been married for 71 years. They met as teenagers living on the same block in Queens Village, Long Island, N.Y., and were introduced after Al, who had taken a liking to Jean, continued to deliver free papers to her house on his route as a paperboy.
"My father asked, 'Why do we keep getting the paper?'" Jean recalls with a smile, as her family did not subscribe to the periodical Al delivered.
"It worked," Al says, shrugging and smiling.
The two were married in 1940 when they were both 21. After bouncing around the country a bit, they settled in California and raised four children — two boys and two girls. Al worked as a stained glass maker, Jean worked as a homemaker, occasionally taking a job in retail.
Jean was diagnosed with cancer, quite by accident, when she went in for a computerized tomography scan of her stomach at El Camino. The couple could have gone to Stanford for treatment right away, but decided to wait a few months for a new machine that would be at El Camino Hospital soon.
"It was the newest and the best," Al says of the couple's decision to wait for the CyberKnife — the name brand for a high-tech surgical technique, which uses beams of highly concentrated electromagnetic radiation to zap cancer cells in patients deemed too fragile to undergo traditional surgery.
Dr. Bob Sinha, president of Western Radiation Oncology, is a CyberKnife operator at El Camino. He pilots the machine, composed of a large robotic arm — the very same type of robotic arm used in automobile assembly lines — and a linear accelerator, which generates powerful, cancer-ablating photons.
A computer, which is synced with X-ray monitors and the photon-blasting robot arm, tracks the minute movement of cancerous growths as a patient breathes in and out — adjusting its algorithm accordingly. If a patient coughs, Sinha says, the robotic arm adjusts, keeping its cancer killing beam trained on the tumor.
Patients remain awake during the procedure, which Stuetzle says is painless.
Doctors have been using photons to fight cancer since the 1960s, Sinha says, but in the past decade they have become incredibly advanced.
Prior to the '60s, Sinha says, the only recourse available to someone suffering lung cancer was to undergo traditional surgery. Doctors would cut a patient open and physically remove the tumor. Traditional surgery is still the most effective and preferred method for younger, more resilient patients. However, for elderly patients such as Stuetzle, or those with heart conditions, opening up the chest cavity is extremely risky.
Beginning in the 1960s, surgeons discovered that they could treat certain kinds of cancer — lung, liver and pancreatic, for example — using photons.
"Cancer does not like photons," Sinha explains. Early forms of this treatment exposed a lot of tissue to electromagnetic radiation, however, which meant the process took as many as 30 sessions to complete.
Over the past decade, these techniques have improved, and their "effectiveness has gone way up," Sinha says. Advancements in the field have allowed doctors to focus their photons with "sub-millimeter" precision, which, in turn, has made it possible to more than double the power of the beams used without impacting non-cancerous tissue. And the more powerful the beam, the shorter the treatment. Stuetzle's treatment was done in three 30-minute bursts.
The Stuetzles, who grew up during a time when having a radio was a novelty, say they were amazed with the CyberKnife treatment. "I think it's marvelous," Jean says.
That sense of wonder is not lost on Sinha, who says that even when he was in medical school in the early 1990s, he "had no expectation that we would be able to advance this quickly."
Back when he was in school, Sinha says, only about 20 percent of lung cancer tumors were ever fully ablated by photon treatment. Today that number is around 90 percent, and the tests so far indicate that Stuetzle falls within that percentile.
"It's hard to even say how gratifying it is," Sinha says.
The Stuetzles, it seems, would agree: since her surgery, Jean exercises on a stationary bike several days a week and, according to Al, "She eats as good a meal as I do."
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