From Bugles To Breasts: Dr. Robert Kuske's Advances In Breast Cancer Treatment
Not all heroes wear capes or carry Batman-like toys.
In fact, in breast cancer pioneer and Scottsdale resident Dr. Robert Kuske’s case, he wears a lab coat and carries a bugle.
Yes, a bugle.
“When I was 18 years old, I left my hometown in Ohio for the bright lights of Wisconsin to play in the Bugle Corps while training to become a doctor,” Dr. Kuske says.
Over his four-year career with the group, and while getting his college education, he eventually helped to take the troop to the No. 1 ranking in the world. At 21, he was aged out of the program and put his passion into medicine — even helping to conduct nuclear physics research during his final year of professional playing.
“While I still played for fun, breast cancer treatment became my true passion thanks to my favorite professor and long-time mentor Dr. Aron,” Dr. Kuske says.
Dr. Kuske would indeed go into Dr. Aron’s profession — as a breast cancer specialist — eventually while serving as Chairman of Radiation Oncology at the famed Ochsner Clinic in New Orleans and co-developing a five-day radiation therapy alternative for women with early stage breast cancer called Accelerated Partial Breast Irradiation (APBI).
“Nationwide, more than 200,000 women are diagnosed with breast cancer each year,” Dr. Kuske says. “Surgical removal of the cancerous lump via lumpectomy is usually the first step in treatment, followed by either mastectomy or radiation.”
Today, most women choose radiation because the survival rate for such treatment is the same as with mastectomy for select early-stage breast cancers, and it allows the patient to preserve her breast.
“External beam radiation therapy, the common treatment today for early-stage breast cancer, is safe and very effective,” Dr. Kuske says. “But, it can take six time/energy-consuming weeks of daily treatment with side effects.”
APBI – or breast brachytherapy – has been researched and tested by Dr. Kuske since 1991 as a treatment method after lumpectomy. He has advanced the techniques and technology, and championed the research just as he championed his Bugle Corp into the mainstream all those years ago.
As his research progressed, Dr. Kuske found almost all of his cancer patients were strictly those with breast cancer.
So, when he moved to Scottsdale in the mid-2000s, Dr. Kuske partnered with fellow breast cancer innovator Dr. Coral Quiet and founded Arizona Breast Cancer Specialists in Scottsdale, the first organization worldwide dedicated to exclusively treating women with breast cancer with radiation.
With his focus strictly on treating breast cancer, he has been more determined than ever to move his APBI research further upstream – into the mainstream. As such, today he is co-principal investigator in the largest breast cancer radiation trial in medical history. His trial, sponsored by the National Cancer Institute, is testing 4,300 women with head-to-head, six-week, whole breast radiation versus his five-day APBI.
“I am within months of finishing the trial and believe the results will cause the biggest paradigm shift in how patients will be treated since Marie Curie herself discovered radium in 1896, which led to radiation treatment,” Dr. Kuske says.
In addition, his breast centers have also recently invested in a new technology to help women with large breasts obtain safer treatment.
“We’ve partnered with Varian Medical Systems to offer the Pivotal™ treatment solution for prone breast cancer care, a critical technology for large-breasted women that allows them to obtain treatment in the prone, or face-down, position,” Dr. Kuske says.
With this option, they are literally turning breast cancer treatment upside down.
Growing evidence shows considerable advantages in treating larger-breasted women in the prone position rather than in supine, meaning on one’s back.
According to Dr. Kuske, the advantages include a significant reduction in radiation to the heart and lungs, attainment of good dose homogeneity, minimized respiratory motion and reduced skin toxicity. The Pivotal treatment solution for prone breast care combines the prone technique with an innovative couch-top device. The design enables treatment of both right and left breast, including whole breast, partial breast and APBI.
This work has not gone unnoticed. In fact, Dr. Kuske was a 2012 finalist for both the Health Care Leadership and Health Care Hero Awards, respectively.
Oh – and he is still bugling. In fact, he volunteers his time to the Arizona Academy of Drum and Bugle Corps as its vice president and as a fundraiser. He works to help raise hundreds of thousands of dollars each year to take his kids nationwide to compete just as he did.