For four close family members who died of cancer, for her three furry “babies” at home, MaLora Bush has found more than just a job she loves, but a life’s mission.
Bush, whose prior training and experience have been in human medicine, is the radiation therapist and medical dosimetrist at the Animal Cancer Care and Research Center in Roanoke, a compassionate care hospital and groundbreaking research arm of the Virginia-Maryland College of Veterinary Medicine.
The center’s research is translational, in that findings may lead to improved treatments and possible cures for human cancer as well as for animals.
Cancer is a personal matter for Bush. She lost her father to lung cancer and her grandmother to colon cancer, then nursed her first husband for two years as he succumbed to brain cancer and later her mother as she died from pancreatic cancer.
The possibility that her work now may contribute to finding treatments and cures for human cancer is a driving passion for Bush.
“That is a huge, huge, huge positive for me, what goes on in here and how that will translate from the patients that we treat to the patients who are treated in the human field,” Bush said. “It excites me, the things that are taking place here, as far as chemotherapy and radiation and even surgery that potentially could benefit people like my mom and my first husband, whose journey ended early. That’s kind of like the cherry on top of the sundae for me.”
Bush is a certifiable dog lover – she calls labradoodle Molly, golden retriever Ruby Mae and toy poodle Stinky her “babies,” even with three grown children – but her background was in human medicine before she was hired at the animal cancer center soon after it opened in 2020.
“So, interestingly enough, they’re all jealous,” Bush said of her past medical colleagues. “And very intrigued because radiation oncology in veterinary medicine is fairly new, and in the human world, it’s been around a long time.
“We have our linear accelerator that is top of the line. In my opinion, and I’ve been to all the cancer centers within a two-hour radius of here, the nicest one that I have had the privilege to treat with is the one that I have here. The commitment Virginia Tech has made is phenomenal because this is an extremely advanced linear accelerator. It’s what a lot of human facilities are moving toward, and we’re very, very privileged to have that here.”
Dan Vruink, the center’s administrator, agreed with Bush about the prowess of the linear accelerator and said her role is critical to the collaborative approach with board-certified veterinary specialists on the oncology team.
“The Animal Cancer Care and Research Center is fortunate to be one of the few locations in the world equipped with the latest generation Varian Edge linear accelerator for veterinary use,” said Vruink. “Using this technology, MaLora is able to deliver unique radiation treatment options to our patients, not only increasing their quality of life, but also providing hope to the families of their beloved pet in their unique cancer treatment path.”
Bush’s own unique path was a circuitous one from her early childhood in the Southwest Virginia town of Pound and her high school graduation from Salem High School in the Roanoke Valley.
She has worked as a certified nursing assistant, a behavioral health case manager, and then a cashier and ultimately an operations trainer for 15 years with a large grocery store chain as she also raised three children.
But then, her first husband, David, was diagnosed with terminal brain cancer at age 42, and amid her caring for him, the grocery chain restructured and she was out of a job she might have kept to retirement otherwise.
A friend’s suggestion led her to Roanoke neurology specialist Timothy Hormel, seeking a new job as a medical records compliance officer and, at times, a medical assistant.
Unknowingly at the time, it was the start of a new career focus.
She was brutally honest about her time needs with her new potential employer.
“At some point, he’s going to go into hospice care, and I’m not going to be able to work any longer,” Bush said she told Hormel. “And if he has a seizure or if he has an event, I’m going to have to leave at an instant. And he also sees a neuro oncologist at UVA. So at least once or twice a month, I’m going to need days off to go do that. I will tell you that is not easy. However, someone in the medical field such as Dr. Hormel saw benefit in that because he said if I cared that much and I was that honest, that I would give his patients the same amount of care. And so he hired me.”
When David died at 44, Bush was determined that she “hadn’t gone through that for nothing.” Inspired by Robert Heath, David’s radiation oncologist, she enrolled in the radiation oncology therapy program at Virginia Western Community College in Roanoke.
But a month before her graduation from the two-year program, while she was working a clinical rotation at LewisGale Medical Center in Salem, her mother was diagnosed with terminal pancreatic cancer. Bush would do her dosimetry rotation on one floor of the hospital, then go to another floor to spend time with her mother, catching what sleep she could in a couple of chairs. Her mother died seven months after the diagnosis.
“From the minute she was diagnosed, she completely changed her whole personality, her voice, everything changed,” Bush said. “I think just the word ‘cancer’ impacts you. Our patients [pets at the cancer center[ don’t know what that means. And I think that’s a blessing. In my opinion, and there’s nothing scientific other than what I have observed, they do better with the treatment because they don’t know what that word means. They’re living in the present, they don’t know they have cancer.”
Bush worked radiation therapist jobs in human medicine in Abingdon, Harrisonburg, and Lynchburg and eventually became a clinical instructor at Virginia Western. It was then that an opening for a “locum,” or a backup, for the radiation therapist at the animal cancer center came open.
Within weeks of her first stint as the locum, the animal cancer center’s main radiation therapist left for a job in Raleigh, North Carolina, and Bush came on board full-time in early 2021 while still juggling her clinical instructor job at Virginia Western and therapist job in Lynchburg.
With a new master’s degree from John Patrick University in medical dosimetry – the science of calculating and measuring medical radiation dosage – and her recent board certification, in addition to her extensive radiation oncology experience, Bush was well equipped for her role at the cancer center.
As a dosimetrist, Bush outlines all the organs on computer images of a CT scan, a process called contouring. “If I don’t contour it, I have no way of knowing what the dose is going to be,” she said. “So the most important thing is that I know what each organ and the tumor is going to get for that dose for that treatment, because there are endpoints on organs, that if you exceed that, you’re going to have some sort of toxicity, or some sort of chronic effect.
“The goal is to kill the cancer, and spare everything around it,”
Treatment plans developed by Bush go through quality assurance and physics testing to make sure it will translate to the computer.
The patient is set up on the first day of treatment using a laser system and marks from a CT simulation and treatment planning device, then positioned properly to begin receiving the focused radiation beam. Onboard imaging with the linear accelerator is completed to verify treatment volume location by comparing the images from the planning CT.
“If necessary, I am able to move the couch the patient is on in six different directions,” Bush said. “I am able to move as little as sub-millimeters to ensure the alignment of the area being treated.”
From there the linear accelerator begins delivering radiation to the patient. Treatment is completed within minutes.
As pets are brought back for post-treatment recheck CT’s, the previous scans can be used to evaluate the result of treatment to the tumor.
Working in the clinical realm at a facility devoted to research has sparked new horizons for Bush she is beginning to explore, seeking a doctorate in health science through the Massachusetts College of Pharmacy and Health Sciences.
“If you would have asked me before I came here if I would have enjoyed or if I would have liked research, I would have said absolutely not,” Bush said. “I’m a people person, and nothing about that excites me. However, I have been proven very wrong by being in this building because I get very excited. And I’m excited about what that will bring. Who knows, maybe one day I will be doing my own research.”
– Andrew Mann