By Emily Williams
One of Dr. Susan Salter’s favorite rooms in the Bruno Cancer Center at St. Vincent’s Birmingham, where she is a radiation oncologist, is a patient consultation room.
Staff at the cancer center donated money to have the room named in honor of one of their late co-workers.
“This individual was a key member of the cancer center team for many years, and developed a brain tumor,” Salter said.
Though the individual did pass, the consultation room is filled with her memory; rocks she collected and wrote inspirational words and scripture on during her treatment decorate the room.
“It was very hard on the staff, but before she passed, she wrote and gave these rocks to every single person in the department,” Salter said.
Salter pointed out her rock, resting on a stand on a side table with inspirational scripture written across it in black ink. The stand still had a note attached addressing the gift to Salter.
This is just one of many inspirational and touching encounters Salter has experienced working in oncology at St. Vincent’s.
Family Influence
Growing up in Montevallo in a family full of doctors, Salter said, her entrance into the medical field was something of a natural progression.
It began with her grandfather, Dr. Paul Salter, who was a surgeon in Eufaula. Her father, Dr. Paul Salter Jr., was a general surgeon at St. Vincent’s and her mother, Dr. Merle Salter, was a radiation oncologist.
“Around the dinner table, we were talking about medicine,” she said.
Salter said she knew just about every doctor’s lounge in Birmingham from spending time in them when her dad was called in for emergency surgery.
“It was a way of life for us,” she said. “It was just a natural progression for me. I knew medical school was going to be hard, but I knew I did not want to do law school.”
Save someone knocking on her door to offer her a direct path to become editor for Vogue, Salter knew she would become a doctor just as her brother, Dr. Paul Salter III, and sister, Dr. Sally Salter-Blackwell, had.
With her husband, Steven Hydinger, Salter lives in Mountain Brook, where her 12-year-old son, Grayson, and 16-year-old daughter, Salter, have helped inspire her involvement in the community.
She’s on the board of review for the Boy Scouts and on the board for the Mountain Brook City Schools Foundation. Though Grayson is more inclined to a future in technology, Salter sees her daughter making her own way in the medical field in the future.
“She would be a great one,” she said. “She’s very caring, very sweet, very smart. Looking at her, you would want her to treat you.”
Salter found her place in oncology through her mother, who was a radiation oncologist for 30 years. About 25 of those years she spent at UAB before working in private practice.
“When I was a resident, I said, ‘I wanted to see what she did. I had heard so many good things,’” Salter said. “But I thought there was no way I was ever going to do radiation oncology.”
Eager to test the waters, she did an elective with her mother, and the rest was history.
“Not many people can say it, but I can say that God put me here to do this. I know that for a fact,” she said.
There is an art to radiation oncology, according to Salter. It takes a special touch because it calls a physician to work closely with the patients and help make a battle with cancer – which is often long and arduous – as peaceful as possible.
“I’m here to help guide people and make the best decisions. I’m here to help people live whenever possible, and I’m here to help people die,” she said. “Death can be very graceful and peaceful for the family if it has to happen.
“I may not always be able to help cure them, but I may be able to help them in other ways.”
For Salter, the recipe to a peaceful transition through treatment is creating a community that offers a variety of support programs along with the best techniques, all pieced together by an amazing staff.
“I’ve been (at St. Vincent’s Birmingham) for 23 years and there are people who have been here much longer than me – for 30 to 35 years,” Salter said. “Every single person has been hand-picked by God to serve here, and they stay here.”
Just as radiation oncology was a calling in Salter’s life, serving the Bruno Cancer Center in any capacity has been a calling for each of her co-workers. The job requires the staff to have the ability to remain positive for the sake of the patients.
One of the people patients meet in the center is concierge and cancer survivor Frankie Vickers. With the help of the St. Vincent’s staff, he was able to navigate through treatment for head and neck cancer as well as prostate cancer, and now he spends his days greeting the patients and families who enter the facility, helping them navigate their experience and providing inspiration.
“It starts from valet – the minute you get out of the car – to the minute you leave,” Salter said. “Every person they see knows their name and knows who they are. That’s what sets us apart and makes us the best community hospital in the city.”
The goal is to treat the whole patient, Salter said, providing programs such as pet-therapy with Hand in Paw, art classes, counseling and meetings with dieticians along with cutting-edge treatments. Sometimes, she said, it’s just a matter of listening to what a patient is going through and what their caregivers are going through.
“Not only are you going through this, but your entire family is going through this, and you’ve got to give and take with them as well,” she said. “We’re trying to get the whole story … listening to what’s going on and being aware of the family dynamic to help them work it out.
Personalized Treatment
Treating the whole patient in a personalized way is the way of the future in cancer treatment, Salter noted.
“I would give up my job any day to find a cure for this,” she said.
In the meantime, the world of cancer treatment is advancing before her eyes.
Two of the most important leaps that have occurred in her field have changed the way her patients recover from their treatments.
Stereotactic body radiation therapy uses focused beams to target cancer, which allows doctors such as Salter to offer non-invasive treatments that in the past would have required surgery.
The biggest game changer, to Salter, is treatments for prostate cancer that significantly reduce side effects from radiation treatment. Prostate cancer is the second-most common cancer occurring in American men, behind skin cancer, according to the American Cancer Society.
St. Vincent’s is the first hospital in Birmingham to have the Calypso® technology and the first in Alabama to use the SpaceOAR® System, Salter said. With SpaceOAR (Organ At Risk), Salter injects a hydrogel that solidifies into a putty-like barrier between the prostate and the wall of the rectum. Radiation moves through the putty, greatly reducing the damage to the rectum.
In addition, Salter places GPS beacons in the prostate that allow the Calypso machine to track the prostate, which can move up to a centimeter during a normal radiation process.
“When you treat the prostate, if it moves outside of the field, the machine cuts off,” Salter said. “That precision and decreasing the side effects to the bladder and rectum is a game changer, and the treatments only take about five minutes.”
It’s all about making treatments as comfortable as possible for patients, Salter said. Outside of radiation treatments, that lies in the vast number of medications that are being created. Salter sees a cure for cancer being found in learning more about what causes each specific cancer and hopefully, finding out how to stop them. “It may not happen in our lifetime, but I think it could happen in our kids’ lifetime,” Salter said. “There will be certain cancers that (we) can cure.
“There are certain cancers now that they can basically treat like other chronic conditions such as diabetes,” she added. “You know you’ve got it, but you just keep it in check with different medications and treatments.”
