Wednesday, May 25, 2011

New machine provides fast, accurate radiation

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Debra Douglas diagnoses cancer for a living, but when she learned she had a benign brain tumor, she said she came unglued.

"I couldn't breathe. It was frightening," said Douglas, 56, of Urbandale.

Problems with double vision sent her to the eye doctor, and an MRI showed a benign tumor on the third cranial nerve on her brain stem. For treatment, she was able to take advantage of TrueBeam STx technology, which has been available at John Stoddard Cancer Center since March.

Douglas's treatment included a series of radiation treatments over five days. Each treatment lasted roughly two minutes and her appointment ran a little more than a half hour, which meant she could return to work as a cytologist at The Iowa Clinic after each appointment. Previously, the process would have involved hour-long treatments spread over six weeks.

Douglas said her tumor is small, about five millimeters, which made TrueBeam a good choice for treatment.
"I can come here and finish out my routine like normal. It's been great," she said.

TrueBeam is a major advancement for cancer patients and John Stoddard is one of the few centers in the country to use it.

The technology allows for more accuracy, comfort and speed, said Dr. Robert Isaak, radiation oncologist at the cancer center. The equipment includes a mini CAT scan that revolves in a circular fashion around the patient, and delivers a higher dose output in the targeted area.
The machine uses an infrared camera to position patients and performs a CAT scan to ensure accuracy down to the millimeter. Images taken before and during the procedure are used by technicians for comparison using a split computer screen.

Isaak said Douglas's tumor is located in a tight spot that also controls much of the eye movement. Because it is benign, it won't spread or infiltrate other structures. Instead, it grows and can pinch and squeeze the nerve.
Dr. Robert Kerr, a neuro surgeon with The Iowa Clinic and the Neuroscience Institute, said treating while the tumor is smaller and in a minimally invasive manner is a huge benefit, compared to months of recovery from cranial surgery that also carries higher risks.

"The options are really to watch and to wait, versus waiting until this becomes much, much bigger and it becomes an absolute necessity to treat. When you do that in these deep and very critically located tumors, your chances of damaging or giving her permanent deficits at that point is much, much higher," he said.
Dr. Robert Goebel, medical director of radiation oncology at John Stoddard, added that comfort and accuracy are the key features of TrueBeam.

"The faster the treatment, the less of a chance you have that there is going to be any patient movement. It's extremely accurate and extremely fast," he said.

Kerr added that TrueBeam is helping John Stoddard build a neuro-oncology program. The equipment allows for more effective, less-invasive treatment, which can more easily treat spinal cord cases, difficult focused brain tumors and skull-based tumors.
"These are things we wouldn't have been able to do before, and now we can," he said.

Douglas' treatment took one week to complete and she will return in three months to monitor the progress of the tumor.


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