New machine provides fast, accurate radiation

Written by

ESTELA VILLANUEVA-WHITMAN- www.desmoinesregister.com

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.

Oncologists use robots to fight cancer

by: www.smartplanet.com


year, Jean Stuetzle, 92, learned she had lung cancer and was given few options to make her well again. Then, she visited radiation oncologist Robert Sinha at El Camino Hospital in Silicon Valley. He told Jean about CyberKnife, a non-invasive procedure that uses a robot and targeted radiation to eliminate cancerous tumors. SmartPlanet looks at the new technology and how it's working on cancer patients like Stuetzle.

            

Intraoperative Radiation Therapy (IORT)

Intraoperative radiation therapy (IORT) is an intensive radiation treatment that delivers a concentrated beam of radiation to tumors as they are located during surgery. IORT allows direct radiation to the tumor while sparing normal surrounding tissue. The type of IORT most commonly used at Mayo Clinic is also called intraoperative electron radiation therapy, or IOERT.

Thousands of people have received IORT treatment at Mayo Clinic. The IORT team at Mayo Clinic includes specialists in radiation oncology who perform the procedure, surgery,anesthesiology and pathology. In Arizona, Mayo Clinic is one of only a few institutions in the United States that uses a Mobetron, a mobile device that can provide radiation therapy in the operating room.

Conditions treated with IORT

IORT is used for cancer that cannot be cured with surgery alone and for tumors that are either attached or close to vital tissues. Recurrent rectal cancer is the most common condition treated with IORT at Mayo Clinic. IORT is also used to treat:

• Cervical, uterine and ovarian cancers
• Prostate, bladder and kidney cancers
• Stomach, pancreatic, colon, rectal and anal cancers
• Soft tissue sarcoma

For people who have recurring cancer and people who have locally advanced cancers, IORT can be an effective therapy in achieving long-term tumor control.

How it works

IORT is almost always used along with external radiation prior to surgery. During surgery, after the surgeon removes as much of the tumor as possible, a machine called a linear accelerator delivers a concentrated beam of electron radiation directly to the tumors. The surgeon moves healthy organs out of the radiation field to prevent damage, and special tubes are used to focus the beams safely on the tumor(s).

IORT also may be used when the remaining tumor is too small to see.

Advantages of IORT

IORT allows doctors to administer high doses of radiation to tumors without exposing nearby healthy organs to radiation. A single dose of intraoperative radiation may have as much effect on the tumor as 10 to 20 daily radiation treatments. IORT offers the following benefits:

• Higher radiation dosage to cancer cells
• Faster radiation delivery during surgery
• Decreased radiation exposure to normal surrounding tissue
• Safer application compared with traditional radiation treatments

Like other treatments, IORT carries some risks. Mayo Clinic doctors discuss the benefits and risks with people to help them decide on a treatment.

by:www.mayoclinic.org

External Radiation Therapy

What Is Radiation Therapy? 

Cancer is a disease that causes cells to grow abnormally and out of control. In radiation therapy, high-energy X-rays are directed at a person's body to kill cancer cells and keep them from growing and multiplying.

Most people have been exposed to radiation in t he form of an X-ray — most likely at a dentist's office. And just like the X-rays given in the dentist's office, radiation therapy is painless. But unlike a typical X-ray, the radiation isn't used just to create a picture of a tooth or broken bone. Radiation therapy delivers higher doses of radiation so that the radiation will kill cancer cells and shrink tumors.

While it's killing the cancer, radiation therapy also can damage normal cells. The good news is that normal cells are more likely to recover from the effects of radiation. Doctors take precautions to protect a person's healthy cells when they're giving radiation treatments.