TOP TECHNOLOGY Two work stations provide a window view of the CT scanner at Aultman Hospital. The equipment is used in Image Guided Radiation Therapy that does less harm to healthy tissue and organs. |
Canton Repository, Nov. 20, 2007
BY DIANA ROSSETTI, REPOSITORY LIVING SECTION WRITER
Three-dimensional, even four-dimensional (video) radiation therapy for cancer patients permits physicians to zero in on their intended target greatly reducing collateral damage to surrounding tissue and organs.
Aultman Hospital's new Intensity Modulated Radiation Therapy (IMRT) equipment allows staff radiation oncologists like Dr. Rodney J. Ellis to customize treatment for patients with prostate, breast, pelvic and head and neck malignancies.
"Over the last 50 years, radiation therapy has strived to improve radiating the tumor while sparing damage to healthy tissues and organs. Our stronger computers and other advanced equipment now can shape that treatment," said Ellis of Stark Radiation Oncology. "It allows us to 'wrap' the radiation to the exact shape of the tumor from every angle resulting in fewer side effects with higher cure rates."
Charles Roy of Canton was the first patient to receive the state-of-the-art treatment but he was not without concerns. Roy, 67, was a prostate cancer patient.
"It was definitely worth the wait because my side effects are real mild," said Roy, a retired crane operator and avid hunter. "Nothing near the stories you hear from other radiation patients."
TARGETING IS KEY
While the new equipment does not change the number of radiation treatments, it can be given in higher doses.
"I can remember when I trained at James Cancer Center at Ohio State University in the early '90s," recalled Ellis. "We would give six and a half weeks of radiation for prostate cancer then stop because you might damage the bladder or rectum. Unfortunately, that would only cure two-thirds of the patients. By giving higher doses just to the prostate over a nine-week periods, the cure rate can be higher than 90 percent."
The hospital's CT scanner is specifically designed for radiation oncology. It even can produce four-dimensional imaging of the tumor, meaning real-time video. This is crucial since, for example, in a lung cancer patient, the tumor moves with every breath the patient takes. In prostate cancer, the tumor moves as the rectum fills and empties.
"By doing a video, we can take the movement into account in planning to help capture the tumor in motion," Ellis explained.
Prior to radiation, prostate patients undergo a CT scan that takes X-rays. A non-invasive ultrasound procedure can "see" through the abdominal wall revealing the prostate and the bladder. Together, the two procedures help radiation oncologists pinpoint the prostate. Tiny freckle-like tattoo marks are left on the patient's belly. Then, every day just prior to treatment, the prostate again can be targeted using the tattoo marks and adjusting for tumor movement.
PATIENT CONCERNS
When Ellis explains the new procedure to patients, he said many of their concerns are allayed.
"Radiation oncology are not words that give a warm, fuzzy feeling," he acknowledged. "The Cold War was when radiation was a danger. Both words intimidate patients but, with this, most people walk away with a positive experience. The biggest thing is adding functional images and not relying just on anatomical images."
The use of positron emission tomogaphy (PET) imaging shows the behavior of tissue. The patient is given an intravenous injection of sugar tagged to a radio-labeled tracer which gives off X-rays.
In the body, the sugar-tracer mixture is metabolized. Because cancer cells need more energy and are growing faster, they need the sugar. Thus, the PET scan quickly identifies the cancer cells because they behave differently.
In the past, the side effects of radiation therapy for prostate cancer could include an irritated bladder and rectum, frequency of urination and general fatigue. Breast cancer patients reported skin redness and irritation at the site.
Because of the expense of the new equipment, treatment costs are higher, said Ellis, an associate professor of radiology at Northeastern Ohio Universities College of Medicine and assistant professor of urology at Case School of Medicine.
"But when we can greatly reduce the side effects and have a higher cure rate," he concluded, "I don't think you can put a value on that."
Reach Diana Rossetti at (330) 580-8322 or e-mail:
diana.rossetti@cantonrep.com
