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PostPosted: Mon Jul 04, 2011 7:56 am 
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Palliative radiotherapy for bone metastases in the last 3 months of life: Worthwhile or futile? - Abstract

To determine the efficacy of radiotherapy for the palliation of pain from bone metastases among patients in their last 3 months of life.

Mutually exclusive, prospectively gathered Edmonton Symptom Assessment System and Brief Pain Inventory databases compiled from patients with bone metastases receiving palliative radiotherapy were reviewed. Demographic information and response rates from patients dying within 3 months of beginning radiotherapy were analysed.

From a total of 918 patients, 232 dying within 3 months of beginning treatment were identified. There were 148 men and 84 women. Their median age was 69 years and their median Karnofsky Performance Status was 60. The three most common primary cancers were lung (34%), prostate (18%) and gastrointestinal (14%). Fifty-eight percent of patients received single fraction treatment. A pain response was evaluable for the 109 (47%) patients with available follow-up information. The overall response rates were 70% at 1 month and 63% at 2 months, which included complete and partial responses in accordance with the International Bone Metastases Consensus definitions.

Despite their limited lifespan, patients reported pain relief after palliative radiotherapy. Patients suffering from painful bone metastases with an estimated survival of 3 months should still be considered for palliative radiotherapy.

http://www.urotoday.com/prostate-cancer ... tract.html


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PostPosted: Tue Jul 05, 2011 7:58 am 
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Advanced form of radiotherapy to be made available on NHS

An advanced form of radiotherapy, called stereotactic body radiotherapy (SBRT), should be made available on the NHS to all suitable patients with cancer in England, according to new guidance (pdf).

SBRT is a precise form of radiotherapy that spares more healthy tissue than conventional radiotherapy and may help to improve survival.

Unlike standard radiotherapy, which uses one beam to deliver high doses of radiation, SBRT uses several beams which each deliver a very small amount of radiotherapy.

The beams can be aimed at the tumour from a number of different angles, thereby targeting the tumour very precisely while minimising the dose of radiation to surrounding healthy tissues.

SBRT also requires fewer treatments than standard radiotherapy.

The technique can be delivered using a standard linear accelerator, although new machines are now available that are specifically designed to administer SBRT.

New guidance on the therapy, published by the NHS National Cancer Action Team, recommends that all suitable cancer patients in England should have access to SBRT, in particular those with early lung cancer who are unable to have surgery, for whom evidence in support of the technique is strongest.

SBRT should be available at units where at least 25 patients per year will be treated with the technique, and which have the necessary quality assurance safeguards in place.

Patients with head and neck, liver and spinal tumours should only be given SBRT at specialised centres that treat large volumes of patients.

The guidance also emphasises the need for more clinical trials to determine the therapy's effectiveness for different types of cancer.

Peter Kirkbride, England's national clinical advisor for radiotherapy, revealed: "There is the potential for a large number of cancers currently being treated by long courses of external beam radiotherapy, which often cause significant side effects, to be treated and cured with shorter courses of more accurate radiotherapy with consequently fewer side effects.

"Excitingly there is also the potential for tumours which are currently not treatable by conventional methods to also benefit."

The guidance was welcomed by the National Radiotherapy Awareness Initiative - a group of organisations including Cancer Research UK and the Royal College of Radiologists.

Dr Jane Barrett, president of the Royal College of Radiologists, revealed that almost half of all patients whose cancer is cured receive radiotherapy.

She explained: "SBRT is particularly useful in some of the more difficult to treat cancers. We are pleased this cutting-edge form of radiotherapy will soon be available to all cancer patients who can benefit from it."

Hilary Tovey, Cancer Research UK's policy manager, said: "Radiotherapy is an important part of cancer treatment. We want the NHS to ensure that this treatment is available to all patients who might benefit. Guidance like this is an important step in the right direction.

"But we're also asking the government to take steps to ensure that radiotherapy gets the priority it deserves. This means making sure that the NHS has the right number of trained staff and specialised equipment to ensure that patients aren't missing out."

http://info.cancerresearchuk.org/news/a ... le-on-NHS-


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PostPosted: Wed Jul 06, 2011 8:06 am 
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Starter’s orders for survivor Lily

A YOUNG cancer survivor will officially launch a charity marathon set to raise more than £50,000.

Lily Slater had to undergo 14 months of radiotherapy and chemotherapy after being diagnosed with a brain tumour in 2007.

That treatment has thankfully ended, but seven-year-old Lily still has to receive daily growth hormones by mouth and injection.

Lily will again cut a ribbon to launch the Cancer Research UK Relay for Life at Monkton Stadium, Jarrow, on Saturday, July 16.

Watching Lily start the charity relay – which last year raised £51,000 for vital cancer research – will be her parents, Shirley and Glyn Slater, plus her twin sister, Willow, from Boldon Colliery.

Mrs Slater said: “Lily has cut the ribbon to start the relay for the last three years, and she really looks forward to it.

“Our family loves supporting the event, and the girls like being there at the start of the relay.”

The annual charity challenge will take place over July 16 and 17, with teams running continuously for 22 hours.

Dozens of teams have already signed up for the fundraising marathon, which is organised by Ann Walsh, a teacher at Epinay Business and Enterprise School, Jarrow, who has seen her family affected by cancer.

She said: “Lily is a great example of a cancer survivor, and we are looking forward to seeing her cutting the ribbon again to launch this year’s relay.”

The Relay for Life includes a moving candlelit ceremony around the Jarrow athletic track, when charity champs remember those family members and friends lost to cancer.

Any team wishing to take part in the Relay for Life, which starts at 11am, should call Mrs Walsh on 536 8562 or e-mail: annwalsh11@aol.com

http://www.shieldsgazette.com/news/star ... _1_3544319


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PostPosted: Thu Jul 07, 2011 7:25 am 
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Advanced Radiotherapy Stops Mesothelioma Tumor Growth

Advanced new radiotherapy techniques may be more effective – and less toxic – for hard-to-treat mesothelioma patients.
Caused by exposure to asbestos, malignant pleural mesothelioma is a fast-growing cancer that spreads across the membrane that encases the lungs. Radiotherapy is often used as part of a multi-modality approach to keep mesothelioma from spreading. But because of the size and irregular shape of mesothelioma tumors, as well as their proximity to the lungs and heart, there is a high risk of damaging vital organs with conventional external beam radiotherapy.

Now, a study out of Australia demonstrates that new, more precise methods of radiotherapy delivery may be the best hope of controlling the growth of mesothelioma tumors. A team of radiologists at the University of Melbourne examined the outcomes of 14 mesothelioma patients who were treated with either high-dose three dimensional conformal radiotherapy (3DCRT) or intensity-modulated radiotherapy (IMRT) following surgery. Both technologies are designed to deliver higher doses of radiation into mesothelioma cells by customizing the shape of the beam. All of the patients in the study had treatment planning and post-treatment analysis using FDG-PET/CT scans.

Although four of the 14 patients did show signs of mesothelioma recurrence at the irradiated site, the remaining ten did not, an in-field local control rate of 71%. In addition, there were no serious treatment-related toxicities with either of the two types of high-dose rate radiotherapy methods. Median survival was 25 months from diagnosis and 17 months after starting radiotherapy.

Half of the patients did have metastases to other spots after their radiotherapy, but, for two patients, the radiotherapy appears to have stopped the mesothelioma in its tracks; as of the writing of the study, these patients had no further tumor growth and no metastases.

Reporting in the Australian Medical Journal, Journal of Medical Imaging and Radiation Oncology, the authors concluded, “Radiotherapy should be considered to prevent or delay the local manifestations of progressive disease in suitable patients after surgery including extrapleural pneumonectomy and pleurectomy/decortication.” They go on to suggest that higher doses of radiation may result in even more effective palliation of mesothelioma symptoms.

http://www.survivingmesothelioma.com/ne ... ?ID=001120


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PostPosted: Fri Jul 08, 2011 7:24 am 
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My experience as a cancer patient in the United States

I left Nairobi three weeks ago to seek further treatment for my prostate cancer in America’s advanced cancer institutions.

On arriving in Atlanta on June 20, I spent the first week booking appointments with Emory University Hospital Cancer Center, the Georgia Cancer Center and Radiotherapy Centers of the United States of America. Although the three are different and independent institutions, their ownership is jointly shared making specialists easily share information regarding the latest research findings and unique cases they come across.

The first thing you discover is that doctors do not work alone on a patient. They find it easy to pick a phone and call another doctor if they find your case unique or unusual.

My first port of call was at Dr. Frederick J. Schnell’s office, the Medical Director of the Newton Country Radiation Therapy Center. After going through my profile from Dr. Maurice Wambani in Nairobi, he chose to have a one-hour one-on-one discussion with me. I had to tell my story from my own perspective.

His aim was to establish if I had been in honest discussions with my doctor in Nairobi because as he later informed me; treatment of cancer depends very much on the patient as much as on the doctor in charge. At the time of meeting Dr. Schnell, I still had the catheter and tubes for dialysis on my chest. These were the gadgets that had been planted on my body in mid-May at MP Shah Hospital when I needed to ease pressure on my kidneys and detoxify my circulation system.

Although under normal circumstances the catheter should have been changed daily based on the USA standards, mine had been with me for close to six weeks. He, therefore, chose to remove it and asked me to observe for at least 48 hours if I could do without it.

To confirm that I was fine without one, he gave me a lot of liquid to drink and remained in the clinic for at least one hour to see if I could pass urine without the assistance of the catheter. When I finally did that, he released me to go home but instructed his nurse to give me two new catheters to take with me in case I needed them. My wife was instructed on how to insert them.

On reading my test reports in Nairobi and seeing that at the start of my treatment I had a PSA level of 817 and a Gleason scale of 7, he quickly referred me to an oncologist at Emory University Hospital the same afternoon who examined me then referred me to Dr. Kevin Peacock, a specialist in Oncology and Haematology in Conyers, Georgia

Before Dr. Peacock saw me, I had to fill a 16-page questionnaire detailing my family history, drug allergies and the drugs I had been taking since I was diagnosed with prostate cancer. In this category, I had to include any drug unauthorised by the Federal Drug Authority of the United States. They would include any African, Chinese or Indian herbal medicines. Once he was satisfied, he took my blood samples to confirm my PSA and Gleason levels.

On realising that my PSA had been declining, he chose to continue with the same treatment but added more oral drugs to fortify the hormonal injection I had received in Nairobi the week I left. Before I left his clinic, he referred me to a conference for cancer patients organised by the RC Cancer Centers of the United States of America in Conyers.

Founded over 30 years ago, the centre specialises in prostate cancer research but also conducts weekly talks to cancer patients so that they can be better informed of new methods of managing the disease. What I discovered in my first meeting was that I was the only person whose PSA was 817 at the time of diagnosis.

Because most Americans go for routine PSA checks, theirs are discovered before reaching level four PSA count. On telling my story, Dr. Brendon immediately advised that chemotherapy and radiotherapy were not the way to go in my case. Like Dr. Peacock, he advised that I continue with hormonal therapy.

In the last 30 years, doctors at the RC cancer centres have treated more than 12,500 men for prostate cancer with a procedure called ProstRcision. From their research, over 80 research papers have been published and peer-reviewed in medical journals or presented at medical conferences.

In a nutshell, the centres strive to provide a decision-making process to enable the patient select the best treatment method for curing prostate cancer.

http://www.newvision.co.ug/D/8/20/759642


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PostPosted: Sat Jul 09, 2011 7:11 am 
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Brave mother and toddler daughter both beat cancer after starting treatment on the same day

Discovering that your child is ill with a life-threatening disease is every parent's worst nightmare.

But for Jilly Duckworth it was just the beginning of three years of torment.
The brave 42-year-old was devastated when her daughter Evie was diagnosed with a neuroblasta tumour in her kidney when she was just nine months old.

But while the youngster was in isolation following stem cell treatment, Jilly found a lump in her right breast which also turned out to be cancer.

The pair began their treatment on the same day - with Evie having radiotherapy before sitting on her mum's lap while she underwent chemotherapy.

Now, both former nurse Jilly and Evie, four, have completed their treatment and been given the all-clear.

Jilly, of St Werburgh's, Bristol, described the moment her world collapsed as she discovered her own cancer - while watching Evie fight the disease herself.

She said: 'My biggest fear was not being able to look after Evie or having to be in hospital too much.

'She was on a lot of morphine because the treatment had such a high dose. She had been breastfeeding but stopped because her mouth was so sore.

'That was when I discovered the 5cm lump.

'My chemotherapy started the same day that she started her radiotherapy, and as I walked through a link corridor from the Children's Oncology Hospital to the Adult Oncology Hospital, the words of John Lennon came to my mind "Nobody told me there'd be days like these".

Evie was just eight months old when she went into Bristol Children's Hospital for a scan and doctors were alerted to the possibility of cancer.

A month later a neuroblasta - a malignant tumour - was confirmed and Evie underwent chemotherapy and an eight-hour operation.
She then had a transplant of her stem cells because the cancer had spread to her bones.

Her mum, noticed a 5cm lump on her breast when Evie was 15 months old and was diagnosed with breast cancer.

She started chemotherapy at Bristol Oncology Centre on the same day as Evie began radiotherapy at Bristol Children's Hospital.

Evie's treatment ended in May 2009 and Jilly's a month later, on Evie's second birthday. The pair still have regular checks.

In another tragic twist, Jilly's mother was diagnosed with bowel cancer and is now nearing the end of her treatment.

Jilly found laughter helped her through the tough times and began writing songs about cancer and its treatment.

She will perform her songs - with names such as Baldly Go, Cancer Thug and Meditate or Medicate - in front of thousands tomorrow at Bristol's Race For Life event for Cancer Research UK.

Her songs can be found on www.singalongacancer.co.uk.

http://www.dailymail.co.uk/health/artic ... ds-newsxml


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PostPosted: Sun Jul 10, 2011 6:58 am 
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Experts' predictions for the future of radiation medicine

Nearly two-thirds of cancer patients receive radiation therapy. However, irradiation of healthy, nonmalignant tissue around the tumor and along the radiation beam pathway can cause morbidity and increases the risk of secondary cancers, particularly in younger patients, limiting therapeutic radiation doses that can be delivered to the tumor.

Advances in robotic positioning, computers, and real-time imaging are improving radiotherapy planning, fractionation, and the precision of radiation delivery, reducing target margins to allow more aggressive stereotactic radiotherapy regimens and improved tumor control—even in challenging cancers with complex tumor contours, according to speakers at the Future of Radiation Medicine 2011 symposium.1,2 The symposium was held in Scottsdale, Arizona, February 17, and was sponsored by Elekta Oncology (Stockholm, Sweden; www.elekta.com), which produces stereotactic radiotherapy systems and other radiation therapy equipment and information systems. Speakers at the symposium have received research support from Elekta.

Presentations described emerging radiotherapy modalities for breast, lung, and liver cancer; metastatic brain cancer; and complex spine tumors, and research into the supplementation chemotherapy regimens that target molecular pathways in patients with some genetic cancer risks with these radiotherapy modalities. Summary papers and video presentations from the symposium are available online.1,2 Researchers at the symposium also discussed the promise of emerging radiotherapy techniques for managing chronic pain and neurodegenerative disorders.

Cancer radiotherapy outcomes have been blatantly unsatisfactory for patients, according to Professor of Radiation Oncology and Neurosurgery Robert D. Timmerman, MD (University of Texas Southwestern, Dallas); although, patient-reported outcomes are rarely the end point focus of clinical trials. “In the future, radiation therapy for cancer will be significantly different than today's treatments, simply because current outcomes are unsatisfactory to patients,” Timmerman said at the symposium.

Large prospective radiotherapy patient registries that track survival, disease recurrence, and quality of life are needed to facilitate comparative effectiveness research on patient outcomes, Timmerman said. He supports the American Society for Radiation Oncology (ASTRO)'s proposal for a national clearinghouse for all clinical cancer treatment study data to ensure that researchers have access to both positive and negative trial data, with which truly evidence-based standards can be developed.

AN EMERGING STANDARD OF CARE

Just as computerized treatment planning, multileaf collimators and intensity-modulated radiotherapy (IMRT), and 3-dimensional conformal radiotherapy improved precision and reduced the severity of morbidity throughout the 1990s, Timmerman predicted, technological advances are allowing image-guided hypofractionated stereotactic body radiation therapy (SBRT; also known as stereotactic ablative radiotherapy [SABR]) to emerge as a standard of care for lung, liver, and spine tumors in patients who are not candidates for surgery.3,4

Increased radiation targeted allows delivery of larger fractions of optimal therapeutic radiation doses at each patient visit, thereby reducing the overall time of therapy. Conventional external-beam radiotherapy will be supplanted by SBRT or image-guided hypofractionated radiotherapy (IGHRT), which he described as a hybrid between SBRT and conventional radiotherapy. IGHRT offers real-time imaging to track and accommodate tumor motion, such as that caused by patient respiration—a major challenge in hypofractionated lung tumor radiotherapy—and allows so-called 4-dimensional conformal irradiation of tumor tissue. IGHRT is already widely used for breast and prostate cancer. Clinical research of SBRT for the treatment of metastatic bone and lymph node tumors, and primary breast, prostate, pancreas, and kidney cancer is now underway.3

Radiation oncologist Brian D. Kavanagh, MD (University of Colorado at Denver), who has collaborated with Timmerman, also sees a central role for IGHRT or SBRT for cancer radiotherapy within the coming decade. “It's very possible that within 10 years a huge percentage of patients—particularly those with prostate, breast, and lung cancers—will be treated completely, even with a curative intent, with IGHRT or SBRT,” Kavanagh told the symposium audience.2,3

SBRT applications may be integrated with emerging targeted-molecular chemotherapy agents for patients with genetic cancer predispositions, Kavanagh predicted. Preliminary data from a phase II clinical trial already suggests SBRT may improve survival rates achieved with erlotinib (Tarceva) in patients with non-small cell lung cancer (NSCLC) by as much as 12 months compared with survival rates of patients receiving erlotinib alone. (This study was not a randomized, controlled trial, however, and the comparison is based on a previous series of patients treated with erlotinib alone.)

Personalized therapies may represent major advances for patients with rare, genetic-vulnerability cancers. Kavanagh cited SBRT therapy with crizotinib, an experimental chemotherapy agent that blocks a molecular pathway involved in tumor growth in 5% of patients with NSCLC, for example. Crizotinib has very limited long-term efficacy because of the rapid evolution of crizotinib-resistant tumor clones, but patient survival times may be prolonged with SBRT.3 Kavanagh and his colleagues at the University of Colorado are using SBRT to target crizotinib-resistant tumors as they are detected, though a formal evaluation of this approach has not yet been completed.

Dheerendra Prasad, MD, (medical director, Radiation Medicine, Roswell Park Cancer Institute, Buffalo, New York) argued that currently prevailing preferences for whole-brain irradiation over stereotactic brain radiotherapy for the treatment of intracranial metastatic tumors may be changing as the role of salvage therapy in prolonging patient survival times is increasingly appreciated.5

In clinical trials, superior tumor control and progression-free survival was superior for patients who received whole-brain radiotherapy combined with stereotactic radiosurgery compared with patients who received only stereotactic radiosurgery, Prasad acknowledged. However, those trials failed to account for salvage therapy following treatment failure.5 Metastatic brain cancer patients who received stereotactic radiosurgery first required fewer salvage treatments than patients who underwent whole-brain irradiation.5 Nor did previous clinical trials measure the impact of neurocognitive impairment on quality-of-life, Prasad said. Irradiating the entire brain can eradicate undetected microtumors; however, healthy brain tissue is also irradiated, impairing memory and fine motor control functions.5

SAFETY CONCERNS WITH HIGHER RADIATION DOSES

As more aggressive radiotherapeutic regimens become widespread, identifying potential points of failure and ensuring radiation safety for patients and radiotherapy personnel becomes imperative, noted Eric Ford, assistant professor of Radiation Oncology and Molecular Radiation Sciences (Johns Hopkins University, Baltimore, Maryland). “Potential points of failure are scattered throughout the treatment process, so systematic tools must be developed that can uncover them when quality assurance does not,” Ford said.

Radiation therapy should borrow the failure mode and effects analysis techniques originally developed in the automotive and software industries, Ford argued.6 These tools allow analysis of the probability and severity of a potential failure based on historical data, including detailed data on near misses, and are a regulatory requirement for radiation therapy equipment manufacturers but not radiotherapy clinics.6

Pre-treatment safety checklists such as those used by airline pilots (and increasingly in medical surgery, anesthesiology, and infection control), are powerful tools for ensuring radiation safety but only if they are consistently and correctly used. For example, a simple five-item checklist has dramatically reduced the rate of opportunistic central-line catheter patient infections at Johns Hopkins, Ford reported.6

“It's really about more than checklists,” Ford said. “It's about standardization—figuring out the important tasks, how to do them, and doing them the same way every time.” Portal-dosimetric comparisons of planned and delivered radiation doses, and forcing functions as simple as using patient bar codes to confirm patient identities and treatment records, play a key role in radiotherapy safety.

http://www.oncologynurseadvisor.com/exp ... le/207073/


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PostPosted: Mon Jul 11, 2011 6:48 am 
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Cancer centre failed patients

Dr Anesa Ahamad, radiation oncologist and former chief operating officer at the Brian Lara Cancer Treatment Centre, was sent on leave in May 2010, one month before senior medical physicist Damian Rudder made the discovery that patients were being over-radiated and two months before her contract came to an end.

In an exclusive interview with Camini Marajh of the Sunday Express, Dr Ahamad, who now lives in Key West, Florida, talks about her last year at BLCTC and the radiation accident which delivered higher doses of radiation than had been prescribed to 223 patients.

When did you find out that BLCTC had failed to conduct the mandatory annual QA (Quality Assurance) on the linear accelerator and what did you do?

In April 2010 I alerted the board of the centre that the annual quality assurance check for the linear accelerator was due. An external physicist visited and informed me on April 23, 2010, that the 2009 annual quality assurance check for the linear accelerator had not been performed. I immediately raised the issue with board members of the BLCTC by phone and e-mail, and in person with the CEO, and underscored the urgency of performing the annual QA, and insisted it be done as soon as possible by a qualified medical physicist.

Instead of reacting appropriately, I was told that I was making "irresponsible and inciteful" statements. Board members replied to me stating that there was no need to worry and that the machine had had its other recent periodic quality assurance tests (which are of a different level of detail than that of the annual QA tests). I sent the protocol for these tests and continued to pressure the board to have the annual QA on the linear accelerator performed until I was asked to go on indefinite leave on May 12, 2010, and prohibited from entering the premises or communicating with patients or staff.

Despite my qualifications, I was never allowed to make substantive decisions regarding staffing or other major operational decisions for the centre. Hiring and firing of staff and the contracting of services were decisions made by the board of BLCTC, who were all, with the exception of myself, board members, shareholders, or otherwise associates of Medcorp. Medcorp also runs St Clair Hospital, Doctors Radiology Centre and St Clair MRI.

I had fundamental disagreements on administrative and quality-of-patient care matters throughout my tenure with the board, and my relationship with the rest of the board and its parent company, Medcorp became more strained over time. This underlying tension was exacerbated by my insistence that the lack of the 2009 annual QA of the linear accelerator was a problem that required immediate attention.

Damian Rudder's discovery of the linear accelerator miscalibration occurred during his June 2010 annual QA of the machine, which I believe never would have occurred when it did without my insistence that such a QA battery of tests was absolutely essential to the safe operation of the linear accelerator. Far more patients would have been affected by the dose delivery error of the machine if the error had been caught later.

Did you raise as an issue of concern or alarm the absence of a senior medical physicist at the clinic and if so, what was management's response?

Even before Damian Rudder departed the BLCTC I had advised the board to continue negotiating to retain his services, even if on a part-time basis, as his level of qualifications and experience would be difficult to replace in Trinidad. When he left I repeatedly advised the board that a qualified senior physicist needed to be on board.

The next most senior physicist on staff had worked under Damian Rudder for approximately 18 months, had received some instruction on radiotherapy and medical physics at the MD Anderson Cancer Center in Houston, and had attended courses from the linear accelerator's manufacturer, all in addition to her formal academic education.

After Mr Rudder left the BLCTC I was given assurances by members of the board that a search for a senior physicist replacement was ongoing; one result of that effort was a qualified senior physicist from India temporarily working at the Centre in 2009. As I noted above, decisions on hiring and firing were made by the Board of the BLCTC, and my requests for staff were often ignored or given low priority. I continuously pressed for a qualified physicist for the centre and at each Board Meeting I repeated the request for this key staff member, with the exception of the period in 2009 when we had such a physicist on-site.

As a physician whose primary goal it is to provide hope and to heal, what was your reaction when you learnt that patients under your care were administered doses of radiation way over what you had prescribed in their treatment plan? And, what if anything, did you do about it?

I became extremely concerned for patients in June 2010 when Mr Rudder informed me of his findings at the BLCTC, during a time when I had been requested to go on indefinite leave from the Centre. It was personally distressing to know that after taking great care and effort to ensure that the correct dose is calculated and administered, staying back at the centre late at night to complete radiotherapy planning on each patient, lobbying the BLCTC board for sufficient staff, support, and equipment, and training all members of our staff how to keep patients as the centre of our practice, that all of that effort was now contaminated with the fact that a disparity existed between the dose I planned for a patient and the actual dose delivered by the linear accelerator.

You have to understand that a large amount of my education in the UK and US has been in learning how to properly create a computer-generated plan for radiation therapy for patients; I take a CT image of a patient, identify the cancer and healthy tissues, and painstakingly determine the dose required to kill cancer cells while preserving healthy tissue, and I do this in numerous "slices" for each patient so that the resulting 3-D radiotherapy plan is accurate at all points and from all angles.

I then work with the physicists to take my plan and do the necessary calculations so that a linear accelerator can deliver the radiotherapy, and I make them rework their calculations until the result is within extremely high standards of care, sometimes quibbling over a few millimetres of discrepancy. Patients are carefully immobilised during the planning and treatment process to ensure they are in the exact same position every time, ensuring that the dose delivered is as close to my plan as possible, sometimes requiring the creation of custom devices or novel procedures to keep patients as still as possible.

When I was told that the linear accelerator output was off by a substantial amount, and that the dose delivered to the patient was different than what I prescribed, I realised that all of the effort was now tainted, and I was extremely upset. Up until that point I had no suspicion, nor could I have been reasonably expected to know, that the machine, new as it was, would have been adjusted to the point of significantly altering the radiation output of the linear accelerator.

Given that the linear accelerator in question was new in 2007 and was of extremely high quality, the dose delivered would not vary significantly unless the dose output was deliberately changed. I was never informed of any such changes.

After Mr Rudder informed me of the dose output discrepancy, and despite being on leave, I contacted the board and insisted that they take immediate urgent action, and recommended specific responses based on international guidelines for such incidents, including informing all patients affected once that had been determined.

I contacted each member of the board. I also contacted my professional colleagues and seniors in the US and UK, including former heads of national professional associations, the Royal College of Radiology, heads of departments at leading cancer centres, and representatives of the linear accelerator manufacturer and maintenance companies in order to get their advice on how to best handle the situation.

I assured Medcorp that I was willing to come in and assist with all the recommended actions for taking care of patients, the most important of which was the immediate determination of patients currently on treatment and whether they had received higher doses than prescribed. If that were the case their radiotherapy regimes, which take weeks to complete in most cases, could be adjusted so that the final dose delivered to the patients would have met the dose originally prescribed.

I was informed that the matter was being handled, but time was of the essence, patients were still being treated (with the exception of a one-day hiatus), and when I failed to receive sufficient assurances that the Board of the BLCTC would take appropriate action I contacted the CMO of the Ministry of Health on June 18, 2010, and expressed my concerns in the strongest and most urgent terms.

I was the first person to report the general details of the incident to the Ministry of Health, and I encouraged Mr Rudder and Ms Sue Jaan Meijas, physicists who had discovered and confirmed the miscalibration respectively, to present their findings and concerns to the CMO as soon as possible, going so far as scheduling a time for them to meet the CMO in order to get action on this matter. They presented their findings to the CMO on Tuesday 22nd June.

It was as a result of my meetings with the CMO to report the incident and my urging of Mr Rudder to report his findings that PAHO was called to investigate. I have no idea what would have happened if we hadn't communicated this incident to the Ministry of Health, and even they were apparently slow to act or release information to the public.

Aside from this incident, and the aforementioned concerns regarding the lack of a supervising senior physicist for part of our time treating patients, I believe we held to the highest standards of patient care just as I was trained to provide. I can only hope that through careful determination of required doses, meticulous planning, and consistent patient immobilisation we minimised the effect of this radiation dose delivery discrepancy on those affected.

Some people have suggested that when the going got tough, you got going and bailed out on BLCC and the patients you treated. Could you provide some background on the circumstances leading to your separation from BLCC?

On March 19, 2010 I was informed that Medcorp, the parent company of the BLCTC, decided to not renew my five-year contract, which was due to conclude at the end of July, 2010. This was three months prior to the discovery of the dose discrepancy by Damian Rudder, and thus entirely unrelated.

Medcorp's decision in this regard had nothing to do with this incident or the quality of my patient care, but was instead founded on fundamental administrative disagreements regarding the execution of my employment agreement. The details of those disagreements are confidential and unrelated to patient care or the staffing of the Centre. Any suggestions that I bailed on the BLCTC or my patients are completely unfounded. I had no authority at the Centre except what the Board allowed, and in addition to not renewing my employment agreement they also requested on May 12, 2010 that I go on indefinite leave and prohibited me from contacting patients or staff of the Centre.

Several reasons were given for this request, but I do not think it is coincidence that this request for me to go on indefinite leave and not have contact with the Centre occurred on the heels of my insistence that a costly annual QA check be immediately commissioned for the linear accelerator in order to ensure the safety of our equipment.

A small number of patients previously treated at the BLCTC approached me for clinical opinions or follow-up visits after my time at the BLCTC, and if they opted to not be seen at the BLCTC I welcomed them to be seen by me. Even now I remain in email contact with patients, although being based outside of Trinidad has certainly made it more difficult to do so. I hope that by shedding light on this incident the affected patients receive proper diagnosis and any necessary treatment and support.

Did you knowingly send any patient under treatment for radiation knowing that there was a calibration issue or any problem at all with the Linac equipment?

No. Never. It would be unethical to do this. I didn't know about the radiation overdose issue until June 2010. At the time I was on leave from the Centre, and another oncologist was managing patients at the Centre in my stead; I was not in a position to make any patient management decisions once the overdose was discovered.

Once the error was detected I recommended to the board and the CMO that all radiotherapy be immediately halted so that patients currently on treatment could have their radiation plans altered to take into account any variances in the radiation output of the machine. Prior to June 2010 I was unaware of any problems with the linear accelerator, and as a physician had no way of being aware of such problems.

As a physician who has treated some of the affected cancer patients, what are some of the likely side effects given the radiation doses administered in error?

The side effects will vary according to the part of the body that was treated. The most significant side effects of an overdose are not the early effects that are observed during the treatment—these usually get better. The most feared effects are called late effects and can occur anytime over the lifetime of the patient. The radiotherapy prescription includes the dose to be given to the tumor as well as the dose limits to the normal organs – based on a century of research and observation.

Each organ can tolerate a specific effective dose. The effect depends on the absolute dose and the dose per treatment (late side effects increase as the dose per treatment increases). In the case of an overdose – both the total dose and the dose per fraction increases so that it is not a simple calculation.

The effective overdose has to be calculated using a linear quadratic equation. Effects of overdose are malfunction of the organ overdosed, ulcers, bleeding, pain, narrowing or obstruction of organs, hardening of tissue and tissue breakdown. The symptoms will be different according to the body part. Treatment is also different and may include symptom control, hyperbaric oxygen, medication to improve oxygenation or surgery.

Comment on the Ministry of Health's response to the radiation accident?

Finally this is a sign that the new Minister is bringing an era of accountability and transparency to the health sector and that the patients affected by this incident are given any support and care they require, and hopefully that regulations and systems are put into effect that would require all radiotherapy facilities to be independently audited by trained physicists to ensure that the highest standards are maintained.

Why did it take a year for the Ministry of Health to publicly acknowledge the amount of patients affected? They were informed in June 2010. I may have been bound by confidentiality agreements, and in fact was prevented from knowing the full extent of the incident due to Medcorp's insistence that I remain on leave and refused me access to the Centre and its patients, but the Ministry of Health could have and should have acted sooner than this.

I am disappointed that it has taken this long for the Ministry to make public the barest details of the PAHO report. I am also disappointed in their action. By suggesting that patients return to the BLCTC to determine if they were affected by the incident, after Medcorp has presumably known about the issue for over a year and demonstrated an unwillingness to act appropriately with regards to the incident, seems to be counterproductive at best.

What assurances can the Ministry provide that patients who return to the BLCTC will receive objective and fair assessments of their condition? Perhaps if Medcorp had shown they were willing to make things right from the moment the linear accelerator error was discovered I would have more faith in their ability to handle this unfortunate situation properly.

This is just not the case, and asking patients to put their trust in Medcorp again doesn't seem like the best way to handle the situation. At the very least an independent oncologist familiar with radiation necrosis and radiation overdose symptoms should be provided by the Ministry of Health to help sort out the patients affected.

I want to also state that I have pressed the Ministry of Health since 2004 to introduce radiation protection legislation and regulations in keeping with IAEA recommendations, including requirements for staff at radiotherapy centres. Since then I have delivered to the Ministry of Health numerous technical references that would enable them to create sufficient regulations to ensure the safety of radiation therapy.

I personally lobbied for some sort of radiotherapy safety regulations at the level of the Ministry and its committees and in the Draft National Cancer Plan. I have contacted each new Minister of Health offering my assistance in any way possible, and have often offered my services pro bono in the interest of safely developing our cancer treatment systems.

I hope that, with the extent of this incident now made more public, that the need for a comprehensive and systematic approach to cancer treatment is taken as a higher priority for the nation.

http://www.trinidadexpress.com/news/Can ... 77238.html


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PostPosted: Sun Jul 24, 2011 7:02 am 
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Study Finds Flaws in NCI Data on Radiation for Breast Cancer

July 22, 2011 — The National Cancer Institute (NCI) calls its Surveillance Epidemiology and End Results (SEER) database "the premier source for cancer statistics in the United States," but researchers at the University of Michigan have found that some of the treatment information collected by the program may not be complete, according to an article published online June 29 in Cancer.

A team led by Reshma Jagsi, MD, PhD, associate professor of radiation oncology at the University of Michigan Medical School in Ann Arbor, found discrepancies between patient reports and SEER data while researching treatment experiences and decision making among patients with breast cancer.

In the current Cancer study, patients with breast cancer were surveyed from 2 SEER registry locations: Los Angeles, California, and Detroit, Michigan. Their data were then matched to their SEER records. A total of 2290 patients between the ages of 20 and 79 years with nonmetastatic breast cancer diagnosed between June 2005 and February 2007 were surveyed. Of the 1292 patients who reported receiving radiation treatment, 237 (21%) were coded in the SEER database as not having done so. The rate of underascertainment was higher for patients surveyed in Los Angeles than those surveyed in Detroit: 32% vs 11.25% (P < .001).

The researchers concluded that the "SEER registry data as currently collected may not be an appropriate source for documentation of rates of radiotherapy receipt or investigation of geographic variation in the radiation treatment of breast cancer."

Dr. Jagsi said that her team did not find problems with SEER data on cancer incidence, but the state registries that collect data for NCI may not always capture follow-up data on patients.

"We're not saying that SEER is bad at collecting incident cases of cancer," she said. "They do that very well.... What has become more challenging over time has been capturing things like radiation treatment."

Although it might be more straightforward to capture a surgical treatment, it may be harder to capture information on radiation treatment because it is increasingly offered in the outpatient setting, she said. Also, women often receive radiation after they complete chemotherapy, according to Dr. Jagsi and colleagues.

Abram Recht, MD, a Harvard Medical School professor and deputy chief, Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, said in an email that the findings on radiation therapy are very important.

"If the coding of the SEER data-base is seriously inaccurate, then any conclusions drawn from studies using that information cannot be trusted fully," he noted.

The article points out that major studies on the appropriateness of care delivered to patients with breast cancer, including rates of receipt of radiotherapy after breast-conserving surgery, have relied solely on the SEER data. These studies also offered evidence of race and geographic disparities.

Better data are needed to support findings such as these, Dr. Jagsi said.

"In order for us to design clinical policy and interventions appropriately, we have to understand exactly what is going on and not have artifacts from inaccurate data collections introduced," she said. "With increased interest in comparative effectiveness research, more and more researchers are using registry databases like SEER. If the quality of the data in some of these databases has limitations, these must be understood to avoid potentially misleading conclusions that affect both clinical decision-making and policy," Dr. Jagsi noted in a press release.

The researchers worked closely with the SEER staff, 2 of whom are coauthors on the paper.

Brenda Edwards, PhD, a senior advisor for cancer surveillance at NCI who was not an author on the paper, said the research shows "our data on radiation treatment is probably less complete than we thought it was."

Some of the problems stem from differences in the way Detroit and Los Angeles capture data, and from California's budget crisis, which cut into the state's capacity to collect data, she said.

Dr. Edwards agreed that the study suggests researchers need to be careful when using databases such as SEER.

"When you are doing outcomes research, you really need to look at the strengths and weaknesses of your data and not push the data source beyond what it can do," she said.

http://www.medscape.com/viewarticle/746865


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PostPosted: Sat Aug 27, 2011 6:53 am 
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New cancer treatment offered locally

PARKERSBURG -What has been called a cutting edge cancer treatment is now available in the Mid-Ohio Valley.

Dr. Gabor Altdorfer and Dr. Michael Galloway, radiation oncologists at the Camden Clark Medical Center, have been using high dose radiation brachy therapy to treat cancer in the lungs, prostate, gynecological and esophageal cancer and will soon be used in the treatment of breast cancer.

Galloway said the new treatment can be used on a wide range of cancers.

"Treatment of other cancers is possible; you can even treat skin cancer with this," he said. "It is a focused and tailored treatment that goes directly into the space where the tumor was located or in the tumor."

Altdorfer said the new treatment is quicker and more convenient for the patient. For some cases of breast cancer the treatment can be done in a week but some will need follow up with chemotherapy, he said.

"Part of this treatment was available with low dose therapy with a three-day admission, bed rest immobilized with possible complications," he said. "This is all out patient; the patient comes in, the procedure is one hour and they come back the next week. We can treat a certain subset of breast cancer in five days, in the morning and afternoon right into the tumor cavity the treatment is five minutes."

Altdorfer said brachy means treating the tumor from inside out instead of from the outside in through normal tissue before it gets to the tumor. The radiation source is placed inside or adjacent to the tumor, making it safer for the patient and those administering treatment, he said. It is a very rapid and intense form of treatment, he said.

"It is applicable for about 10 percent of patients, but it's available," Altdorfer said. "We should be proud the hospital administration is supportive of this upgrading."

Altdorfer said prostate cancer research shows the treatment is comparable to the cyber knife treatment.

"It is very interesting; it is helping some patients who would otherwise struggle and have to leave the community for health care," he said.

Prior to the introduction at Camden Clark Medical Center, the closest treatment locations were Charleston, Morgantown and Columbus.

Altdorfer said the first treatments were done seven years ago and the results have been good. Locally, he said, the first treatments were administered two weeks ago and seven people have been treated.

http://www.newsandsentinel.com/page/con ... l?nav=5061


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PostPosted: Tue Feb 14, 2012 6:51 am 
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Radiation After Lung Cancer Surgery Doesn’t Help All: Study

MONDAY, Feb. 13 (HealthDay News) — For older people with a certain type and stage of lung cancer, administering radiation treatment after surgery may not extend survival, according to a new study.

Radiation is not without risks, and the new study “questions the benefit of this treatment,” said study leader Dr. Juan Wisnivesky, an associate professor of medicine at Mount Sinai School of Medicine in New York City.

He and his team looked at survival outcomes in more than 1,300 lung cancer patients with locally advanced disease, 710 of whom got the postoperative radiation therapy. It is routinely given in an attempt to prevent recurrence.

No substantial survival benefits were found at one year or three years.

“We found in this group of elderly patients, many of whom received the treatment, the use of the treatment did not appear to help them live longer,” he said.

Patients in the study, all 65 or older, had stage 3 non-small cell lung cancer and involvement of N2 lymph nodes. Their cancer had spread but not widely. All had been diagnosed from 1992 through 2005 and were included in the U.S. Surveillance, Epidemiology, and End Results database, which is linked to Medicare.

The study, published online Feb. 13 in the journal Cancer, was funded by the U.S. National Cancer Institute.

About 226,000 new cases of lung cancer will be diagnosed in the United States this year, 90 percent of which will be non-small cell, according to the American Cancer Society. Within non-small cell cancers, there are three main subtypes.

Previous studies looking into the survival benefits of post-op radiation for this group of patients have produced mixed results, Wisnivesky said.

However, in his study, he found no substantial differences between those who had the treatment and those who didn’t. And, radiation therapy carries risks. Besides the inconvenience of the additional treatments, the therapy can cause irritation of the lungs and inflammation of the esophagus, he said.

“Patients need to be well informed,” he said. “They have to have a good discussion with their doctor about what are the potential benefits,” he said. They also need to discuss possible side effects.

Another expert, Dr. Dan Raz, an assistant professor of surgery at City of Hope Comprehensive Cancer Center in Duarte, Calif., emphasized that the study is not talking about all stage 3 lung cancer patients, but only a specific group, those with stage 3 non-small cell and involvement of the N2 lymph nodes.

“It’s a small subset of patients” of all lung cancer patients, he said, adding that it’s a challenging group.

Some previous small studies have also suggested that post-op radiation may be unnecessary in these patients, and the new findings add to that argument, he said.

“In the end, survival and quality of life are the most important things for patients,” Raz said. But recurrence, a key factor, was not addressed in the study, he said.

The new finding “wouldn’t change the way I treat patients, but I think it raises a very important point.”

What’s needed is a trial comparing use of post-operative radiation and its non-use in this group of patients, Raz said. According to Wisnivesky, such a study is under way in France, but will take several years to finish.

http://news.health.com/2012/02/13/radia ... all-study/


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PostPosted: Thu Mar 01, 2012 6:19 am 
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Some with lung cancer get unhelpful radiation

NEW YORK (Reuters Health) - Older adults who have surgery for a particular type of lung cancer often have radiation therapy afterward. But a new study suggests that the radiation typically does nothing to extend their lives.

The findings, which appear in the journal Cancer, highlight the overall issue of "overtreatment" in medicine -- that is, giving patients tests and treatments that lack strong evidence of a benefit.

In this case, researchers looked at government data on elderly Americans treated for a particular stage and type of non-small cell lung cancer.

Non-small cell lung cancer accounts for about 90 percent of lung cancer cases in the U.S., but it's further divided into complicated groupings based on the size of the tumor and other factors.

Patients in this study had stage 3, N2 lung cancer, which means it had spread to particular nearby lymph nodes. People with that type of lung cancer can have surgery to remove the cancer -- and it's been thought that radiation after surgery could help their chances of avoiding a cancer recurrence.

But the actual research evidence on that has been mixed. And in general, experts have recommended against routinely using radiation for these patients.

The current findings back up that advice, according to Dr. Juan P. Wisnivesky of Mount Sinai School of Medicine in New York.

Using a government database, Wisnivesky's team was able to look at long-term survival among 1,300 Americans age 65 and up who had surgery for stage 3, N2 lung cancer between 1992 and 2005.

More than half of those patients -- 54 percent -- received radiation therapy after surgery. But overall, their survival odds over the next three years were no better than those of patients who had no radiation therapy.

INDIVIDUALIZED CARE

In general, most people do not survive this form of lung cancer for long.

If there's only "microscopic" disease in the N2 lymph nodes, five-year survival rates range from 20 to 35 percent. But the outlook is dimmer when the cancer has invaded the lymph nodes more extensively.

Based on the current findings, radiation after surgery may not improve patients' survival chances.

But treatment decisions should still be based on individual patients' situations, according to Wisnivesky.

"I think this treatment option should be discussed with patients," he told Reuters Health in an email, "but physicians should be clear that there is no strong evidence from (clinical trials) supporting use of post-operative radiation therapy."

Along with the lack of a clear survival advantage, there's the big issue of side effects, Wisnivesky pointed out.

Radiation therapy can cause fatigue, nausea and vomiting, or damage the lungs or esophagus (the passage through which food moves into the stomach).

But Wisnivesky also stressed that his findings relate only to elderly adults with stage 3, N2 lung cancer. They don't say whether the effects of radiation might be different for younger patients or those with different lymph-node involvement.

$800 BILLION IN WASTE?

The study had its limitations, the authors note. It's based on information from a cancer registry, and not a clinical trial where patients were randomly assigned to have radiation therapy or not -- which is considered the "gold standard" in medical research.

But the researchers did account for a number of possible differences between radiation and no-radiation patients -- like their overall health and demographics.

What's really needed, according to Wisnivesky, is a clinical trial that tests radiation versus no radiation in this group of lung cancer patients. Just such a trial is underway in France, but it will be several years before it's finished.

More broadly, the issue of unproven medical tests and treatments is grabbing more attention, as the U.S. government seeks to control costs while extending healthcare coverage to millions more Americans.

Earlier this month, the American College of Physicians said it was rolling out new guidelines on when doctors should perform various screening and diagnostic tests, and when they can be avoided.

According to some estimates, the U.S. wastes about $800 billion -- or about one-third of all annual healthcare spending -- on unneeded medical tests, procedures and extra days in the hospital.

http://www.healthnews.com/en/news/Some- ... EdrxrA4v3/


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PostPosted: Fri Mar 30, 2012 4:13 pm 
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Tiny particles deliver big radiation to cancerous tumors

SAN ANTONIO -- San Antonio scientists are developing a new way to target deadly brain tumors. The treatment uses tiny particles to deliver big amounts of radiation.

Glioblastoma is a life-threatening tumor. About 13,000 Americans are diagnosed with this cancer each year.

“It remains an incurable malignancy,” said Andrew Brenner, M.D., Ph.D., a neuro-oncologist with the Cancer Therapy and Research Center at the U.T. Health Science Center in San Antonio. “The survival rate is only around 14-and-a-half months on average for glioblastoma.”

Conventional radiation is delivered from the outside. Amounts are limited, though, since healthy tissue is also zapped.

Now, an experiment using lab animals has yielded encouraging results.

Rat brains are about the size of a walnut. Scientists inject them with tumors, then treat them with tiny nanoparticles. The radiation is packaged in a cell-like membrane composed of fatty molecules.

The radiation only travels a few millimeters and it’s delivered from the inside.

“The radiation only goes to the area that we really want to target and really spares the normal brain,” Brenner explained. “And that means that we can give tremendously higher doses.”

In fact, the doses of radiation in the experiment were 25 to 30 times higher than current doses.

Tumors in treated rats were eradicated. The impressive results were published in the journal Neuro-Oncology.

At the South Texas Research Facility of UTHSC, scientists hope to translate their lab-setting, theoretical approach to people soon. A clinical trial is possible in just a few months.

To treat the cancer without destroying the healthy brain would be a major step forward.

“It’s something that nobody else is doing,” Brenner added. “We really are doing something really out of the box. And so, it’s exciting when you can be a part of something like that.”

Scientists are excited about the nanotherapy radiation approach. They said it has the potential to help patients with other kinds of cancerous tumors, too.

http://www.kens5.com/news/Tin-particles ... 94965.html


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PostPosted: Fri Apr 06, 2012 7:01 am 
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Hypofractionated Stereotactic Radiotherapy to Surgical Cavity After Resection for Brain Metastasis

Hypofractionated stereotactic radiotherapy (SRT) appears to be safe and effective in preventing recurrence at resection cavities following surgical resection of brain metastasis and may spare many patients from whole brain radiotherapy (WBRT) and its adverse effects, according to Hsiang-Hsuan M. Yu, MD, of the Moffitt Cancer Center in Tampa, Florida (AACR abstract 737).

A total of 25 to 30 Gy in 5 daily fractions over a 1-week period was prescribed to the resection cavity with a margin of 2 mm expansion (median dose 28.5 Gy) between 2 to 4 weeks postoperatively.

Synchronous oligometastasis, if present, was treated with radiosurgery. No patients received upfront WBRT. All patients were followed up for at least 6 months. The radiographic end point was local tumor control at resection cavity.

Preliminary analyses showed a local control rate of 86% at 12 months at the resection site; none of the patients developed radiation-induced injury at the resection site.

Although WBRT decreases the risk of recurrence at the resection site, it is also associated with neurocognitive complications. Postoperative radiosurgery is a new technique aimed at decreasing recurrence and sparing patients from WBRT, but a single high-dose fraction may increase radiation-induced necrosis.

“Hypofractionated SRT delivers a higher radiobiological dose which may potentially provide higher local tumor control, and fractionation may lower risk of radiation-induced injury,” explained Dr. Yu.

http://www.cancernetwork.com/conference ... 65/2055633


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PostPosted: Thu Apr 19, 2012 6:48 am 
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Sound waves used to treat prostate cancer

A new prostate cancer treatment using high-frequency sound waves may be a viable alternative to surgery and radiotherapy with less chance of incontinence or impotence, researchers say.

A clinical trial funded by Britain's Medical Research Council examined the efficacy of a new treatment known as high-intensity focused ultrasound (HIFU), that can target areas just a few millimetres in size.

''The results … show that 12 months after treatment, none of the 41 men in the trial had incontinence of urine and just one in 10 suffered from poor erections - both common side effects of conventional treatment,'' a statement said.

''The majority of men [95 per cent] were also cancer-free after a year.''

The findings were published in the journal Lancet Oncology.

Treatment involves radiotherapy or removing the prostate surgically - both methods that can damage surrounding healthy tissue, in some cases leading to incontinence or erectile dysfunction.

HIFU targets a small area affected by cancer - the sound waves causing the tissue to vibrate and heat up, killing the cancer cells.

''Our results are very encouraging,'' Dr Hashim Ahmed, who led the study, said.

''We're optimistic that men diagnosed with prostate cancer may soon be able to undergo a day-case surgical procedure, which can be safely repeated once or twice, to treat their condition with very few side effects. That could mean a significant improvement in their quality of life.''

There will be a larger trial to examine whether the new therapy, already in use in hospitals for several years, was as effective as the standard treatment. Men can live with the disease for years and many have to weigh whether they want to risk the side effects of treatment.

http://www.canberratimes.com.au/world/s ... z1sQXmxXRY


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