Stereotactic Body Radiation Therapy offers some patients an opportunity for cancer treatment without surgery or chemotherapy.
This new technology is now offered at Susan B. Allen Memorial Hospital, following the addition of a Varian TrueBeam Linear Accelerator System in April 2015 and a Siemens Large Bore CT Scanner in August 2016 at the SBA Cancer Center.
“It offers as little as one – up to five – treatments versus the up to 45 treatments with traditional radiation,” said Jamie Richards, Radiation Oncology Manager at Susan B. Allen. “There is no surgery, recovery time or risk of infection.”
“It’s actually pretty amazing they have this for the size of El Dorado,” said Dr. Barbara Luder, Radiation Oncologist at the Hospital. “Usually, people would have to go to Wichita.”
Whether or not a person is eligible for this treatment will depend on the case, as well as the location of the cancer.
“The radiation is very highly focused,” explained Dr. Luder. “It uses a lot of little beams that don’t hurt the tissue they travel through, but where they converge is the high intensity dose of radiation. Think of it as knifeless surgery. It is ablation of the tumor.”
“The accuracy of these treatments allows us to give more radiation to the tumor and less to the healthy tissue surrounding it,” added Richards.
The two major areas where Susan B. Allen will focus treatments will be in the brain and lungs. They have done treatments with brain cancer already and are just starting lung treatments.
“The treatment of lung cancer was so discouraging my whole career until recently,” Dr. Luder said. “With our new lung cancer screening program here at SBA, we will be seeing more highly curable, early stage lung cancer, which is what we want to treat with stereotactic radiosurgery.”
With stereotactic radiation it only takes three to five treatments for lung cancer and there is rarely skin reaction with the treatment. It is a good option if the patient wishes to avoid surgery, with the other options for lung cancer being a wedge resection or removal of the lobe or entire lung.
“The side effects are nothing compared to lung surgery,” Dr. Luder said.
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She said most patients are older or heavy smokers. They also usually have other medical conditions to prevent or complicate surgery.
“Stereotactic radiation is proving so successful,” Dr. Luder said. “When looking at the five-year follow-up, which is the measure of permanent cure in cancer medicine, you’re seeing great numbers in those who used stereotactic radiation.”
In the brain, the treatment depends on the type of tumor.
“Several types of cancer tend to eventually spread to the brain,” Dr. Luder continued. “The rule is if there are one to three spots, the national guidelines recommend this highly focused treatment on just the spots, rather than whole brain radiation treatment, which was the normal treatment in the past.” This type of treatment is usually a single treatment with the stereotactic radiation.
“Patients can live longer and less commonly have it come back in their brain,” Dr. Luder said.
Stereotactic body radiation also can be used for retreatment, where before patients were told there were no good options.
“Because this is so targeted, we can give three to five treatments in a previously treated area,” Dr. Luder said.
The only limitation with stereotactic body radiation is if the patient needs a larger area covered, such as when lymph nodes need treated.
“It is a highly precise and higher dose treatment, as well as more convenient for patients, than having to come in every day Monday through Friday for treatment,” Richards explained.
During the treatment, the patient lays on the table for 20 to 30 minutes. The first visit takes a little longer, lasting about 45 minutes. During that visit, they do a CT scan to develop the customized treatment plan using the highest possible dose for the cancer, while protecting healthy tissue. That scan takes into account such things as the patient’s breathing, so the tumor always stays within the field for treatment. The radiation will turn on and off as it comes into the patient’s body at optimal beam angles.
“It takes into account all of the movements,” Dr. Luder said.
There also is equipment that helps hold the patient still during the scans and treatment, as well as limit deep breathing. They do the treatments two to three times a week because of the stronger dose.
To help with treatments, the Cancer Center also added the Varian Perfect Pitch 6 Degree of Freedom ® Robotic Couch in December 2016. This lets them move the table around until the patient is in the correct position for treatment based on daily CT imaging.
Dr. Luder said stereotactic radiation is something people should think about depending on their circumstances.
“It’s the up and coming thing,” she said. “The role of surgery for lung cancer and brain metastasis is declining because of this new technology.
“Within the next two to three years, we may have adequate data internationally to begin using this technology to treat other cancers such as early, favorable prostate cancer with five treatments,” Dr. Luder said.
The funds for the TrueBeam were partially raised by the community of El Dorado at their annual fundraising gala in 2015. Dr. Luder is amazed at a community this size being able and willing to raise funds like this. “I knew I liked the community aspect of this hospital and cancer center when I was here between its opening in 2003 and 2006. This degree of support from a community, though, is nothing short of amazing. The residents here are generous and should be very proud of what they have accomplished for this center and the hospital in general.”
About Susan B. Allen Memorial Hospital
Susan B. Allen Memorial Hospital is a not-for-profit, general acute care hospital that includes a 24-hour physician staffed emergency department, family birth center, home health agency, dialysis center, cancer center, and a family medical care facility in Augusta. The Hospital is governed by a local board of citizens, and is accredited by the Joint Commission.