Pinpoint Treatment
By John Edison, Grand Forks Herald, N.D.
Jan. 1–When Devils Lake’s Tom Lamotte was diagnosed with prostate cancer, he looked around the country to find the best treatment options. He found a promising option in other states, and was willing to spend several weeks in California to receive proton treatment.
After more research, however, Lamotte discovered the best treatment for him was much closer to home. “After checking all those out, I finally realized I had the best option an hour and a half from my home,” he said.
With new technology in Grand Forks and plans for continued growth at local cancer centers, Lamotte and patients like him may not have to travel as far as they think to receive the latest cancer treatments.
Lamotte, who was diagnosed with cancer about a year ago, received radiation therapy at the Cancer Center of North Dakota in Grand Forks with the facility’s new On-Board Imager. The device, which is an accessory for medical linear accelerators, is an automated system for image-guided radiation therapy. It uses X-ray images to pinpoint the site of a tumor.
Dr. William Noyes, a radiation oncologist at CCND, said the technology allows him to pinpoint the location of a tumor to within half a millimeter.
He said this is important because it allows physicians to treat cancer without affecting healthy tissue surrounding tumors. He said the more precise treatment cuts down on some of the unpleasant affects some patients feel after treatment.
Lamotte’s treatment did not leave him feeling ill afterward. “If I would have a treatment, I’d go right back to work. I didn’t even know it,” he said.
As a small-business owner, Lamotte said the duration of the treatment was also convenient for his schedule. He underwent 39 treatments administered once a day for about eight weeks. It broke down to five treatments a week, with each visit lasting about 15 to 20 minutes. “It’s a pretty quick process,” he said.
Lamotte is now cancer free.
Latest technology
According to Dr. Walter Curran, an expert in the field of radiation oncology at Philadelphia’s Thomas Jefferson Hospital, On-Board Imaging is a promising new technology for radiation therapy.
“It really is a new approach. It’s an exciting approach,” he said.
Curran said about 60 percent of cancer patients receive radiation at some point during their treatment, and the linear accelerator is the most common way to give radiation.
A patient receives a CT scan for treatment planning before radiation therapy begins. That information is then used to target treatment. However, a patient’s body can change over the course of treatment.
For example, if a patient loses or gains weight, Curran said On-Board Imaging allows physicians to quickly adapt individual treatment to changes in the body. “You can really get kind of real-time CT scanning information on the day that the patient comes to the linear accelerator,” he said.
He added that physicians can get quick CT internal anatomic information in about a minute with the technology.
Noyes said CCND is the first facility in North and South Dakota to offer On-Board Imaging to its cancer patients.
The equipment, which arrived in August, allows for more precise administration of radiation therapy. “If a patient is concerned that they want the most accurate treatment, we are the most accurate in the state,” said Noyes.
A high degree of precision is important for treating tumors located near the body’s critical structures, such as the brain, eyes or lungs. “You don’t want to irritate all those adjacent tissues, that’s when you would want precision,” Noyes said.
He uses the technology primary to treat cancer with its an early stage or cancers that are close to important body tissues and structures. Physicians do not often use On-Board Imaging to treat aggressive cancers or cancer in its advanced stages, said Noyes.
“We don’t use it for all patients, maybe only 40 or 50 percent of the patients under treatment really need that precision. There are some cases where we don’t need it,” he said.
Expanding options
Altru Health System is also looking into ways it can stay at the forefront of cancer treatment. Going into the next year, Altru will put $4.5 million into upgrading its cancer center.
Radiation oncology specialist Dr. John Simmons said Altru is currently focused on bringing PET-CT scanning technology to its facility. The technology combines positron emission tomography with a CT scan to allow physicians to gather both anatomic and metabolic information from a patient.
Essentially, doctors can see not only what an area of the body looks like internally, but also how it is functioning.
“The PET scanning looks at processes, functions, in the body and the (CT scan) looks at structures and it marries the two together . . . you can not only see what’s going on, but you can very precisely locate it,” Altru chief operating officer Dave Molmen said. “The treatment can be very exactly tailored to what the patient’s need is.”
Simmons said the technology can be used for early detection of cancer and to determine radiation dosages during treatment. It also helps target the tumor while minimizing the side effects of treatment.
Altru currently does not have On-Board Imaging, but Simmons said the hospital is interested in the technology.
In 2008, Molmen said Altru plans on replacing its linear accelerators with a new generation of equipment. The hospital also plans on adding another interventional radiology suite to its two existing ones.
Interventional radiology is a subspecialty of radiology that involves the use of image guidance to conduct less invasive surgical procedures.
Tom Lamotte of Devils lake with the Cancer Center of North Dakota’s on-board imager that was used for radiation therapy. Lamotte is cancer free. Herald photo by John Stennes.
Tom Lamotte of Devils lake with the Cancer Center of North Dakota’s on-board imager that was used for radiation therapy. Lamotte is cancer free. Herald photo by John Stennes.
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Copyright (c) 2007, Grand Forks Herald, N.D.
Distributed by McClatchy-Tribune Business News.
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