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Albuquerque Journal

HEALING, WITH PRECISION High-tech options are less invasive

 
By Rick Nathanson/Journal Staff Writer
 

 Jill Baron was on the road to recovery after being treated for breast cancer when she learned in October that she had extranodal lymphoma, a type of cancer that starts in tissue rather than in a lymph node.

 After a series of diagnostic tests, Baron, 45, was referred into Lovelace Medical Center’s Cancer Care Program, where she began treatment on their new TomoHD linear accelerator.

 Tom Hoff had surgery eight years ago for a tumor on his kidney. It was successfully removed; this past summer he learned that he had another tumor, this time in his brain.

 In August, Hoff, 73, was treated with a single session on the new Perfexion Gamma Knife machine at Lovelace. He will return early this year for a follow-up visit, but doctors have told him they believe the tumor is gone.

 Lovelace has dramatically improved treatment options and outcomes for people with some types of cancers, thanks to an $11 million investment in three new high-tech pieces of medical equipment installed within the last nine months.

 “These machines can deliver higher doses of radiation very precisely, spare normal surrounding tissue from being radiated and render the cancer cell dead or incapable of growing,” says Dr. Paul Anthony, medical director of the Department of Radiation Oncology at Lovelace Medical Center.

 Consequently, he says, patients being treated with these machines experience less severe side effects.

 Other major medical centers in Albuquerque have their own high-tech treatments for cancer patients.

 The three Lovelace machines are the TomoHD and the Varian 21iX, both linear accelerators, and the Perfexion Gamma Knife machine, all of which perform stereotactic body radiosurgery, which is essentially surgery without a scalpel for patients whose cancers are generally not amenable to more invasive surgery. 

 The TomoHD (Helical Direct) machine has a round opening around which a pencil-like beam of radiation travels in a circular fashion. The patient lies on a moveable table that passes through the opening, where the patient is scanned, tumors are imaged and radiation is delivered in a pulse-like sequence.

 “It can be used for just about any kind of cancer, but the ones with the best rate for reducing complications is lung, prostate and head and neck cancers,” says Anthony.

 The Varian 21iX is a “step and shoot” radiation machine with a gantry or armature that rotates around the stationary patient. It’s used more for surface cancers, like breast and skin cancers, he says.

 The machine also has a “gating” feature that is useful in treating cancers in the abdomen and chest, such as lung cancer. “If you’re breathing heavily, then the cancerous tissue is moving up and down in the body and it’s more difficult to hit with the beam,” Anthony says.

 The gating feature allows real time tracking of the tumor as it shifts position with respiration. “The beams of radiation turn off when the tumor isn’t in the precise location, and turn back on when it is.”

 The TomoHD and Varian 21iX can cut the time of treatment from three to eight weeks for a normal course of radiation, to as little as five sessions done over five consecutive days, depending on the size and location of the tumor as well as other factors.

 The Perfexion Gamma Knife is the latest generation of gamma knife machines, and one of only about 50 in the world, Anthony says. The Perfexion is used primarily on brain tumors where surgical excision is not practical. The cure rate is very high for cancers that originate in the brain and have not metastasized from other parts of the body, he says. It can also be used for tumors in the cervical spine and neck.

 A frame is attached to the patient’s head and then anchored to a table. The Perfexion machine images the tumor and then uses the power of 192 beams of radiation focused on a single point. The focal point changes until the entire tumor has been targeted.

 The Perfexion machine can address multiple brain tumors in one treatment in as little as two hours, sparing patients from whole brain radiation that requires three weeks of daily treatments and can result in a loss of brain function.

 Hoff says doctors told him his brain tumor, above his left eye and about as big as a thumbnail, could have been surgically removed. Instead, they suggested using the Perfexion Gamma Knife machine “because it would be a lot less traumatic and easier than cutting.”

 Preparation took more time than the procedure. “I was only in the machine for 30 or 40 minutes,” he says.

 “My wife’s cousin had something similar in a different part of the brain 20 years ago and they had to cut the skull open and go in and surgically take it out. Compared to that, this is a snap.”

 Baron, whose previous breast cancer was treated with surgery, says her lymphoma diagnosis did not lend itself to the same invasive approach.

 “I knew there was new technology out there, but I really had no idea that this machine was here and how effective it would be,” she says. “I go every day for 20 days. I’m in the machine for about 15 minutes, but most of that time is setup. The radiation is delivered in about two minutes.”

 Among the side effects from her treatment were feeling tired, having a sore throat and temporary changes in the way things taste. “Now even water tastes salty to me, which is minor compared to the benefit,” she says.

 “It’s definitely been a good experience, which sounds insane when you’re talking about cancer, but I think the more people know about treatments out there, the less afraid they will be. It’s not all unicorns, glitter and butterflies, but neither is it doom and gloom. It’s a very hopeful process.”

Jill Baron, left, speaks to radiation therapist Sandra Candelaria following her treatment on the TomoHD machine at the Lovelace Radiology and Oncology Building. The light display on the ceiling is meant to have a calming effect on patients undergoing treatment.

 

A radiation therapist preps Jill Baron for the 18th of 20 sessions she is undergoing in Lovelace’s TomoHD linear accelerator for treatment for extranodal lymphoma.
 
 Tom Hoff’s non-cancerous brain tumor was treated with the latest generation of Perfexion Gamma Knife machine.
 

 Source: Albuquerque Journal

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