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Provision CARES Proton Therapy - Knoxville Archives - Provision Healthcare

Provision Healthcare Introduces a Major Advancement in the Care of Cancer Patients and Treats First Patients at the Provision CARES Cancer Center Using ProNova’s Innovative Proton Therapy System

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Provision Healthcare, an industry leading innovator in comprehensive, collaborative cancer solutions, is pleased to announce successfully treating the first patients on Provision’s newly developed ProNova SC360 proton therapy system at the Provision CARES Cancer Center in Knoxville, Tennessee.  Read More

Letter to the Editor – Knoxville Lucky to have Proton Therapy

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Letter to the Editor
June 16, 2015

Knoxville lucky to have proton therapy

The Provision Center for Proton Therapy at Dowell Springs off Middlebrook Pike is a feather in our collective cap. We should be aware of what an honor it is to have one of the 14 such centers operating in the nation. I understand that St. Jude Children’s Research Hospital is changing to proton therapy for its patients. In this day of Internet research, we can easily educate ourselves and be our own advocates when faced with decisions about treatment. In our case, proton treatment for a tumor was met with some resistance, but we persisted. We are fortunate that we did.

Our family physician recommended we obtain a second opinion from the radiation oncologists at Provision. Knoxville’s proton therapy center was not ready, so we traveled to the MD Anderson Cancer Center in Houston. Our experience was gratifying and successful. Two and a half months of pinpoint radiation in small, daily doses produced no rash, no burns and no discomfort. The tumor was dissolved. We observed the same comfort level in the hundreds of patients we came to know. We are hopeful that legislation before the Tennessee House will be approved so insurance companies will be mandated to help with proton therapy. It is a shame that our neighboring states already have such mandates and we do not. It is helpful to know that the centers will provide help with travel plans, financial issues and housing. I personally have nothing to gain from promoting our local facility. There is just a warm place in my heart because our community was chosen for this type of treatment.

Mary Helen Jost,
Knoxville.

Provision Center for Proton Therapy Treats 1,000th Patient

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Provision Center for Proton Therapy Treats 1,000th Patient

Knoxville, TN (June 7, 2016)—

Today, 1,000 patients have graduated from the Provision Center for Proton Therapy, completing their course of proton therapy as part of their journey to defeating cancer. The 1000th patient marks an important milestone in the proton center’s development into a critical component of the comprehensive cancer campus at Dowell Springs and as a community resource in East Tennessee. Read More

Provision medical director speaks at ASTRO on benefits of SpaceOAR gel product

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Knoxville, TN (Oct. 19, 2015)—ASTRO Booth #250—Marcio Fagundes, M.D., medical director ofProvision Center for Proton Therapy, will speak today in San Antonio, Texas, at the 57th annual meeting of the American Society for Radiation Oncology (ASTRO) on the results of using a product that helps protect prostate cancer patients from radiation exposure.

Six months after being the first proton therapy center to use SpaceOAR, more than 100 Provision patients have received the spacer, which fills the gap between the prostate and rectal wall, protecting the rectum from any minimal radiation exposure that may be incurred during treatment.

The injection replaces the familiar balloon once inserted into the rectum of men before being treated for prostate cancer. The one-time gel injection prevents irritation and injury that can occur with the daily balloon placement in addition to preventing longer-term impacts of treatment such as prostatitis. Following treatment, the gel simply is absorbed into the body and discharged in the patient’s urine.

Manufactured by Augmenix, Inc., SpaceOAR is the first product in the United States FDA-approved to protect the rectum in men undergoing prostate cancer radiotherapy. Provision Center for Proton Therapy began using SpaceOAR just a week after FDA approval. Provision now serves as a training center where the product manufacturer, Augmenix, brings physicians from other centers to learn the injection technique.

“We were the first center, and I was the first physician to be certified to use SpaceOAR in external beam therapy, once the product was released by the FDA” said Fagundes, a board certified radiation oncologist. “We were a pioneer in introducing this and it has proven to be highly effective for our patients.”

Seventy-year-old Frank Potts from Columbia, SC, the 100th patient to receive the spacer, said he was pleased Provision is using the hydrogel in lieu of the daily balloon procedure.

“I’m really, really pleased with the spacer,” Potts said. “I’ve had no discomfort, no problems. And to the extent that it’s a medical improvement over the balloon, I can’t imagine not doing it.”

About Provision Center for Proton Therapy

Provision Center for Proton Therapy is the first cancer treatment center of its kind in Tennessee and only the third in the Southeastern United States. Open to all credentialed physicians and health systems in the region, the Provision Center for Proton Therapy has three treatment rooms and is able to treat up to 900 cancer patients annually. The center utilizes intensity modulated pencil beam scanning, the most accurate proton beam therapy in the world. This advanced cancer treatment capability is available in only a handful of cities. Provision Center for Proton Therapy is one of only 17 proton therapy centers in the nation and 50 in the world.

Provision and RaySearch partner on RayStation proton therapy training

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KNOXVILLE, Tenn. (Oct. 18, 2015)—ASTRO Booth #250—Provision Healthcare is partnering with leading treatment planning software developer, RaySearch Laboratories AB, to offer new user education at the Provison Center for Proton Therapy’s state-of-the-art treatment and training facilities.

Provision was the first proton therapy center to adopt the company’s system, called RayStation, and has worked collaboratively with RaySearch since the launch of the Provision Center for Proton Therapy in January 2014.

“Over the past nearly two years, we have put RayStation through its paces, and we are pleased with the results. The physicists and medical dosimetrists who come for training will have a chance to learn from our clinical staff and see RayStation in action at a working medical center,” said Niek Schreuder, chief medical physicist for Provision Center for Proton Therapy. “Our world-class proton therapy facility plus a modern, fully-equipped training center will provide both classroom and hands-on instruction for the staff who will be working with patients and physicians in treatment planning.”

Trainers from Provision and RaySearch will conduct five-day training sessions, starting in January 2016, in both basic and advanced proton therapy planning.

“Although RaySearch provides planning training for our customers in our training center in New York, having a clinical site that can provide the entire spectrum of knowledge and experience is very valuable – especially a site like Provision that has been so successful in their implementation,” said Marc Mlyn, President of RaySearch Americas, the American subsidiary of RaySearch Laboratories AB. “We are pleased to partner with the Knoxville team to offer such a high level of training.”

Because proton therapy is applied so precisely to a tumor, careful planning is essential to ensure the protons hit their target and to minimize damage of non-cancerous surrounding tissue. RayStation allows for detailed planning, while accounting for potential changes and needed adjustments over the weeks a patient undergoes treatment. Provision has experience in treating a range of tumor types and disease sites and will provide instruction in patient data management, patient modeling, planning and optimization, automated planning techniques and adaptive planning.

About Provision Healthcare
Provision Healthcare is a comprehensive healthcare group in the United States integrating clinical services, R&D, manufacturing, investment and a charitable foundation. With an emphasis in cancer, Provision Healthcare is committed to providing cutting edge treatment, early detection and personalized care for cancer patients around the world.

About Provision Center for Proton Therapy
Provision Center for Proton Therapy is the first cancer treatment center of its kind in Tennessee and only the third in the Southeastern United States. Open to all credentialed physicians and health systems in the region, the Provision Center for Proton Therapy has three treatment rooms and is able to treat up to 900 cancer patients annually. The center utilizes intensity modulated pencil beam scanning, the most accurate proton beam therapy in the world. This advanced cancer treatment capability is available in only a handful of cities. Provision Center for Proton Therapy is one of only 17 proton therapy centers in the nation and 50 in the world.

About RaySearch

RaySearch Laboratories AB (publ) is a medical technology company that develops advanced software solutions for improved radiation therapy of cancer. RaySearch markets the RayStation® treatment planning system to clinics all over the world. In addition, RaySearch’s products are distributed through licensing agreements with leading medical technology companies. RaySearch’s software solutions are used by over 2,500 clinics in more than 65 countries. RaySearch was founded in 2000 as a spin-off from Karolinska Institutet in Stockholm and the company is listed in the Small Cap segment on NASDAQ OMX Stockholm.

Eddie Check aims to honor a dad and save lives

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Kevin Kirkland was a high school senior on the football practice field when he learned his father, Eddie, had been diagnosed with late-stage prostate cancer. Four years later, his dad died from the disease. Kirkland doesn’t want anyone else to go through that experience.

Eddie Kirkland’s diagnosis was particularly difficult for Kevin because his mother had died a year before from breast cancer. Breast cancer was just gaining the public’s attention, while prostate cancer lurked in the shadows.

“Back in 1972, you didn’t hear people talk about prostate health, you didn’t hear people talk about PSA tests because there were no PSA tests,” he says. “I always said one day I wanted to do something that impacted men’s health like breast cancer awareness has impacted women’s health.”

More than 30 years later, Eddie Check was born. The program pairs free PSA tests for men with a Medic blood drive. The fi rst event in 2004 had one Medic bus and did 50 PSA tests and collected 50 units of blood. At its beginnings, the initiative was called the Eddie Kirkland Memorial Blood Drive and Free PSA Testing Event Radio talk show host Phil Williams said ‘come get your Eddie Check’ on the air one year and the name stuck. The event is coordinated by Nisus Corp., where Kirkland now serves as president and CEO.

A year later, there was a second event, expanded to a second location. This year, there will be Eddie Check drives in 10 locations throughout eight East Tennessee counties. The initiative involves live radio shows on location with partners including News Talk 98.7, WIVK and WNML and an annual blood drive contest with football fans at the University of Florida. Last year, the program collected 1,200 units of blood with more than 1,000 PSA tests conducted.

“All of a sudden it really started gaining its own strength and its own personality,” Kirkland says. “We’ve had tremendous support from the hospital community over the years. And then when Provision Center for Proton Therapy opened, they became our medical sponsor, and they’ve been an absolutely wonderful advocate and partner. And the Provision CARES Foundation now pays for all of the PSA tests.”

The event allows men, many of whom are hesitant to set up an annual physical exam, to get the PSA test for free while also performing a community service.

“Men don’t really like to go to the doctor, let’s just face it, they don’t,” Kirkland says. “With Eddie Check they can just stop by and get a free PSA test.”

For Kevin Wathen of Maryville, getting a PSA test through Eddie Check revealed what a recent trip to his doctor had not: an elevated PSA level. A follow-up biopsy with a urologist revealed that nine of the 12 samples tested positive for cancer.

“There were no symptoms to tell me there was a problem,” Wathen says. “If I hadn’t had the test done I wouldn’t have given it any thought.”

As a result of Eddie Check, Wathen learned of his diagnosis and became an early patient at Provision Center for Proton Therapy. There, his prostate cancer was treated with protons, a type of radiation that pinpoints a tumor and spares much of the healthy tissue around it. This reduces side effects such as incontinence and impotency as well as discomfort during the time of treatment. Wathen was one of the fi rst to receive hypofractionated proton therapy treatments at the center, a shortened, more intense course that allows therapy duration to be cut in half.

“It still doesn’t feel like I ever had cancer,” he says.

Wathen says he would recommend men of all ages taking advantage of the free annual PSA test, at least to establish a baseline for further testing.

“Especially with Eddie Check being available at no charge,” Wathen says. “I’d do it every year.”

As Eddie Check has grown and expanded, Kirkland says more men locally are becoming familiar with the risk of prostate cancer and how to keep tabs on their health. After 11 years of the Eddie Check program, men often approach him to discuss early detection.

“I think the education and the promotion we put out for prostate health have really resonated,” he says, adding that other programs coordinated by local hospitals and advocacy organizations have provided a boost to the most common of men’s cancers. “I think all of that has really improved education on prostate health. It has made us proud to be a small part of that.”

Lenoir City single mother fundraising after insurance won’t pay for proton therapy cancer treatment

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LENOIR CITY (WATE) – A single mother with four kids says she is at a crossroads after her insurance provider refused to cover her treatment.

Marla Cortez, 42, has an aggressive form of breast cancer, located right next to her heart and lung. Her oncology team prescribed proton radiation therapy, but unfortunately her insurance won’t cover the treatment. Cortez said she has appealed Aetna Insurance four times, but her only recourse is to pay $75,000 out of pocket.

“It’s very frustrating. You talk to everyone and they say tell you this is what you need. Then this insurance company, this big conglomerate, says no you don’t need it,” Marla said.

In March, a state Senate committee refused to act on a bill that would require health insurance companies to cover proton therapy treatment for cancer at the same levels it covers other radiation therapies. Knoxville’s Provision Center for Proton Therapy was behind the bill, but the insurance industry lobbied against the bill. That decision has left Cortez with very few options.

“We’ve been in this battle for a while even though proton therapy has been around for a long time. It’s probably more political than the technology itself,” explained Bill Hansen with the Provision Center for Proton Therapy, about how patients like Marla struggle to get covered by insurance providers.

“What we tend to see is that we treat a lot of children and older adults because Medicare covers it. So it’s been the people in the middle being denied this treatment,” he added.

The Lenoir City community has come together to help the single-mother raise money for treatment. Di’lishi, a new yogurt bar in Lenoir City created “Marvelous Marla Monday.” On Monday proceeds from yogurt purchased will benefit Cortez.

A friend of Cortez has also set up a GoFundMe page. The page has already received over $7,000 in donations.

“This is pretty overwhelming,” Marla said, about the community support.

Hansen says they’re pushing another bill in 2016 that would cover proton therapy for cancer patients.

Kentucky Family Seeks Out Proton Therapy in Knoxville

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Bearden Shopper News

August 5, 2015

As with all of her children, it was when Linda Ferrell saw the first image of her tiny daughter that it felt like she was really hers. That initial connection came not through a sonogram but a photograph of her fourth child, Emma, who made her entrance into the family from China a few months later.

“The picture is what’s pretty amazing,” says Linda Ferrell. “It was love at first sight.” Fifteen-month-old Emma joined a seven-year-old sister, also from China, plus two older brothers, Linda and husband David’s biological children, to complete the family. And life was good as Emma excelled in school, played softball, grew up.

Then in the spring of 2014 she got sick. There were headaches. She lost her voice. She lost 10 percent of her body weight. Her pediatrician kept insisting it was a virus. “That went on almost a month,” Linda says. When Emma was finally admitted to the hospital, an MRI showed a brain tumor encasing her entire left ventricle and making its way toward the right.

“You immediately think of the future — a future possibly without her,” Linda says. “But that is so brief. We’re a family that wants to find solutions, and we’re not going to waste our time crying. We’re going to find out how to help her. She didn’t deserve anything less than that.” Emma’s doctors didn’t mention proton therapy, but Linda did her research online and discovered it as a treatment option particularly ideal for pediatric patients. Unlike conventional radiation, protons deposit their energy directly at a tumor target, sparing much of the surrounding, healthy tissue — especially important for a growing, developing brain. Originally planning to travel to Seattle from Kentucky, she called Provision Proton Therapy Center and spoke with Dr. Matt Ladra about Emma’s tumor, which she describes as “relatively rare and very aggressive. One of the biggest reasons we chose Provision is that Dr. Ladra really did his due diligence,” Ferrell says. “He spent a lot of time talking to experts who knew about Emma’s cancer.” He concluded she was a candidate for proton therapy.

First, there was surgery — which removed a “good portion” of the tumor. Six rounds of chemotherapy, followed with a subsequent highdose round in an attempt to further reduce the cancer cells remaining in her body. Then there was a stem cell transplant to boost recovery of her white blood cells. After this physical onslaught, including months spent in and out of the hospital, Emma and her Mom made the five-hour journey to Knoxville where they stayed for seven weeks of proton therapy treatment at Provision Proton Therapy Center. Treatment at Provision provided welcome relief. Emma responded well to proton therapy, experienced only minor fatigue and retained a good appetite most of the time, gaining weight she had lost during chemo.

“It was pretty wonderful,” Linda says. “Emma’s been through quite a bit over the last year. With the treatment at Provision, it was pretty easy. I’m a huge advocate for proton therapy.” The Hospitality Department at Provision helped the Ferrells arrange their travel plans, suggested activities around town such as the Knoxville Zoo, and was there for them every step of the way during their stay in Knoxville. “The guidance that we received from everyone at Provision made the hardship of being away from home a little bit easier,” said Linda.

The road to recovery is not over yet. Emma still struggles with her appetite. This year she goes back to school, a process Linda knows will be challenging as she battles the lingering effects of chemo and a year practically lost because of her illness. But she has endured amazingly so far. “She’s stoic, she’s stubborn, and that’s really what got her through it,” Linda says. Unselfconscious over her scar and hair loss, through the surgery, chemo and physical challenges, ‘she never shed a tear,’ she says. The experience has brought the family closer, especially Emma and her older sister, Sarah, now 19 and a junior pre-med student. Since Emma got sick, Linda says, Sarah has decided to specialize in pediatric cancer.

With a diagnosis like Emma’s, “your whole life changes,” says Linda. “It doesn’t end once you’re treated. We don’t know what the future’s going to bring. “But we’re so thankful to have her.”

Provision center perfect destination for doctor and his young patients

When Matt Ladra learned of the opportunity to practice radiation oncology at Provision Healthcare in Knoxville, Tenn., he was a bit skeptical. “I had been thinking about California,” his home state, Ladra said. But the avid outdoorsman, who’d never visited East Tennessee, didn’t realize how well it would suit him — both personally and professionally. “Provision is a pretty unique model for proton centers,” says Ladra, who came from a Pediatric Proton fellowship at Massachusetts General Hospital/Harvard Medical School. His experience also includes a master’s degree in public health and a research fellowship with St. Jude Children’s Research Hospital at a project in Rabat, Morocco. In 2005 he received the Arnold P. Gold Humanism in Medicine Award at Tulane School of Medicine for students who embody ideas and attitudes lending to humanism in medicine. Provision’s innovative approach to cancer care appealed to Ladra, whose experience includes a number of articles in peer-reviewed medical journals, particularly focusing on pediatric cancers. Proton therapy is recognized as a uniquely ideal alternative to conventional radiation for pediatric cancer, in which the goal is to spare as much of the child’s growing, developing body as possible from damage caused by the treatment. Protons, unlike x-rays, can be specifically targeted to a tumor, resulting in no exit dose of radiation to the patient and a reduction of the impact on healthy surrounding tissues and organs.

Ladra works with a patient’s primary care physician and pertinent specialists to obtain records and learn about the case. Then he takes time with each patient and his or her family to determine the best route of treatment. Ladra was the leading radiation oncologist in the care of Ehkam Dhanjal, a pediatric patient who traveled from England to Knoxville for proton therapy treatment of his brain tumor. In Dhanjal’s case, the consultation was done via Skype to limit the amount of travel time required for his family.

“We walked around the center with the computer so they could see everything,” Ladra says.

For pediatric patients in particular, Provision works closely with partner health care providers to ensure that all of their needs are met. Pediatric endocrinologists, medical oncologists, nephrologists and anesthesiologists are among those who become involved in children’s care.

“There’s a much more multi-disciplined approach with pediatric cases,” he says. Depending on the rarity of the cancer, he will consult with experts across the country to determine the best course of treatment for a particular patient. And, as it turned out, Ladra found Tennessee a pretty nice place to live, too. He enjoys weekends hiking and fly-fishing in the nearby Smoky Mountains, as well as the life-style of Knoxville’s vibrant downtown. He says patients appreciate Knoxville as an ideal place to come for treatment. For out-of-towners, it is easy to navigate and offers many options for recreation and relaxation when patients aren’t in treatment. When they are, he says, the ambience and friendliness of a smaller health care cam pus helps patients and their families feel at home. “Everyone makes them feel like they’re part of our family,” he says. “You can’t beat that.”
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Provision’s proton center treats 500th patient

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By Carly Harrington | Knoxville News Sentinel
4:00 PM, Jul 9, 2015

When Lou Lovingood, a 63-year-old grandmother from Sweetwater, was diagnosed with breast cancer earlier this year, she didn’t shed a tear.

Those came, she said, after receiving the first letter from her insurance company denying coverage for proton therapy, a type of radiation treatment that targets a specific location while minimizing damage to surrounding tissue and organs.

“It was the first time I had cried after all of this, after I got my first denial,” said Lovingood, who has now been denied twice and is appealing to her insurer again.

Lovington had lumpectomies in both breasts after her diagnosis, and completed her 33rd and final proton treatment Thursday at the Provision Center for Proton Therapy. She was the center’s 500th patient, and used the spotlight during a special celebration to share her insurance story.

“My diagnosis today could be yours tomorrow,” she said. “We want the best level of care for everybody. If there is something better that’s out there, we should have the right to it. We have to stand up and use our voice to say, ‘You can’t treat us this way.’”

Lovingood, co-owner of Sweetwater Insurance Agency, used savings put up for retirement to pay for the treatment. Others, she said, may not be so fortunate.

For the past two years, Provision has unsuccessfully prodded the state Legislature to get involved in getting proton therapy covered. The most recent bill called for proton to be covered by insurers at the same levels it covers other radiation therapies.

Insurers have argued that the more-expensive treatment isn’t cost effective and is not necessarily better than traditional radiation therapies.

Provision opened in January 2014 and is treating about 80 patients a day with proton therapy. More than 44 different cancers in various locations have been treated.

It also now has pencil beam scanning in all three of its treatment rooms, giving physicians more-precise capability, said Bill Hansen, vice president of business and strategic development at Provision Health Partners.

Looking ahead, Provision plans to continue to expand into different disease sites and offer more trials with some other newer treatment techniques.

Lovingood, for example, is the first person the center has treated for bilateral breast cancer.

“We’re trying to treat as much cancer as we can as noninvasive as possible,” Hansen said. “More time and energy is going to be spent in early detection, free screenings and finding programs that can match up.”