National Radiologic Technology Week honors radiation therapy and medical imaging professionals..

How Radiation Therapy and Medical Imaging help shape cancer patient experience

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Every year in early November, the American Society of Radiologic Technologists (ASRT) celebrates National Radiologic Technology Week. It’s an opportunity to recognize the crucial role that medical imaging and radiation therapy professionals play in patient care and safety. The celebration takes place during the week of November 8, which is the day Wilhelm Conrad Roentgen discovered the x-ray in 1895.

The Radiologic Technologists (R.T.s) at Provision CARES Proton Therapy are an integral part of our team. They are educated in anatomy, patient positioning, examination techniques and radiation safety, allowing them to perform highly skilled and precise procedures. Most importantly, though, they are on the frontlines of caregiving during treatment. All of our R.T.s are passionate about Provision’s Culture of CARE, putting the patient’s comfort, safety and overall experience first.

To show our appreciation for the Radiologic Technology (Rad Tech) staff at Provision, we’re taking a closer look at the industry to which they’ve devoted their lives, and how their jobs help shape the cancer patient experience.

WHAT IS RADIOLOGIC TECHNOLOGY?

Following Roentgen’s discovery, the x-ray gained popularity as a way to diagnose and treat illness in the early 1900s. The x-ray machine remained the primary tool of medical imaging until the 1960s and 1970s, when newer procedures like computed tomography, mammography and sonography became commonplace in the healthcare industry1. The x-ray is also a traditional tool used for radiation therapy to treat cancer. In the 1950s, however, proton radiation therapy for cancer treatment was introduced. Since then, studies have shown proton therapy avoids unnecessary radiation to nearby healthy tissue and organs, reducing the risk of side effects2. There are now more than 30 proton therapy centers in the United States.

Modern Radiologic Technology covers two main areas – medical imaging and radiation therapy. According to the ASRT, there are several practices in which an R.T. can specialize, including general radiography, computed tomography (CT), mammography, magnetic resonance imaging (MRI), radiation therapy and others.

In the medical imaging field, an R.T. is responsible for making sure the patient is properly positioned for a quality diagnostic image. Rad Techs in medical imaging are typically specialists, like Radiographers, Mammographers, Sonographers, MRI techs or CT Techs.

A Radiologic Technologist may also choose the radiation therapy path. Radiation Therapy is the administration of targeted doses of radiation to a patient’s body to treat cancer or other diseases. In this case, an R.T. would be a member of the Radiation Oncology team and could work as a Medical Dosimetrist or Radiation Therapist.

RADIOLOGIC TECHNOLOGY AT PROVISION

Radiologic Technology is part of the patient experience from diagnosis all the way through treatment and the cancer care experts at Provision can help coordinate each step of the process. Of course, radiation therapy is at the heart of what we do – treating cancer with proton therapy – and we are proud of the work our Radiation Therapists do and the passion they show for everyone who walks through our doors. Along the course of your treatment, you may also meet MRI Techs, CT Techs, Medical Dosimetrists and other radiologic specialists.

Radiation Therapy team from Provision CARES Proton Therapy NashvilleAll of these Radiologic Technology roles are highly specialized and require quality education and experience. Most importantly, though, each of our R.T.s believes in Provision’s Culture of CARE. It is our mission to respect the dignity and value of every person by providing an environment of compassion, sensitivity and thoughtful consideration.

The Rad Tech staff at Provision is also dedicated to increasing awareness about the benefits of proton radiation therapy. In fact, the ASRT Foundation recently recognized Justin Pigg, Manager of Radiation Therapy at Provision CARES Proton Therapy Nashville, with its International Speakers Exchange Award for his efforts to promote the sharing of research, best practices and professional development in the radiologic sciences. As a recipient of this award, Pigg presented “Technical Aspects of Proton Therapy” at a Radiologic Technology conference in Nova Scotia.

THE BENEFITS OF PROTON RADIATION THERAPY

Proton therapy for cancer treatment has become a trusted method for precisely targeting tumors and reducing the risk of side effects. The advantage of proton therapy is distinct from traditional radiation therapy because the timing and dosage of proton energy can be specifically controlled. Since a proton beam can conform to a tumor’s shape and size, maximum beam energy is deposited directly into the tumor, decreasing the risk of damage to surrounding tissue and organs. Protons have unique characteristics that prevent radiation from traveling beyond the tumor. Contrastingly, traditional radiation therapy deposits energy from x-ray beams along the entire path of the beam. Radiation is absorbed from the time the beam enters the body until it exits on the other side of the tumor area.

Provision CARES Proton Therapy uses the most precise form of proton therapy, called pencil beam scanning. Pencil beam scanning provides even greater customization and precision in cancer treatment. Physicians use a proton beam only millimeters wide to target the tumor area with the highest radiation dose, while controlling both the depth and the position of the beam and planning the exact point at which the proton beam stops inside the body. This means there will be no exit dose, sparing even more healthy tissue and organs from unnecessary radiation.

Proton therapy is beneficial for treating patients with a localized tumor where cancer has not spread to other parts of the body, or in situations where tumors cannot be removed with surgery. It may also be an option if a patient requires radiation therapy in addition to surgery or chemotherapy. We encourage you to speak with one of cancer care experts to find out if proton therapy is right for you.

Ultimately, Provision CARES Proton Therapy is passionate about caring for anyone who is fighting cancer. In honor of National Radiologic Technology Week, thank you to all of our Rad Techs who help us live up to that mission.

 

Sources:

  1. American Society of Radiologic Technologists. History of the American Society of Radiologic Technologists. https://www.asrt.org/main/about-asrt/asrt-history
  2. Baumann BC, Mitra N, Harton JG, Xiao Y, Wojcieszynski AP, Gabriel PE, Zhong H, Geng H, Doucette A, Wei J, O’Dwyer PJ, Bekelman JE, Metz JM. Comparative effectiveness of proton therapy versus photon therapy as part of concurrent chemo-radiotherapy for locally advanced cancer. American Society of Clinical Oncology poster session. June 1, 2019.

 

Breast Cancer Awareness Month

Breast Cancer Facts: 5 Common Myths Debunked

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One of the toughest parts about researching breast cancer online is trying to sort fact from fiction. The internet is full of half-truths, conflicting reports and flat-out myths about the disease. Provision CARES Proton Therapy is committed to our Culture of CARE, putting the patient experience first. So, for Breast Cancer Awareness Month, we’re debunking five of our most commonly heard myths. All of these breast cancer facts have been verified for quality and accuracy by our cancer care experts to help you make an informed decision about your healthcare.


MYTH: I found a lump in my breast, so I have cancer.

TRUTH: Lumps don’t always indicate cancer. Likewise, the absence of lumps doesn’t always mean you don’t have breast cancer.

While the most common symptom of breast cancer is a lump, most breast lumps are caused by conditions other than cancer. According to the Centers for Disease Control and Prevention (CDC), the two most common causes are fibrocystic breast condition and cysts. Fibrocystic condition causes noncancerous changes in the breast that can make them lumpy, while cysts are small fluid-filled sacs that develop in the breast.

The American Cancer Society (ACS) says lumps are more likely to be cancerous if they are painless, hard and have irregular edges. However, some breast cancers can be painful, soft or round. That’s why you should always check with your doctor if you notice any changes in your breasts.

There are many other symptoms of breast cancer, even if a lump is not detected. These can include swelling of the breast, skin dimpling, breast or nipple pain, nipples turning inward, red or flaking breast skin, nipples discharging fluids other than breast milk, and swollen lymph nodes under your arm or around your collar bone. The ACS recommends contacting your doctor if you experience any of these symptoms.


MYTH: Breast cancer only happens to older women.

TRUTH: Breast cancer can develop in younger women, too, as well as men.

While your risk does increase with age, the NCI reports women in their 30s have a 1 in 208 chance of developing breast cancer. By the time a woman reaches her 40s, that risk has increased to 1 in 65. Overall, it’s estimated that 1 out of every 8 women in the United States will develop breast cancer at some point in her life.7

Breast cancer in men accounts for less than 1% of cases in the United States. However, the ACS says male breast cancer is on the rise.1 Unfortunately, a higher percentage of men are diagnosed with advanced-stage breast cancer, likely a result of less awareness and fewer early-detection screenings.

If you’ve been diagnosed with breast cancer and would like to learn more about proton therapy as a possible treatment, please visit our Proton Benefits page or contact a Care Coordinator.


MYTH: My family has no history of breast cancer, so I am not at risk.

TRUTH: While a family history of breast cancer does put you at greater risk, most women who develop breast cancer do not have a family history of the disease.1

According to the CDC, a family history of breast cancer may put you at higher risk for the disease, but is not indicative of whether you’ll actually develop cancer.2 In fact, the ACS says most women with one or more affected first-degree relatives (parents, siblings, children) will still never be diagnosed.

The CDC provides a table with examples of average, moderate and strong family health histories, along with suggestions for preventative measures each group can take. Regardless of your family history, the CDC recommends you get mammograms and other breast exams as recommended by your doctor, maintain a healthy weight and exercise regularly. As family history of breast cancer increases, genetic counseling becomes an option to test for hereditary breast cancer. Be sure to talk to your doctor about what screenings are best for you and when you should get them.


MYTH: A double mastectomy will eliminate my risk of breast cancer.

TRUTH: If the cancer is detected early enough, other treatment options can eliminate the cancer without removing the entire breast.

A mastectomy involves removing the entire breast and is typically performed when breast-conserving surgery (lumpectomy) is not an option. However, women with early-stage cancers can typically choose between the two types of surgeries. The ACS notes that while it’s normal for your gut reaction to be to “take out all the cancer as quickly as possible” with a mastectomy, the fact is that, most of the time, a lumpectomy combined with radiation therapy results in the same outcome.

Many patients at Provision CARES Proton Therapy choose to combine a lumpectomy with proton radiation therapy. Proton therapy for breast cancer treatment is non-invasive and painless, causing less cosmetic damage than conventional x-ray radiation. It is extremely precise and therefore more effective at targeting cancerous cells without causing damage to surrounding breast tissue. Because proton radiation has little to no impact on a patient’s energy level, quality of life during treatment is improved.

For women who do opt for a mastectomy, it’s important to remember that post-surgery treatment is still necessary. Even after removing the breast, there’s a small chance the cancer could recur on residual breast tissue or the chest wall. You should continue to perform self-breast exams and see your doctor on a regular basis.


MYTH: Antiperspirants and wire bras can cause breast cancer.

TRUTH: There has been no conclusive evidence linking antiperspirants or bras to breast cancer.

Rumors have swirled across the internet claiming underarm antiperspirants cause breast cancer. The National Cancer Institute (NCI) says the basis of these claims is the aluminum-based active ingredient in antiperspirants. Some scientists have suggested that absorbing these aluminum compounds into your skin could increase your risk factor for breast cancer.4 Still, no clear link has ever been established between antiperspirants and breast cancer. In fact, the NCI even cites a study from 2002 that concluded there is no increase in risk for breast cancer among women who reported using an underarm antiperspirant.3

Another rumor making its rounds across cyberspace is that wearing a wire bra can increase your risk of breast cancer. This myth was debunked by a 2014 study published by the American Association for Cancer Research. According to the authors, it had been suggested in the media that bras impede lymph circulation and drainage, interfering with the process of waste and toxin removal.6 However, the study concluded that wearing a bra had no effect on your risk of breast cancer.


Sources:

  1. Breast Cancer Facts & Figures 2017-2018. American Cancer Society. https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/breast-cancer-facts-and-figures/breast-cancer-facts-and-figures-2017-2018.pdf
  2. Breast and Ovarian Cancer and Family History Risk Categories. Centers for Disease Control and Prevention. https://www.cdc.gov/genomics/disease/breast_ovarian_cancer/risk_categories.htm
  3. National Cancer Institute. Antiperspirants/Deodorants and Breast Cancer. https://www.cancer.org/cancer/cancer-causes/antiperspirants-and-breast-cancer-risk.html
  4. Darbre PD. Aluminium, antiperspirants and breast cancer.Journal of Inorganic Biochemistry 2005; 99(9):1912–1919. [PubMed Abstract]
  5. Mirick DK, Davis S, Thomas DB. Antiperspirant use and the risk of breast cancer.Journal of the National Cancer Institute 2002; 94(20):1578–1580. [PubMed Abstract]
  6. RayCC. Q and A – Bras and Cancer [Internet]. NY times; 2010 [cited 2013 Dec. 16]. Available from: http://www.nytimes.com/2010/02/16/science/16qna.html?ref=science.
  7. Howlader N, Noone AM, Krapcho M, et al. (eds). SEER Cancer Statistics Review, 1975-2016, National Cancer Institute. Bethesda, MD,https://seer.cancer.gov/csr/1975_2016/, based on November 2018 SEER data submission, posted to the SEER web site, April 2019.

 

proton therapy for breast cancer treatment

Proton Therapy for breast cancer treatment ‘safe and effective’ concludes new study

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Proton therapy for breast cancer treatment is “safe and effective.” That’s the conclusion of a new study released in the Journal of Clinical Oncology, which highlighted proton therapy’s ability to control cancer cells with much less toxicity in the heart and lungs as compared to conventional (x-ray) radiation therapy.

“In our prospective trial of women with locally advanced breast cancer who required treatment of the internal mammary nodes, proton beam radiation therapy was safe and effective,” says Shannon M. MacDonald, MD, of Massachusetts General Hospital in Boston, and colleagues.

Breast cancer tumors usually occur in the lobules and ducts of the breast, which are used in the production and delivery of breast milk. Breast cancer is the most common cancer among women aside from skin cancer. Men are also susceptible to breast cancer, although the disease is rare among males.

As with other cancers, the best possible outcomes for breast cancer treatment come through early breast cancer care. Proton therapy has unique attributes that reduce radiation exposure to normal, healthy organs3,4. This is especially important in left-sided, node positive breast cancer patients (those who need the internal mammary nodes irradiated), as the cancer is close to critical organs such as the heart and the lungs.

How Massachusetts General Hospital conducted the study

Researchers enrolled 70 prospective patients with nonmetastatic breast cancer who required radiation therapy to the chest wall and regional lymph nodes. The average age of enrollees was 45, with patients ranging from 24 to 70 years old. The vast majority (91%) of evaluable patients had left-side breast cancer, and all but four patients had stage II-III disease. Only one patient did not receive chemotherapy in conjunction with proton radiation therapy.

The study, which lasted from 2011 to 2016, specifically chose patients whose treatment would include irradiation of the internal mammary nodes (IMNs). This made them suboptimal candidates for conventional radiation therapy, since exposure to the IMNs would also increase radiation to the heart and lungs. According to the study’s authors, that has been associated with an increased risk of cardiac events.

The benefits of proton therapy, however, significantly reduce exposure to the heart and lungs. It’s an advanced form of radiation therapy that precisely targets a tumor using a single beam of high-energy protons to kill cancer cells. Unlike conventional photons, which have almost no mass and extend beyond a tumor through the body, protons are relatively heavy and will hit their target – then stop. This spares nearby healthy tissues and organs from receiving unnecessary radiation.

Summary of the study’s results

Proton therapy for breast cancer treatment received high marks from this study. Of the 69 evaluable patients, the 5-year cancer recurrence rate was just 1.5% and the 5-year overall survival rate was 91%. Those positive results go hand-in-hand with low rates of severe side effects. Study authors reported no patient developed grade 3 pneumonitis (inflammation of the lungs) or grade 4 or higher toxicity in the lungs. They also reported no significant changes in cardiac function or key cardiac biomarkers.

Dr. MacDonald and colleagues concluded that “Proton beam radiation therapy (RT) for breast cancer has low toxicity rates and similar rates of disease control compared with historical data of conventional RT.”

Dr. Ben Wilkinson, MD, FACRO, Radiation Oncologist and Medical Director at Provision CARES Proton Therapy Knoxville says the findings of this study support the success he’s seen at Provision.

“Among mostly young women with left-sided breast cancer receiving regional nodal irradiation, proton therapy produces excellent target coverage with miniscule cardiac doses and low rates of lung toxicity,” Dr. Wilkinson says about the study’s conclusion. “When we treat breast cancer, those lymph nodes run very close to the heart. Proton therapy allows us to deliver the dose to the tumor site and spare the surrounding area – the heart, lung, chest wall, and even the esophagus.”

What’s next for proton therapy research?

The authors of the study from Massachusetts General Hospital say their findings open the door for more extensive studies in the future. “No early cardiac changes were observed,” they note, “Which paves the way for randomized studies to compare proton beam radiation therapy with standard radiation therapy.”

In fact, the results of the study bode well for a more comprehensive trial already underway to compare proton therapy with conventional x-ray therapy. The Radiotherapy Comparative Effectiveness (RADCOMP) Consortium Trial, which began in 2016 and will continue until at least 2022, is being conducted by the University of Pennsylvania, in conjunction with the Patient-Centered Outcomes Research Institute.

According to the U.S. National Library of Medicine, it is a pragmatic randomized clinical trial of patients with locally advanced breast cancer. More than 1,000 patients will be randomly assigned to receive either proton therapy or x-ray therapy. Each patient will have a 50-50 chance of getting into either treatment group. Both groups will be followed for at least 10 years after completing radiation therapy. The trial’s ultimate goal to is to study the patients’ quality of life outcome to help decide which is the best treatment option for future patients with breast cancer – proton therapy or x-ray therapy.

The Benefits of Proton Therapy for Breast Cancer Treatment

Proton therapy shows remarkable promise and advantages over conventional therapy in the treatment of breast cancer. It is a type of radiation that stops at a very specific point in the targeted tissue; conventional radiation continues beyond the tumor. In breast cancer, this means on average no radiation to the heart and on average 50% less radiation to the lung5 as compared with conventional radiation.

Proton therapy is extremely precise and therefore more effective at targeting cancerous cells without causing damage to surrounding breast tissue. It is not a substitute for a lumpectomy. Rather, it is used as an alternative to conventional radiation therapy. After surgery a breast cancer patient may receive 2-6 weeks of proton therapy.

Sources:

  1. Phase II Study of Proton Beam Radiation Therapy for Patients with Breast Cancer Requiring Nodal Irradiation. Journal of Medical Oncology
  2. Pragmatic Randomized Trial of Proton vs. Photon Therapy for Patients with Non-Metastatic Breast Cancer: A Radiotherapy Comparative Effectiveness (RADCOMP) Consortium Trial. ClinicalTrials.gov
  3. MacDonald S, Specht M, Isakoff S, et al. Prospective pilot study of proton radiation therapy for invasive carcinoma of the breast following mastectomy in patients with unfavorable anatomy – first reported clinical experience. Int J Radiat Oncol. 2012;84(Suppl 3):S113-S114. Abstract 281
  4. Moon SH, Shin KH, Kim TH, et al. Dosimetric comparison of four different external beam partial breast irradiation techniques: three-dimensional conformal radiotherapy, intensity-modulated radiotherapy, helical tomotherapy, and proton beam therapy. Radiother Oncol. 2009;90:66-73.
  5. Early Toxicity in Patients Treated with Postoperative Proton Therapy for Locally Advanced Breast Cancer. U.S. National Library of Medicine, National Institutes of Health

 

Experts Agree: Proton Therapy is an Excellent Choice for Treating Pediatric Cancers

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The American Society for Radiation Oncology (ASTRO), the world’s premier organization in Radiation Oncology, states that “solid tumors in children are considered among the highest priority for proton therapy”in its Model Policy.  Based on this prioritization, a group of 24 internationally recognized leaders in the various specialties in oncology, convened in 2015 to define proton therapy’s role in pediatric cancers, identify which cases yield the most benefit from a limited resource, and set priorities for future development in the field.

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Provision CARES Proton Therapy Knoxville Welcomes Radiation Oncologist Dr. Lavey

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Ben Wilkinson, MD, Medical Director of Provision CARES Proton Therapy Knoxville welcomes Robert S. Lavey, M.D., M.P.H. to the Provision CARES team.

Dr. Lavey has been board-certified in Radiation Oncology since 1988.  He graduated magna cum laude from Harvard University and earned his Doctorate in Medicine from Stanford University. He completed his residency in radiation oncology at Duke University and was awarded National Institutes of Health Postdoctoral Fellowships in the Stanford University Department of Medicine and the University of California, Berkeley School of Public Health.

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15th Annual Eddie Check Event

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Free PSA Test and Blood Drive at Provision CARES Proton Therapy Knoxville September 13th and 14th!

Eddie Check is celebrating its 15th anniversary of offering men across East Tennessee a free PSA test and raising awareness for prostate cancer. On September 13th and 14th, you are invited to get a free screening test for prostate cancer as well participate in a blood drive. (more…)

Provision Receives Positive Recognition in National Oncology Journal

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Clinical trials have a vital role in the advancement of medicine. Physicians rely on sound clinical evidence which meets strict scientific standards, along with their personal experience and knowledge of the patient, to guide treatment decisions. Medical societies and insurance companies also use the results of studies to create treatment and coverage guidelines.

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Educational and Cognitive Late Effects of Cancer Survivors

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By Marriah M. LCSW, Medical Social Worker at Provision CARES Proton Therapy, Knoxville

Cognitive health is just as important as physical health, especially following cancer treatment. Depending on your diagnosis you may have had chemotherapy or radiation, both of which may affect memory, concentration, or the ability to perform well in school or at work.  These side effects may last for a short time or they may persist for many years following treatment.  Additionally, it is important to know that you may not notice signs of side effects from your treatment until a while after treatment has ended. Side effects which occur a few months or even years after treatment are called late effects.

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