Delaying cancer screening tests during COVID puts patients at risk

Delayed Cancer Screenings in COVID-19 Era Put Patients at Risk

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When the COVID-19 pandemic began, life as we knew it came to an abrupt halt. That included routine healthcare visits, as many providers postponed appointments and cancer screening tests that were deemed “non-essential.”

In the United States alone, an estimated 22 million cancer screening tests were disrupted by COVID-19 from April to June 2020. As a result, about 80,000 patients could be at risk for delayed or missed diagnoses.

The IQVIA Institute for Human Data Science recently published these estimates as part of its report on shifts in healthcare demand, delivery and care during the COVID-19 era. In this article, we’ll look at how diagnostic procedures for some of the most common cancers are impacted. We’ll also share some tips to help you move forward with your cancer-related care in a timely and safe manner.

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Sarcoma Awareness Month is in July

Sarcoma Awareness Month: Shining Light on the ‘Forgotten Cancer’

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When you mention the word “cancer,” most people think of more common cancers like breast, lung and prostate cancer. However, July is designated as Sarcoma Awareness Month. It’s an opportunity to help raise awareness about a disease that’s often considered the “forgotten cancer.”

Sarcoma is a cancer of the body’s connective tissues. It begins in bone or soft tissues like fat, cartilage or muscle, and can affect both children and adults. Sarcoma Awareness Month raises awareness of a disease that’s relatively rare. This helps advocacy groups, who are often hindered by the fact that many people don’t even know this type of cancer exists. The public’s lack of awareness and understanding of sarcoma makes it much more challenging to secure funding for research and treatment development.

In this article, we’ll help you develop a better understanding of what sarcoma is, why we have Sarcoma Awareness Month, how you can help the cause, and how proton therapy can help treat sarcoma patients.

What is Sarcoma?

Sarcoma is a broad term for a cancer formed in connective tissues – the cells that hold the body together. It can begin in a variety of cell types, including bone, fat, muscle, cartilage, tendons, blood vessels or other supportive tissue.

Sarcomas are frequently found in a person’s arms or legs, since this is where most of our body’s connective tissue lives. However, since sarcomas can form anywhere in the body, there are hundreds of different subtypes of the disease.

These are broken up into two main categories:

As their name would suggest, soft tissue sarcomas start in soft tissues like muscle, fat, nerves and tendons. Specific types of soft tissue sarcoma include rhabdomyosarcoma, vascular tumors and Kaposi sarcoma.

Non-soft tissue sarcomas form in the bone. The most common bone cancer is osteosarcoma, which usually occurs in the large bones of the arm or leg. Other types include Ewing sarcoma, malignant fibrous histiocytoma and chondrosarcoma.

Signs of Sarcoma

Symptoms of sarcoma do not always appear in the early stages of the cancer. However, signs of soft tissue sarcoma can include a lump or swelling, often appearing as a painless lump under the skin of your arm or leg. As the sarcoma gets bigger, it may begin to press on nearby organs, nerves or muscles, which can result in pain or trouble breathing.

Pain is the most common symptom of bone cancer, but not all bone cancers cause pain. Other symptoms include a lump that may feel soft and warm, an unexplained fever, or a bone that breaks for seemingly no reason.

If your doctor suspects you may have sarcoma, they will most likely perform a physical examination or imaging tests (x-ray, CT scan, ultrasound, MRI or PET) to help diagnose it. They may also choose to perform a biopsy and/or blood tests to confirm the diagnosis and determine the severity of the cancer.

Sarcoma Treatment Options

Because there are so many different types and stages of sarcoma, there are many different treatment options. The type, size, location and stage of the cancer all factor into the treatment plan, as do the patient’s age and overall health.

Standard sarcoma treatment plans include surgery, chemotherapy, radiation therapy, cryosurgery, targeted therapy, or a combination of these. It’s important to be your own health advocate by understanding all of your treatment options, and the possible side effects of each.

Treating sarcoma with proton therapy

Since radiation therapy is often part of the treatment plan for sarcoma patients, it’s important to understand the different types of radiation, and the possible side effects of each. Proton therapy is an advanced form of radiation therapy that reduces your risk of treatment-related side effects compared to traditional x-ray radiation.

Traditional radiation therapy uses x-rays (or photons). Because of the physical nature of photons, much of the healthy tissue and nearby organs that surround the tumor are exposed to unnecessary radiation. On the other hand, proton therapy uses relatively heavy particles (protons) that can be precisely controlled to release most of their energy at the tumor site. This avoids unnecessary radiation to the surrounding heathy tissue and vital organs. As a result, the patient’s risk of short-term and long-term side effects is significantly reduced.

Why do we have Sarcoma Awareness Month?

Sarcoma is a very rare cancer in adults, accounting for just 1% of all adult cancers. While it is slightly more common for children (about 20% of pediatric cancers), there is still a relatively small number of people diagnosed with sarcoma each year, compared to some of the more prevalent cancers.

Because of its scarcity, sarcoma is often referred to as the “forgotten cancer.” This can make it difficult for advocacy groups to raise money for research and treatment development, since many people aren’t even aware of sarcoma’s existence.

Throughout the month of July, the sarcoma community bands together to help advocate for the needs of sarcoma patients, survivors and their families. Through social media, educational conferences and fundraisers, Sarcoma Awareness Month helps highlight the need for more research and better treatments.

How you can get involved in Sarcoma Awareness Month

There are plenty of ways you can help contribute to the cause. Sharing photos, videos and infographics on social media is a great start. The Sarcoma Foundation of America (SFA) has even created shareable graphics to help make it even easier for you.

You can also get involved by contacting your congressional leaders or local media. Tag them in your social posts using the hashtag #SarcomaAwareness.

The annual Race to Cure Sarcoma is a fundraiser spearheaded by the SFA. This year, the national race will be held virtually on July 25, 2020. There are also regional races scheduled in several cities across the country. Due to COVID-19 restrictions, the events happening during Sarcoma Awareness Month will be virtual races, but those scheduled for later in the year may still happen in person.

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As part of the Provision CARES Cancer Network, Provision CARES Proton Therapy has locations in Knoxville and Nashville, Tenn. If you or someone you know has cancer, we encourage you to call a Provision treatment center near you. One of our Cancer Care Experts can speak to you about your specific diagnosis and help determine if proton therapy is right for you.

 

 

CDC guidelines for visiting doctor during coronavirus pandemic

CDC announces guidelines for safely visiting your doctor during coronavirus pandemic

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The Centers for Disease Control and Prevention (CDC) recently announced new guidelines to help you stay safe when visiting your doctor or getting a prescription filled. In this article, we’ll outline some of the most important takeaways to help you stay safe during healthcare-related trips. More specifically, we’ll also share how those tips can be applied for people who are dealing with cancer.

As local governments loosen coronavirus restrictions and more businesses re-open their doors, it’s important for people to continue practicing preventive actions in order to slow the spread of COVID-19. These new guidelines from the CDC are designed to help you make an informed decision on when it’s appropriate to venture out of your home, and how to protect yourself and others when you do decide to go out.

THREE KEY TAKEAWAYS FOR HEALTHCARE-RELATED TRIPS

1. Consider telehealth/touchless options

The first key takeaway from the CDC guidelines on visiting your doctor is to find out whether your healthcare provider offers any telehealth options. Many doctor’s offices have telehealth programs that allow you to do a virtual video chat with a physician. It may also be possible to speak with your healthcare provider through secure communication lines using telephone or email.

If you need to pick up a prescription, check to see if your pharmacy offers touchless services like drive-thru, curbside pickup or mail-order delivery. You can also ask your doctor if it’s safe for them to prescribe a larger supply than normal, so you won’t need to refill the prescription as often.

For cancer patients in particular, we are strong advocates for moving forward with your care in a timely and safe manner. In some cases, this may be as simple as a phone call to your physician, who determines that a delay in treatment is appropriate. Others may need to avoid delays in cancer treatment. Provision CARES Proton Therapy offers both in-person and telehealth consultations to help cancer patients make an informed decision about the timeliness of their treatment.

To learn more about Provision’s telehealth program, please read our Telehealth Frequently Asked Questions.

2. Practice preventive actions

If you decide to visit your doctor in person, there a few simple things you can do while out in public to protect yourself and others from COVID-19. These include washing your hands often, social distancing, and covering your mouth and nose with a cloth face cover. We encourage you to review the CDC’s guidelines on face coverings to better understand when and how to wear them, as well as which groups of people should not wear them.

All Provision CARES Proton Therapy centers have implemented preventive safety measures to protect the health and safety of our patients, employees and visitors. When you come to Provision for an in-person consultation, treatment or follow-up, you can rest assured we are doing everything we can to keep you safe. This includes limiting the number of visitors allowed with each patient and pre-screening everyone who enters our facilities.

To learn more about our pandemic response, please read our COVID-19 Frequently Asked Questions.

3. Keep a few items handy

When visiting your doctor, the CDC guidelines suggest having the following items on hand:

  • Cloth face covering
  • Tissues (to help you avoid touching your face)
  • Hand sanitizer (should contain at least 60% alcohol)

For the safety of patients, employees and visitors, many doctor’s offices now require you to wear a face covering inside their facilities. This is true for all Provision CARES Proton Therapy centers. If you do not have your own face covering, we will be happy to provide one for you upon arrival. As an added precaution and to encourage frequent handwashing, we have also increased monitoring and refilling of soap and hand sanitizer dispensers throughout our centers.

TIPS FOR OTHER ESSENTIAL TRIPS

Aside from medical visits, there are plenty of other reasons to leave your home. Whether it’s running errands, dining out, or going to the park, the CDC has guidelines for just about every situation.

Most importantly, if you are sick or have symptoms of COVID-19, which include a fever, cough or shortness of break, the CDC recommends you stay home and avoid in-person contact with others. Try taking advantage of delivery services and online options for common errands like grocery shopping, take-out dining or banking.

Some of the CDC’s other guidelines are universal no matter what your reason for going out, including wearing a cloth face covering, social distancing, using hand sanitizer while out and about, and washing your hands when you get home.

For more specific guidelines for certain situations, please visit the links below:

Running Errands: This set of guidelines includes grocery shopping, deliveries and takeout, banking and getting gas.

Personal and Social Activities: These guidelines cover dining out, hosting a gathering, using a fitness center, going to a salon, visiting a library, and traveling overnight.

Using Transportation: This includes guidelines for the use of public transit, rideshare/taxis, and personal vehicles.

Visiting Parks and Recreational Facilities: This section has some helpful Do’s and Don’ts if you plan to visit national, state, or local parks, as well as beaches, pools, and playgrounds.

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As part of the Provision CARES Cancer Network, Provision CARES Proton Therapy has locations in Knoxville, Tenn. and Nashville, Tenn. If you or someone you know has cancer, we encourage you to call a treatment center near you. One of our Cancer Care Experts can speak to you about your specific diagnosis and help determine if proton therapy may be right for you.

 

NAPT celebrates 30 years of supporting access to proton therapy

National Association for Proton Therapy celebrates 30 years supporting access to proton therapy

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The National Association for Proton Therapy (NAPT) announced it will host its annual National Proton Conference through a virtual experience. The online event, which will take place on July 24, 2020, is a celebration of the organization’s 30-year anniversary of supporting access to proton therapy, one of the world’s most advanced cancer treatments.

NEW PLANS, SAME MISSION

The NAPT was planning to host the 2020 National Proton Conference in Nashville earlier this year, with keynote speaker Scott Hamilton, an Olympic Gold Medalist and U.S. and World Figure Skating Champion. However, the group was forced to shift their efforts to offer an interactive live virtual conference due to the COVID-19 pandemic.

“We knew in early March that it would not be safe for our attendees to travel and gather in person at our National Proton Conference,” says Jennifer Maggiore, NAPT Executive Director. “Just as it is vital for cancer care to continue in this pandemic, we felt it was important to support patients by ensuring education about advanced treatments continues for the proton therapy community.”

As part of its mission, NAPT supports increased awareness and access to proton therapy by providing education and bringing leaders in the field together. This is especially important now, with the travel concerns brought on by COVID-19, as many cancer patients who need proton therapy do not have access to it in their region.

In response to the global crisis, Maggiore says the NAPT quickly re-worked the logistics of its conference so the proton therapy community would not miss an opportunity to learn about the latest advancements in the field of Proton Beam Therapy (PBT). There has been significant research published recently supporting the benefits of PBT. The NAPT says the need to educate the community on that research in a timely manner validates their decision to move forward with a virtual conference.

WHAT TO EXPECT AT THE 2020 NAPT CONFERENCE

The original conference planned a special reception in Nashville to celebrate 30 years as the “Voice of the Proton Community.” Now, the online conference will feature a virtual Happy Hour with a nod to Nashville’s “Music City” fame.

“For the virtual conference, we are supporting the community of musicians who are unable to perform during the pandemic by hiring Nicole Zuraitas to provide live music at our virtual Happy Hour,” explains Maggiore. “We will toast to our 30-year anniversary at the end of the conference. This will be a great opportunity to engage with our proton therapy community in a safe environment.”

The conference will still include a speech from Hamilton, says Nancy Howard, 2020 Conference Chair and Vice President of Marketing at Provision CARES Proton Therapy. “We are honored that Scott Hamilton will kick off the conference with a welcome to conference attendees,” Howard remarks. “He is a cancer survivor and a true advocate for cancer patients and proton therapy.”

In addition to these festivities, the program agenda includes presentations from leaders and experts in proton therapy from Penn Medicine, Johns Hopkins Proton Center, Mayo Clinic and other leading cancer programs. These speakers will share their insight on relevant research and issues affecting cancer patients.

“During this pandemic, we have witnessed the decline in access to cancer care and major barriers for patients seeking preventative and curative treatment for cancer,” adds Maggiore. “It is more important than ever to strengthen our collaboration through shared knowledge to advocate and promote cancer care, research and access to the most advanced and innovative technologies available for cancer patients.”

MORE ABOUT NAPT

The NAPT began as the Proton Therapy Consortium in 1990. It is an independent nonprofit organization founded with the goal of educating and increasing awareness about the clinical benefits of proton therapy. Currently, its members include 37 of the nation’s leading cancer centers, some of which are comprehensive cancer centers as designated by the National Cancer Institute, as well as members of the National Comprehensive Cancer Network.

“NAPT evolved beyond my wildest dreams,” says Len Artz, one of the organization’s founding members. “It continues to make a profound difference in patients’ health and wellbeing. It stands on the shoulders of many proton community leaders over the years. It continues to grow as an organization and expand its outreach that makes me very proud.”

The NAPT states is mission is to work collaboratively to raise public awareness of the clinical benefits of proton therapy, ensure patients’ choice and access to affordable proton therapy, and encourage cooperative research and innovation to advance the appropriate and cost-effective utilization of proton therapy.

Provision CARES Proton Therapy is a member of the NAPT and shares a similar vision of making proton therapy a clinical reality. With locations in Knoxville and Nashville, Provision represents the only cancer centers offering proton therapy in the East and Middle Tennessee regions. As of June 2020, the centers have treated more than 4,000 patients with a wide range of cancer types.

Male cancer patient using telehealth

Telehealth can help cancer patients during coronavirus pandemic

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Trying to navigate your cancer care journey is challenging enough without the added stress of a global pandemic.  Normally, you would schedule an in-person consultation with a physician to discuss your treatment options. Understandably though, many cancer patients now have reservations about going out in public during the coronavirus pandemic. Thankfully, telehealth provides a safe way for someone with cancer to continue moving forward with their care in a timely manner.

Provision CARES Proton Therapy implemented an expanded telehealth program in March 2020. This has allowed us to continue helping cancer patients in a safe environment, while also limiting the number of people at our centers. Since March, our physicians have conducted many telehealth consultations and virtual follow-up appointments. Our telehealth program allows someone who has been recently diagnosed with cancer to remain at home and speak directly to a physician through a video connection about their diagnosis, treatment options and next steps.  Our Cancer Care Experts can help patients through this process.

CANCER CARE PROVIDERS TURN TO TECHNOLOGY

The coronavirus pandemic has changed many aspects of the healthcare industry. When the outbreak began to gain momentum in the United States, hospitals made operational changes to accommodate a potential influx of COVID-19 patients. Many general practitioners and specialists began to postpone well-visits and elective procedures. Specialty healthcare providers, including cancer treatment centers, also made adjustments to keep their patients, employees and visitors safe. Many of those providers, including Provision CARES Proton Therapy, turned to technology, broadening their ability to provide cancer care through the use of telehealth.

A recent survey indicated nearly half of all physicians are now communicating with patients through telemedicine, a stark rise from just two years ago. The survey, conducted by Merritt Hawkins, a physician search firm, in collaboration with The Physicians Foundation, sought to learn how COVID-19 is impacting physicians and how they are responding. It found that 48 percent of physicians are using telemedicine with patients. A similar study by The Physicians Foundation in 2018 had that number at just 18 percent.

The increase in telehealth usage was aided further after the Centers for Medicare & Medicaid Services announced they would broaden access to Medicare telehealth services as part of the federal government’s emergency pandemic response.

CANCER & TELEHEALTH FROM A PHYSICIAN’S PERSPECTIVE

James Gray, MD, FACRO, Medical Director at Provision CARES Proton Therapy NashvilleSince the use of telehealth for medical appointments is becoming more common, we’re providing some firsthand insight into how it works and why it’s such a valuable tool for cancer patients. We asked the medical director of Provision CARES Proton Therapy Nashville, Dr. James Gray, a few questions about his experience with telehealth during the pandemic. Dr. Gray is a board-certified radiation oncologist who has spent 30 years studying cancer and helping patients navigate their cancer care journey.

What are your general thoughts on the use of telehealth for cancer care?

“I believe telehealth substantially contributes to our ability to communicate with patients.  While this applies across all areas of healthcare, it particularly applies to services which are restricted or to which there is limited access.  Proton therapy is a prime example of this.  I can interact with and advise patients who might not otherwise find it reasonable or even possible to travel to our center, or any other proton center.  Such patients may find that proton therapy has possible benefits for their circumstance and might make the trip worthwhile.”

What kind of feedback have you heard from cancer patients who’ve used telehealth?

“Generally good.  Telehealth allows us to help prevent a delay in the cancer patient’s process. As long as an in-person assessment is not necessary, then a telehealth consult allows me to counsel a patient quite well based on medical records and images forwarded to us in advance.  If equally feasible, an in-person visit is still superior for this communication, but a telehealth visit allows me to get the message across and answer the patient’s questions.”

What would you tell a patient who’s nervous about trying a telehealth appointment?

“I reassure the patient and family members that the telehealth visit can start the process of managing their cancer, but more interactions will follow in order to answer subsequent questions and direct further workup of their disease.  If the reason the patient feels nervous or uncomfortable is simply a technology concern, we can have our administrative staff reach out to them and their family to provide assistance.”

As a doctor, how has telehealth helped you during the coronavirus pandemic?

“It allows me to interact with more patients, and in a more timely manner, than I otherwise could due to visitation restrictions, or perhaps just logistics of travel for the patient.  I receive gratification from counseling patients through a rough time, always hoping to alleviate concerns and fears about issues they don’t understand and taking away some of the uncertainty of their next steps.”

Are there other ways cancer care providers are taking advantage of technology during the pandemic?

“Besides avoiding unnecessary contact between care providers and patients, physicians have suspended our in-person meetings called tumor boards or tumor conferences.  But there is a silver lining to this change because we have been forced to become better at virtual meetings, allowing us to exchange ideas and recommendations through audio/visual software.  Again, in-person meetings will likely always be preferable when reasonable, but the ability to attend the meeting virtually from your office or home has been given a big boost during this time.  Ultimately, comfort with this type of meeting attendance makes the meeting more accessible.  And the more we interact, the better we explore all options for our patients.”


To learn more about Dr. Gray and the other board-certified radiation oncologists at Provision CARES Proton Therapy, please visit Our Physicians page. If you are interested in learning more about proton therapy or scheduling a telehealth consultation, please call the Treatment Location closest to you and speak with one of our Cancer Care Experts.

A message from Provision leadership regarding COVID-19 (coronavirus)

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In response to the presence of COVID-19 (coronavirus) in Tennessee, effective Friday, March 13, Provision is taking the following preventative measures to protect the health of our patients, employees, and visitors:

  1. All patients are asked to bring no more than one visitor or caregiver with them to our center.
  2. Upon arrival at any of our centers, patients and visitors will be asked to complete a brief COVID-19 screening questionnaire.
  3. Visitors and/or caregivers that are experiencing any symptoms associated with COVID-19 or have traveled to/from any area that has been significantly impacted by COVID-19 will be asked to leave the building.
  4. All non-essential gatherings have been discontinued for the foreseeable future, including chat sessions, patient luncheons, and facility tours.
  5. More comprehensive cleaning and disinfection procedures have been implemented at all of our facilities.
  6. All patients, visitors, and employees are being asked to wash their hands often, maintain physical distance of at least three feet from others, and follow good cough/sneeze etiquette.
  7. All employees are screened daily for symptoms associated with COVID-19 to determine whether they may continue providing care at the Center.
  8. All patients are screened daily for symptoms associated with COVID-19 and, depending on the outcome of the screening, may be asked to postpone their appointment until they have been tested for the virus.

If you have questions or concerns regarding COVID-19, please visit our COVID-19 FAQ section to learn more about the steps we are taking to ensure your cancer treatment does not get delayed.

Provision doctor diagnosed with cancer, chooses proton therapy for his own treatment

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This story starts the way a lot of cancer stories start. A visit to the doctor for an unrelated issue. A few tests. And then, while trying to solve one problem, the doctor discovers another – a red flag.

That discovery sparks a journey down a road far too many have traveled. First, more trips to the doctor. Then more tests. And then the waiting. Waiting with fear and uncertainty – hoping for the best, but preparing for the worst. Until eventually, the wait is over and the news is in…

It’s cancer.

And from there, this story continues down a common path. Mulling over questions like “How bad is it?” and “How do I deal with this?” Determining the options and choosing a treatment. And of course, fighting the cancer.

There’s something uncommon about this story, though – the person making the journey. Because he’s literally been down this road hundreds of times before. He knows the roadmap better than most, because he’s guided people through it for decades.

The only difference this time? He’s no longer the guide. This is his journey.

FROM DOCTOR TO PATIENT

James Gray, MD, FACRO, Medical Director at Provision CARES Proton Therapy NashvilleDr. James Gray is a board-certified Radiation Oncologist and the Medical Director at Provision CARES Proton Therapy Nashville. His career includes work with the National Naval Medical Center and the National Cancer Institute. He began practicing radiation oncology in Nashville in the mid-1990s, including membership in Tennessee Oncology, one of the largest privately-held physician groups in the country. He has established his reputation as a pioneer in the industry, performing many advanced procedures never-before-seen in the region.

Accomplishments and accolades, aside, it’s Dr. Gray’s passion and commitment to his patients that define him. He’s spent 30 years studying cancer and helping patients navigate the difficult path of fighting it.

“I get to work with patients in a time of dire need for them. They undergo a diagnosis of cancer, and this is terribly frightening for most people to accept and move forward,” says Dr. Gray. “Helping someone move through that. Counseling them. Making them understand their disease. That’s what brings joy to me – the actual effort of bringing this understanding to those patients and then bringing the best possible care to them. That drives me every day.”

Then, in 2019, he visited a physician to check out a minor health issue. During that visit, Dr. Gray underwent a PSA level screening. Much to his surprise, the levels came back slightly elevated – a possible indication of prostate cancer.

“I realized with that PSA level, I needed to pursue this, and I went to see another physician – an outstanding urologist – and he proceeded with a diagnostic work up. That led to some other lab tests, an examination and then a biopsy.”

Dr. Gray recalled the anxiety he felt during the days following the biopsy. “You’ve got to wait maybe 3 or 4 days to get the pathology results back. I got to live firsthand that trepidation – that worry of, ‘Oh gosh. I hope it’s not cancer.’”

Unfortunately, though, it was cancer. Prostate cancer.

“It put me in a unique position where I’ve actually counseled patients who’ve just gotten this news. I’ve counseled probably more patients in this setting than anybody else in the area. All of a sudden, I’m counseling myself. Now, I’m the patient.”

WEIGHING THE OPTIONS

After receiving the news of his cancer diagnosis, Dr. Gray says he had a 30-year head start on the typical patient. As an established Nashville oncologist, he already had a strong grasp on the answers to questions like, “What does this mean for my life?” and “Am I going to die from this?” However, it was still important for him to remain objective, gather information about the severity of his cancer, then step back and make a clear treatment decision.

The initial decision for most prostate cancer patients is to determine whether the cancer is actually worthy of treatment, or if it would be more appropriate to observe it through active surveillance. In Dr. Gray’s case, he felt the cancer was threatening enough to treat immediately.

The next big divide – the “fork in the road,” as Dr. Gray calls it – is to decide whether to remove the prostate surgically or treat the tumor with radiation therapy.

“For me, that was not a difficult decision,” he says. “Knowing what I know about the likelihood of getting rid of the disease and the likelihood of having any kind of consequences from the treatment itself, I knew pretty quickly that I wanted to have radiation.”

That led to his next decision – choosing a radiation therapy method. There are many options for prostate cancer patients, including traditional x-ray radiation, radioactive seed implants (brachytherapy) and proton therapy.

For Dr. Gray, this was another easy decision. “One of the key advantages of proton therapy is that we’re putting (radiation) into the tumor with as little unnecessary dose to other tissues as possible. That inherently reduces the possibility of side effects – fatigue, difficulty with urination or bowels in my circumstance. So statistically, I am convinced. I’ve seen the data. I know what I consider to be the best treatment for prostate cancer, in my particular setting, was a proton therapy treatment system.”

“And fortunately, I happen to work at a proton system.”

WORK-LIFE BALANCE

They say it’s important to have a good work-life balance in your career. In Dr. Gray’s case, those two worlds collided as soon as the radiation oncologist began his proton therapy treatment in Nashville.

“I could actually go to work every day and receive a treatment – close to six weeks of treatment – but I was just going to work. And for 20 or 30 minutes, I stepped into the patient role, had my treatment, then went back into the doctor role.”

Dr. Gray remembers the transition from doctor to patient being fairly easy, mainly because of the trust he had in the treatment itself, as well as the Provision CARES team performing the treatment.

“For a lot of patients, they have to slowly gain the trust in me as their physician. They have to gain the trust in the people that are going to do their treatment. They have to gain the trust in the technology,” notes Dr. Gray. “I didn’t have those misgivings. I knew that when I was being treated, very bright people were watching over the treatment and making sure it was done right. I know how competent, outstanding and professional those people are, so I didn’t have any qualms about that.”

In fact, Dr. Gray’s positive attitude during his treatment actually helped the other staff members deal with a situation in which their colleague, friend and mentor was battling cancer – and they happened to be the ones treating it.

“I’ve never been in that situation before where you’re treating someone that you know so closely,” remembers Justin Pigg, Radiation Therapy Manager at Provision Nashville. “But to Dr. Gray, he just wanted to be treated like any other patient. He wanted the patient experience.”

“He was really calm and really strong through it, and I think that helped everybody else be calm, as well,” says Valerie Bohannon, the proton center’s Patient Concierge.

That sense of calm among the team was critical, as just about everyone at Provision Nashville had some role in Dr. Gray’s treatment.

“It’s all the way from the top to the bottom,” Dr. Gray says. “Every member of this staff had something to do with making sure my treatment went well. They all wished me well. They all asked me how I was doing. They were genuinely concerned about this.”

And that concern – that culture of care – is what Provision is all about. Dr. Gray hears it from his patients all the time.

“They will tell me how impressed they are from the moment they walk in the door to the time they’re leaving the center. They felt like they’ve been enveloped in care. And I felt the exact same way. It was obvious to me that I was brought into that care – that love – that people wanted me to do well.”

WALKING IN THE PATIENT’S SHOES

Dr. Gray, a Nashville oncologist, completing his proton therapy treatment at Provision CARES NashvilleDr. Gray successfully completed proton therapy in January 2020, placing him in a rare category of radiation oncologists who’ve actually been through the very cancer treatment in which they specialize. He says the entire experience impacted the way he’ll approach his role as a doctor going forward.

“It was enlightening. Going through the treatment myself gave me quite a bit of a different perspective. It’s important for me to understand that my personal experience can be translated only some degree to my patients, but at least having a taste of it allowed me to understand a bit more how they see it – how they experience the whole treatment process.”

That “taste” of proton therapy, as he calls it, will now be another tool for a Nashville oncologist who is passionate about making this effective and successful treatment available to as many people as possible.

“Some people suggested I had to choose proton therapy because I work at a proton therapy center. No, not necessarily. I’m not going to compromise my own good health just to make a point in my professional career. I wanted to have the best outcome, and I genuinely believe my best outcome would be achieved through the use of proton therapy.”

And with 36 operating proton centers across the country, why did he choose to be treated at Provision CARES Proton Therapy Nashville? He says that was another easy decision.

“Why would I leave here when I know I’ve got great people here to treat me. I can get world class treatment by world class people just downstairs from my office. Why wouldn’t I take advantage of that?”

Lung Cancer Awareness Month

Lung Cancer awareness efforts focus on smoking prevention

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Lung Cancer Awareness Month is dedicated to educating the public about the prevalence of the disease in the United States, and providing resources on prevention, screening and treatment.

According to the American Cancer Society (ACS), lung cancer will kill more than 140,000 people in 2019, making it by far the leading cause of cancer death among both men and women. It is the second most common cancer in both men and women (not counting skin cancer). For men, prostate cancer is the only cancer more common, while in women breast cancer is more common.

Smoking is the leading cause of lung cancer. The ACS reports 80% of lung cancer deaths are caused by smoking.1 However, non-smokers can also develop the disease. This could be caused by exposure to radon, secondhand smoke, air pollution, asbestos, diesel exhaust or other chemicals.

PREVENTION IS KEY

With such a high percentage of lung cancer cases linked to smoking, efforts to reduce the prevalence of the disease are largely focused on kicking the tobacco habit.

“Smoking continues to be the #1 most preventable cause of death and disease in the U.S.,” says Kerri Thompson, Public Health Educator for the Knox County Health Department (KCHD) in Knoxville, Tenn. “It kills so many people and it’s something that can be prevented.”

Thompson spearheads KCHD’s tobacco prevention programs, which focus on three main areas: Youth Prevention, Secondhand Smoke Reduction and Smoking Cessation (quitting). Through educational programs designed to teach children about the dangers of smoking, KCHD hopes to dramatically reduce tobacco product usage in our next generation.

“We’re trying to change the trajectory so, hopefully, we can have an impact on lung cancer,” Thompson notes. “Having (our youth) not use tobacco or not be addicted to nicotine in the first place is really key to addressing the huge impact that smoking has on society.”

Knox County’s programs aimed at youth education actually have a trickle-down effect, impacting its Secondhand Smoke Reduction and Smoking Cessation efforts, as well. Children tend to share resources they receive in school with their parents in hopes they will then try to quit. One of these resources is the Tennessee Tobacco Quitline. This is a free service that offers personalized support from counselors who are trained to help you kick the habit. More resources to help you quit smoking can be found at Smokefree.gov.

When it comes to quitting, Thompson says relapse is common, so persistence is very important. “When someone quits smoking, on average it takes seven to 10 times for someone to quit for good. Many people think since they’ve been smoking for years, the damage is already done, so what’s the point in quitting.” However, if there’s one thing she hopes people take away from Knox County’s education and prevention efforts, it’s this – “It’s never too late to quit.”

LUNG CANCER SCREENING CAN SAVE LIVES

According to the National Cancer Institute (NCI), risk factors for lung cancer include tobacco use, secondhand smoke, family history, HIV infection and environmental risks like exposure to asbestos, radon  or other substances. If you believe you may be at risk for lung cancer, you should start by speaking to your doctor. A general practitioner can perform an assessment, then offer advice for your next step. This could be a referral to a pulmonologist or oncologist, or a prescription for nicotine replacement therapy. Since early detection is so important, at-risk individuals may also benefit from a lung cancer screening.

The NCI says the most effective type of screening is a low-dose spiral Computed Tomography (CT) scan. In its National Lung Screening Trial, the NCI studied people between 55 and 74 years old who had smoked at least one pack of cigarettes a day for 30 years or more. They compared low-dose spiral CT scans with another type of screening, chest x-rays. Researchers observed a 20% lower risk of dying from lung cancer in people who received low-dose spiral CT scan screenings.2

Fortunately, there are resources available to help people get screened. The American Lung Association (ALA) offers an online quiz to help you determine whether you are at risk. The ALA can also help you find information about insurance coverage and screening facilities near you.

In an effort to make lung cancer screenings more accessible, CHI Memorial Hospital in Chattanooga, Tenn. brings low-dose CT scans into the community with its Breathe Easy mobile lung CT coach. The bus serves counties from three different states in the Southeast.

PROTON THERAPY AS A TREATMENT

Given the serious prognosis of lung cancer, it’s important to evaluate all your treatment options before making any decisions. Treatment for lung cancer is based mainly on the type (non-small cell vs. small cell) and the stage of the cancer. Other factors like a person’s health and lung function should also be considered. Treatment options may include surgery, chemotherapy and radiation therapy.

Doctors and scientists have been studying the results of proton therapy in the treatment of non-small cell lung cancer (NSCLC). One study in particular showed that patients with Stage 3 NSCLC who were treated with proton therapy experienced lower rates of lung and esophagus inflammation compared to patients treated with traditional (x-ray/IMRT) radiation.3

Proton therapy for lung cancer treatment is non-invasive and usually painless. Physicians provide doses of radiation to specific areas, controlling the depth of the protons emitted and reducing the impact on the surrounding tissue. Provision CARES Proton Therapy uses a technique known as pencil beam scanning, which provides precise dose of radiation to targeted areas, resulting in a decreased risk of side effects. Proton therapy decreases the risk of damage to healthy tissue and organs surrounding the cancer. This is because the unique physical properties of protons allow the radiation dose to better conform to your cancer, avoiding unnecessary radiation to nearby areas. This is especially important for lung cancer treatment because the tumor may be close to your heart, healthy lung and other critical organs.

Since each cancer diagnosis is unique, we encourage anyone seeking treatment options to speak with one of our Cancer Care Experts to see if proton therapy is right for you.

 

Sources

  1. American Cancer Society. What Causes Lung Cancer? Read More
  2. National Cancer Institute. National Lung Screening Trial. Read More
  3. National Cancer Database Analysis of Proton Versus Photon Radiaion Therapy in NSCLC. Read More
  4. American Cancer Society. Key Statistics for Lung Cancer. Read More
  5. Proton Beam Radiotherapy and Concurrent Chemotherapy for Unresectable Stage III Non–Small Cell Lung Cancer Final Results of a Phase 2 Study. Read More
  6. High-dose hypofractionated proton beam radiation therapy is safe and effective for central and peripheral early-stage non-small cell lung cancer: results of a 12-year experience at Loma Linda University Medical Center. Fractionation 10 for PBT vs 6-8 weeks for IMRT. Read More

 

Provision CARES Proton Therapy Orlando announces arrival of cyclotron in Hamlin development

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WINTER GARDEN, Fla. — Provision CARES Proton Therapy Orlando is under construction in the Hamlin development in Southwest Orange County. The center will offer one of the most promising new cancer therapies available, proton therapy; and will utilize the latest advancement in proton therapy systems, the ProNova SC360 manufactured by ProNova Solutions, LLC located in Maryville, Tennessee.

On Wednesday, November 20, one of the key components of the proton therapy system, the cyclotron, will travel from Cape Canaveral to Hamlin on a flatbed truck along a FDOT pre-approved route. The cyclotron travel time is expected to take approximately four hours before arrival at Hamlin. The cyclotron generates the proton beam that is used to treat patients through the ProNova SC360 system. Delivery of the cyclotron is a milestone event in the construction of the proton therapy treatment center.

Once the cyclotron has arrived at the proton center, the Provision team, which includes personnel from ProNova Solutions, Sumitomo Heavy Industries, Ltd., Barnhart Crane & Rigging Co., will then begin the rigging and installation of the cyclotron into the new proton therapy center building. Following installation of the cyclotron, installation, testing and commissioning of the ProNova SC360 will continue as the proton therapy center building is completed.

The cyclotron accelerates a proton beam that is incorporated into the ProNova SC360 delivery system and then used to deliver this advanced cancer treatment. This treatment provides a means to treat the cancer and spare the patient with fewer side effects.

The Provision CARES Proton Center is located in the 17-acre Provision CARES Cancer Center in Hamlin and is a member of the Provision CARES Cancer Network. Provision CARES Cancer Centers with Proton Therapy are also located in Knoxville, TN, Nashville, TN and recently announced Kansas City, KS, where all Provision centers provide comprehensive and integrated diagnostic and therapy services for all patients and all physicians who need those services.

Provision’s leadership team, cancer center partners, and media will be viewing the cyclotron delivery from the construction site at 15775 New Independence Parkway, Winter Garden, Florida.

ABOUT PROTON THERAPY

Proton therapy is an advanced form of radiation therapy that uses a single beam of high-energy protons to treat various forms of cancer. Proton therapy treats tumors by directing protons into the tumor site destroying cancerous cells. Unlike with other forms of radiation, radiation oncologists can control both the dose and range of protons, which allows the maximum deposition of energy into the tumor. This reduces damage to nearby healthy tissue and limits negative side effects. Proton treatment can be combined with chemotherapy and biological treatments, depending on the cancer type, to provide better outcomes with less tissue damage. According to the National Association of Proton Therapy, there are currently 35 proton therapy centers in operation.

ABOUT PROVISION’S PRONOVA SYSTEM

An affiliate of Provision Healthcare, ProNova Solutions, LLC is committed to making proton therapy accessible to a greater number of patients and physicians worldwide. ProNova was founded by former leaders of CTI Molecular Imaging, which brought positron emission tomography (PET) technology out of the laboratory and made it a clinical reality for millions of cancer patients. Today the same team is redefining cancer treatment once again with the introduction of the first and only superconducting 360-degree compact proton therapy system. It is the only proton therapy system developed in a clinical setting, benefitting from continuous input from physicians, medical physicists, and therapists during design and development. The system includes state-of-the-art features such as pencil beam scanning and advanced imaging with cone-beam CT, all in a compact design.

ABOUT PROVISION HEALTHCARE

Provision Healthcare, LLC was formed in 2005 with the purpose of developing innovative healthcare solutions focused on improving patient care and clinical outcomes and developing support for research, educational and charitable causes. Provision has developed a unique, comprehensive expertise in proton therapy including Provision’s patient focused “Culture of Care” that distinguishes Provision from other proton and cancer center developers and operators that have a much narrower focus. The combination of unique expertise and an innovative, entrepreneurial approach continues to propel Provision towards a position of industry leadership with respect to both cancer care and proton therapy.

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.