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Dec

2019 Year in Review at Provision CARES Proton Therapy

Year in Review: 2019 at Provision CARES Proton Therapy

Major milestones. Community outreach. Inspirational moments.

Those are some of the recurring themes we noticed as we looked back on the highlights of 2019 at Provision CARES Proton Therapy. It was a year marked by plenty of “firsts,” as well as a concerted effort to be an innovative leader in cancer treatment, and a commitment to our mission of making proton therapy more accessible to patients around the world.

Here are some of Provision’s key moments from 2019.

DR. LAVEY JOINS PROVISION
2019 started out with an exciting addition to our expert team of Board-Certified Radiation Oncologists, as Robert Lavey, MD, MPH joined Provision CARES Proton Therapy Knoxville. Dr. Lavey has vast experience in treating all types of cancers and is an internationally recognized expert in pediatric malignancies.

He is also passionate about serving and educating the community to decrease the chance of developing cancer, improve care and ease the journey during and after treatment. To read more about Dr. Lavey’s career, family and other interests, visit this blog post from January.

KNOXVILLE CELEBRATES 5^TH ANNIVERSARY
Our Knoxville center opened its doors to patients on January 20, 2014. Since then, we have treated nearly 3,000 patients from dozens of states and even a number of different countries. It’s taken just five years for the Knoxville campus to grow into a comprehensive cancer treatment location. In addition to the Proton Therapy Center, the campus is also home to services for oncology, surgery, immunotherapy, traditional radiation, clinical trials, health and fitness, physical therapy, imaging and more.

NATIONAL PROTON CONFERENCE
In March, Provision was proudly represented at the National Proton Conference in Miami. We strive to be experts in the industry so we can provide our patients with the highest level of treatment. This conference, hosted by the National Association for Proton Therapy (NAPT), is an excellent opportunity to learn about a wide range of topics, including clinical and business operations, patient advocacy, research and advances in proton therapy technology.

Not only did a number of Provision team members attend this event, they also made valuable contributions. Our speakers served on a number of panels and spoke at sessions on topics such as patient experience and proton therapy education.

CHIEF MEDICAL PHYSICIST SPEAKS AT CIRMS
In April, Our VP and Chief Medical Physicist, Niek Schreuder, traveled to Maryland to join a group of leading industry experts at the Council on Ionizing Radiation Measurements & Standards (CIRMS). The 27^th annual meeting of CIRMS focused on “Strengthening the Economy and Homeland Security with Radiation Measurements and Standards.” As a worldwide leader in his field, Mr. Schreuder had the opportunity to present a lecture on the Economics of Particle Therapy.

NASHVILLE TREATS 1^ST PATIENT WITH PRONOVA SC360 SYSTEM
On April 29, Provision CARES Proton Therapy Nashville successfully treated the first patient on its ProNova SC360 proton therapy system. This milestone established a new standard of excellence with the world’s smallest 360-degree superconducting compact gantry for protons.

The ProNova SC360 Proton Therapy System, manufactured at Provision’s ProNova Solutions in Maryville, Tenn., includes state-of-the-art features like pencil beam scanning and advanced imaging with cone-beam computer tomography (CBCT) for adaptive treatment, all in a compact design.

The size, cost and capabilities of the SC360 make it the smallest, most economical and most operationally flexible unit in the pipeline today. “This is a no-compromise solution,” said Terry Douglass, Chairman of Provision Healthcare. “It delivers not only reduced cost and compelling economics, but greater clinical capabilities than other proton therapy system suppliers.”

COMMUNITY RALLIES AROUND TEEN FIGHTING BRAIN CANCER
May marked an important graduation at our Knoxville center. Mason, a high school student from Cleveland, Tenn., rang the victory bell after completing proton therapy treatment for a rare form of brain cancer. It was incredible to see the support from the Chattanooga and Cleveland communities throughout Mason’s journey. His story was featured in the Cleveland Banner, on News Channel 9 and other radio stations and media outlets in the area.

In a post on the “Team Mason Strong” Facebook page, his mother said, “It is such a blessing that Provision Proton Radiation Therapy is in Knoxville. So thankful we get to do treatment so close to home.” To read more about Mason’s story and see why Provision is proud to be on #TeamMasonStrong, visit this blog post from May.

PROSTATE CANCER 101 LAUNCHES
As part of our community outreach efforts, Provision launched a free community information session called “Prostate Cancer 101: Understanding the Journey, Diagnosis, Treatment and Survival.” Ben Wilkinson, MD, FACRO, the Medical Director and Radiation Oncologist at Provision CARES Proton Therapy Knoxville, delivered presentations throughout the year about the latest developments in prostate cancer.

Community members who attended had the opportunity to visit our Knoxville center and learn about the most advanced diagnostic tools and current trends in treatment, including multiparametric MRI, genomic classification, when to use active surveillance and how to preserve quality of life after a prostate diagnosis.

NASHVILLE CELEBRATES 100^TH PATIENT GRADUATION
Shortly after opening its second treatment room, Provision CARES Proton Therapy Nashville celebrated its 100^th patient graduation. Patients, ambassadors and staff gathered to watch James ring the victory bell. It was certainly a momentous occasion for our Nashville center!

FROM EMPLOYEE TO PATIENT: CASEY’S STORY
As a Care Coordinator at our Knoxville center, Casey spends her day at work talking with patients and answering their questions. However, she now has the unique perspective of being on the other side of those calls, as well.

Late in 2018, she was diagnosed with breast cancer for the second time in her life. After finishing her breast cancer treatment at Provision’s Knoxville Center earlier this year, Casey decided she wanted to share her story to help others navigate their cancer journey.

Being both a former patient and a Care Coordinator allowed Casey to write a blog series to help guide patients through diagnosis, treatment and recovery. Her story was also featured on WBIR’s Buddy Check 10 earlier this year. To read more about Casey’s story, visit these blog posts:

Surviving Breast Cancer (Part 1) – Learning she has cancer for a second time
Surviving Breast Cancer (Part 2) – Preparing for treatment
Surviving Breast Cancer (Part 3) – Starting treatment
Surviving Breast Cancer (Part 4) – Ringing the bell

A MONTH OF ‘FIRSTS’ FOR NASHVILLE
With the 360-degree gantry up and running, things really began to pick up at our Nashville center this summer, making July a month of milestones for the center. They treated their first breast cancer patient on July 9, followed by the first treatments of esophageal, lung and central nervous system cancer.

EDDIE CHECK BREAKS RECORD
Each year during Prostate Cancer Awareness Month, Provision partners with Nisus Corporation and Medic Regional Blood Center for Eddie Check, a two-day event offering free PSA screenings. In 2019, Eddie Check broke a record with 1,420 screenings. That’s more than 300 more than last year, and 140 more than the previous record!

In addition to the screenings, Medic received 845 blood donations over the two-day period, which is more than double their daily average. It was an amazing turn out and we’re proud to be a part of an effort in which more than 1,400 men took the potentially life-saving steps for early detection of prostate cancer.

PROVISION CARES PROTON THERAPY KANSAS CITY ANNOUNCED
In September, we announced another expansion to the Provision CARES Cancer Network with plans to develop a proton therapy center in Kansas City. Located in the Lenexa community, Provision CARES Proton Therapy Kansas City will serve patients in the surrounding region with advanced cancer care. Like Nashville, the Kansas City center will also use the ProNova SC360 Proton Therapy System to provide the most innovative treatment available.

ASTRO CONFERENCE
Our commitment to being leaders in the proton therapy field continued in September, as a group of Provision representatives traveled to Chicago for the 2019 American Society of Radiation Oncology (ASTRO) Annual Meeting. By participating in conferences like this, Provision is able to keep up with rapidly evolving technologies and methodologies of radiation therapy. The ASTRO meeting is also a great opportunity for global collaboration as we work to make proton therapy more accessible around the world.

NASHVILLE CELEBRATES 1^ST ANNIVERSARY
October marked one year since Provision CARES Proton Therapy Nashville treated its very first patient. Employees from our Nashville center gathered to celebrate the 1^st anniversary and give thanks for the team members, patients and families who helped make the first year a very fulfilling one. It was a journey founded on establishing new standards of excellence, curating Provision’s Culture of CARE and serving middle Tennesseans with the most advanced cancer care in the world.

AMBASSADORS REUNITE FOR HOMECOMING
One of the most exciting “firsts” of the year came in November, when dozens of Provision Ambassadors reunited at our first-ever Ambassador Homecoming. Provision graduates from eight different states joined us for a weekend that included a Homecoming Dinner Program, tours of our Knoxville center and ProNova Solutions, and plenty of free time to catch up with friends and staff members.

DEVELOPMENTAL MILESTONE FOR PROVISION CARES PROTON THERAPY ORLANDO
A crucial delivery was made in November, as Provision CARES Proton Therapy Orlando announced the arrival of its cyclotron. One of the key components to the proton therapy system, the cyclotron generates the protons that are used to destroy cancer cells. Upon delivery, the Provision team began the rigging and installation of the cyclotron into the new proton therapy center building.

This was a milestone event as we work to expand the Provision CARES Cancer Network and bring the latest advancement in proton therapy systems to central Florida.

DR. GRAY DELIVERS KEYNOTE SPEECH AT LUNG FORCE EXPO
We were honored to have the American Lung Association invite Dr. James Gray, Medical Director at Provision CARES Proton Therapy Nashville, to be the keynote speaker at this year’s LUNG FORCE Expo.

This annual event takes place during Lung Cancer Awareness Month. It was a great opportunity for Provision to help spread awareness of the latest trends, resources and research about radiation therapy for lung cancer.

As we reflect on the past year and remember all of these key moments, Provision is very excited to think about what lies ahead in 2020.

• Milestone events such as Knoxville’s 5^th anniversary, Nashville’s 100^th graduation and Orlando’s cyclotron installation
• Inspiring moments like #TeamMasonStrong and Casey’s story
• Community outreach initiatives like Eddie Check and Prostate Cancer 101

We are confident these accomplishments, combined with our commitment to being innovative leaders in proton therapy and serving patients through our Culture of CARE, will help propel Provision into a brand new decade.

Nov

Lung Cancer awareness efforts focus on smoking prevention

By Provision CARES Proton Therapy

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

American Cancer Society. What Causes Lung Cancer? Read More
National Cancer Institute. National Lung Screening Trial. Read More
National Cancer Database Analysis of Proton Versus Photon Radiaion Therapy in NSCLC. Read More
American Cancer Society. Key Statistics for Lung Cancer. Read More
Proton Beam Radiotherapy and Concurrent Chemotherapy for Unresectable Stage III Non–Small Cell Lung Cancer Final Results of a Phase 2 Study. Read More
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

Sep

Proton Therapy Coming to Kansas City with Opening of Provision CARES Proton Therapy Center

By Provision CARES Proton Therapy

Knoxville, Tennessee (September 12, 2019) – – Provision Healthcare announces the expansion of the Provision CARES Cancer Network with plans to develop the Provision CARES Cancer Center and Proton Therapy Center in Kansas City, Kansas. The center will be the first in Kansas, located in the Lenexa community of Kansas City to serve patients in the area and surrounding region with advanced cancer care. Proton therapy precisely targets tumors thus reducing the risk of side effects and providing improved outcomes and quality of life for patients both during and after treatment

“The Kansas City Provision CARES Cancer Center and Proton Therapy Center will be the fourth Provision CARES center in the U.S. as Provision Healthcare continues to develop the network and pursue our mission to make advanced cancer care and proton therapy more accessible by developing cancer centers and proton therapy centers in the U.S., Asia, and around the world,” said Dr. Terry Douglass, Chairman and CEO of Provision Healthcare.

Kansas City’s proton therapy treatment center will be a three-treatment room center and will utilize the latest proton system technology of ProNova Solutions, which is a Provision Healthcare company. “Our team is honored to create, deliver and expand innovative technology that brings advancements and solutions to cancer care with our ProNova SC360”, said Joe Matteo, President of ProNova Solutions. Provision Solutions will provide the development, training and management of the proton therapy center and cancer center. It is projected that approximately 1,000 patients per year will be treated at the proton center. The development of other medical office space will provide additional complementary cancer services adjacent to the proton therapy center.

About Provision Healthcare

Provision Healthcare, LLC (Provision) 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 that distinguishes it from other proton and cancer center developers and operators that have a much narrower focus. The combination of our unique expertise and innovative, entrepreneurial approach continues to propel Provision towards a position of industry leadership with respect to both cancer care and proton therapy.

About ProNova Solutions, LLC and the ProNova SC360 Proton Therapy System

ProNova Solutions, LLC, a Provision Healthcare company was founded by current leaders of Provision and 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, making proton therapy a clinical reality. It is the only proton therapy system developed in a clinical setting, benefitting from continuous input from physicians, medical physicists, and therapists during the entire course of 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.

Contacts:

Nancy Howard
Provision Healthcare – Knoxville, TN
nancy.howard@provisionproton.com
(865) 603-0865

Sep

Am I at Risk for Prostate Cancer?

By Provision CARES Proton Therapy

September is Prostate Cancer Awareness Month. It is important to know if you are at risk of prostate cancer and whether you should get an annual Prostate-Specific Antigen (PSA) level test.

In Tennessee, as well as the United States, prostate cancer has the second highest new cancer rate overall and is the number one cancer for new cancer types among men.⁽¹⁾According to the Center for Disease Control (CDC), there are an estimated 3,110,403 men living with prostate cancer in the US. Based on their 2014-2016 data, approximately 11.6% of men will be diagnosed with prostate cancer at some point in their lifetime. According to SEER, there will be an estimated 174,650 new cases of prostate cancer in 2019 with an estimated 31,620 deaths from prostate cancer. The five year survival rate for prostate

Prostate cancer is most frequently diagnosed among men aged 65-74 with a median age of 66. However, 9.2% of new prostate cancer cases are among men under the age of 55.⁽²⁾

In addition to age, other factors can increase the risk of being diagnosed, including family history, genetic factors, race, lifestyle and dietary habits.

If an immediate family member such as your father or brother have been diagnosed with prostate cancer, then your risk of developing prostate cancer is 2 to 3 times higher than normal. Your risk increases with each relative that has been diagnosed with prostate cancer. Your risk will also increase if two or more close relatives on the same side of the family have been diagnosed with prostate cancer before the age of 55.⁽³⁾

African American men have a higher risk and are more likely to be diagnosed at a younger age and have been found to have a more aggressive tumor.

There have not been any studies to prove that diet and nutrition has any direct correlation with developing prostate cancer. However, if a male who is overweight is diagnosed with prostate cancer, they are at a greater risk for developing a more aggressive cancer.

While there can be lifestyle and dietary habits that can increase your risk of prostate cancer, there are a few myths that have been rumored to increase your risk of prostate cancer. Sexual activity level is a non-factor as well as having a vasectomy. Alcohol is another non-risk factor for prostate cancer.

If you do have any of these risk factors, it is important to have your PSA level checked annually. If you do have an elevated PSA level, your doctor can provide information on additional testing to confirm your diagnosis.

Source:

(1) Center for Disease Control. Prostate Cancer Statistics. https://www.cdc.gov/cancer/prostate/statistics/index.htm

(2) National Cancer Institute. Surveillance, Epidemiology, and End Results Program. Cancer Stat Facts: Prostate Cancer. https://seer.cancer.gov/statfacts/html/prost.html

(3) Cancer.Net. Prostate Cancer Statistics. https://www.cancer.net/cancer-types/prostate-cancer/statistics

Aug

The Important Role of Dosimetrists in your Proton Therapy Treatment Plan

By Provision CARES Proton Therapy

It only takes a few minutes for patients to receive their daily proton therapy treatment. However, for each treatment course there has been hours of prior planning to develop the best treatment plan according to the radiation oncologist’s prescription. The treatment plan comprises of the exact dose and beams and patient positioning aspects required to deliver the dose to the target volume.

Protons are positively charged particles that have a unique range of penetration into the patient’s body. This is characterized by the Bragg Peak. The Bragg Peak occurs at the point where the highest dose of radiation is delivered to the patient’s body. Dosimetrists use physics software tools to determine how to formulate the proton beam i.e. the beam energy and intensity in order for the Bragg Peak to occur at the site of the tumor. With protons, there is minimal entrance dose and no exit dose. The Bragg Peak happens at the tumor because the protons stop which makes proton radiation therapy so precise.

The dosimetry team works closely with the medical physicists and the radiation oncologists to determine the exact physics behind every single proton beam received by patients. No two treatment plans are the same. Treatments are completely customized based on the individual’s tumor, body and other factors.

One of the most important goals for our dosimetry team is to find the best treatment plan for every individual patient that minimizes the radiation to healthy tissue and critical organs. They do this using pencil beam scanning technology, where the beam of radiation, which is just millimeters wide, are controlled in position and depth in order to bypass nearby organs and targeting the tumor directly. The precision of proton therapy pencil beam scanning in conjunction with the dosimetrists who prepare the best treatment plans ensures that patients receive less radiation outside the target areas and therefore reduces side effects while maintaining their quality of life both during and after treatment.

Provision’s team of Dosimetrists in Knoxville is led by Valerie Coffman who is a board-certified dosimetrist with more than 5 years of experience in proton dosimetry. Including Valerie, Provision has a team of 4 board certified dosimetrists, two dosimetrists that just finished dosimetry training at provision and two dosimetry interns. The dosimetry team works in close collaboration with 4 board certified Medical physicists, two residents and one physics assistant.

In Nashville, Provision’s team of dosimetrists is led by Joe Simmons who is a board-certified dosimetrist with more than 15 years of experience in proton dosimetry. Including Joe, the Nashville team has 3 board certified dosimetrists and one dosimetry intern working with 3 board certified medical physicists and one physics assistant.

Together, our team of medical dosimetrists and physicists work to ensure that our patients receive the best treatment plans possible based on the prescribe radiation dose from our radiation oncology team.

Aug

Surviving Breast Cancer (Part 3)

By Provision CARES Proton Therapy

Casey’s Story: Starting Treatment

Casey is a two time breast cancer survivor who is sharing her experience during her proton therapy treatments at Provision CARES Proton Therapy Knoxville. Catch up on her story first by reading part one and part two of her blog series. As a Care Coordinator for Provision CARES Proton Therapy Knoxville and going through radiation therapy for the first time for recurring breast cancer, I can absolutely say that radiation therapists are gems…each and every one of them.

After initial office visits, CT Simulation, and treatment planning are finished it is time to start radiation therapy and these folks, the radiation therapists, are right there in the trenches with you. For the next 7 weeks I will see these wonderful people day in and day out to “finish off” this breast cancer.

Working at Provision gave me a sense of calm about the end result but to be candid, I was still nervous about the process. Would I know what to do and say? Is it weird to just lay on the table and be alone while radiation is being delivered? What does it feel like? Will I be self-conscious being exposed from the waist up?

Trust me when I tell you these therapists are experts at what they do. Zane, who manages the radiation therapists, was present for my first day. He explained everything to me as it was happening which was particularly helpful to me. A quick example: Zane explained body positioning, and how important it was to relax while being still. Proton therapy is very individualized which means no two plans are alike. Your plan is specific to your tumor size and site, your physical body size and contours and believe it or not, your breathing! These radiation oncologists and physicists think of everything.

After putting on a gown you are escorted to the treatment room and use a step stool to get on to a slightly raised table. In my case, radiation was going to be delivered with my arms above my head while I was lying flat with my knees slightly bent and supported. There is a mold for my arms to rest in that was made specifically for me. I remained covered up with a sheet until it was time for the actual treatment which was important to me. The next and maybe most appreciated step for me: MUSIC! It was calming and an immediate source of comfort for me. The therapists will ask you each day what you feel like listening to that day. This was a godsend to me as the music eased my nerves and passed the time.

I was unprepared for, but very impressed by, the perfection in positioning the therapists strive for. This is of utmost importance as the precise delivery (within a millimeter) of the proton beam depends on it. Before your actual treatment, one of our Radiation Oncologists will check the position of the patient and give the okay for proton delivery. The therapists leave the room and you are alone for about 90 seconds during treatment. You are never truly alone as you are being watched remotely, and after a few treatments you become very accustomed to the whole process.

Truthfully, it is a very quiet and calm time in the treatment room. There were no smells or sounds to really get used to and I did not “feel” the radiation delivery. For me, it was a time of reflection…a time to really think and appreciate what these fine folks do day in and day out. I never got the feeling that it wasjust a job for them. I always felt like I was the only patient there that day when in reality, there were up to 80 patients being treated in three treatment rooms.

Weekly visits with the clinical team are also part of your radiation therapy treatment. This is an important step in monitoring your skin and any other changes you may be going through such as fatigue. As I proceeded through treatment my only symptom was a significant “sunburn” to the areas treated. I was prepared for this and used creams and lotions that were suggested by my doctor. It was an easily forgotten side effect for me, though uncomfortable for a short period of time.

Every Friday I was given a treatment schedule for the next week. Wait, no weekends?.. a whole two days without radiation treatment? I wondered “What will I do without the conversations and encouragement from Amos, Chris, Jamie and Jennifer?” They were my people. My lifesavers. My friends. I can do this, and I will do this with the help of these compassionate, kind and relatable therapists.

To follow Casey’s story, please follow us on Facebook.

Jul

Surviving Breast Cancer (Part 2)

By Provision CARES Proton Therapy

Casey’s Story: Preparing for Treatment

Casey is a two time breast cancer survivor and care coordinator at Provision CARES Proton Therapy Knoxville. She answers phone calls and helps answer the questions of cancer patients every day, but with her experience on both sides of the phone, Casey is offering readers a unique perspective as someone who has been both a patient and someone who helps patients. To meet Casey, you can read part one of her blog series, Casey’s Story: Learning she has cancer for a second time

After all my tests and scans were complete, it was definite. Dr. Brig, my medical oncologist, told me I would have radiation therapy as part of my treatment protocol to make sure I never see this breast cancer again. My doctor knew that I know how important of a role proton therapy will play in my life with left sided breast cancer. Was I excited to undergo 34 radiation treatments? Not at all. Was I anxious about the possible side effects and time involved? I knew I would be tethered to Knoxville for the next 6.5 weeks, with only weekends off in between treatments. I mean, several months ago, I actually had a life! I regrouped and breathed a sigh of relief because I knew I would be in good hands at Provision.

A consult with one of our radiation oncologists is always the first step. A care coordinator that I have worked with for the past 2 years quickly gathered all my medical records and set me up to see Dr. Ben Wilkinson who spent time with me explaining how many fractions (treatments) of radiation I needed and how it may affect the skin around my left breast and axilla area, as well as my fatigue levels throughout treatment. He reassured me that he would be checking me weekly, right after one of my treatment days. Brittany, one of our awesome nurse practitioners, would also check my skin regularly. No stone would be unturned. If I needed anything, I knew who to ask.

Very shortly after consult I had what is called a CT Simulation. This is essentially a scan of your body to provide the contours needed for treatment planning. It took about an hour which was a bit longer than I expected in a slightly uncomfortable position with my arms above my head and lying flat on the table. Kerry, one of our incredible radiation therapists, made this procedure seamless for me. Not only is she an expert at what she does but she cares…and shows it in her disposition and heart-warming smile. A physicist, Sammie, was also present to help with body positioning and placement. We all know Sammie to be brilliant, energetic, beautiful and funny. She was one of many who would be making sure I never see breast cancer again.

After CT Simulation, I waited. I waited for these committed, hardworking, all knowing people behind closed doors of Provision Cares Proton Therapy to plan my treatment. They are a team of radiation oncologists, dosimetrists, physicists and radiation therapists. Not your average run of the mill people, but exceptionally trained and smart folks. All of whom are working on a treatment plan for me to be able to continue living my best life. It is truly humbling to me to be surrounded by such intelligence and excellence. It is fun too…. we laugh a lot at work and we appreciate each other. Not a bad gig for this girl. I love coming to work.

In the meantime, I patiently waited for my start date and appreciated all the hard work that brought me to this point in my interaction with Provision from a patient’s viewpoint. Many, many people got me to this point. The Finance/Insurance teams who work tirelessly to verify insurance benefits and fight for coverage….the Concierge team who coordinate countless appointments and make sure you as a patient are up to date on where you are supposed to be and what time….and our fabulous Hospitality team who treat you and your family members like guests in their home. What we call our “Culture of Care” is experienced in all facets of care at Provision. We know it is a hard time…a scary and challenging time, for many patients and their loved ones. We want our patients and their families to feel respected and cared for. I always smile when I peek downstairs at our lobby and see patients having coffee and chatting…after their treatment is finished. It is a beautiful thing. The next step for me? Starting my treatments.

To continue to follow my journey and read updated blog posts, please follow Provision on Facebook.

Jun

Surviving Breast Cancer (Part 1)

By Provision CARES Proton Therapy

Casey’s Story: Learning She Has Cancer for a Second Time

I have always considered myself a normal girl with a fairly normal life. Married to a great guy. I am healthy and active with 3 kids and a precious granddaughter who, along with my husband, are the loves of my life. We have lived in Knoxville for the past 18 years and feel blessed to have found this great part of East Tennessee to work, raise our kids and find wonderful friends. I have been working at Provision for two years now as a Care Coordinator, a position that I feel very comfortable with since I am a breast cancer survivor and can easily empathize with the patients. Recently, after two years at this job I love, I was again diagnosed with breast cancer. Although I have never blogged a day in my life, when presented with the opportunity to share my journey and my point of view from both sides of treatment, I thought it would be another way to help others facing cancer and radiation therapy – and for that reason, I was all in.

In 2012, while busy raising my then young teenagers, I was diagnosed with early stage breast cancer. My particular diagnosis required a bilateral mastectomy and reconstruction, and subsequent chemotherapy and immunotherapy. Relatively straightforward and at times challenging, but doable.

As a Care Coordinator, we are often the first person an individual who has been newly diagnosed with cancer or a concerned family member or friend speaks with when they call Provision CARES Proton Therapy for information. Almost always, this person is anxious, scared and uninformed about their illness. We do our very best here at Provision to provide a compassionate ear while collecting patient records and facilitating a consult date so that our radiation oncologists, clinical nursing and radiation therapy teams can address the patient’s treatment needs in a timely manner.

To hear for the second time in 6 years, “you have breast cancer” is enough to rock anyone’s world. I heard this news in the fall of 2018. Now, this mom of 3 children and one beautiful 6-year-old grandchild, was full of shock, fear and dread of what was in my immediate future: a whole lot of treatment that would NOT BE FUN and would cause me to again, lose my hair and my energy. And then maybe eventually… my life. We knew nothing at this point only that here we were AGAIN. It was a very dark time for my family. And for me.

Once the shock wore off, the Care Coordinator part of me began to surface. I knew immediately what I had to do to combat this disease for the second time. After a bilateral mastectomy and reconstruction in 2012, along with chemotherapy, I realized that radiation therapy would be in my immediate future. Recurrent breast cancer requires and arsenal of incredibly bright practitioners, along with state-of-the-art drugs and treatment. I knew right away that with left sided breast cancer, Proton Therapy is the recommended treatment in order to spare the heart and lungs from unnecessary radiation exposure. I knew that we (Provision) had a brilliant clinical team and a caring and conscientious support staff, state of the art technology and extensively trained radiation therapists.

This was not going to be a sprint…. but more of a marathon. As a former triathlete of 30+ years, I tend to think of things in segments or parts. Chemotherapy was the swim portion of the race. I hated getting in the pool, but knew I had to put the time in. Biking is fast and deliberate, and I related that to my surgery. Let the surgery be seamless and without complications (no bike wrecks). Get that cancer outta there! The last part of a triathlon is the running segment and I compare that to my upcoming radiation treatments. At this point you are tired and simply want a cold drink and some shade. But one must push on at this point and finish strong. Just like you surround yourself with training partners you trust and who make you feel good about your efforts, the same is true for your radiation treatment team.

I knew, without a doubt, that I would be well taken care of at Provision from start to finish. With all of this in mind, I also feel that everyone’s cancer journey is different. In this series of blogs, I’m sharing a little peek into my journey which I hope will give you or a loved one faced with a cancer diagnosis some peace of mind and maybe a smile along the way.

To continue to follow my journey and read updated blog posts, please follow Provision on Facebook.

Jun

New Study confirms proton therapy results in fewer side effects for many cancers.

By Provision CARES Proton Therapy

In the largest side-by-side comparison study of its kind, proton therapy was found to have fewer side effects while maintaining similar survival rates when compared to traditional X-ray radiation therapy.

The study, led by Washington University School of Medicine in St. Louis and the Perelman School of Medicine at the University of Pennsylvania, included almost 1,500 patients receiving combined chemotherapy and radiation therapy for lung, brain, head and neck, gastrointestinal and gynecologic cancers that were localized to one part of the body and had not metastasized. A combination treatment of chemotherapy and radiation therapy is a standard treatment leading to cure for many non-metastatic cancer. However, it is common for patients of this treatment regimen to experience severe side effects that can significantly reduce quality of life and in some cases require hospitalization, trading cure for side effects.

Proton Therapy is an advanced form of radiation therapy that uses protons to deliver the radiation directly to the tumor. Protons are positively charged particles that have a unique characteristic allowing more of the radiation dose to be directly deposited at the tumor. There is minimal entrance dose and no exit dose, significantly reducing radiation received to nearby healthy tissue and organs when compared to X-ray therapy that uses photons which travel all the way through the body and pass through healthy tissue on the way out. Both proton and X-ray radiation therapy are FDA approved.

According to the research, after controlling for differences between the groups, such as age and additional medical problems, the researchers found that patients receiving proton therapy experienced a two-thirds reduction in the relative risk of severe side effects within 90 days of treatment, compared with patients receiving X-ray radiation therapy. “We looked at grade-three side effects—including pain or difficulty swallowing, difficulty breathing, nausea, or diarrhea, among others—often severe enough for patients to be hospitalized,” says the study’s lead author Brian Baumann, an adjunct assistant professor of radiation oncology in the Perelman School of Medicine and an assistant professor of radiation oncology at Washington University School of Medicine in St. Louis. “Our clinical experience is that concurrent chemoradiation therapy patients treated with protons, rather than photons, tend to have fewer side effects. While there is some literature supporting that finding for several disease sites, we did not expect the magnitude of the benefit to be this large.”

Furthermore, the researchers found no difference between the two groups in survival, suggesting that proton therapy was just as effective in treating the cancer even as it caused fewer side effects. Overall survival at one year for the proton therapy group was 83 percent of patients versus 81 percent for the X-ray radiation therapy group.

To learn more about the benefits of proton therapy, visit our proton benefits page.

Source: 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.

May

Celebrating Nurses Week 2019

By Provision CARES Proton Therapy

Content and information were written in conjunction with Lindsay Chandler, RN, BSN, OCN Nursing Manager for Provision CARES Proton Therapy Knoxville

May 6^th-12th is a week of excellence for every nurse, and marks a time to acknowledge accomplishments, compassionate patient care and professionalism for the nursing society. The conclusion of Nurses Week is May 12^th, in honor of the mother of nursing, Florence Nightingale. Florence Nightingale was born on May 12^th, 1820, and she was the innovator of modern nursing. It was through her teaching, compassion, leadership and influence, that the world of nursing has evolved into what it is today.

2019 itself is a hallmark celebration for the nursing community. There are over 4 million Registered Nurses in the United States of America, and registered nurses comprise the largest group in healthcare! The American Nurses Association created the tagline for this year’s National Nurses Week is “4 Million Reasons to Celebrate” which is a nod to nurses’ sheer numbers and an open invitation to #ThankaNurse for enriching our lives and the world we live in.

May is also Oncology Nurse Month. As a cancer treatment facility featuring proton therapy, Provision CARES Proton Therapy Centers would also like to take a moment to highlight the role of the Oncology Nurse. Oncology Nurses care for people of all ages who are diagnosed with cancer. Oncology nurses provide support not only to patients, but their caregivers and families during an especially stressful time in their lives. An Oncology Nurse can gain knowledge through professional development and complete an examination to become an Oncology Certified Nurse (OCN). This certification signifies that a nurse has the knowledge and proficiency to care for patients with the diagnosis of cancer and marks a level of high achievement in the Oncology community.

Please join us in recognizing all the compassion and dedication our amazing nursing team provides at Provision Cares Proton Therapy Center. Our nursing team is responsible for documenting detailed health assessments for patients newly diagnosed with cancer, providing patient education founded on evidence-based practice, providing recommendations for screenings and follow up suggestions for abnormal values to ensure early intervention, administering medications, assisting in procedures, utilizing assessment skills and critical thinking to triage and identify acute or emergent conditions, participate in interdisciplinary team rounds to provide the highest quality of patient care.

Provision would like to acknowledge nurses throughout our country and how they influence and inspire as they practice their art of healing. Happy Nurses Week 2019!