News and Blog

Surviving Breast Cancer: Casey’s Story (Part Three) Starting Treatment.

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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.

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

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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

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Upcoming Event: Prostate Cancer 101: Understanding the Journey Diagnosis, Treatment, and Survival

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Join us for a free presentation to learn more about the latest developments in prostate cancer. Dr. Wilkinson will discuss 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.

Friday, September 20th from  930-11a

Hosted by: Provision CARES Proton Therapy Knoxville, 6450 Provision CARES Way, Knoxville, TN 37909

RSVP: To reserve your seat, please RSVP to Jenni Turner at 865.321.4539 or jenni.turner@provisionhp.com

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Free PSA level screenings offered throughout East Tennessee

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Eddie Check® and the Provision CARES Foundation Team Up for Blood Drive and Free PSA Screenings

Available at 16 different East Tennessee locations across 10 counties on September 12th & 13th.

Unbelievably, One in nine men will be diagnosed with prostate cancer during his lifetime – and one in 41 will die from it. Prostate cancer is second only to skin cancer as the most common cancer in American men and second only to lung cancer as the leading cancer-based cause of death in American men. The American Cancer Society estimates that in the U.S. during 2019, about 174,650 new cases of prostate cancer will be diagnosed and 31,620 men will die from it.

But there’s still good news. If prostate cancer is caught early, the 5-year survival rate is nearly 100%. The numbers say it all: Get tested!  Prostate cancer is rare before age 40, so if you are 40 or older, the first step is a free, simple PSA screening that only requires a blood sample. “PSA” stands for prostate-specific antigen, a protein produced by prostate cells. The PSA test is done to help diagnose and follow prostate cancer in men.  No certain PSA level is called normal or abnormal, and an elevated level does not mean you have prostate cancer – only a biopsy can diagnose cancer. Always discuss PSA test results with your doctor and be sure to have a digital rectal exam (DRE), as about 6% of men with prostate cancer continue to have normal PSA.

In 2004, Rockford-based Nisus Corporation, a manufacturer of green products for the pest control and wood preservation industries, teamed up with area hospitals and MEDIC Regional Blood Center to create Eddie Check, an annual event that adds free PSA screening for prostate cancer to blood drives. It was a simple strategy using MEDIC’s already existing resources to make it fast and easy for men to get a blood sample drawn for the screening. Nisus has a personal stake in the fight; marketing vice president Jim Gorman is a prostate cancer survivor, while company president Kevin L. Kirkland lost his father, Eddie Kirkland, to the disease. In fact, “Eddie Check” is named for Eddie Kirkland.

Once again, Nisus, MEDIC, Provision CARES Proton Therapy, and Provision CARES Foundation join with sponsors WIVK FM 107.7, Sports Radio WNML 99.1 FM & 990 AM, NewsTalk 98.7 FM, WVLT, and Abacus Arts, Inc.

Sites and Locations

Thursday, September 12

Friday, September 13

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Am I at Risk for Prostate Cancer

Am I at risk for prostate cancer?

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September is Prostate Cancer Awareness Month.  It is important to know if you are at risk and if 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 in the risk of being diagnosed with prostate cancer 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 of prostate cancer 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 prostate 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

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The Important Role of Dosimetrists in your Proton Therapy Treatment Plan

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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.

 

 

 

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Surviving Breast Cancer: Casey’s Story (Part 2) Preparing for Treatment

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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.

 

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Upcoming Events: Prostate Cancer 101: Understanding the Journey Diagnosis, Treatment, and Survival

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Join us for a free presentation to learn more about the latest developments in prostate cancer. Dr. Wilkinson will discuss 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.

Friday, July 26th from 930-11a and Friday August 23rd from 930-11a

Hosted by: Provision CARES Proton Therapy Knoxville, 6450 Provision CARES Way, Knoxville, TN 37909

RSVP: To reserve your seat, please RSVP to Jenni Turner at 865.321.4539 or jenni.turner@provisionhp.com

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Proton therapy for treating left-sided breast cancer plays a crucial part in sparing damage to your heart.

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As with other cancers, the best possible outcomes for breast cancer treatment come through early breast cancer care. However, if breast cancer is diagnosed, treatments can include chemotherapy, hormone therapy, targeted therapy, surgery, and radiation. As there is not one perfect formula to eliminate the disease, many patients will need to undergo a combination of these treatment methods.

When it comes to radiation therapy, it is important to know your options and which type of radiation treatment is best for you.

Proton therapy is an advanced form of radiation therapy that is noninvasive and precisely targets your tumor using a single beam of high-energy protons to kill cancer cells. Proton therapy’s unique characteristics as a positively charged particle can precisely deposit radiation directly in the cancerous tumor with no exit dose. Both x-rays and protons damage cancer cells, but unlike standard radiation therapy, proton therapy deposits the majority of the radiation dose directly into the tumor. This spares nearby healthy tissues and organs from receiving unnecessary radiation, thus reducing damaging side effects and complications, compared to conventional radiation.

This is especially important in left-sided breast cancer, as the cancer is close to critical organs such as the heart and the lungs.

According to research published in JAMA Internal Medicine, women who have received breast cancer radiation treatment via x-rays face a 0.5% to 3.5% higher risk for heart attack or other cardiovascular issues. The risk is highest among women who’ve had conventional radiation to the left breast because of the target’s close proximity to the heart.

A European study in The New England Journal of Medicine revealed that the harmful cardiovascular effects typically begin to emerge as soon as five years after cancer radiation treatment.

With proton therapy treatment for breast cancer, on average, there is no radiation to the heart and 50% less radiation to the lung as compared with conventional radiation.

Furthermore, a 2014 clinical trial by Loma Linda University found that 90% of proton therapy cases result in “good: to “excellent” cosmetic result for partial breast radiation patients during the five years following treatment.

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

For left-sided breast cancer patients, this could be the key to a healthier life after treatment.

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Surviving Breast Cancer: Casey’s Story (Part One) Learning she has cancer for a second time

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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.

 

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