News and Blog

Nov
06
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.

 

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Oct
30
Breast Cancer Awareness Month

Breast Cancer Facts: 5 Common Myths Debunked

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

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

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

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

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

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

MYTH: Breast cancer only happens to older women.

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

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

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

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

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

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

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

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

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

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

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

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

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

MYTH: Antiperspirants and wire bras can cause breast cancer.

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

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

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

Sources:

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

 

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Oct
21
proton therapy for breast cancer treatment

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

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

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

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

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

How Massachusetts General Hospital conducted the study

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

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

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

Summary of the study’s results

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

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

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

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

What’s next for proton therapy research?

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

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

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

The Benefits of Proton Therapy for Breast Cancer Treatment

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

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

Sources:

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

 

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Sep
17

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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Sep
04

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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Sep
04

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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Sep
03
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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Aug
20

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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Aug
10

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.

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Jul
03

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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