Mar
12

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

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

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

It’s cancer.

…CONTINUE READING

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.

 

Aug
20

How Dosimetry Helps Shape 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 have been hours of prior planning to develop the best treatment plan according to the radiation oncologist’s prescription.  Dosimetry plays a vital role in proton therapy, helping to create a unique treatment plan comprising of the exact dose,  beam angles and patient positioning aspects required to deliver the dose to the target volume.

READ MORE

Aug
15

Provision Dosimetrists Win Big with Protons

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Provision Dosimetrists Win Big with Protons

In honor of National Medical Dosimetrist’s Day, Provision CARES Proton Therapy Knoxville wants to call attention to recent accomplishments of members of our medical dosimetry team. This spring, medical dosimetrists from all over the world participated in a competition to create the best dosimetry plan to treat a specified breast cancer patient.  The Provision dosimetrists’ submissions were awarded top scores.

(more…)

Feb
23

Provision dosimetrist ranks with best in planning contest

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When his boss sent out an email encouraging those in the Provision medical physics department to participate in an international treatment planning competition, Kevin Kirby decided to give it a shot.

Sponsored by ProKnow, a radiation analytics and quality assurance company, the assignment of creating a radiation treatment plan for a head and neck cancer case attracted more than 200 entries.

In the final results, Kirby’s entry ranked 21st among 238 treatment plans, and first among proton therapy entries.

“A perfect score was 150,” said Kirby, a medical dosimetrist at Provision Proton Therapy Center. “I got 144.” The top score was 146.9.

He is the second Provision employee to place high in the ProKnow competition, known as the QADS Plan Study. Samantha Hedrick, a medical physicist, achieved third place out of 124 entries in 2013.

ProKnow develops and sells software to “help improve the standard of care in radiation oncology” through analytical tools and databases that help customers measure and track their planning efforts with a goal of identifying best practices for treating a variety of diseases.

The plan Kirby submitted was scored on a scale of 20+ criteria categories, with the ultimate goal of providing the most dose to the tumor versus the least dose to the surrounding, healthy parts of the body.

Kirby credited his treatment modality, proton therapy, with giving him an edge over competitors using conventional radiation treatment methods.

Proton therapy is particularly suited to treatment of head and neck cancer, because “you are dealing with some very critically sensitive areas to radiation, such as the spine and brain,” Kirby said. “Proton therapy is just one of the top ways to treat one of the most difficult areas to get to in the body.”

“Kevin is an outstanding dosimetrist.  Along with the rest of our staff, Kevin’s knowledge and work ethic has kept Provision’s planning capabilities at the forefront of radiation therapy,” said Ben Robison, Provision director of medical physics.

Kirby’s high score got him a phone interview with ProKnow in which he was asked about his personal background and more details about his planning methods. ProKnow is making the interview available via its website. Ranking so high among other treatment plans is quantitative validation that proton therapy and, specifically, the medical care at Provision, is best-in-class, he said.

“There’s a lot of hyperbole,” Kirby said. “This is a blind, metric product that shows our treatment is one of the best in the world. It just validates what we’re doing here.”

Mar
24

Dosimetrists focus on finding perfect proton path

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Not too long ago, radiation prescribed for cancer treatment was calculated by physical measurement and mathematic formulas worked out by hand.

Now computers do much of that detail work, but the job of a dosimetrist is as important as ever in making sure patients receive the right dose of radiation in exactly the right place. And thanks to advancements in the field—the development of proton therapy and advanced application technologies such as pencil-beam scanning, sophisticated software modeling platforms and high tech imaging capabilities—patients receive precise, customized therapy that’s the best in the world.

Kevin Kirby is one of six dosimetrists who work at Provision Center for Proton Therapy. These experts in the delivery of radiation for treatment of cancer work with radiation oncologist and physicists to determine the best treatment plan and then ensure its successful delivery, says Kirby, who spoke recently at a patient chat, held each Wednesday at the proton therapy center. The talks provide information on a variety of topics of interest to patients and their families.

“Our job is to create (proton therapy) dosage that focuses just in the tumor,” Kirby says. “We figure out the best way to position the patient so we can minimize any radiation to excess tissue.”

With the pencil beam application ability, calculations must be made to determine the direction and length of path for the protons being channeled to the tumor. In some cases, treatment can be made challenging by the location of the tumor, on the lung, for instance, in which radiation must be administered while the patient is breathing.

“We are able to predict the motion of the lungs by using four-dimensional CT scans to develop the treatment plans,” he says.

A laundry list of equipment and programs are involved in coming up with the unique plan for each patient. In the case of the lung cancer patient, for example, a respiratory device helps plan for treatment between breaths. Medcam marries patient x-rays with CT scans to aid dosimetrists, physicians and physicists in creating the treatment protocol. A software package called “Matrix” serves as quality assurance for treatment before it starts, even sending protons into the nozzle through which they’ll be delivered to the patient. Treatment planning software serves as a “flight simulator, which also allows for changes in the treatment plan based on shifts inside a patients body during the course of therapy. Another program, Mosaiq, records the treatment itself, creating a unique therapy chart for every patient.

Among the team of caregivers, physicians prescribe and monitor treatment, physicists manage the entire process on both the equipment and treatment delivery side and therapists interact directly with patients who are receiving therapy. Dosimetrists, says Kirby, focus specifically on the way radiation—in this case, proton therapy—targets the cancer in the patient’s body.

“We take the prescription the doctor gives and determine how to deliver it,” he says.

May
20

Provision & Raysearch: A look at proton therapy treatment planning

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Provision Center for Proton Therapy is the star in this movie produced by RaySearch and featuring the company’s software system, RayStation. The system allows physicians create custom and adaptable treatment plans for proton therapy patients.

Provision has been utilizing RayStation for treatment planning since the center opened last year. The result? World-class cancer care.

Jul
11

What is Dosimetry?

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I am a Medical Dosimetrist here at the Provision Center for Proton Therapy in Knoxville.  The reason for this blog post is to answer a question I have been asked by many friends and family. What is Dosimetry?  As I was writing this, I found it amusing that Microsoft Word underlines the word Dosimetrist in red due to the fact it doesn’t recognize the spelling.  To put it quite simply a Dosimetrist is one who measures dose.

So what are the responsibilities of a Medical Dosimetrist in the field of proton therapy?  A Dosimetrist is an individual that is part of a Dosimetry team that has many roles and duties.  Although the duties of a Dosimetrist are numerous, I am going to outline three of the major responsibilities of a Dosimetrist.  They are importation, contouring and planning.

IMPORTATION

The first of these is to import the CT scan into a treatment planning computer.  After a patient comes in on their first day and gets their treatment planning CT scan, the images are sent electronically to Physics where a Dosimetrist will import those images into a treatment planning computer and, if necessary, will fuse them with any other test they may have had, such as an MRI or a PET/CT.  Fusing is when a Dosimetrist overlays and aligns the treatment area found on a previous PET/CT or MRI with the treatment area on the treatment planning CT images.  Not all cases need to be fused and the necessity of whether to fuse or not is dictated by the Physician.

CONTOURING

Once the images are fused, the second responsibility of a Dosimetrist is to contour in the “organs at risk” or as we refer to them: O.A.R.’s.  Organs at risk are defined as organs that are in the path of the beam and/or are in close proximity of the beam and have a low radiation dose tolerance.  An example of these would be the eye when treating the brain, the heart when treating a lung or the bladder when treating the prostate.  To contour these structures the Dosimetrist will use the treatment planning software to trace around the organs that are represented on the treatment planning CT images.  Once these organs and tissues are drawn the physician will come in and contour in the area that needs to be treated to their prescribed dose.   It is during this time that the number of beams and their angles are discussed.

PLANNING

After the Physician has contoured in the treatment area, sometimes referred to as the Region of Interest, and the Dosimetrist has contoured in the O.A.R’s, the Dosimetrist can start the most important part of their job, the planning.  How a patient will be treated is collectively decided by the Physician, the Dosimetrist and the Medical Physicist.  The Physician will let the Dosimetrist know how much radiation they want delivered to the treatment site and in how many fractions or days.  The Dosimetrist will then enter that information into the treatment planning system and create a plan that will deliver that dose to the cancer while sparing as much healthy tissue as possible. After the plan has been approved by the Physician and has passed Physics Quality Assurance testing it is then exported to the treatment console for the Radiation Therapists to deliver daily treatments to the patient until the prescription is fulfilled.

I hope this answers a few of your questions and spurs a few more.  Please feel free to ask me or any other staff members any questions you may have about your treatment.

jeff-stamper

Jeff Stamper is a Medical Dosimetrist at Provision Center for Proton Therapy.