New study shows lung cancer proton therapy may reduce risk of heart disease

New study suggests proton therapy for lung cancer lowers risk of heart disease

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When treating lung cancer with radiation therapy, there is a significant concern that the treatment dose will expose the heart to excess radiation. One way to avoid this unnecessary radiation is by using proton therapy, a more precise form of radiation therapy as compared to traditional radiation therapy (x-rays/photons).

Researchers now say there is a link between lung cancer proton therapy and a reduced risk of certain heart diseases, including mini-strokes and heart attacks.

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Study finds PSA test for prostate cancer has long-term benefits

PSA test for prostate cancer offers long-term benefits, study finds

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September is Prostate Cancer Awareness Month and it’s common to hear public service announcements reminding men to get a prostate-specific antigen (PSA) test. Afterall, prostate cancer is the second leading cause of cancer death among American men and early detection is the best prevention.

However, recent recommendations from the U.S. Preventive Services Task Force (USPSTF) cast doubt on whether the potential risks associated with PSA screening are worth the reward. Now though, new research suggests those risks may be exaggerated.

The long-term benefits of the PSA test for prostate cancer may outweigh any potential harm according to a recent paper published in the New England Journal of Medicine (NEJM). While current guidelines advise patients and physicians to determine the value of routine PSA screening on a case-by-case basis, researchers suggest that perceptions of PSA tests as ineffective are based on overstated harms and point to evidence showing that screenings can reduce death rates and prevent metastatic disease.

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Delaying cancer screening tests during COVID puts patients at risk

Delayed cancer screenings in COVID era put patients at risk

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

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

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

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Proton therapy cancer treatment significantly lowers the risk of second cancer compared to IMRT and 3DCRT

Proton Therapy significantly lowers risk of second cancer

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X-ray (also called photon) therapy has long been known to cause the development of potentially deadly new cancers in patients who undergo radiation therapy to treat their cancer. However, research shows that patients who choose proton therapy for cancer treatment have a significantly lower risk of developing a second cancer later in life.

In a  comprehensive study published last month in Cancer, the prestigious, peer-reviewed journal of the American Cancer Society, researchers at Stanford University found that patients who were treated with x-ray therapy developed more than three times as many new cancers as patients treated with proton therapy.1

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NAPT celebrates 30 years of supporting access to proton therapy

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

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

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Male cancer patient using telehealth

Telehealth can help cancer patients during coronavirus pandemic

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Trying to navigate your cancer care journey is challenging enough without the added stress of a global pandemic.  Normally, you would schedule an in-person consultation with a physician to discuss your treatment options. Understandably though, many cancer patients now have reservations about going out in public during the coronavirus pandemic.

Thankfully, telehealth provides a safe way for someone with cancer to continue moving forward with their care in a timely manner.

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Research shows liver cancer proton therapy can help improve survival rate

Liver cancer patients may benefit from advantages of proton therapy

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Liver cancer proton therapy can improve the overall survival rate for patients, according to a new study. This good news for proton advocates comes on the heels of another study identifying predictors to help reduce liver damage from radiation, which could give doctors better insight when determining a patient’s treatment plan.

In a news release from the American Society for Radiation Oncology (ASTRO), Laura Dawson, MD, President-elect of ASTRO and a professor of radiation oncology at the Princess Margaret Cancer Center in Toronto, remarked on the promise this shows for patients with hepatocellular carcinoma, an often fatal type of liver cancer. “There is hope for patients with liver cancer, with more treatments becoming available in recent years,” said Dawson. “These studies show that protons, like photons, may be used to treat patients with HCC with a high rate of tumor control and a reduced risk of adverse effects.”

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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.

 

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

 

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 of prostate cancer and whether you should get an annual Prostate-Specific Antigen (PSA) level test.

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

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

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

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

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

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

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

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

Source:

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

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

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