1 in 4 Lung Cancers are in Never Smokers

When every extra day counts, turn to the CyberKnife.

Did you know that “never smokers” make up 28% of new diagnosis of early stage non-small cell lung cancer patients?

 Dr. Eric Lim and colleagues from London looked at 2,170 British men and women who had  lung cancer surgery from March 2008 to November 2014.   

The remarkable finding was that “never-smokers” with lung cancer increased each and every year from 13% in 2007 to 28% in 2013.  And the trend was due to a dramatic increase in the absolute numbers of “never smokers” with lung cancer.   Fifty five percent of those patients with lung cancer were found “incidentally.”  That is to say, their lung cancers were found by CT scans, PET-CT scans, X-rays, or MRI’s ordered for other reasons-not because their physicians suspected lung cancer.  Only 14% of patients had symptoms of lung cancer-like coughing up blood or profound shortness of breath. 

Like many good medical studies, Dr. Lim’s article raises more questions than answers.  Were these lung cancer patients who were “never smokers” exposed to second-hand smoke at home or in the workplace?  What about other exposures, like chemical toxins, in the workplace?  Are there differences in “never-smokers” who live in the city versus out in the country?  What about family history?  Do the same trends hold for people in the US? 

So whether it’s family history, genetics, race or just bad luck remains to be seen.  But the good news is that lung cancer caught early is highly curable.  Cure rates are now in the 80-90% range for 5 years.  And you may not need surgery at all.  Many studies have now shown that Cyber Knife radiosurgery is equal to or even better than open surgery for patients with early stage lung cancer.  And Cyber Knife is done as an outpatient-no incision, no pain, and no long hospital stays; eliminating the complications that go along with surgery.

So if you have any questions about your lung cancer, please free to call me, Dr. Edward Hughes

What’s the Big Deal about the CyberKnife? Why only 5 Treatments?

The Superior Precision of the CyberKnife allows for Only 3-5 Treatments Most Cancers.

Simply put, CyberKnife Stereotactic Ablative Body Radiotherapy, or SABR for short, controls cancers even better than predicted.  For example, the results for patients with early stage lung cancer have been particularly striking. Studies have shown 85-90% cancer control rates with a 3-5 CyberKnife treatments versus only 30% with 30-40 ordinary radiation treatments.  This means that  85-90% of lung cancer patient treated with the CyberKnife got rid of their cancer. That is a huge increase in successful cancer treatment. More people are beating their disease with the CyberKnife than with ordinary radiation therapy.

Because of this success, a lot of research is being done to find out why it is working so well. And to learn how else SABR can be used to treat cancers and other diseases. Here are some cutting-edge facts:

CyberKnife Damages Cancer’s Blood Supply  

  1. In a recent editorial, oncologist Dr. Paul Sperduto and colleagues stated “the literature supporting this phenomenon (high-dose radiation results in indirect tumor cell death) is not fragmentary, but actually quite robust….  However, we have consistently underestimated the role of indirect cell death by devascularization and its possible role in radiation-induced immune enhancement.”  (Int. J Radiation Oncol Biol Phys. 91, No.1,pp121-13, 2015)
  2. When you cut off the blood supply to the cancer cells, they die. Decades of research shows that a few high doses of radiation will damage the blood vessels supplying the tumor. There is now active research combining Avastin, a drug that blocks blood vessel formation and SABR. Using Avastin and the Cyber Knife may double the efforts to cut off the tumor’s blood supply.

 CyberKnife Can Generate an Immune Response to Attack the Cancer

CyberKnife may help unleash your body’s own immune system to fight your cancer. Recent studies suggest that SABR cause the body to release tumor-specific antigens. These antigens are unique molecules released after radiation destruction of cancer and can generate a cancer-specific immune response.  Once again, there is now active research combining SABR, like that delivered by CyberKnife, with the recent FDA approved drugs called immune checkpoint inhibitors.

CyberKnife Tracks Your Cancer As It Moves

Much like a jet-fighter pilot who always has an enemy target in its cross-hairs, CyberKnife can track your lung cancer as it moves with each and every breath.  CyberKnife’s pencil thin beams of radiation can destroy your tumor, while sparing surrounding normal tissues.  Because of this precision, CyberKnife  uses hundreds of beams of radiation instead of 5 – 7 beams delivered with other radiation machines. With the CyberKnife you do not have to hold your breath during treatment. You just lie still and the machine does all the work for you. Each treatment typically takes a mere 25-50 minutes, with plenty of breaks if needed.

It is not just lung cancers that move. Prostate cancer, liver cancer, pancreas cancer, and many other cancers move inside the body. CyberKnife is the only radiation device that directly watches your cancer as it moves, keeping collateral damage to a minimum.

If you or a loved one has cancer, learn all the options. Discover more here. CyberKnife maybe the answer to beating your cancer. Call me to discover how I can help win your fight.

Computers Helped Save My Life

The CyberKnife can give 300+ beams of controlled radiation to a lung tumor, all while the patient breathes normally.

“I have cancer growing inside of my lungs. I can’t see it. I can’t touch it. But I know that it is there”, shares John, a computer technologist from West Chester.

John states that the doctors have shown him the medical images of his lungs so that he could see his cancer. “Even though I have seen in CT scans and MRI’s, it is still hard to believe. I thought that my increased congestion was due to allergies. I work with computers all day long, but now computers are helping to save my life.”

In addition to the advanced medical images that diagnosed John’s cancer, the treatment that he chose is also possible because of the advances in computer technology. Surgery was not an option for John because it would have damaged the healthy tissue and was close to his heart. He chose to have radiation therapy with Dr. Ed Hughes instead.

“The fact that we can now use advanced computer imaging during John’s treatment to actually see inside his lungs; has been the biggest medical breakthrough in my 35 year career”, explains Hughes. The CyberKnife’s computers actually track the motion of John’s breathing so that it can deliver the radiation with sub-millimeter precision to only the cancerous tissue.

“Knowing that the doctors could see inside my lungs and that the CyberKnife was so precise and so accurate, helped me to relax. I work. I support my wife and 3 kids. I was not only afraid for my life, but afraid to take off work to recover”, says John. He was able to have 3 CyberKnife treatments that lasted about half an hour each. He was able to keep working and was able to keep up with his active family.

It has been 14 months since his CyberKnife treatments and he is now cancer free. (original blog was in July of 2014)

John shares his enthusiasm, “I have always loved computers. They have fascinated me since I was a teenager and now they have saved my life.”

John was just in to visit with us and he is still cancer free thanks to Dr. Hughes and the CyberKnife. If you want help like John, call Dr. Hughes today.

Elderly Lung Cancer Patients Fear Treatment

CyberKnife is the answer for early stage lung cancer, especially in those older than 70. The decreased complication risks make it ideal.

So many of my elderly patients are now asking whether it’s worth it or not to treat early-stage lung cancer. “I have to die of something!”

But Dr. Walter Curran and colleagues from Emory University School of Medicine may now have a good answer to that important question.  From 2003-2006, the National Cancer Data Base was analyzed for patients 70 years or older with early stage lung cancer who chose either a watch and wait approach or stereotactic radiosurgery, like that delivered by Cyber Knife.  Their findings were reported in the August 2015 Journal of Cancer. The results were striking.  Senior patients with early stage lung cancer treated with stereotactic radiosurgery had better survival than those patients who chose a watch and wait approach.  Importantly, those patients were treated with stereotactic radiosurgery were no sicker initially than those who chose a watch and wait approach.  And they fared much better afterwards.

Stereotactic Radiosurgery, Like that Delivered by Cyber Knife, May be the Solution to Those Fears 

Stereotactic radiosurgery, like that delivered by Cyber Knife, has produced the same lung cancer control rates as surgery for early stage lung cancer patients, but with far fewer side effects.  No incision.  No pain.  And no hospitalization.  Cyber Knife is done on an outpatient basis.  It’s now considered the standard of care for early stage lung cancer patients who are “medically inoperable” or too sick for surgery.

Recent results indicate that Cyber Knife stereotactic radiosurgery may be just as good as open surgery for medically operable patients, or those patients who are healthy enough for open surgery like lobectomy or video-assisted lobectomy.  In a study in the June 2015 issue of the medical journal Lancet Oncology, Dr. Chang and coworkers reported that early-stage lung cancer patients treated with stereotactic radiosurgery had a 95% survival at 3 years versus only 79% for patients with surgery.  And the complications with open are far more severe.  My conclusion is that Cyber Knife radiosurgery may be just as good as open surgery even for young patients who are fit as a fiddle.

So What’s  a Senior with Early Stage Lung Cancer To Do?

Dr. Jonathan Beitler  of Johns Hopkins, commenting on this study, stated “I have to say that it seems to be the surgical community has resisted a large-scale randomized trial and from their point of view, who could blame them?  On the other hand, are they looking out for the patient’s or for themselves?”  That’s a sobering thought.  While I’ll never comment on another person’s motives, I know that it can take a while before doctors change their practice habits.  After all, it took over 50 years for surgeons to learn that a radical mastectomy just simply didn’t work.  More is not always better.  I do think it’s a good idea, may be even mandatory, for all early-stage lung cancer patients, young or old, to see a radiation oncologist experienced in Cyber Knife before undergoing the cold, hard steel sharp edge of the scalpel.  It just may be in the patient’s best interest.  Each and every week when I see early-stage lung cancer patients in consultation, I have to dispel a lot of myths about Cyber Knife.  In this day of data driven decision making, it’s important to have the facts from a number of sources.
So if you have any questions, please feel free to call me, Dr. Ed Hughes, at 855-DAYTON1

CyberKnife for Early Stage Lung Cancer Continues to be Superior to Surgery

Two years after this study was published, survival rates for lung cancer patients treated with the CyberKnife continue to climb. Lung cancer patients treated with the CyberKnife are simply outliving those who had surgery. This is fantastic news! Read more about the original study here:

Treatment for lung cancer with radiation therapy is proven to be superior to surgery. In a landmark study published in the Lancet Oncology June 2015 16(6) 630-637, cancer specialists reported that early stage lung cancer patients treated with stereotactic ablative body radiotherapy (SABR), like that delivered by CyberKnife, had a 3 year overall survival of 95%. Surprisingly, early stage lung cancer patients faired much worse with open surgery (lobectomy) with a 3 year overall survival of only 79%.

CyberKnife treatment stands in stark contrast to surgery. CyberKnife is a highly specialized form of radiation therapy done on an outpatient basis in 3-5 visits, with no pain and no cutting. A lobectomy on the other hand is a major operation where surgeons open your chest and remove an entire lobe of your lung. Requiring a prolonged hospital stay with all the risks of surgery on the chest.

Dr. Joe Y. Chang, a professor of radiation oncology at the world famous M.D. Anderson Cancer Center told Medscape, “For the first time, we can say that the 2 therapies are at least equally effective, and the stereotactic ablative radiotherapy (CyberKnife) appears to be better tolerated and might led to better survival outcomes for these patients.”

WHY IS THIS IMPORTANT FOR PATIENTS AND PHYSICIANS TO KNOW?

I believe this study is telling us that CyberKnife is a good solution as compared to open surgery. And a solution that does not require a major operation. No incisions, no pain, and no prolonged hospital stays with a difficult recovery. CyberKnife is painless and quick. You simply lay on a table and relax. No need to even get undressed.

WHAT IS THE CYBERKNIFE ADVANTAGE?

There are other stereotactic systems found at area hospitals. However, the CyberKnife is the ONLY stereotactic radiation device that actually breathes with you. There is no breath holding. This system has real time x-ray imaging that tracks your movement ensuring that it only targets the tumor and spares healthy tissue. This results in fewer long term side effects and offers immediate results.

First Dayton is the ONLY cancer center in southwest Ohio with the CyberKnife system for treating lung cancers. Discover if CyberKnife is the right choice to treat your lung cancer by calling me today, Dr. Ed Hughes at 855-DAYTON1.

Learn more about CyberKnife Treatment for Lung Cancer here.

Politics, Patients, and Prostate Cancer

YOU OWE IT TO YOURSELF TO TALK TO YOUR DOCTOR ABOUT PROSTATE CANCER SCREENING

Whatever your politics, it’s true that ObamaCare came between you and your doctor in more ways than one.  Nothing says that more than the USPSTF decision to reverse its recommendation about PSA screening for prostate cancer.  USPSTF is a mouthful that stands for United States Preventative Services Task Force. 

USPSTF reversed its recommendation for PSA screening for prostate cancer for men 70 years and younger.  The USPSTF now says there is “at least a moderate certainty that the net benefit is small.”  Jamie Bearse, the CEO of ZERO, a patient advocacy group said “While the improved recommendation is a step in the right direction, there is much work to do.  We must undo a decade-long message that discouraged men from getting tested, and encouraged men to talk to the doctor about their risks and the test.”  In 2012, the USPSTF advised against all PSA testing in men of any age. 

But for men 70 years and older, I urge you to discuss PSA testing with your doctor.  Some risks are not so obvious.  For example, a history of breast cancer and ovarian cancer in your family may indicate a greater risk for prostate cancer in men.  Other factors are well-known.  African-American men have a greater risk of prostate cancer than white man.  And recent work from the Johns Hopkins University School of Medicine showed that 2/3’s of all prostate cancers are just due to chance or bad luck.  So it is not so simple as it seems.

 If you have any questions about PSA testing or treatment of your prostate cancer, please feel free to call me, Dr. Edward Hughes, at 855-Dayton 1.  I guarantee that I will see you in consultation within 1-3 days of your phone call.

CYBERKNIFE TREATMENT THROUGH THE EYES OF A CHILD

Cancer treatment with the CyberKnife system is so easy for the patient that we would even allow a child to watch. The patient simply lays on a table for 25-60 minutes while the CyberKnife moves around them. They are able to take breaks, sit up or even take a bathroom break if needed. But they do not feel anything. Treatment is painless. They go about their normal day afterwards. Watch and see.

Real Hope for Stage 4 Lung Cancer

An Important Question  

What options are there for stage 4 non-small cell lung cancer patients with limited metastatic disease – the cancer has spread to less than 3 organs other than the lung? 

Study after study have shown that most failures of chemotherapy are exactly at the places of the original lung cancer, and not new sites.  So why not focus on those areas instead of giving more “maintenance” chemotherapy? 

An Important Clinical Trial  

Dr. Daniel Gomez and colleagues spearheaded a clinical trial (ClinicalTrials.gov space NCT01725165) that randomly assigned stage 4 lung patients to “maintenance” chemotherapy versus local therapy (mostly radiation, but some with surgery) versus no treatment at all. 

The multi-center study was published in the British journal called The Lancet Oncology in December 2016, pages 1672-1682.  To be eligible for the clinical trial, stage 4 non-small cell lung cancer patients had standard chemotherapy and were in relatively good shape after chemotherapy treatment. 

A Breakthrough Result 

Although only 74 lung cancer patients were entered into the clinical trial from 2012 to 2016, a real breakthrough result was seen.  The breakthrough result was that the local therapy group (radiation or surgery) survived 12 months versus 4 months for the “maintenance” chemotherapy group.  The clinical trial was closed early because the doctors saw better results in the local therapy group (radiation or surgery) versus the “maintenance” chemotherapy group. 

Where Do You Go from Here?  

As a CyberKnife cancer specialist in Dayton Ohio, CyberKnife offers our stage 4 non-small cell lung cancer patients real hope.  And CyberKnife can help you beat your non-small cell lung cancer without surgery.  No pain and no incisions. Real hope for another year of symptom free survival. 

If you have any questions about your lung cancer, please feel free to call me, Dr. Edward Hughes at 855-Dayton 1.  Or visit our website and I guarantee that I will see you within 1-3 days of your phone call.

2 Key Studies for Seniors with Lung Cancer

With only 1 CyberKnife Treatment needed, you can get back to doing what is important.

At the recent 2017 Multidisciplinary Thoracic Cancer Symposium, there were 2 key studies that will benefit our seniors with lung cancer. 

The first study showed that early stage lung cancer patients treated with stereotactic body radiotherapy (SBRT), like that delivered by CyberKnife, survived just as long as patients with surgery.  SBRT controlled 84.5% of the lung cancers in seniors with stage I lung cancer. 

“Definitive lung SBRT in patients 80 years and older appears to be safe and efficacious,” said lead author Dr. Richard Cassidy III of Emory University in Atlanta. 

In Dr. Cassidy’s study, the average age was 85 years and 40% had adenocarcinoma of the lung while 29% had squamous cell lung cancer. 

The second study reported by Dr. Singh from the Roswell Park Cancer Institute showed that the “one and done” approach with SBRT may be just as good as 3 treatments in 1 week. This means that they only had 1 treatment and no more. Lung cancer patients were selected for the “one and done” SBRT because these patients had small lung cancers at the edge of the lung, minimizing radiation exposure normal lung tissues. 

“Our study is the first to show that 1 fraction of SBRT, a one and done treatment approach, is as good as 3 fractions for early stage lung cancers in terms of survival and toxicity,” said Dr. Singh. This means the patient  only needs to have one 30 minute radiation therapy treatment before they get back to the important things in their life.

The one and done study was a so-called phase II trial so we will need to await the results from the gold standard phase III trial in the future. 

The CyberKnife Advantage 

CyberKnife is the only SBRT machine out there that continuously tracks your lung cancer while you breath-sparing more normal lung tissue.  There’s no incision, no pain, and no hospital stay. 

If you have any questions about your early stage lung cancer, please feel free to call me, Dr. Edward Hughes, at 855-Dayton 1.  I guarantee that I will see you in consultation within 1-3 days of your phone call.

REAL HOPE FOR STAGE 4 LUNG CANCER

When every extra day counts, turn to the CyberKnife.

When Just Doing the Same Thing Doesn’t Work

The outlook for someone with stage 4 non-small cell lung cancer with only a few metastases is not promising.  After the upfront chemotherapy, the treatment options have been limited to “maintenance” chemotherapy that does not provide a great quality of life.  “Maintenance chemo” is continuing with the same regimen that was prescribed for the original lung cancer and the few metastatic sites.  Many studies have shown that most cancers come back at the site of the original lung cancer and the original metastatic sites, and not new sites.  So why not focus on those areas instead of just giving more chemotherapy?

Look For Better Answers

Dr. Daniel Gomez and colleagues set out to determine if there is a better treatment for Stage 4 non-small cell lung cancer patients who have 1-3 new areas of cancer spread. He spearheaded a clinical trial that randomly assigned patients to A) “maintenance” chemotherapy B) local therapy like radiation or surgery to those metastatic spots or C) no treatment at all.

Patients who had standard chemotherapy and were in relatively good shape after chemotherapy treatment were eligible for the clinical trial. Many medical oncologists (chemo doctors) were reluctant to let their patients in the trial due to their belief that more chemo must be better than anything else. But, they soon learned that more chemo is not better for survival or for quality of life.

A Breakthrough Result  

Although only 74 lung cancer patients were entered into the clinical trial from 2012 to 2016, a real revolutionary result was seen.

Group A (more maintenance chemo) = 4 month survival

Group B (local radiation or surgery) = 12 month survival

Group C (no additional treatment) = 4 month survival

The clinical trial was closed early because the doctors learned very quickly that treating the metastatic spots was so much more effective than continuing with the same chemotherapy. These doctors switched their patients protocols immediately. 

What Does This Mean for You 

Radiation therapy to these new metastatic spots can be done very quickly and painlessly. Treatment with the CyberKnife is the perfect option to beat your non-small cell lung cancer without surgery.  No pain and no incisions. And it allows you more time for the important things in your life. CyberKnife is real hope for another year of symptom free survival.

If you have any questions about your lung cancer, please feel free to call me, Dr. Edward Hughes at 855-Dayton 1.

I guarantee that I will see you within 1-3 days of your phone call for a consultation.