Monthly Archives: August 2016

Exercise to Keep Cancer Away

Dr. Edward Hughes discusses the importance of exercise not only to prevent cancer, but to prevent cancer recurrence. Exercise is especially important for breast cancer survivors to prevent lymphedema. Share this video with everyone you know.

Cyber Knife for Metastatic Cancer offers Real Hope

It’s been over 20 years since Dr. Sam Hellman and Dr. Ralph Weichselbaum, two radiation oncologists from Harvard University and then the University of Chicago, proposed the concept of “oligo metastasis” (J Clin Oncol 13; pp 8-10, 1995).  “Oligo” is derived from the Greek meaning “few.” 

The revolutionary concept that Drs. Hellman and Weichselbaum proposed was a stepwise growth of cancer that occurs with an intermediate state of a few or “oligo” metastases before becoming more widespread.  In 1995, “oligo metastasis” was just that idea.  With the breakthrough technology that is stereotactic radiosurgery, like that delivered by Cyber Knife, there is now have real hope in treating patients with “oligo metastasis” with few harmful side effects. 

In a landmark study, Dr. Ost and coworkers from Europe, reported on 119 men with recurrent prostate cancer in 3 sites or fewer who were treated with stereotactic radiosurgery, like that delivered by Cyber Knife.  96% of the metastasis were in bone or lymph nodes.  The results were dramatic with 90% of the “oligo metastases” controlled by stereotactic radiosurgery at the 5 year mark- very long-term cancer control.  Radiosurgery also delayed the start of hormonal therapy for over 2 years.  And 39% of these men were free from the development of other sites of distant metastasis. 

Importantly, the senior author and leader of the European group, Dr. De Meerleer also reported spectacular results with radiosurgery, like that delivered by Cyber Knife, for patients with metastatic kidney cancer, a cancer previously described as “radioresistant” (Lancet Oncology 15; pp 170-177, 2014).  An incredible finding for patients with metastatic kidney cancer, a result in 1 of 7 cases, was the disappearance of other metastases that were far away from the metastasis treated by stereotactic radiosurgery.  Dr. DeMeerleer believes that Cyber Knife generated a potent immunologic reaction that is widespread. 

With Cyber Knife, there is now real hope for patients with oligo metastases from a number of different cancers, like prostate, kidney, lung and breast.

For more information about Cyber Knife for oligo metastasis, please feel free to call me, Dr. Edward Hughes, at 855-Dayton1.

 

Cyber Knife is the Best for Brain Metastasis

Why Cyber Knife?   

Stereotactic radiosurgery (Cyber Knife)  alone – without whole brain radiation – is now considered the standard of care for patients whose cancer has spread to the brain in only 1-3 places.

But did you know that 3 Cyber Knife treatments are better than a single dose of Gamma Knife for patients whose metastatic brain tumors are greater than 2 cm? 

In a breakthrough study, Dr. G.  Minniti  and co-workers looked at 289 patients with brain metastasis greater than 2 cm who underwent radiosurgery as primary treatment.

Head frame is screwed into the skull for treatment with the Gamma Knife.

A head frame is screwed into the skull for treatment with the Gamma Knife.

The remarkable finding was that patients who underwent 3 doses with the Cyber Knife not only had better control of their brain metastasis but also had less risk of a bad side effect called brain necrosis.  Brain necrosis can result in weakness, numbness, speech problems and seizures.  So preventing brain necrosis and its side effects is very important for quality of life.  Dr. Minniti’s study was reported in the prestigious International Journal of Radiation Oncology Biology and Physics (95:1142-1148,2016). 

The Cyber Knife Difference  

A soft mess mask is designed for each patient receiving treatment with the Cyber Knife.

A soft mess mask is designed   for each patient receiving treatment with the             Cyber Knife.

So for patients whose brain metastasis are greater than 2 cm, Cyber Knife appears to be theanswer.  Cyber Knife’s accuracy is comparable to Gamma Knife, but Cyber Knife treatment is painless.  A custom mask holds your head in place with no pain and no incisions.  For Gamma Knife treatment, your neurosurgeon needs to give you conscious sedation and local anesthesia in order to screw the Gamma Knife frame into your skull.  It’s not a procedure that you want to go through 3 consecutive days in a row. Learn more about the Cyber Knife treatment here.

If you have any questions about your brain tumor treatment, please feel free to call me, Dr. Edward Hughes, at 855-DAYTON1.  I guarantee that I will see you in consultation within 1-3 days, an unparalleled guarantee for any cancer specialist in Southwest Ohio.

Liver Cancer: A Better Way to Treat this Deadly Disease

Liver Cancer is the Most Common Cancer Worldwide  

Most Americans are shocked to learn that primary liver cancer – also called hepatocellular carcinoma or HCC-is the leading cause of cancer deaths worldwide.

And it is becoming more common here in America.  Why so?  Because a number of risk factors are on the rise, like hepatitis C, cirrhosis from alcoholism, diabetes, and obesity.

Although surgery is the first choice for patients with primary liver cancer or HCC, most patients are not surgical candidate at the end of the day.  But hope is on the way. 

The Best Way to Treat Liver Cancer 

In a breakthrough study from the University of Michigan, Dr. D.R.  Wahl and colleagues found that stereotactic radiosurgery, like that delivered by Cyber Knife, is better than radiofrequency ablation or RFA, especially for primary liver cancers that are bigger than ¾ of an inch (2 cm). Radiosurgery was the same as radiofrequency ablation for liver cancers less than 2 cm. Their study was published in the prestigious  Journal of Clinical Oncology, February 10, 2016 issue. 

With stereotactic surgery, like that delivered by Cyber Knife, primary liver cancer control was very good: 97.4% at 1 year and 83% at 2 years for primary liver cancers greater than 2 cm. 

The Cyber Knife Advantage  

Cyber Knife is real breakthrough technology.  Cyber Knife is the only radiosurgery system that continuously tracks your tumor’s motion.  And liver tumors move a lot with breathing-sometimes 2 inches or more.  So Cyber Knife can spare more normal liver because Cyber Knife is the only radiosurgery system that breaths with you. 

If you have any questions about your liver cancer or cancer that has spread to your liver, please feel free to call me, Dr. Edward Hughes, at 855-DAYTON1

Breast Conserving Therapy vs. Mastectomy?

Are cancer patients listening to the media more than their own doctors? Angelina Jolie's double mastectomy is not the right choice for most woman.

Are cancer patients listening to the media more than their own doctors? Angelina Jolie’s double mastectomy is not the right choice for most woman.

The past year America has been overwhelmed by the race for the Presidency.  Every day we hear speeches from the Presidential candidates.  The next day we hear from the “fact-checkers” who disprove a lot of the candidates’ claims.  But do facts really make a difference anymore?

That’s the question I have been asking for the past 25 years about lumpectomy and radiation therapy(breast conserving therapy) for early stage breast cancer patients.  Do the facts really make a difference anymore in a country where more and more early stage breast cancer patients undergo mastectomy?

Breast Conserving Therapy vs. Mastectomy

In a landmark study of 7,552 Dutch women with early-stage breast cancer (T1 N0), Dr. M.C. van Maaren and co-workers showed that women treated with lumpectomy and radiation therapy had a significantly better 10 year metastasis-free survival compared with those women treated with mastectomy.  Their study was published in the internationally prestigious journal Lancet Oncology, June 22, 2016 issue.

Are these new and surprising facts?  Not at all.  For the past 25 years, study after study-many with level I evidence, the best medical evidence-have shown that lumpectomy and radiation therapy is at least equivalent to mastectomy in terms of breast cancer control and survival.  Yet the number of women undergoing mastectomy in America continues to increase.

Why Not Mastectomy?

Mastectomy has profound side effects, both physically and emotionally.  But the facts have shown for decades that breast conservation with lumpectomy and radiation therapy is just as good as mastectomy, if not better.  The new Dutch study confirms that it is better for those women with small breast cancers, less than 2 cm and without spread to the lymph nodes.

I believe it is by duty as a breast cancer specialist to make my patients aware of the facts, and not give in to the current, popular trends.

If you have any questions about your breast cancer, please feel free to call me, Dr. Edward Hughes, at 855 Dayton 1.  I have a ‘no excuses’ approach to cancer care, one that beings with the patient and ends with wellness for a better quality of life.

I have written about lumpectomy and radiation therapy being at least as good if not better than mastectomy in a number of my previous blogs. Learn more by reading posts on January 19, 2016October 13, 2015; and August 4, 2015.