Monthly Archives: September 2016

Radiation Versus Chemo-Not Even Close

Radiation Therapy alone cures more cancers than Chemotherapy.

Radiation Therapy alone cures more cancers than Chemotherapy.

Radiation therapy, not surprisingly, is easy to demonize. Radiation therapy is often misunderstood not only by patients but also by physicians. But did you know that radiation therapy alone can cure many more cancers, including 2 of the 4 major cancers – like lung cancer and prostate cancer – than chemotherapy?

Chemotherapy alone can cure only the rare solid cancers of choriocarcinoma in women and testicular cancer in men.  Chemotherapy of course can cure a number of hematologic malignancies like leukemia and lymphoma.

Yet it’s the solid tumors – breast cancer, lung cancer, colorectal cancer and prostate cancer – that kill most Americans.  And radiation therapy stands front and center in the battle against those cancers.

Major advances in radiation beam aiming and shaping – like IMRT and high dose rate brachytherapy implants – have reduced collateral damage to surrounding normal tissue.  And stereotactic radiosurgery, like that delivered by Cyber Knife, has done that and more. Cyber Knife has reduced overall radiation treatment times from 6-8 weeks to 3-5 days.

SOLID CANCERS CURED BY                                      SOLID CANCERS CURED BY                                     RADIATION ALONE                                                     CHEMOTHERAPY ALONE     
  • Prostate                                                           Choriocarcinoma in women
  • Head and Neck                                               Testicular Cancer
  • Lung
  • Cervical
  • Skin

Our national meeting is taking place in Boston this week.  The title of the meeting is “Enhancing Value and Improving Outcomes.”  Lots of new information will be presented.  Lots of new technologies and improvements on existing technology will be highlighted.

I wonder if the forest will be lost for the trees?  The real story of radiation therapy over the past 50 years is that radiation therapy alone can cure many more cancers than chemotherapy and at a fraction of the cost.  Yet there is no mention of radiation therapy in the Obamacare “Moon Shot Against Cancer”.

That message has been lost under the burden of Obamacare as radiation therapy reimbursement has been cut dramatically – threatening the future of radiation therapy itself.

If you have any questions about treatment of your cancer, please feel free to call me, Dr. Edward Hughes, at 855-Dayton1.  We are the only cancer center in Dayton that guarantees that you will be seen within 1-3 days of your call, not 1-3 weeks.

Prostate Cancer Watchful Waiting-Success or Failure?

Know the whole truth about watchful waiting.

Know the whole truth about watchful waiting.

Are you contemplating ‘watchful waiting’ for your early stage prostate cancer? Does your family practice or internal medicine doctor have all of the details or just the headlines?  Sometimes this strategy can be a big gamble. The roll of the dice can lead to no progression of your disease or painful spread of the disease.

The September 14, 2016 issue of the prestigious New England Journal of Medicine published an article that showed that survival at 10 years was nearly identical for men who elected watchful waiting compared to those who had surgery or radiation therapy.  Nonetheless, the devil is in the details.  The results clearly showed that those men who elected watchful waiting had a higher likelihood of metastasis or spread to the bone compared to those men who underwent surgery or radiation therapy.

“The clinical significance of this finding is that with the use of active monitoring, more men will have metastasis and the side effects of salvage treatment (meaning at least lifelong intermittent androgen deprivation therapy), which are not inconsequential,” wrote Dr. Anthony D’Amico, chief of genitourinary radiation oncology at the Dana-Farber Cancer Institute in Boston.

From my point of view, there are pluses and minuses to watchful waiting.  But in Dayton, Ohio many physicians simply read the headlines of the article without carefully looking at the details of watchful waiting. In my experience, few men and their doctors follow  the guidelines that have been published concerning watchful waiting.

For example, Dr. Laurence Klotz from Toronto critically analyzed the outcomes of watchful waiting for men with low to intermediate risk prostate cancer.  Dr. Klotz reported his findings at the May 2016 meeting of The American Urologic Association.  Dr. Klotz found that the risk of prostate cancer death at the 15 year mark was only about 5%.  Dr. Klotz protocol is one of the most generous compared to the protocol from Johns Hopkins.  In fact, only 20% of men who present with prostate cancer would qualify for the Hopkins protocol compared to 50% in the Toronto protocol.

The Toronto protocol calls for the following for men with Gleason score 6 or lower prostate cancer with so called non-extensive disease or low percent of positive biopsies. The current protocol that Dr. Klotz adopts is:

  • Eligibility: Most men with Gleason score 6 prostate cancer or lower, and a PSA less than 15 ng/ML.
  • Workup: MR scan and targeted biopsies are done for all men with high-volume Gleason score  6 prostate cancer
  • Follow-up: PSA every 6 months
  • Confirmatory biopsy or MR scan within 1 year.  If the MR is negative and there is a low risk disease, biopsy is optional.
  • Repeat MR/biopsy every 3-5 years until age 80.

In my experience in Dayton, Ohio few men have insurance coverage for MR scans and even fewer will submit to repeat biopsies.

So if you elect watchful waiting, you need to know the real risk of recurrence.  That is to say, just getting a PSA every 6-12 months will not cut it if you truly want to catch prostate cancer early and avoid spread to bone.

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

The First Dayton Cyber Knife Difference-Prostate Cancer

Treatment with the Cyber Knife is painless.

Cyber Knife treatment is painless and it only takes 5 treatments that can take less than 1 hour. Men do not even have to undress for the treatment; it is that simple.

First Dayton Cancer Care began treating prostate cancer patients in 2012 with the Cyber Knife Stereotactic Radiation Therapy System. Since that time, we have performed over 2,500  treatments.  Our physicians have over 30 years of experience treating prostate cancer with a wide range of treatment systems. They have seen for themselves the dramatic difference treatment with the Cyber Knife makes a man’s quality of life and survival.

Discover the First Dayton Difference:

  • 98.8% PSA control rate on our very own patients since 2012.
  • Cure Rates are as good as surgery, but without painful cutting and surgical side effects.
  • Better Quality of Life by lowering risk of embarrassing side effects.
  • Cyber Knife is the ONLY real-time motion tracking radiation system, killing the cancer while sparing health tissue and organs.
  • Drive yourself to and from treatment in just 5 visits. No hospital stays.
  • Everyone has front row parking.
  • Continue to work.
  • Visit with our physicians within 1-3 days of your phone call.

If you have any questions about your prostate cancer, call me, Dr. Ed Hughes at 1-855DAYTON1.

September is Prostate Cancer Awareness Month

September is Prostate Cancer Awareness Month. Are you wearing your Blue Ribbon? Where are the walks, the rallies, the NFL players? Men do not like to talk about it. But it is very important that every man is aware of the importance to be screened.

Cancer.org tells us, “About 1 man in 39 will die of prostate cancer. Prostate cancer can be a serious disease, but most men diagnosed with prostate cancer do not die from it. In fact, more than 2.9 million men in the United States who have been diagnosed with prostate cancer at some point are still alive today.” However if prostate cancer goes untreated it can cause some series health problems such as urinary incontinence, erectile dysfunction and worst case scenario-metastasize to other organs that can lead to death.

Watch as Dr. Hughes discusses the importance of Prostate Cancer Screenings on Living Dayton.