Category Archives: Lung Cancer

VA Medical Centers Beat Lung Cancer with the CyberKnife

The VA knows the importance of the CyberKnife for treating our veterans with lung cancer.

In the study of more than 1,600 veterans with early-stage lung cancer, stereotactic radiosurgery, like that delivered by the CyberKnife, more than doubled the chances of surviving compared to conventional radiation. Importantly, the study was conducted at VA Medical Centers over the past decade. The study was presented at the 2016 meeting of the American Society of Therapeutic Radiology and Oncology or ASTRO.

Dr. Brian Kavanagh, a Past President of ASTRO, told the Medscape news, “Although we are talking about treatments of an advanced technology that has only been allowed in the last 10 years or so, it is also smarter, more efficient and more cost effective way to do things. It involves fewer trips to the treatment center for the patient, fewer side effects, and is generally easier to take.” CyberKnife treatments for lung cancer are painless and can take as little as 20 minutes each. Only 3-5 treatments are needed.

CyberKnife has also been shown to be just as effective as open surgery for patients with early stage lung cancer, but without the hospitalization, the risks of open surgery, and the pain and recovery. CyberKnife is available only at First Dayton Cancer Care in the Dayton Region. And CyberKnife is the only radiation device that breathes with you as it tracks your tumor with every breath.

If you have questions about treatment of your early stage lung cancer, please feel free to call, Dr. Edward Hughes at 855-DAYTON1. I guarantee I will see you within 1-3 days of your call.

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

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.

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.

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.

Give Yourself a Lifesaving Gift – Get Screened

Low-dose lung CT scans can save lives – as many as 30,000 Americans each and every year.

But lung cancer screening can give smokers a false sense of security.  An unexpected consequence of lung cancer screening with low-dose CT scans show that many smokers continued to smoke.  It was as if a negative screening lung CT scan gave them a new lease on their smoking lives. 

With a Negative CT Scan, Can I Still Smoke?  

The short answer is NO WAY!  The 2016 analysis of the National Lung Screening Trial (NLST) concluded that those men and women who stopped smoking for 7 years had a 30% decrease in lung cancer deaths.  That’s huge. 

Dr. Nicole Tanner of the Medical University of South Carolina was the senior author on the study that was published in the March 1, 2016 issue of the American Journal of Respiratory and Critical Care. 

With a Negative CT Scan Do I Need Another Lung Scan? 

The short answer is YES!  And more often than what you think.  Waiting 2-1/2 years between low-dose lung CT scans resulted in detecting lung cancers at a more advanced stage when it’s less curable.

The Dutch-Belgian Lung Cancer Survey Trial showed that 17.3% of lung cancers were stage III or stage IV when smokers were screened 2-1/2 years later compared to 6.8% for smokers screened more frequently. 

The Dutch-Belgian results were published in the June 30, 2016 issue of the journal Thorax. 

What are My Recommendations?  

CT Scans are painless and non-invasive.

For smokers, I recommend getting screened right away for the first time and then every 12-18 months thereafter.  In this Holiday Season, the gift of a $99 low-dose CT scan at First Dayton Cancer Care just may be lifesaving for you and for your loved ones. 

If you have any questions about lung cancer screening or your lung cancer treatment, please feel free to call me, Dr. Edward Hughes, at 855-DAYTON1

KEYTRUDA USES IMMUNE SYSTEM TO FIGHT LUNG CANCER

keytruda“It is a new day for lung cancer…  For the first time, we will be offering immunotherapy to our lung patients,” commented Dr. Stephan Zimmerman of University Hospital in Switzerland.  Dr. Zimmerman was stunned by the breakthrough trial showing that the immunotherapy drug Keytruda or pembrolizumab outperformed standard chemotherapy in a very specific group of patients with non-small cell lung cancer. Keytruda is a new cancer drug called an immune checkpoint inhibitor.  Keytruda helps your own immune system to be released to fight your lung cancer.  It’s just one of many drugs in the “personalized medicine” revolution.

KEYNOTE-024 STUDY SHOWS EXTENDED LIFE EXCPENTANCY

The breakthrough results come from the KEYNOTE-024 study published in the October 9, 2016 issue of the prestigious New England Journal of Medicine.  In this landmark study of 305 patients with advanced non-small cell lung cancer, survival (without lung cancer progression) was extended from 6 months to 10 months.  To look at the KEYNOTE-024 study another way, 70% of immunotherapy patients were alive at 1 year compared to adjust 54% of chemotherapy patients.

Although this breakthrough study is exciting, Dr. Jean Charles Soria from the Gustave Roussy Institute in France commented to Medscape, “… so the patients who are in this trial probably represent only 10% of the patients seen in clinical practice.”  But if you happen to be one of these patients, Keytruda may just be the answer for you.

WHO CAN BENEFIT FROM KEYTRUDA

Non-small cell lung cancer patients now eligible for the immunotherapy drug called Keytruda include those patients whose lung cancer biopsy showed no EGFR or ALK mutations but high levels of a cancer cell protein called PD-L1.  So it is crucial that your cancer specialists order those tests on your biopsy.

If you have any questions about your lung cancer diagnosis or treatment options, please call me, Dr. Edward Hughes, at 855-Dayton 1.

 

CYBERKNIFE: PERFECT CHOICE FOR SENIORS WITH LUNG CANCER

CyberKnife is perfect for the elderly with early stage lung cancer. No surgery means fewer risks.

CyberKnife is perfect for the elderly with early stage lung cancer. No surgery means fewer risks.

Stereotactic radiosurgery, like that delivered by CyberKnife, has become the “standard of care” for stage I lung cancer patients considered to be medically inoperable or if a patients is too sick for surgery.  A new study of 62,213 patients 60 years and older with stage I lung cancer, showed that stereotactic radiosurgery increased the 2 year survival rate to 58% compared to 39% for seniors treated with conventional radiation. 

Dr. Andrew Farach told HemOnc Today that “Our findings indicate that physicians should feel confident recommending radiation therapy to patients who are too sick to undergo surgery or choose not to undergo surgery for other reasons.”  Dr. Farach and his colleagues reported their findings at the September 2016 meeting of the American Society of Therapeutic Radiology and Oncology(ASTRO) in Boston last month. 

THE CYBERKNIFE ADVANTAGE 

CyberKnife is the only stereotactic radiosurgery device that continuously tracks your lung cancer as you breathe.  CyberKnife treatments are painless-no incision. CyberKnife treatments are completed in only 3-5 outpatient visits.  In fact, many of our patients can drive themselves to and from visits. 

Many of our seniors have many medical problems that limit their surgical options.  And CyberKnife is a perfect alternative.  At the prestigious Massachusetts General Hospital in Boston, there has been a drop in surgery for seniors with early-stage lung cancer with many choosing stereotactic radiosurgery. 

“It is a rare situation where the more convenient therapy is also the more effective therapy,” said Dr. Farach of Houston’s Methodist Hospital at the ASTRO 2016 press conference last month. 

First Dayton is the only cancer center in Southwest Ohio using the CyberKnife to treat lung cancer. 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 in 1-3 days of your call. Expertise. Experience. Caring. The First Dayton CyberKnife difference.