Category Archives: Survivorship

A Cancer Diagnosis: 5 Questions You Need to Ask Yourself

Take the time to ask yourself these important questions.

Facing cancer is one of life’s biggest stresses.  Your mind and your heart seem to race in a thousand different directions all at once.  And everyone has a story or an opinion.  You don’t know who or what to believe. 

So it’s important to settle down and take some time alone to answer some questions BEFORE you talk to your cancer doctor.

 1.  Do I really understand what’s going on with my cancer? 

2. Where can I get information about what is likely to be ahead of me?  And how much information do I really want? 

3.  What are my biggest fears and worries about the future? 

4. How much am I willing to go through in order to gain more time? 

5. How much does my family really know about my wishes? 

That checklist is an important first start.  I’d recommend trying to answer these questions for yourself.  I know it’s difficult.  But at the end of the day, only you know what is best for you. 

If you have any questions about your cancer diagnosis or treatment, 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 call.

CyberKnife: Beat Prostate Cancer Without Surgery

Only You Know What’s Best For You   

Seems like a simple idea, doesn’t it?  But it may not be so simple when you’re diagnosed with prostate cancer.  A lot of emotions come into play.  And there are so many choices. Your emotions tell you that you’ll be all better once the prostate is cut out of your body.  But it’s just not that easy. 

To the surprise of most men, the chance of recurrence at the site of surgery is an all too common problem.  That’s right.  Up to 20% of men following surgery need radiation because of rising PSA levels.  And it just doesn’t stop there.  After surgery, there may be embarrassing side effects like incontinence – leaking urine when you least expect it. 

The CyberKnife Solution 

With CyberKnife, there is no pain, no cutting.  CyberKnife is done as an outpatient in only 5 visits.  CyberKnife is not surgery at all.  CyberKnife is a highly specialized radiation machine that tracks your cancer continuously.  And it’s the only radiation machine out there that does so. 

What does this mean for you as a prostate cancer patient?  Better prostate cancer control and fewer side effects. 

The Proof Is In the Results 

Dr. Robert Meier of the Swedish Medical Center in Seattle was the lead investigator of the study of 309 men with newly diagnosed prostate cancer treated at 21 community, regional, and academic cancer centers across the United States.  The prostate cancer patients were treated with stereotactic body radiotherapy (SBRT), like that delivered by CyberKnife. 

The results were impressive:

1).  97% of men were free from prostate cancer progression at 5 years 

2).  Only 4 of 309 men had serious side effects.  And the side effects were usually temporary. 

At the 2016 Meeting of the American Society of Therapeutic Radiology and Oncology, Dr. Meier said “After following patients for more than 5 years, we found that serious side effects from a brief course of SBRT were uncommon and that cancer control rates were very favorable compared to historical data.” 

The First Dayton CyberKnife Difference 

I’m proud to report that prostate cancer control rates were a bit better at First Dayton CyberKnife. 

First Dayton CyberKnife’s Results (January 2012- September 2016):

1). 98.8% of men were free from prostate cancer progression at 5 years. 

2). 0 of 187  men had serious side effects.

First Dayton CyberKnife is the only SBRT machine in Dayton that continuously tracks the movement of your cancer.  It’s easy to understand that a lung cancer moves with your breathing.  But your prostate also moves as well during radiation.  With CyberKnife tracking, your continuous prostate tracking means less scatter radiation to your rectum and bladder.  And that means less side effects for you. 

Here the facts for yourself.  Only you know what’s best for you.  If you have any questions about your prostate cancer, I guarantee that I will see you in 1-3 days.  You be the judge.  Call me, Dr. Edward Hughes, at 855-Dayton 1

Lightning Can Strike Twice: Why Follow-up Visits Are Important

A new study of over 32,000 patients showed that survivors of certain cancers, namely head and Cancer-Screeningneck cancer, bladder cancer, and lung cancer are at an increased risk of another, yet different cancer.  And the second cancer can be lethal – and it’s called non-small cell lung cancer.

Dr. Geena Wu presented her research from the City of Hope National Medical Center at the recent 2016 annual meeting of the Society of Thoracic Surgeons Dr. Wu and colleagues looked at the SEER national database of 32,058 patients with a prior cancer who then went on to be diagnosed with a lung cancer 6 months or later following completion of their initial treatment.

Dr. Wu found that patients with a history of certain, specific cancers had higher rates than expected of getting non-small cell lung cancer years after their first cancer was cured.  Survivors of head and neck cancer, lung cancer, and bladder cancer were especially at risk.  Even survivors of lung cancer were at risk for coming down with a completely different second, unrelated lung cancer.  And it follows that smoking is not only the likely culprit of not only the first cancer, but the second one as well. Smoking can cause multiple cancers.

As a cancer specialist, I see patients for follow-up visits each and every day.  I hear the same story.  “I’m finally done with surgery.  I’ve been through months of chemotherapy and weeks of radiation.  And now I have to come for follow-up visits, not just for months but for years? So why won’t you specialists just give me a break?”  The answer, without question is that follow-up visits are important. You need to continue to be screened for other cancers.

Unfortunately there is no limit on the number of cancers a person can get. Especially when you are talking about cancers that can be driven by lifestyle choses such as tobacco use. Cancer screenings like mammograms, colonoscopies, skin checks, and low dose lung cancer CT scans all still need to be performed on a regular basis for cancer survivors. These routine follow ups are more important for survivors than for those who have never had cancer.

I hear our survivors tell me on a day-to-day basis, “But can’t my family doctor just do the follow-up visits?”  I think that follow-up visits by primary care physicians are ideal, but a recent poll of primary care physicians showed the two thirds preferred follow-up visits for cancer be done by cancer specialists, not the family doctor.  I think that primary care physicians are already put upon to look after your general health in a 15 minute visit.  I think the cancer specialists are uniquely trained to spot early signs of recurrent cancer as well as spotting the symptoms of a new, unrelated cancer.  Once again, early detection is key to survival.  Follow-up visits with your cancer specialist is time well spent.

If you have any questions, please feel free to call me, Dr. Edward Hughes, at 855-DAYTON1.

Extending Survival with Radiation after Prostate Cancer Surgery

The surprising fact to most men who undergo surgery for prostate cancer is that about 25% need radiation even after surgery.  But who should undergo radiation?  And when?

A recent report from the 2016 Genitourinary Cancer Symposium sheds some light on the issue.  Dr. Danielle Rodin and co-workers looked at the clinical records of 388 men at the Massachusetts General Hospital who underwent prostate cancer surgery followed by radiation because of a rising PSA level months to years after their surgery.  Of those 388 men who had salvage radiation, only 4 died from prostate cancer.  The Massachusetts General Hospital findings confirmed the risk factors for a rising PSA after surgery-a higher Gleason score, cancer

PSA needs to be followed after surgery.  Salvage radiation is often necessary.

PSA needs to be followed after surgery. Salvage radiation is often necessary.

invasion through the capsule, and invasion into the seminal vesicles found at time of surgery.

 But the new finding from Dr. Rodin’s study centers on the importance of PSA doubling time.  Dr. Rodin commented “We found that when the PSA level was less than 1 ng/ML, PSA doubling time was actually a more significant predictor of disease progression than the actual PSA level itself.”  

The absolute PSA level does not have to be very high before radiation is recommended by most prostate cancer specialists.  When the PSA has reached a threshold of only 0.3 ng/ML, each further increase of 0.1 ng/ML resulted in higher rates of prostate cancer progression.  Dr. Rodin went on to comment that “When you are looking at a patient and evaluating all the risk factors, if you see a rapid doubling time in a patient with a very low PSA, I think that would support starting salvage radiation therapy.” 

So What’s A Prostate Cancer Patient To Do? 

I strongly believe that prostate cancer patients who have surgery need to be proactive.  I think that they need to ask their urologist exactly what was found at surgery.  Was their cancer worse than what was thought prior to surgery?  Did the Gleason score go up as compared to the biopsy before surgery?  Did their prostate cancer go through the capsule or into the seminal vesicles?

And remember the importance of PSA doubling time-even a score of only 0.3 ng/ML that doubles to 0.6 ng/ML in less than 12 months is reason enough to start radiation therapy.  And do ask your urologist to actually calculate your own PSA doubling time.  Your health and quality of life may well depend upon it. 

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

 

Computers Helped Save My Life

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

The Cyber Knife 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 it 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 less than an hour. 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.

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.”

This was originally posted in July of 2014. John is still cancer free thanks to Dr. Hughes and the Cyber Knife. If you want help like John, call Dr. Hughes today.

5 Things You Need to Know When You Finish Cancer Treatment

Here is a blog post that Dr. Hughes wrote a while ago. It is a favorite of his patient’s so we thought it was worth repeating.

5 Things You Need to Know When You Finish Cancer Treatment

Now what? Is that it? Am I done with cancer? How do I keep it away? How do I know it’s not back? Why do I feel lonelier now than I did during treatment?

Eating Healthy is part of the Top 5

Eating Healthy is part of the Top 5

These questions often plague a cancer survivor. It can be frightening to finish treatment. For the past few months you have seen physicians, nurses, therapists and other health care professionals sometimes daily; and now you are on your own. Here are 5 things I tell my patients.

  1. Make sure you have a treatment summary and a survivorship plan from each of your cancer specialists. And make sure that your primary care physician has a copy too.
  2. Understand that the transition from cancer specialists back to your primary care physician may result in a lot of anxiety for you and your family. That is normal. And o.k. Trust this doctor.
  3. Make sure you and your primary care physician keep a watch for signs of late treatment side effects. Let your primary care physician know about any new symptoms that you may experience. While I don’t want you to become paranoid, I do want you to communicate with your doctor. If in doubt, call your specialist.
  4. Keep up to date screening recommendations for people with your type of cancer. Follow the survivorship plan carefully. Also continue to have the recommended screenings for other types of cancers. Just because you had one type, unfortunately doesn’t make you immune to others
  5. Embrace new healthy habits, like a good diet and daily exercise. You have been given another chance. Make the best of it.

Many survivors have a New Normal. It will take some time for your body to find this new normal. Your energy levels, eating habits, and appearance may have changed. Find out what is best for the new you. Worrying about recurrence is a part of this new normal. It can be healthy as long as it doesn’t consume you. Following these 5 steps can help you to be a healthy, happy survivor. Our nurses will be happy to help you create your survivorship plan.