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.

Prostate Cancer: Only You Know What’s Best for You

The Superior Precision of the CyberKnife allows for    Only 5 Treatments for Prostate Cancer.

It seems like a simple idea, doesn’t it?  Only you know what is best for you.  But for patients with prostate cancer, it may be a matter of life and death. 

Since I  treated our first patient with CyberKnife over 5 years ago, I have been more impressed with this breakthrough technology each and every day.  Yet there remains a lot of negative information out there in Dayton, even by healthcare professionals who should know better.  I suppose it can be chalked up to a doctor turf war.  But if you are the man with prostate cancer, you only want to do what is best for you.  And that means not only curing your prostate cancer, but also having a good quality of life afterwards.  By that I mean a life without urinary leakage and other embarrassing side effects.

SEEK YOUR OWN TRUTH 

I encourage men and their families to go out and dig up the information for themselves on their prostate treatment options.  I think it’s crucial for men with prostate cancer to take their time and talk to prostate cancer specialists, both urologists and radiation oncologists.  I would also ask the radiation oncologist how many different ways he or she can actually treat prostate cancer with radiation.  Do they have only one kind of technology?  At First Dayton CyberKnife I have more options than any other center in Dayton, including CyberKnife, IMRT, and temporary radiation implants. 

PROVEN RESULTS

A remarkable result for CyberKnife for men with low and intermediate risk prostate cancer was reported at the 58th Annual Meeting of the American Society for Radiation Oncology.

17 different CyberKnife centers studied the long-term results of 259 prostate cancer patients treated by CyberKnife.  The results were astounding.  At the 5-year mark, the prostate cancer free survival rate was 100% for low risk patients and 88.5% for intermediate risk patients.  At First Dayton CyberKnife, my results are even better.  At the 5-year mark our prostate cancer free survival rates were 98.8%.  And no patient had severe side effects requiring medical therapy or surgical therapy for complications. We have performed over 1,800 CyberKnife treatments.  

WHAT IS SPECIAL ABOUT THE CYBERKNIFE?

Why is prostate cancer treatment by CyberKnife better?  Simply put, CyberKnife is designed to deliver stereotactic ablative body radiotherapy or SBRT.  CyberKnife is given in 5 visits, with no pain and no cutting. There is no surgery. Plus with only 5 treatments instead of the standard 40, men can get back to living their normal life quicker.  

CyberKnife is breakthrough technology that delivers high doses of radiation with an extremely high degree of precision.  CyberKnife is the ONLY radiation device out there that has the unique capability of continually tracking your prostate cancer movement and automatically correcting for that movement in real time.  The prostate can move as much as 10 mm in as little as 30 seconds.  That exquisite precision is exactly how CyberKnife treats with 5 high doses of radiation without damaging surrounding organs, like the bladder and rectum.  

Dr. Donald Fuller in San Diego, the lead investigator of this study said “Outcomes from this long-term, prospective study reinforced that CyberKnife prostate SBRT is highly effective, with typically minimal side effects and impact on quality of life during and after treatment. It is important to note that nearly 90% of patients in the study were treated at community facilities across the United States, which may provide reassurance for men with localized prostate cancer that the results are achievable in their community setting.” 

If you have any questions about your prostate 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 in 1-3 days.  And when you call us, you will speak to a real person, and not be put on hold or transferred to a call center.

BEAT SKIN CANCER WITHOUT SURGERY

It is hard to imagine on a stormy day like today, but for many of us, Spring Break is right around the corner. You are never too young or too old, to take care of your skin. Dr. Hughes explains his state-of- the-art treatment for skin cancer that is simple and painless. No cutting. No scars. And takes just a few minutes to have fresh new healthy cancer free skin.

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.

Medical Costs: Still a Guessing Game?

The same drug, the same procedure, the same test but prices can vary greatly depending on who provides the service. Patients have a RIGHT to know the price so they can make smart choices or set up a payment plan.

Any consumer knows that the secret to staying on a budget is comparing prices when you shop.  In today’s world, the internet gives us excellent resources to do this easily. We search for the best price. That’s easier said than done in America’s Health Care System, where the prices for doctor visits, diagnostic tests and surgical treatments can be hard to find out in advance. 

Only 14 of 50 states in America have laws that call for “Price Transparency” – knowing the cost of care before it’s done. 

Now President Trump has proposed “Price Transparency” for all healthcare providers.  The goal is to help patients shop around for a CT scan, MRI scan, or even a hip replacement; the same way they shop for food, clothing, and shelter. 

Ohio politicians also dipped their toes in the “Price Transparency” swamp.  The Ohio House of Representatives and Senate unanimously passed the Healthcare Transparency Law in June 2015.  Gov. Kasich promptly signed the bill shortly thereafter. 

But the Ohio Hospital Association (OHA), joined by the Ohio State Medical Association (OSMA), had a judge issue an order preventing the law from going into effect on January 1, 2017-an astounding 18 months after it was enacted. In 18 months, these groups could not establish regulations that insurers agreed upon. Everyone is looking out for themselves regardless of what is best for the patient.

All parties involved have given lip service to this Healthcare Transparency Law yet it has been legally blocked from taking effect. They claim the problem is lack of  available information because of too many contracts with different prices.  It’s hard to believe that Big Hospitals do not know the upfront costs of their own CT scans, cardiac stress tests or hip replacements.  It just does not ring true.

Smaller practices typically use the same 25 medical codes, so they should be able to easily create a cost estimator for those top codes. The patient will need to understand that this is simply an estimate. Once the claim is filed the insurance carrier could leave more or less responsibility to the patient.  A reasonable percentage of variance should be easy to establish. Typically an estimate is just that – it could vary 5% more or 5% less.

There’s just no need to keep healthcare prices a guessing game.  Our Governor, The Honorable John Kasich, needs to hear from you.

Governor Kasich can be reached at 614-466-3555. Call him or his staff and tell them how you feel about this issue. Your voice really does matter. 

And don’t just stop there.  Next time you are at a doctor’s office or getting a CT scan or having surgery, ask what your out-of-pocket cost will be.  You do have time to shop around.  Medical costs should not be a guessing game any longer. 

I know what I am talking about.  First Dayton Cancer Care has been providing upfront, out-of-pocket cost for patients since opening in 2003.  It is just the right thing to do. 

If you have any questions about your cancer, its diagnosis or its treatment, call me, Dr. Edward Hughes, at 855-DAYTON1.

Can Smokers Kick One Habit but Pick up Another?

I am asking smokers to add another habit to their lives. Only this one is a good habit!

On February 2, 2017 a research letter in the prestigious medical journal JAMA Oncology reported that only 3 to 4% of smokers underwent a low-dose CT scan to find a new lung cancer in 2010.  And the response was much the same in 2015: 3.3% in 2010 versus 3.9% in 2015.

Dr. Jemal, the senior researcher of the JAMA Oncology study, said “We estimated that by 2015 there would be 6.8 million smokers eligible for screening, but only 262,000 were screened.”

CT Scans Can Save Smokers’ Lives

In 2017, lung cancer will kill 160,000 Americans.  Most smokers, about 85% in fact, are diagnosed when their lung cancer is inoperable or has spread to other critical organs, like the liver, brain, or bone.  With stage III or stage IV disease, there is little hope for cure or even survival beyond a few years.  When diagnosed early, lung cancer is highly curable with surgery or with a noninvasive technique called stereotactic ablative body radiotherapy (SBRT), like that delivered by CyberKnife.

In 2011, the National Lung Screening Trial (NLST) showed that screening current or former smokers with low-dose CT scans could save 30,000 Americans each and every year.  But we’re far from that goal. 

Is the Glass Half Empty or Half-Full?

I think a response of 3-4% is actually pretty good.  Why do I say so?  The best marketers out there tell me that a “good response” to direct marketing is just 0.1 to 0.25% – over 20 times lower than the success rate for screening smokers for lung cancer with low-dose CT scans.

Let’s face it.  It is difficult to get people’s attention.  Americans are bombarded by information every day-from TV, newspapers, and the Internet.

In the JAMA Oncology article, Dr. Jemal seemed to point the finger at uninsured patients, Medicaid patients, and even family doctors who may be unaware of the power of low-dose CT scans for screening for early stage lung cancer.

Dr. Jemal said “Screening requires a lot of things. First you have to educate the physicians and the patients and half of your patients are not covered by Medicare,” as reported by AuntMinnie.com

The First Dayton Cancer Care Solution

At First Dayton Cancer Care, a low dose CT scan for screening current or past smokers costs only $99.  And we’ll also see if your insurance covers the cost.  Many private insurance carriers do.

The CT scan is painless-no injections or needles-and takes only a few minutes of your time.

It’s never too late to stop smoking. But I’m asking smokers to kick the habit and take up another. I’m urging them to get in the habit of a yearly screening CT scan for lung cancer.

The response to the Federal Government’s low-dose CT scan screening for lung cancer has been a start, but one that I would not call good.  My conclusion, to paraphrase Prime Minister Nehru, is that our approach needs to be better.

If you have any questions about screening for lung cancer or other cancers, please feel free to call me, Dr. Edward Hughes, at 855-Dayton1.

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