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EXPERIENCE MATTERS IN CANCER TREATMENT

Dayton’s Most Experienced Radiation Oncology Experts.

Dr. Ed Hughes recently celebrated the 15th Anniversary of opening his freestanding radiation oncology center, First Dayton Cancer Care. Dr. Hughes’ experience does make a huge difference in the lives of his patients. With over 35 years of perfecting his craft, he still believes in seeing the patient as an individual who deserves the best medical care available. This is why he remains independent of any of the hospital systems. He believes that a excellent patient care is about people providing this care and their knowledge and experience enhances his work as a physician. First Dayton’s team of experts is beating the odds for our prostate cancer patients.

For our prostate cancer patients, a 98.8% PSA control rate at 5 years and no grade 3 complications-better than the National CyberKnife Registry.  At First Dayton CyberKnife, prostate cancer is treated in 5 visits, with no incision and no pain.  There is little chance of embarrassing side effects like incontinence. 

We achieve such spectacular results?  CyberKnife is the only radiosurgery instrument that continuously tracts tumor and organ movement during treatment-sparing more normal organs. 

With CyberKnife for prostate cancer, I can mimic temporary prostate implants-but without the uncomfortable, invasive procedures.  With CyberKnife, I can deliver higher doses of radiation to those regions of the prostate containing cancer while sparing the urethra. Despite what ordinary cancer centers may claim,  no other device can do the same.  And it goes without saying that those ordinary cancer centers do not tackle prostate cancer patients with their stereotactic machines. 

Ordinary cancer centers talk about speed, but First Dayton CyberKnife provides real results with exquisite precision.  And it is all done in an outpatient setting, with no pain and no incisions.  Our patient can get off the CyberKnife treatment table and resume their normal activities immediately.

Experience matters. And we have the most experienced team in Dayton.

 

IMPROVED QUALITY OF LIFE AFTER LUNG CANCER TREATMENT WITH CYBERKNIFE

The CyberKnife improves Quality of Life

Lung Cancer is a life threatening disease. While lung cancer often strikes those with a history of tobacco use, it can strike anyone. There is a lot of research trying to determine the best course of treatment. Most compare surgical removal of the affected lung with use of chemotherapy and/or with use of radiation therapy. What we do know is that different stages of the disease respond to different treatments. We do know that advanced disease may require all 3 types of treatment, while early stage disease may require just one. With all of this research, why don’t doctors do the same thing for every patient?

WHAT YOU CAN DO

What researchers are not able to quantify, is the individual human being. There too many variables as to the individuals personal habits, other health issues, and family history. This is why research cannot always be certain, but should be used as a tool. Your physician needs to use it as a tool to help you; the individual person. You need to ask the questions and help make the best decisions for your own life.

WHAT YOUR DR. KNOWS

In 2017, the American Society for Radiation Oncology (ASTRO) and the American Society of Clinical Oncology(ASCO) recommended the use of Stereotactic Body Radiation Therapy (SBRT) alone to treat early stage lung cancer. And upon reviewing some new research by Chad Rusthoven, MD on early stage lung cancer, Charles  Bankhead of MedPage Today concluded that “Patients show significantly better overall survival at 3 years with SBRT and numerically superior recurrence-free survival.”

This is great news! People with early stage lung cancer will live longer if treated with SBRT instead of traditional open surgery. So now every physician is going to do this right? Well, now it is up to the patient to not only ask for radiation treatment, but to ask for the right one.

NOT ALL TREATMENTS ARE EQUAL

What equipment is used to deliver the SBRT has a huge effect on the patient’s Quality of Life. Not all SBRT treatments are the same. There are a few different systems used to deliver the radiation to the lung. Selecting the right one is important and research does not always account for  Quality of Life or side effects. Is treatment uncomfortable? Do I have to hold my breath? What is life like after treatment? Will I have the energy to do things? Will I be coughing all the time? Can I enjoy the life I have left?

SBRT treatment with the CyberKnife System drastically reduces side effects. It is the ONLY treatment delivery system that uses real time imaging while giving the patient over 300 beams of radiation. It is the ONLY treatment that actually breathes (moves) with the patient to target only the cancerous lung tumor. The patient does not need to hold their breath, but can breathe naturally during the short treatments. This one of a kind treatment reduces those side effects while it kills the cancer. Therefore it damages less healthy tissue than other types of radiation.

Charles B. Simone II, MD of the University of Maryland Medical Center concluded his study and learned that, “(SBRT) has emerged as the standard of care for patients with medically inoperable lung cancer.”

Lung Cancer treated with stereotactic body radiation therapy(SBRT) has been proven to be the standard of care, but treatment with the CyberKnife Treatment System has been proven to improve Quality of Life as well.

See How the CyberKnife can Beat Your Cancer.

CURB SIDE CONSULT WITH DR. HUGHES: LUNG CANCER STAGE IV

Today’s Curb Side Consult: Adding CyberKnife treatments after chemotherapy may help patients with stage IV non-small cell lung cancer

Marge from Kettering, sits down to talk to Dr. Ed Hughes, radiation oncologist, about her lung cancer.

Marge Has So Much to Live For

Marge: “I heard a lot of good things about CyberKnife for patients with early stage lung cancers.  Only 3-5 visits.  No cutting.  No pain.  Done as an outpatient.

But I have stage IV non-small cell lung cancer. It’s in my left lower lung. I had chemo and the lung cancer shrunk up, but it’s not gone.  And I still have a spot on my liver and a spot on my spine. I know that my cancer is bad. But I want to live as long as I can without symptoms. Can CyberKnife help me?”

 Dr. Hughes: “That’s a great question, Marge. I now have some answers for you, some real options.  And the answer is “possibly.”  So what does it depend on?  Stage IV non-small cell lung cancer patients who may benefit from CyberKnife include those patients who:

 1).  Had at least a partial response or even stable disease after chemotherapy.

 2).  Had only a few sites of metastatic disease, so-called ‘limited metastatic non-small cell lung cancer.’

So Marge, your situation is a quite common one.  Up to 70% of stage IV non-small cell lung cancer patients have partial responses or stable disease following first-line chemotherapy.  The key is to make those chemo responses last longer.  I think real breakthrough progress has been made recently.”

Marge:”So what happens now after my chemo is done?  Are there studies to prove that this treatment plan is going to work?”

Dr. Hughes: “A small, but crucial study done by Dr. Iyengar and Associates at the University of Texas Southwestern Medical Center showed that adding stereotactic ablative body radiotherapy (SABR), like that delivered by CyberKnife, extended survival from 3.5 months to 9.7 months.  Quite remarkable results.

Importantly, major side effects from SABR, like that delivered by CyberKnife, were well tolerated.  In a press release at the September 2016 ASTRO annual meeting, Dr. Iyengar said, “The addition of consolidative radiation did not increase toxicity, which allowed patients to continue onto additional systemic therapy that is important to controlling aggressive metastatic disease.”  So with good collaboration between your medical oncology doctor and your radiation oncology doctor, CyberKnife can be given safely and effectively, even with chemotherapy or immunotherapy. Real hope is here.”

Marge: “So now what happens?”

Dr. Hughes: “As it turns out, the Dayton Clinical Oncology Program (DCOP), of which I am a member, does have a clinical trial called NRG-LU002-that “randomizes” the patient to maintenance chemotherapy versus maintenance chemotherapy plus SABR, like that delivered by CyberKnife.  Another option is to be treated “off protocol” so that you choose CyberKnife and not leave it up to the “coin flip” of a computer as to whether or not you’ll get CyberKnife treatment. But you have to tell your pulmonologist and your medical oncologist you want it.”

 For any questions about your stage IV non-small cell lung cancer, 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.

10 Year Results Prove CyberKnife Provides Excellent Results for Prostate Cancer

Recently published data from a prospective study of 230 men with low-risk prostate cancer showed 98.4% had local disease control 10 years after receiving stereotactic body radiation therapy (SBRT) administered with the CyberKnife system, and toxicity was mild.

“This is a groundbreaking study—the first to report on the efficacy and toxicity of SBRT in the treatment of low-risk prostate cancer following 10 years of treatment,” says Alan Katz, MD, of Flushing Radiation Oncology. “All patients participating in the study were treated with the CyberKnife system, which delivers extremely precise radiation treatments using unique, real-time image guidance and automatic motion correction. The study outcomes were excellent both in terms of disease control and tolerability, and were superior to long-term conventional intensity-modulated radiation therapy, based on results from other studies.”

Study participants completed their entire treatment in just five daily sessions, compared to conventional radiation therapy which typically takes 30 to 40 sessions. Additional 10-year outcomes showed:

  • The disease free survival rate was 93.7%, indicating there were no signs or symptoms of the cancer during the evaluation period;
  • The median prostate specific antigen value was 0.1 ng/ml. A low PSA value is associated with a reduced risk of cancer recurrence or metastases; and
  • Patient-reported bowel and urinary function scores showed initial declines that recovered to baseline where they remained throughout the remainder of the study period.

The prostate gland can move unpredictably throughout the course of treatment, making the ability to track, detect, and correct for motion critically important. Throughout the course of treatment, the CyberKnife system continually collects images to determine exactly where the tumor is, ensuring that clinicians deliver radiation exactly where they want it. The system detects the tumor motion and automatically adjusts the radiation beam in real time to match the motion of the tumor, giving clinicians confidence to apply smaller treatment margins and enabling higher doses and fewer treatments.

“Following early stage prostate cancer diagnosis, men have a variety of treatment options from which to choose,” says Fabienne Hirigoyenberry-Lanson, vice president of global medical and scientific affairs at Accuray. “CyberKnife prostate SBRT is increasingly being selected by men with low- or intermediate-risk disease who opt for treatment with radiation therapy. This new CyberKnife research adds to the most extensive compendium of published prostate SBRT studies available in the industry.”

Dr. Edward Hughes of First Dayton CyberKnife’s results are even more promising with disease free survival rate of 98% at the 5 year mark. Dr. Hughes expects his patients’ 10 year results to surpass those in this study. The improved outcomes are a result of radiation treatment planning done by his Medical Physicist, Matt Kolasa. Planning is individualized for each patient to spare the healthy tissue while targeting the cancer.

Reference

1. Katz A. Stereotactic body radiotherapy for low-risk prostate cancer: a 10-year analysis. Cureus. 2017; doi: 10.7759/cureus.1668.

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.

What’s the Big Deal about the CyberKnife? Why only 5 Treatments?

The Superior Precision of the CyberKnife allows for Only 3-5 Treatments Most Cancers.

Simply put, CyberKnife Stereotactic Ablative Body Radiotherapy, or SABR for short, controls cancers even better than predicted.  For example, the results for patients with early stage lung cancer have been particularly striking. Studies have shown 85-90% cancer control rates with a 3-5 CyberKnife treatments versus only 30% with 30-40 ordinary radiation treatments.  This means that  85-90% of lung cancer patient treated with the CyberKnife got rid of their cancer. That is a huge increase in successful cancer treatment. More people are beating their disease with the CyberKnife than with ordinary radiation therapy.

Because of this success, a lot of research is being done to find out why it is working so well. And to learn how else SABR can be used to treat cancers and other diseases. Here are some cutting-edge facts:

CyberKnife Damages Cancer’s Blood Supply  

  1. In a recent editorial, oncologist Dr. Paul Sperduto and colleagues stated “the literature supporting this phenomenon (high-dose radiation results in indirect tumor cell death) is not fragmentary, but actually quite robust….  However, we have consistently underestimated the role of indirect cell death by devascularization and its possible role in radiation-induced immune enhancement.”  (Int. J Radiation Oncol Biol Phys. 91, No.1,pp121-13, 2015)
  2. When you cut off the blood supply to the cancer cells, they die. Decades of research shows that a few high doses of radiation will damage the blood vessels supplying the tumor. There is now active research combining Avastin, a drug that blocks blood vessel formation and SABR. Using Avastin and the Cyber Knife may double the efforts to cut off the tumor’s blood supply.

 CyberKnife Can Generate an Immune Response to Attack the Cancer

CyberKnife may help unleash your body’s own immune system to fight your cancer. Recent studies suggest that SABR cause the body to release tumor-specific antigens. These antigens are unique molecules released after radiation destruction of cancer and can generate a cancer-specific immune response.  Once again, there is now active research combining SABR, like that delivered by CyberKnife, with the recent FDA approved drugs called immune checkpoint inhibitors.

CyberKnife Tracks Your Cancer As It Moves

Much like a jet-fighter pilot who always has an enemy target in its cross-hairs, CyberKnife can track your lung cancer as it moves with each and every breath.  CyberKnife’s pencil thin beams of radiation can destroy your tumor, while sparing surrounding normal tissues.  Because of this precision, CyberKnife  uses hundreds of beams of radiation instead of 5 – 7 beams delivered with other radiation machines. With the CyberKnife you do not have to hold your breath during treatment. You just lie still and the machine does all the work for you. Each treatment typically takes a mere 25-50 minutes, with plenty of breaks if needed.

It is not just lung cancers that move. Prostate cancer, liver cancer, pancreas cancer, and many other cancers move inside the body. CyberKnife is the only radiation device that directly watches your cancer as it moves, keeping collateral damage to a minimum.

If you or a loved one has cancer, learn all the options. Discover more here. CyberKnife maybe the answer to beating your cancer. Call me to discover how I can help win your fight.

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.

CYBERKNIFE TREATMENT THROUGH THE EYES OF A CHILD

Cancer treatment with the CyberKnife system is so easy for the patient that we would even allow a child to watch. The patient simply lays on a table for 25-60 minutes while the CyberKnife moves around them. They are able to take breaks, sit up or even take a bathroom break if needed. But they do not feel anything. Treatment is painless. They go about their normal day afterwards. Watch and see.