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.


First Dayton Cancer Care Celebrates 14 Year Anniversary

Dr. Hughes enjoys being able to spend a lot of time with patients answering all of their questions. He is able to do that in his own practice.

Local cancer doctor, Ed Hughes, MD, PhD, feels that his cancer patients have rights. They have a right to the best medical care possible. They have a right to choose a treatment that is best for them. They have a right to superior health care at a reasonable cost. They have the right to treatment done quickly. They have the right to quality of life. They have a right to stay in Dayton for world class medical care. The reason this doctor left the hospital 14 years ago is even more important today. As more and more physicians sell out to big hospitals, they are losing their rights.

First Dayton Cancer Care was opened in 2003 because Dr. Hughes believes cancer patients have the right to the best. He is an expert in Radiation Oncology. He uses radiation technology to destroy cancer cells throughout the body. It is virtually painless to the patient. “Radiation therapy is all we do. This is not a side service to us. I have a team of experts. This is our passion,” states Dr. Hughes. Over the past 14 years, Dr. Hughes and his team have given more than 126,500 radiation treatments to more than 7,000 people from the southwest Ohio region.

Dayton has some of the most advanced cancer fighting tools in the world thanks to Dr. Hughes. He has been the driving force to bring advances like robotic seed implants for prostate cancer, Intensity Modulated Radiation Therapy (IMRT) and the CyberKnife Stereotactic Radiation Therapy to our city. He has always been on the forefront of these medical breakthroughs.

Dr. Hughes was one of the first oncologists in the country to use Stereotactic Radiation Therapy. He makes financial investments, often foregoing profits, because he wants his patients to have world class cancer treatments right here at home. Dr. Hughes states, “People ask me all the time, ‘If the CyberKnife is such phenomenal technology then why doesn’t every hospital have one?’ I can honestly tell them that is not a profitable service line. It is simply better medicine. And I believe as a physician, my most important mission is to save lives using every possible tool.”

We asked Dr. Hughes why he chose to leave the hospital and open his own center in today’s challenging health care market. “When I worked at the hospital I was always being told what I could and could not do for my patients. Owning my own practice allows me to care for them as individual people. I can do so much more this way.” For example, First Dayton is the only center in the region to actually pick up patients for their treatments. It is a free car service. Mary of Centerville tells us, “It has been a true blessing to have such fine people drive me to my daily appointments. My kids all work. I don’t know how I would have made it otherwise.”

When you have been told you have cancer, you want answers immediately; so Dr. Hughes will see patients within 1-3 days of their first phone call. Dr. Hughes often spends over an hour with his patients and their family at their initial visit. “I want to learn about this person. I want to present all of the treatment options and help the patient decide what will give them the best chance to beat their cancer. I want to answer all of their questions. I couldn’t spend this much time when I worked at the hospital. People with cancer are scared. Patients want hope.”

The Fight for Freedom from Insurance Companies

USA-Independence-day-best-greetings-2014Independence is the freedom from dependence on or control by another person, organization, or state. Unfortunately today physicians and patients have lost their independence. Physicians are now controlled by hospital administration, government policies, and insurance companies. Patients are dependent on their insurance company. This lack of independence has placed a great strain on how medical care is given in the United States of America. First Dayton Cancer Care is fighting for the right to practice medicine in a way that is best for our patients, not someone’s bottom line.


Any person with insurance who has tried to have a procedure should know the term prior-authorization. This is where the patient and the physician must ask the insurance carrier permission to give treatment. This authorization is solely based on the ‘plan’ that patient has contracted and the formulary that insurance carrier has established for the diagnosis and the treatment requested. They can deny authorization regardless of what the physician feels is the best medical choice. This authorization can take up to 30 days; if initially denied, the entire process can take 60 days. And if authorization is given, there is no guarantee of payment.

The Ohio State Medical Association (OSMA) and First Dayton’s practice manager have spent the past year fighting for Ohio Senate Bill 129 which would regulate how carriers handle prior authorizations. While not every agenda item was approved, we will see an improvement in this process over the next two years. The two key items that will affect the patient the most are more timely decisions and payment for authorized procedures and medications.


Insurance carriers now must give authorization in a timelier manner. For urgent care services consideration must be given within 48 hours of initial request and within 10 calendar days for non-urgent care. This will allow the patient and the physician to move forward with treatment quicker so that a patient is not anxiously waiting to begin very important treatments like that for cancer.

If prior authorization was given, insurers will no longer be able to retroactively deny payment for a claim. This is excellent news for patients and physicians. It basically means that insurers must do what they promise and pay for what they should.

We hope that this change to the authorization process will help patients and physicians alike. Physicians have the training and experience to make the decisions for that individual patient. The doctor to patient relationship is so important to quality health care. We must continue to fight insurance carriers and the government from dismissing the importance of this relationship. The beauty of medicine is treating the entire person not simply the disease on paper. This can only be accomplished when a physician is able to get to know this individual person and work together for their health.

First Dayton stays independent of the hospital systems so that our patients maintain their right to choose the best radiation therapy available today and we will continue to fight insurance carriers for this choice.



While colo-rectal cancer rates are on the rise in the US, the death rates are decreasing.

While colon-rectal cancer rates are on the rise in the US, the death rates are decreasing.

Rectal cancer patients now have a BETTER choice – 5 days of radiation before surgery is just as good as 6 weeks of radiation treatment.  Dr. Smitha Krishnamurthi, a medical oncology expert at Case Western Reserve University in Cleveland said the approach “is shorter, more convenient and less expensive… and appears equally active.”  She commented at the recent GI Cancer Symposium 2016 held in San Francisco. 

In the first key study, 515 patients with locally advanced rectal cancer – cancers too extensive to operate on right away – were given radiation and chemotherapy before their operations. Randomly assigned by computer, half of the patients were to have short course 5 day radiation and the other half were given standard radiation therapy of 28 treatments over 6  weeks.  All the patients also received chemotherapy.  Surgery was scheduled 3 months after starting radiation therapy. 

And the results with short course radiation over 5 days were outstanding.  The survival was the same in the  5 day radiation group as compared to the 6 week group.  But the short course group with 5 days of radiation had significantly fewer side effects. The short course has been  the standard of care in European and Scandinavian countries over the past decade. 

Does Radiation Increase the Risk of a Second Cancer?

At the 2016 GI Cancer Symposium, the second key study was that radiation for rectal cancer did not increase a patient’s risk for a second cancer.  In fact, radiation possibly offered some protection.  “These results were very striking,” said Dr. Claus Roedel, Chairman of the Department of Radiation Therapy and Oncology at the University of Frankfurt in Germany. Dr. Roedel went on to mention another study of almost 21,000 patients with rectal cancers in the US.  There was no increase in the risk for second cancer in patients who received radiation therapy compared to those who received no radiation therapy. 

First Dayton Cancer Care – Dayton’s Leader and Pioneer in Short Course Radiation

Since opening in 2003, the stated mission of First Dayton Cancer Care is to deliver the best in radiation medicine over the shortest  amount of time – but only when the radiation treatment is equally as effective as longer course radiation.  And we have over a decade of experience in short course radiation for a number of different cancers. 

Cyber Knife

           Lung cancer treatment in 3 to 5 visits

           Prostate cancer treatment in 5 visits

           Brain cancer treatment in 1 to 3 visits

Leipzig superficial Radiation

           Skin cancer treatment in 6 to 10 visits over 2-3 weeks

High-dose Rate Brachytherapy

            Breast cancer treatment in 1 week

             Locally advanced prostate cancer in 5 weeks

If you have any questions, please feel free to call me, Dr. Edward Hughes, at 855 Dayton1.  I guarantee that I will see any patients within 1-3 days of their phone call.   



Over 8,000 breast cancer researchers and clinicians attended the San Antonio Breast Cancer

Know the results of these 5 research studies to help make treatment decisions.

Know the results of these 5 research studies to help make treatment decisions.

Symposium meeting in December 2015.  Here are some of the key highlights that I though would be important to our breast cancer patients.

1. Lumpectomy and Radiation Therapy Is Better Than Mastectomy

In a 10 year study of 37,000 women in the Netherlands, the relative risk of death was 20% lower in women who underwent lumpectomy and radiation therapy versus mastectomy alone.  The 10 year overall survival was 76.8% with lumpectomy and radiation therapy versus only 59.7% with mastectomy alone.  Importantly, the overall survival benefits held even for women who had lymph node positive disease.

  1.  With Lumpectomy and Radiation Therapy, It’s a Good Idea to Stop Smoking

Over 40,000 women were studied by the Early Breast Cancer Trialists’ Collaborative Group.  The results were clear cut-those women who underwent lumpectomy and radiation therapy but continued to smoke were at increased risk for lung cancer and heart disease.

The study was somewhat dated as the median time to entry into the study was 1983. And breast radiation therapy has improved dramatically over 30 years.  But I believe these results still ring true.

3. Skipping Chemotherapy Altogether in Postmenopausal Women with Breast Cancer

Post-menopausal women with the so-called luminal A subtype breast cancer can consider skipping chemotherapy altogether and still expect a good prognosis even when node positive (ER/PR positive, HER-2 negative). Analysis of the “old” Danish Breast Cancer Cooperative Group 77B Trial finally confirmed what many clinicians already thought: Patients with low risk breast cancer do not need chemotherapy.

4. Heart Medications Protect against Herceptin Damage

In the MANICORE  study, women taking both the beta-blocker bisoprolol (Concor) and the ACE inhibitor perindopril(Converyl, Aceon) preserved heart function.  The study may be a life saver for many of those breast cancer patients who take Herceptin for months. Herceptin is known to cause heart damage.

5. Preventing Breast Cancer Recurrence In Women with DCIS: Anastrozole May Be Just As Good As Tamoxifen

The IBIS DCIS Trial and the NRG/Oncology/ NSABP-35 trial showed that the drugs are equally effective. Anastrozole is my choice because of its fewer side effects.

Be sure that you consider these 5 facts when you are making decisions about the treatment plan that is best for you. The goal should be do treat your breast cancer without causing further health issues.

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

Shorter Really Is Better

Woman with early stage breast cancer can now rest assured that short course radiation over 3-4 weeks is the same or even better than radiation treatments over 6 weeks.

Researchers at the MD Anderson Cancer Center, led by Dr. Simona Shaitelman, studied over 300 women age 39-years or older with early stage breast cancer, specifically stages 0-II.  All women had a lumpectomy and were then randomly assigned to either short course radiation or standard long course radiation treatments.

The majority of women with short course radiation had fewer side effects and were able to get back to their lives quicker.  The study was published in the August 6 issue of the Journal of the AMA Oncology. “Those patients who received a shorter course reported less difficulty in caring for their families’ needs, “ said Dr. Shaitelman.

Lessons from the Past

The study builds on major advances made in Canada, Great Britain, and Europe over the past 10-20 years.  Those studies were the so-called “gold standard” and compared thousands of women treated with short course versus long course breast radiation after lumpectomy.

In each and every study cancer survival, cancer control in the breast itself, and the cosmetic results were exactly the same whether short course or long course radiation was given after surgery.  Newer studies are now ongoing, based on the biology of breast cancer, that will compare only 5 treatments to 15 treatments.

The Choosing Wisely Campaign

The American Society of Therapeutic Radiology and Oncology or ASTRO has launched a national initiative to encourage women with breast cancer and their doctors to carefully consider using short course radiation after lumpectomy for early stage breast cancer patients.  ASTRO has issued specific guidelines for early stage breast cancer patients who would be candidates for such treatment.

But acceptance has been slow.  Dr. Bekelman and co-workers from the University of Pennsylvania School of Medicine looked at the insurance claims of 14 major commercial health plans.  The results were astounding-only 34.5% of women were treated with short course radiation-despite the results of more than two decade of clinical studies.  The study was published in the March 2015 issue of ASCO Post.

Dr. Hughes and Dr. Marger at First Dayton Cancer Care have prescribed short course breast radiation for over a decade – experience counts.

As always, it’s good to have a second opinion.  If you have any questions about your breast cancer, call me Dr. Hughes at 855-Dayton 1.  I guarantee I will see you in 1-3 days after your call.


Weight Loss in Head and Neck Cancer Patients: It’s Not Just the Cancer That Can Kill You

It’s Not Just Loss of Arm Strength But Also Your Heart Strength That’s Affected

At First Dayton Cancer Care, I see and treat many patients with head and neck cancer each and every week.  I tell them that the big battle ground will be nutrition.  I tell them I don’t want to see them lose weight because it will be muscle rather than fat that they will lose.  After I tell my patients about all the side effects of chemotherapy and radiation treatment, an overwhelming experience to say the least, many patients just smile and say “I need to lose a few pounds anyway.”

Unintentional weight loss in cancer patients-called cachexia-not only results in loss of muscle mass but also may account for loss of heart muscle function.  Cachexia is defined as >5% weight loss and 3 of 5 other factors-loss of muscle strength, fatigue, lack of appetite, loss of muscle mass, low albumin and high C-reactive protein. In a remarkable summary of many studies, Dr. Couch and colleagues showed the cachexia is a major factor in the death of many head and neck cancer patients (Head Neck; 2015; 37: 594-604).  The surprising finding is that heart trouble related to cancer weight loss may account for up to 20-30% of head and neck cancer patient’s deaths.  Even if they are first cured of their cancer.

My clinical instinct over the years was that nutrition was one key to survival.  But I never thought that weight loss in cancer patients could affect their hearts to such an extent.  If Dr. Couch’s studies hold up, head and neck cancer specialists will lose up 30% of patients from cachexia, not cancer. But even more frustrating is the fact that while intentional weight loss is fixable by good nutrition alone, cachexia or unintentional weight loss in cancer patients, is not.  So much more medical work and research is needed here.

Don’t get me wrong.  The medical and technological breakthroughs in head and neck cancer care have been nothing short of miraculous over the past decade.  But I think head and neck cancer specialists need to take nutrition, especially new ways to battle cachexia, much more seriously than in the past.

 Diagnosing Cachexia-Related Muscle Loss Is Not As Easy As You May Think

 Diagnosing muscle loss seems easy, doesn’t it?  Plain and simple.  Just have the doctor or nurse weigh you and examine you.  And taking a good medical history may help.  But it’s not just that easy.

As head and neck cancer doctors, we rely “heavily” on BMI or body mass index-a formula based on height and weight. The BMI alone may mislead cancer doctors, especially in men who have more muscle mass than women.  That’s also true in men and women who are obese – underestimating loss of muscle mass. The change in BMI alone is likely to be misleading as a measure of loss of muscle mass or cachexia.  In fact, the gold standard for body composition assessment- a CT scan of the lower spine and pelvis- is rarely used to diagnose cachexia related loss of muscle mass.  I know of not a single cancer clinic in the country that uses CT scans to assess body composition to diagnose cachexia in cancer patients.

                                                                 CANCER CACHEXIA =

3 or more symptoms                                    +                    Weight Loss > 5% within 12 months

  • Fatigue
  • Loss of Appetite
  • Decreased Muscle Strength
  • ↑CRP or ↓ Albumin
  • Low Fat-Free Muscle Mass on CT Scan
 So What Can A Head and Neck Cancer Patient Do to Diagnose Cachexia?

First and foremost, be upfront and honest with your head and neck cancer specialist.  Do tell your doctors about any loss of muscle strength, fatigue, and lack of appetite.  Ask your doctor about blood tests that measure if you are anemic, have a low level of the blood protein called albumin, or increase in the level of the broad protein called C-reactive protein or CRP for short.

The syndrome of cachexia in head and neck cancer patients-unintentional weight loss, loss of muscle mass, anemia, lack of appetite, and fatigue-is all too common.  But what is starting to be learned about this cancer syndrome may also have profound effects on your heart muscle, resulting in 20-30% of deaths in head and neck cancer patients.

So much more time and money for medical research into cachexia is long overdue.


Skin Cancer and the Art of Treatment Design

Day 1 of Treatment and 2 weeks after treatment. The skin will continue to heal.

Day 1 of Treatment

After 8 treatments

After 8 treatments

12 weeks post treatment

12 weeks post treatment







Despite the fact that most skin cancers are preventable, more than 1 million people will be diagnosed with a new skin cancer this year. If treated correctly and early, skin cancer can be no more than an inconvenience. However, if not treated correctly, it can become deadly.

When you think skin cancer treatment, you think dermatologist. Dermatologists will treat the majority of early skin cancers. But did you know that radiation oncologists have been successfully treating skin cancer for well over 100 years? My predecessors have mastered tried and true techniques however, with advances in technology, I have taken treating skin cancer to a whole new level. Much depends on the type of cancer as well as the location. It is best to know all of your options for treating your skin cancer.


My team at First Dayton Cancer Care were the first in southwest Ohio to use new robotic technology coupled with basic principles of radiation therapy to treat skin cancer. Since its inception in 2003, myself and my team of experts has performed over 3,000 Leipzig Robotic Radiation treatments for early stage basal and squamous cell skin cancer.

The Leipzig Robotic Radiation treatment is an alternative to surgery that targets small skin cancers without pain or damaging surrounding tissue. This is a very superficial radiation treatment that causes no scarring and no incision. A patient simply experiences a ‘sunburn’ in the treatment area. Once new skin has grown, it is healthy and fresh just like a newborn baby.

Leipzig helps fight cancer in hard to reach areas such as ears, noses, lips, scalps and shins. Treatments only take a few minutes in 6 -10 visits. For people with diabetes, peripheral vascular disorders and those on blood thinners the Leipzig treatment is an amazing option. Since it is not surgery, there is no wound that needs to heal and no need to change any medications. This is a wonderful option.


Locally advanced skin cancers don’t stand a chance against tried and true electron beam therapy (EBT). EBT delivers powerful cancer-fighting radiation to the involved layers of the skin and spares the tissues and organs beneath. EBT takes advantage of the 100 year old radiation principle of fractionation -small daily doses over 4 to 6 weeks. Normal tissue surrounding the cancer have time to heal up after small daily doses of radiation – skin cancer cells do not.

I design a custom mold for each patient and then develop a treatment plan to pinpoint the radiation to the skin cancer. I can control the depth and the width of the radiation to ensure that we treat the cancer cells and surrounding margins but leave health tissue unharmed.

Treating skin cancer is a true art. As a physician I really need to understand my patient and their disease to design the best treatment plan for optimal cancer cure rates, but giving special consideration to the patient physical appearance afterwards. It is very exciting to have so many treatment tools at my disposal here at First Dayton Cancer Care.

It is Reds Opening Day. Not all Baseball Traditions are Good.

Baseball’s Long SmokelessTobacco Tradition

Baseball and tobacco traditionally go hand and hand. With the start of baseball season, the debate is renewed. Last year’s passing of  legend Tony Gwynn renewed the debate about smokeless tobacco and its use by baseball players of all ages.

Smokeless tobacco is referred to as dip, snuff or chew and has been banned in dugouts in high school, college, and professional minor league baseball. However, while Major League Baseball (MLB) recognizes the harmful effects, it is not banned. New commissioner Rob Manfred and Tony Thurmond, a state assembly member in California, are both actively advocating for a culture change by asking the MLB Players Union for a ban. In 2011, with the urging from public groups such as the Campaign for Tobacco-Free Kids, the MLB opened a Tobacco Cessation Center that offers educational sessions to their players and staff about the dangers. They are hoping to break this long standing tradition associated with baseball.

Dr. Donald Marger, Oral, Head and Neck Cancer expert at First Dayton CyberKnife, explains that “the cancer causing chemicals in smokeless tobacco is no different than what is in cigarettes and pipes. While they will not contribute to your risk for lung cancer, there is still danger of cancers of the tongue, floor of mouth, throat, gums, cheeks and lips.” Oral, head and neck cancer affects 55,070 newly diagnosed Americans each year with approximately 12,000 deaths. Other health issues include severe dental problems and the terrible staining of the teeth.

Many MLB players and coaches claim to only use dip while in uniform. They say it is simply a habit and a way to relax and pass the time during a game. David Ortiz of the Boston Red Sox only puts snuff in his mouth while he is at bat. Others admit it is a terrible addiction that they simply cannot break and they wish they had never started.

“Cancer of the oral cavity, besides being potentially fatal, almost invariably results in marked physical deformity, swallowing problems, difficulty with speech and breathing. The primary treatment is radical surgery followed by radiation therapy”, explains Dr. Marger.

The debate is not whether dip is harmful ‑‑ clearly it is. The debate is whether or not we want our children looking up to their baseball all-stars and emulating their behavior. At the thousands of baseball fields around our country you see t-ballers chewing bubble gum, high schoolers spitting seeds and professionals spitting tobacco. Would it have made a difference to Tony Gwynn or the many other baseball players with these cancers if someone had told them to never start? Does it need to remain a part of America’s most beloved sport?

April is Oral, Head and Neck Cancer Awareness month. Our local Support for People with Oral and Head and Neck Cancer  will be offering screenings around Dayton the month of April. You will find Dr. Ed Hughes doing FREE screenings on April 18 at the Levin Family Foundation Celebrating Life Health Fair at Sinclair Community College.

Blog contributed by: Kathy Corbett of First Dayton CyberKnife


5 Facts You Need to Know about CyberKnife and Prostate Cancer

Each day I tell patients the truth about CyberKnife.

Each day I tell patients the truth about CyberKnife.

When I sit down each and every week with prospective CyberKnife prostate cancer patients, I have to gently and professionally dispel a number of myths that they heard from other healthcare providers.  I feel like that old Englishman Samuel Johnson who once said “Sir-I can give you the argument-but the understanding can come only from you.”  So here we go.

1. CyberKnife treatment is done in 5 visits over 1 week, not 40 to 45 over 8-9 weeks.  But do you know why this is better?

CyberKnife takes advantage of something called the alpha/beta ratio of prostate cancer, a basic biologic fact.  The discovery that prostate cancer has a very low alpha/beta ratio has been the major, ground breaking finding of the past decade in the radiobiology of prostate cancer.  Dr. Jack Fowler, the esteemed emeritus Professor of Radiobiology at the University of Wisconsin, did a statistical review of over 25,000 prostate cancer patients. Dr. Fowler and co-workers found that patients with low, intermediate, and even high-risk prostate cancer all had prostate cancers with low alpha/beta ratios.  What does this means for you as a prostate cancer patient? It means that fewer, larger doses of radiation are better.  Simply put, because of the low alpha/beta ratio of prostate cancer, CyberKnife can deliver better cure rates with fewer side effects.  CyberKnife treatment has been an outstanding example of bringing research directly to patients with great results.

2. “If I have radiation therapy, I was told that I can’t have surgery.” 

That statement may have been true a decade ago, but it’s not true now.  I personally attended our professional society annual meeting (ASTRO) in September 2014 in San Francisco.  At the session titled “Challenging Cases in the Management of Newly Diagnosed and Recurrent Prostate Cancer,” Dr. Peter Carroll, Professor and Chairman of the Department of Urology at the University of California San Francisco, stated that prostate surgery after radiation can now be performed safely with robotic techniques.  Dr. Carroll has performed over 4,500 robotic surgeries and is a world expert.  Dr. Carroll offered to the audience that any patient and their physician can call him to discuss their situation. Call me directly for more information.

  1. “If CyberKnife is so good, why don’t all hospitals have it?” 

I believe that economics may play a big role in equipment selection by hospital administrators.  Firstly, CyberKnife is much more costly than ordinary linear accelerator devices.  In fact, it’s a $5 million investment.  Secondly, CyberKnife is the only machine solely dedicated to stereotactic ablative body radiotherapy, SABR for short.  Thirdly, CyberKnife radiosurgery costs 25-30% less than ordinary IMRT over 8-9 weeks for prostate cancer.  So when a hospital administrator looks at CyberKnife, they see a device that costs more, treats fewer patients, and gets paid less than an ordinary linear accelerators.  Hospital administrators base their decisions, in large part, on ROI (return on investment).  At First Dayton Cancer Care, I carefully researched all of the available options and picked CyberKnife as the best.  As a practicing radiation medicine specialist with 30 years of experience, I made the decision based on what I call RFP (Return for the Patient).

  1. “My other doctors told me CyberKnife is new, and follow-up results are short.  It’s still experimental.”

There are now a number of publications from Dr. Katz in New York, with 7-year follow-up that showed superior PSA control rates with fewer complications.  Importantly, the side effects with CyberKnife are less severe and of less duration than with IMRT.  Thousands upon thousands of prostate cancer patients have been followed on national registries with the same results.  Each of our own prostate cancer patients at First Dayton CyberKnife is enrolled in a national CyberKnife Registry so that we can monitor our results and compare with those at other centers of excellence.  My team has performed over 1,500 CyberKnife treatments. Every week and I hear from patients who were told by urologists and other radiation oncologists that CyberKnife is new and experimental.  Yet these same physicians rapidly embraced IMRT with only 5-year results.  Enough said.

  1. “Why is First Dayton CyberKnife better than the hospital? “

It’s not just the technology.  It’s all about the people-the expert team that I assembled at First Dayton CyberKnife. That expert team has enabled me to move CyberKnife from a high-tech medical device to a finally orchestrated, precision instrument.  And patients get the time they need for personalized care.  Recently, the medical physics team used the enormous computer capability and the exquisite precision of CyberKnife to develop a radiosurgical treatment plan that mimics our technique with temporary prostate implants.  With this “HDR implant plan” I can deliver a radiation dose to the whole prostate but at the same time deliver extra dose to the sites of prostate cancer shown by biopsy.  All the while, I can spare the normal tissues of rectum, bladder, and urethra.  Dr. Donald Fuller of San Diego reported on similar methodology at the ASTRO meeting in 2014.

Additionally, I have 3 different radiation treatment  suites with 3 different devices for patients with prostate cancer: the CyberKnife suite; the IMRT suite, and the temporary implant brachytherapy suite.  At First Dayton Cancer Care, I have the luxury of tailoring the best treatment for each individual patient.  Not every treatment is right for every person. I help my patients chose what is right for them. And that’s the First Dayton difference.