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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.

Just How Does the CyberKnife Treat Lung Cancer?

100’s of Beams of Radiation are Precisely Delivered with the CyberKnife.

People in Dayton, Ohio are fortunate to have this amazing technology right here in our small town. The CyberKnife is used at World Class Cancer Centers in almost every country to treat cancers all throughout the body, including lung cancer. The challenge that cancer specialists face with lung cancer is that those cancers move as the patient breathes. The CyberKnife Robotic Radiosurgery system offers patients breakthrough technology for the treatment of lung cancer. CyberKnife breathes with you.

The CyberKnife system treats patients with early stage lung cancer with a procedure called stereotactic body radiotherapy or SBRT. SBRT is breakthrough radiation where a few large doses or “ablative” doses are given. It is really radiosurgery not ordinary radiation therapy. So how is this done without harming surrounding, nearby tissues and organs? CyberKnife SBRT uses robotic guided, pencil thin beams of radiation focused on the lung cancer, while minimizing exposure to surrounding healthy tissues, normal lung, heart, esophagus, and spinal cord. CyberKnife treats the lung cancer with exquisite precision.

In the CyberKnife robotic radiosurgery system is the only delivery system that incorporates Synchrony respiratory technology. With synchrony, no markers need to be placed in your lung. No breath holding is required. No cutting. No pain. No invasive procedures.

The synchrony respiratory motion management system has a sophisticated software system that automatically adjusts the aim of the radiation beam to account for tumor movement due to breathing. SBRT systems at ordinary radiation centers usually results in overexposure of healthy lung tissue to radiation because a wider area needs to be treated to account for lung cancer movement during treatment. The CyberKnife system with synchrony technology adjust for movement of the tumor because of breathing, enabling the delivery of maximal doses or ablative doses of radiation to the lung cancer, while minimizing collateral damage to normal surrounding organs and tissues.

The CyberKnife system is the only fully robotic radiation delivery system. A robotic instrument is critical to enable the CyberKnife system to deliver 100s of pencil thin beams in any direction imaginable. SBRT systems at ordinary cancer centers only can go in a circle and deliver a few beams of radiation at a time. CyberKnife can go in any direction imaginable by the radiation medicine specialist. By precisely targeting the lung cancer, the CyberKnife system can deliver ablative doses of radiation with sub-millimeter precision, while minimizing radiation collateral damage to normal surrounding organs and tissues.

Radiation medicine specialist turned to the CyberKnife system when patients prefer a clinically proven, noninvasive procedure or when invasive techniques are ineffective or too risky.

The CyberKnife system was cleared by the US Food and Drug Administration in 1999 to treat cancers in the head and base of skull. The CyberKnife was system was cleared in 2001 for treatment of cancers and every other part of the body. Since then, over 100,000 patients have been treated with CyberKnife for other cancers, like lung, liver, pancreas, kidney, and prostate.

Dr. Ed Hughes and his team have the more experience using SBRT than anyone else in the southwest Ohio region. The experience really does make a difference in treating 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.

CYBERKNIFE: PERFECT CHOICE FOR SENIORS WITH LUNG CANCER

Stereotactic radiosurgery, like that delivered by CyberKnife, has become the “standard of care” for stage 1 lung cancer patients considered to be medically inoperable or if a patients is too sick for surgery.  A new study of 62,213 patients 60 years and older with stage 1 lung cancer, showed that stereotactic radiosurgery increased the 2 year survival rate to 58% compared to 39% for seniors treated with conventional radiation.

Dr. Andrew Farach told HemOnc Today that “Our findings indicate that physicians should feel confident recommending radiation therapy to patients who are too sick to undergo surgery or choose not to undergo surgery for other reasons.”

THE CYBERKNIFE ADVANTAGE

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

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

“It is a rare situation where the more convenient therapy is also the more effective therapy,” said Dr. Farach of Houston’s Methodist Hospital.

If you have any questions about your lung cancer, please feel free to call me, Dr. Edward Hughes, at 855-Dayton 1.  I guarantee that I will see you in 1-3 days of your call. Expertise. Experience. Caring. The First Dayton CyberKnife difference.

VA Medical Centers Beat Lung Cancer with the CyberKnife

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

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

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

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

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

1 in 4 Lung Cancers are in Never Smokers

When every extra day counts, turn to the CyberKnife.

Did you know that “never smokers” make up 28% of new diagnosis of early stage non-small cell lung cancer patients?

 Dr. Eric Lim and colleagues from London looked at 2,170 British men and women who had  lung cancer surgery from March 2008 to November 2014.   

The remarkable finding was that “never-smokers” with lung cancer increased each and every year from 13% in 2007 to 28% in 2013.  And the trend was due to a dramatic increase in the absolute numbers of “never smokers” with lung cancer.   Fifty five percent of those patients with lung cancer were found “incidentally.”  That is to say, their lung cancers were found by CT scans, PET-CT scans, X-rays, or MRI’s ordered for other reasons-not because their physicians suspected lung cancer.  Only 14% of patients had symptoms of lung cancer-like coughing up blood or profound shortness of breath. 

Like many good medical studies, Dr. Lim’s article raises more questions than answers.  Were these lung cancer patients who were “never smokers” exposed to second-hand smoke at home or in the workplace?  What about other exposures, like chemical toxins, in the workplace?  Are there differences in “never-smokers” who live in the city versus out in the country?  What about family history?  Do the same trends hold for people in the US? 

So whether it’s family history, genetics, race or just bad luck remains to be seen.  But the good news is that lung cancer caught early is highly curable.  Cure rates are now in the 80-90% range for 5 years.  And you may not need surgery at all.  Many studies have now shown that Cyber Knife radiosurgery is equal to or even better than open surgery for patients with early stage lung cancer.  And Cyber Knife is done as an outpatient-no incision, no pain, and no long hospital stays; eliminating the complications that go along with surgery.

So if you have any questions about your lung cancer, please free to call me, Dr. Edward Hughes

Computers Helped Save My Life

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

“I have cancer growing inside of my lungs. I can’t see it. I can’t touch it. But I know that it is there”, shares John, a computer technologist from West Chester.

John states that the doctors have shown him the medical images of his lungs so that he could see his cancer. “Even though I have seen in CT scans and MRI’s, it is still hard to believe. I thought that my increased congestion was due to allergies. I work with computers all day long, but now computers are helping to save my life.”

In addition to the advanced medical images that diagnosed John’s cancer, the treatment that he chose is also possible because of the advances in computer technology. Surgery was not an option for John because it would have damaged the healthy tissue and was close to his heart. He chose to have radiation therapy with Dr. Ed Hughes instead.

“The fact that we can now use advanced computer imaging during John’s treatment to actually see inside his lungs; has been the biggest medical breakthrough in my 35 year career”, explains Hughes. The CyberKnife’s computers actually track the motion of John’s breathing so that it can deliver the radiation with sub-millimeter precision to only the cancerous tissue.

“Knowing that the doctors could see inside my lungs and that the CyberKnife was so precise and so accurate, helped me to relax. I work. I support my wife and 3 kids. I was not only afraid for my life, but afraid to take off work to recover”, says John. He was able to have 3 CyberKnife treatments that lasted about half an hour each. He was able to keep working and was able to keep up with his active family.

It has been 14 months since his CyberKnife treatments and he is now cancer free. (original blog was in July of 2014)

John shares his enthusiasm, “I have always loved computers. They have fascinated me since I was a teenager and now they have saved my life.”

John was just in to visit with us and he is still cancer free thanks to Dr. Hughes and the CyberKnife. If you want help like John, call Dr. Hughes today.

Elderly Lung Cancer Patients Fear Treatment

CyberKnife is the answer for early stage lung cancer, especially in those older than 70. The decreased complication risks make it ideal.

So many of my elderly patients are now asking whether it’s worth it or not to treat early-stage lung cancer. “I have to die of something!”

But Dr. Walter Curran and colleagues from Emory University School of Medicine may now have a good answer to that important question.  From 2003-2006, the National Cancer Data Base was analyzed for patients 70 years or older with early stage lung cancer who chose either a watch and wait approach or stereotactic radiosurgery, like that delivered by Cyber Knife.  Their findings were reported in the August 2015 Journal of Cancer. The results were striking.  Senior patients with early stage lung cancer treated with stereotactic radiosurgery had better survival than those patients who chose a watch and wait approach.  Importantly, those patients were treated with stereotactic radiosurgery were no sicker initially than those who chose a watch and wait approach.  And they fared much better afterwards.

Stereotactic Radiosurgery, Like that Delivered by Cyber Knife, May be the Solution to Those Fears 

Stereotactic radiosurgery, like that delivered by Cyber Knife, has produced the same lung cancer control rates as surgery for early stage lung cancer patients, but with far fewer side effects.  No incision.  No pain.  And no hospitalization.  Cyber Knife is done on an outpatient basis.  It’s now considered the standard of care for early stage lung cancer patients who are “medically inoperable” or too sick for surgery.

Recent results indicate that Cyber Knife stereotactic radiosurgery may be just as good as open surgery for medically operable patients, or those patients who are healthy enough for open surgery like lobectomy or video-assisted lobectomy.  In a study in the June 2015 issue of the medical journal Lancet Oncology, Dr. Chang and coworkers reported that early-stage lung cancer patients treated with stereotactic radiosurgery had a 95% survival at 3 years versus only 79% for patients with surgery.  And the complications with open are far more severe.  My conclusion is that Cyber Knife radiosurgery may be just as good as open surgery even for young patients who are fit as a fiddle.

So What’s  a Senior with Early Stage Lung Cancer To Do?

Dr. Jonathan Beitler  of Johns Hopkins, commenting on this study, stated “I have to say that it seems to be the surgical community has resisted a large-scale randomized trial and from their point of view, who could blame them?  On the other hand, are they looking out for the patient’s or for themselves?”  That’s a sobering thought.  While I’ll never comment on another person’s motives, I know that it can take a while before doctors change their practice habits.  After all, it took over 50 years for surgeons to learn that a radical mastectomy just simply didn’t work.  More is not always better.  I do think it’s a good idea, may be even mandatory, for all early-stage lung cancer patients, young or old, to see a radiation oncologist experienced in Cyber Knife before undergoing the cold, hard steel sharp edge of the scalpel.  It just may be in the patient’s best interest.  Each and every week when I see early-stage lung cancer patients in consultation, I have to dispel a lot of myths about Cyber Knife.  In this day of data driven decision making, it’s important to have the facts from a number of sources.
So if you have any questions, please feel free to call me, Dr. Ed Hughes, at 855-DAYTON1

CyberKnife for Early Stage Lung Cancer Continues to be Superior to Surgery

Two years after this study was published, survival rates for lung cancer patients treated with the CyberKnife continue to climb. Lung cancer patients treated with the CyberKnife are simply outliving those who had surgery. This is fantastic news! Read more about the original study here:

Treatment for lung cancer with radiation therapy is proven to be superior to surgery. In a landmark study published in the Lancet Oncology June 2015 16(6) 630-637, cancer specialists reported that early stage lung cancer patients treated with stereotactic ablative body radiotherapy (SABR), like that delivered by CyberKnife, had a 3 year overall survival of 95%. Surprisingly, early stage lung cancer patients faired much worse with open surgery (lobectomy) with a 3 year overall survival of only 79%.

CyberKnife treatment stands in stark contrast to surgery. CyberKnife is a highly specialized form of radiation therapy done on an outpatient basis in 3-5 visits, with no pain and no cutting. A lobectomy on the other hand is a major operation where surgeons open your chest and remove an entire lobe of your lung. Requiring a prolonged hospital stay with all the risks of surgery on the chest.

Dr. Joe Y. Chang, a professor of radiation oncology at the world famous M.D. Anderson Cancer Center told Medscape, “For the first time, we can say that the 2 therapies are at least equally effective, and the stereotactic ablative radiotherapy (CyberKnife) appears to be better tolerated and might led to better survival outcomes for these patients.”

WHY IS THIS IMPORTANT FOR PATIENTS AND PHYSICIANS TO KNOW?

I believe this study is telling us that CyberKnife is a good solution as compared to open surgery. And a solution that does not require a major operation. No incisions, no pain, and no prolonged hospital stays with a difficult recovery. CyberKnife is painless and quick. You simply lay on a table and relax. No need to even get undressed.

WHAT IS THE CYBERKNIFE ADVANTAGE?

There are other stereotactic systems found at area hospitals. However, the CyberKnife is the ONLY stereotactic radiation device that actually breathes with you. There is no breath holding. This system has real time x-ray imaging that tracks your movement ensuring that it only targets the tumor and spares healthy tissue. This results in fewer long term side effects and offers immediate results.

First Dayton is the ONLY cancer center in southwest Ohio with the CyberKnife system for treating lung cancers. Discover if CyberKnife is the right choice to treat your lung cancer by calling me today, Dr. Ed Hughes at 855-DAYTON1.

Learn more about CyberKnife Treatment for Lung Cancer here.

Real Hope for Stage 4 Lung Cancer

An Important Question  

What options are there for stage 4 non-small cell lung cancer patients with limited metastatic disease – the cancer has spread to less than 3 organs other than the lung? 

Study after study have shown that most failures of chemotherapy are exactly at the places of the original lung cancer, and not new sites.  So why not focus on those areas instead of giving more “maintenance” chemotherapy? 

An Important Clinical Trial  

Dr. Daniel Gomez and colleagues spearheaded a clinical trial (ClinicalTrials.gov space NCT01725165) that randomly assigned stage 4 lung patients to “maintenance” chemotherapy versus local therapy (mostly radiation, but some with surgery) versus no treatment at all. 

The multi-center study was published in the British journal called The Lancet Oncology in December 2016, pages 1672-1682.  To be eligible for the clinical trial, stage 4 non-small cell lung cancer patients had standard chemotherapy and were in relatively good shape after chemotherapy treatment. 

A Breakthrough Result 

Although only 74 lung cancer patients were entered into the clinical trial from 2012 to 2016, a real breakthrough result was seen.  The breakthrough result was that the local therapy group (radiation or surgery) survived 12 months versus 4 months for the “maintenance” chemotherapy group.  The clinical trial was closed early because the doctors saw better results in the local therapy group (radiation or surgery) versus the “maintenance” chemotherapy group. 

Where Do You Go from Here?  

As a CyberKnife cancer specialist in Dayton Ohio, CyberKnife offers our stage 4 non-small cell lung cancer patients real hope.  And CyberKnife can help you beat your non-small cell lung cancer without surgery.  No pain and no incisions. Real hope for another year of symptom free survival. 

If you have any questions about your lung cancer, please feel free to call me, Dr. Edward Hughes at 855-Dayton 1.  Or visit our website and I guarantee that I will see you within 1-3 days of your phone call.