Politics, Patients, and Prostate Cancer

YOU OWE IT TO YOURSELF TO TALK TO YOUR DOCTOR ABOUT PROSTATE CANCER SCREENING

Whatever your politics, it’s true that ObamaCare came between you and your doctor in more ways than one.  Nothing says that more than the USPSTF decision to reverse its recommendation about PSA screening for prostate cancer.  USPSTF is a mouthful that stands for United States Preventative Services Task Force. 

USPSTF reversed its recommendation for PSA screening for prostate cancer for men 70 years and younger.  The USPSTF now says there is “at least a moderate certainty that the net benefit is small.”  Jamie Bearse, the CEO of ZERO, a patient advocacy group said “While the improved recommendation is a step in the right direction, there is much work to do.  We must undo a decade-long message that discouraged men from getting tested, and encouraged men to talk to the doctor about their risks and the test.”  In 2012, the USPSTF advised against all PSA testing in men of any age. 

But for men 70 years and older, I urge you to discuss PSA testing with your doctor.  Some risks are not so obvious.  For example, a history of breast cancer and ovarian cancer in your family may indicate a greater risk for prostate cancer in men.  Other factors are well-known.  African-American men have a greater risk of prostate cancer than white man.  And recent work from the Johns Hopkins University School of Medicine showed that 2/3’s of all prostate cancers are just due to chance or bad luck.  So it is not so simple as it seems.

 If you have any questions about PSA testing or treatment of your prostate 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.

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.

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.