Tuesday, October 9, 2012

Radiation--Curse or Cure?

Jim’s physicians have chosen Tomo Therapy to treat his latest (fourth) recurrence of lung cancer. What is it and how does it work?

Radiation for cancer therapy utilizes ions that pass through tissue causing the death of the cells in their path in two ways: 1. apoptosis(cell death within a few hours of radiation) 2. radiation-induced failure of cell division which in turn leads to eventual cell death.

In 2003 following surgery and chemotherapy, Jim took 30 treatments of conventional radiation to eliminate the lesion that penetrated the lining of the lung. The procedure required multiple applications because the total amount of radiation had to be divided into small doses to minimize damage to surrounding healthy tissue. At that time the doctor told us Jim would not be able to take any more radiation to the thoracic area because he had received the maximum lifetime amount.

Thankfully, by 2008, when the cancer metastasized to a spot near the spine, doctors were using IMRT, or targeted radiation making it possible to hone in on specific areas. IMRT, intensity-modulated radiation therapy, is an advanced mode of high-precision radiotherapy that uses computer controlled linear accelerators to deliver precise radation doses to a malignant tumor. Treatment is carefully planned using CT images in conjunction with computerized dose calculations—all to conform with the tumor shape.

Simply, IMRT is a custom tailored radiation dose that maximizes tumor dose and minimizes the dose to adjacent tissues. Because of this innovation, Jim was a candidate for more radiotherapy which successfully obliterated that initial metastasis.

Tomo Therapy is an even more advanced type of IMRT. The patented machine divides the radiation beam into tens of thousands of beamlets delivered so that the intensity can be controlled throughout the tumor and delivered from all angles with great precision. (Conventional radiation allows penetration from only a few directions.)
”Tomotherapy is a quick and painless process, with daily treatments that usually take about 20 minutes. The machine is shaped like a large ring, with a bench — sometimes known as a couch — that slides through the ring’s opening. The radiation therapist positions you on the couch, usually on your back. Once treatment starts, you move slowly through the center of the ring while lying on the couch.”
Bottom line: The patient can take higher doses of radiation in fewer treatments with less damage to surrounding tissue.

Tomorrow jim will take the last of the 5 prescribed treatments. We are meeting with the oncologist to discuss whether he will want to follow up with adjuvant chemotherapy . Jim is praying that it won’t be necessary but we trust Dr. Rios to make the right call. He hasn’t steered us wrong yet. Pray for wisdom as he makes this decision.