cancer treatment

Can IMRT be the cure for a cancer that was thought to be incurable?

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by Oncologic Advisors

There is new hope for some patients with prostate cancer, thanks to a joint study by the Institute of Cancer Research in London and the UK’s leading cancer hospital, the Royal Marsden. The study found that a treatment option called IMRT could cure thousands of men whose disease was before thought to be incurable.

For patients with prostate cancer, the following treatment options are usually advised (depending on how far the cancer has spread and how aggressive it is):
– Hormonal treatment
– Surgery
– Radiotherapy
– A combination of the above treatments

When a patient’s cancer spreads too far (meaning it spreads to the lymph nodes near the pelvis) doctors typically advise against radiation therapy, since radiation in that area can cause damage to the bowel, which could then prove to be fatal. (Telegraph)

So What is IMRT?

IMRT stands for Intensity Modulated Radiation Therapy. It’s a highly targeted form of radiation therapy that the Royal Marsden’s study claims can successfully eliminate cancer without causing fatal damage to surrounding organs.

For the treatment, your doctor uses a computer to plan the exact dose of radiation that will be aimed at the cancer. The computer then uses information about the size, shape, and location of the tumor to determine how much radiation is needed to kill the cancer cells.

The treatment uses the high amounts of radiation that are necessary to completely kill prostate cancer cells while still protecting the healthy cells that surround them. (UCLA) So IMRT can potentially be a safe option for patients whose cancer has spread to the pelvis.

Some newer radiation machines also have imaging scanners built into them to allow the doctor to take pictures of the prostate and make minor adjustments in aiming just before giving the radiation. This is called “image guided radiation therapy” or IGRT. It can help deliver radiation even more precisely, which could result in fewer side effects from the radiation. (American Cancer Society)

If you are considering going through IMRT, be sure to ask your physician about whether or not these additional options can be available to you.

Potential Side Effects of IMRT

Short term side effects of radiation can include:
– Skin damage (like a severe sunburn)
– Temporary diarrhea
– Rectal pain

Some possible long-term side effects can include:
– Painful or frequent urination
– Loose bowels
– Impotence

These problems could develop six months or more after the treatment ends and may be permanent. (Genomic Health) Again, be sure to consult your physician about the likelihood of these side effects and if there are options to help prevent them.

About the Study:

In the study mentioned above by the Institute of Cancer Research in London and the Royal Marsden, 447 men were treated with IMRT and monitored for five years. When the trail began in 2000, many of the patients were considered incurable.

The object of the study was to look at the long term effects of IMRT treatment as well as whether or not it could be used to treat those patients who were considered incurable before.

Study leader David Dearnaley, a professor of uro-oncology at the ICR and consultant clinical oncologist at the Royal Marsden said, “Our trial was one of the first of this revolutionary radiotherapy technique, which was pioneered by colleagues here at the ICR and The Royal Marsden.”

71% of the patients were alive and completely cancer free at the end of the five years. Just between eight and 16% of the patients in the trial suffered from issues with their bladder or bowel.

Ultimately, the trial found that IMRT can in fact be safely given to cancer cells that have spread to the pelvis to help stop the disease from spreading further.

Dearnaley calls the technique a “game-changer” for men with prostate cancer and says, “The work done here has already been carried forward into later-stage phase II and phase III trials. I’m excited to see this treatment become available to every man with prostate cancer who could benefit from it.”

The changes in use of IMRT have caused a “complete revolution” in the way it is delivered, with doses now delivered in only two minutes.

Professor Paul Workman, chief executive of the ICR says, “Radiotherapy is often seen as perhaps old-fashioned and crude compared with other cancer treatments — but nothing could be further from the truth.” With new advances in IMRT and the findings from this study, radiotherapy is now considered a highly precise and sophisticated treatment.

“It’s great to see this long-term evidence of the degree to which precision radiotherapy has transformed outcomes for men with prostate cancer,” Workman says.

How Big of An Impact Does This Study Have?

Prostate cancer affects tens of thousands of men in the U.S. each year, and those rates are rising. In 2017 there were about 161,360 new cases of prostate cancer and about 26,730 deaths from the disease.

Most men diagnosed with prostate cancer don’t die from it. When the disease is caught early, treatment is often successful. More than 2.9 million men in the U.S. who have been diagnosed with prostate cancer at some point in their lives are still alive today.

Still, about 1 man in 7 will be diagnosed with prostate cancer in his lifetime. And often, the cancer is not caught early enough.

Prostate cancer is the third leading cause of cancer death in American men, behind lung cancer and colorectal cancer. The American Cancer Society estimates that 1 man in 39 will die of prostate cancer. (American Cancer Society)

In Conclusion:

Still, even with the new findings from this study it is important to consider your options and decide whether or not IMRT is the right treatment for you.

Dr. Matthew Hobbs, Deputy Director of Research at Prostate Cancer UK said that the findings were promising, but also called for larger randomized trials to confirm definitive answers about the benefits of IMRT and its suitability for different cases. (Telegraph)

IMRT still may not be for every patient, but this new study does provide hope for a number of men who were once considered incurable.

Sources:

http://www.telegraph.co.uk/news/2017/09/26/prostate-cancer-treatment-could-cure-men-no-hope/

http://urology.ucla.edu/body.cfm?id=523

https://www.cancer.org/cancer/prostate-cancer/treating/radiation-therapy.html

https://www.cancer.org/cancer/prostate-cancer/about/key-statistics.html

http://www.myprostatecancertreatment.org/en-US/Home/Prostate-Cancer-Treatment-Options/Radiation-For-Prostate-Cancer

http://www.express.co.uk/life-style/health/858891/prostate-cancer-symptoms-treatment-uk

 

Skin Cancer Treatment: Surgery Is Not Your Only Option

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by Oncologic Advisors

We have all heard the warnings: “If you do not apply sunscreen you will develop skin cancer.” What exactly is “skin cancer” and can a little sunburn actually contribute to the development of skin cancer in the future? According to the Skin Cancer Foundation, “Skin cancer is the uncontrolled growth of abnormal skin cells. It occurs when unrepaired DNA damage to skin cells (most often caused by ultraviolet radiation from sunshine or tanning beds) triggers mutations, or genetic defects, that lead the skin cells to multiply rapidly and form malignant tumors” (Skin Cancer Foundation).

Different types of skin cancers (and pre-cancers)

Actinic Keratosis (Solar Keratosis)

This type of skin cancer (pre-cancer) usually appears on sun-exposed areas. Triggered by the damage of the sun’s ultraviolet rays, these crusty, scaly growths usually appear on a person’s face, scalp, lips, and back of the hand. Moreover, “Treatments destroy the affected area of the epidermis, the outermost layer of the skin, which usually cures actinic keratosis” (American Cancer Society). Treatment options for Actinic Keratosis include Cryosurgery, Topical Medications, Photodynamic Therapy, Curettage and Electrodessication, Chemical Peeling, Laser Surgery, or a combination of therapies.

Basal Cell Carcinoma

This type of cancer is usually caused by sun exposure (long-term and short-term). These abnormal growths appear in the skin’s basal cells. The growths appear as red patches, scars, and bumps. Treatment options for Basal Cell Carcinoma include Curettage and Electrodessication, Mohs Micrographic Surgery, Excisional Surgery, Radiation, Cryosurgery, Photodynamic Therapy, Laser Surgery, Topical Medications, or Oral Medicine for Advanced Basal Cell Carcinoma.

Melanoma

This type of skin cancer is often referred to as the “most dangerous” of the skin cancers. Melanoma is caused by the exposure to ultraviolet rays, which trigger mutations, prompting the skin cells to reproduce rapidly, causing malignant tumors. Moreover, “Most melanoma cells still make melanin, so melanoma tumors are usually brown or black” (American Cancer Society). Treatment options for Melanoma include surgery.

Merkel Cell Carcinoma

This type of skin cancer usually appears on sun-exposed areas (mostly on individuals 50 years or older with fair complexion). Merkel Cell Carcinoma is 30 times rarer than Melanoma (Skin Cancer Foundation). Treatment options for Merkel Cell Carcinoma include surgical excision, radiation, or chemotherapy.

Squamous Cell Carcinoma  

This type of skin cancer is usually triggered by a lifetime of sun exposure. These growths (often scaly, open sores, warts, or red patches) are abnormal cells surfacing in the squamous cells. Although this cancer type usually appears on sun-exposed areas, it can also appear on all areas of the body. Treatment options for this cancer type include Mohs Micrographic Surgery, Excisional Surgery, Curettage and Electrodessication, Cryosurgery, Radiation, Photodynamic Therapy, Laser Surgery, and Topical Medications.

Note about Atypical Moles (Dysplastic Nevi)

 “People who have Atypical Moles are at increased risk of developing melanoma in a mole or elsewhere on the body. The higher the number of these moles someone has, the higher the risk” (Skin Cancer Foundation). If a doctor determines a mole is atypical or if a new mole appears after age forty, a person will need a biopsy. It is crucial to monitor a mole if a doctor determines it is atypical. A doctor may choose to not remove an atypical mole.

Apart from popular belief, surgery is not the only treatment option for skin cancer. If you have been diagnosed with skin cancer, it is crucial that you explore your treatment options prior to committing to any cancer treatment. “We are experts in providing guidance for the non-surgical treatment of skin cancer. We can suggest less invasive options resulting in minimal to no scarring” (OncoLogic Advisors). 

About our service:

OncoLogic Advisors are a group of dedicated, objective oncologists providing navigational assistance to patients who have been diagnosed with cancer. If necessary, we arrange for second or multiple opinions from leading physicians—regionally or nationwide. As objective patient advocates, our approach is revolutionary. We cast a wide net and do the analysis and research, enabling patients to make confident decisions about doctors, treatment centers, and methods of treatment.  We review the risks and benefits of each of those treatments—all while providing support and guidance through each decision point—from work-up and beyond. We prepare patients to ask relevant and necessary questions during their doctor visits. Our current healthcare system lacks objective, expert, oncologist advocates for cancer patients. OncoLogic Advisors, a logical, revolutionary service, is changing the paradigm.

References:

Skin Cancer Foundation. (n.d.). Retrieved December 15, 2016, from http://www.skincancer.org/skin-cancer-information/atypical-moles/treatment

Treating actinic keratosis and Bowen disease. (n.d.). Retrieved December 15, 2016, from http://www.cancer.org/cancer/skincancer-basalandsquamouscell/detailedguide/skin-cancer-basal-and-squamous-cell-treating-actinic-keratosis

What is melanoma skin cancer? (n.d.). Retrieved December 15, 2016, from http://www.cancer.org/cancer/skincancer-melanoma/detailedguide/melanoma-skin-cancer-what-is-melanoma

Seeking a Cancer Second Opinion

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When you or a loved one is diagnosed with cancer, you are bombarded with endless treatment decisions. Since cancer moves fast, you may accept the treatment suggestion from your doctor and start the process to becoming cancer-free. What if there is a better treatment? What if the suggested treatment was not the optimal choice? “One in two people will be diagnosed with cancer in their lifetime. It is estimated that up to one in five of those will be misdiagnosed or mistreated, which may result in increased chances for recurrence or sub-optimal treatment, leading to unnecessary side-effects and complications” (OncoLogic Advisors). Receiving a cancer second opinion ensures you that your diagnosis is correct and your treatment plan is optimal.

Reasons to receive a cancer second opinion:
  • You want to explore all the options
  • You want to ensure your diagnosis is correct
  • You want to learn about clinical trials
  • You have a rare cancer type
  • Many options exist for your cancer type
  • Your doctor is unsure of your treatment
  • You are unsure of your doctor
  • Your doctor is not a specialist in your cancer type
  • You want to be sure you are receiving the optimal treatment
How do I receive a cancer second opinion?

It is important to let your doctor know you wish to seek a second opinion. Most doctors will even recommend a cancer second opinion doctor. Make sure your cancer second opinion doctor has the necessary credentials, board certification, training, and experience. You can find a doctor through a referral, local hospital/clinics, medical associations, American Board of Medical Specialties, American Medical Association, American College of Surgeons, American Society of Clinical Oncology, and OncoLogic Advisors.

What do I bring to my appointment?

You will be asked to bring (or send over) necessary medical records, such as tests results (blood work or imaging tests). Many times the doctor providing the cancer second opinion will request tests or procedures you have already completed, eliminating the repeat process. The cancer second opinion doctor may also request images, such as computed tomography (CT) scan and pathology slides (from biopsy).

What do I discuss in my appointment?

Make sure to listen carefully to your options and take notes during the appointment. If you do not understand the diagnosis, ask questions. It is important that you feel comfortable and confident about the information that is being discussed. Bring a family member or close friend with you to the appointment.

After the appointment:

Now that you have received a second opinion, it is time to find the optimal treatment plan. Make an appointment with your first doctor and discuss the second opinion results. If necessary, arrange for the two doctors to speak and review the case together. Seek a third opinion, if necessary.

Remember – When diagnosed with cancer, time is of the essence. Make sure you receive a timely appointment, to avoid a long interruption time before treatment. At Oncologic Advisors, we understand your time is valuable and provide fast and objective second opinions.

About our service:

OncoLogic Advisors are a group of dedicated, objective oncologists providing navigational assistance to patients who have been diagnosed with cancer. If necessary, we arrange for second or multiple opinions from leading physicians—regionally or nationwide. As objective patient advocates, our approach is revolutionary. We cast a wide net and do the analysis and research, enabling patients to make confident decisions about doctors, treatment centers, and methods of treatment.  We review the risks and benefits of each of those treatments—all while providing support and guidance through each decision point—from work-up and beyond. We prepare patients to ask relevant and necessary questions during their doctor visits. Our current healthcare system lacks objective, expert, oncologist advocates for cancer patients. OncoLogic Advisors, a logical, revolutionary service, is changing the paradigm.