Healthy People Magazine - New radiation treatment for cancer

Winter 2004

New radiation treatment for cancer shows great promise

When St. John’s radiation oncologist Michael Albritton, M.D., told Buffalo resident John McCarthy, 72, about a sophisticated new radiation treatment that could treat his throat cancer while preserving his salivary function, McCarthy thought going through with the treatment was a no-brainer.

Then he learned he would be not only the first St. John’s patient to undergo the new therapy – intensity modulated radiation therapy – but the first patient in the region to undergo IMRT.
“Dr. Albritton told me I would be the first patient in the region to have the therapy, which was kinda scary, at first, but I’m glad that I’ve gone through with it. I thought, whatever functioning I can save, I should save. It was a quality-of-life issue to me,” McCarthy says.

The retired heavy-equipment operator, electrician and self-proclaimed jack-of-all-trades had already undergone surgery in the summer of 2003 to remove a cancerous tonsil, but because the cancer had spread, he needed follow-up radiation treatment. IMRT allows oncologists to treat specific portions of the body, while limiting the radiation dose to the surrounding organs.

In McCarthy’s case, the new therapy, which he received five days a week for six weeks starting Oct. 1, 2003, allowed him to keep his sense of taste intact. A thermal plastic mask, molded to fit his head, allowed the radiation beams to hit their target exclusively during the painless 20-minute treatments.

In addition to cancers of the head and neck, such as McCarthy’s, IMRT is used to treat patients with cancers in other delicate or critical locations in their body, such as in the eyes, spine, breast and prostate. Malignancies in these locations are often adjacent to structures that could be rendered functionless by the radiation used to kill the cancer, says St. John’s Radiation Oncology Director Arnie Shreffler.

“IMRT allows us to beam high doses of radiation to tumors immediately adjacent to those critical structures and drastically reduce the negative side effects of radiation," he says.

The first step in having the capability to provide IMRT at St. John’s was acquiring a new large-opening, oncology-specific CT scanner and new computer system to formulate treatment plans for patients.
"The CT scanner, when used in radiation oncology, gathers large amounts of anatomical data so that we can program our treatment-planning computer systems with patient data. Those systems are used to plan the direction and quantity of radiation beams that will be used to treat the patient's cancer," Shreffler says. "The scanner's larger opening allows us to more accurately assess the patient's anatomy because the patient will be in the actual treatment position instead of just lying flat on a table like a standard CT scanner would require."

Shreffler says IMRT is only possible when large amounts of high-quality, digital patient data are available for treatment planning.
St. John’s treats about 950 cancer patients per year, according to Albritton. About 15-18 percent of those patients, or approximately 150 patients per year, are candidates for the new therapy, he says.