BY ROBIN HUIRAS
Times Correspondent
This story ran on nwitimes.com on Sunday, November 14, 2004 12:19 AM CST
Painful surgeries, drawn-out radiation sessions and the possibility of chemotherapy side effects are thoughts that usually spring to mind when cancer patients are faced with treatment options.
But an innovative new procedure, being performed at the Oncology Institute of The Methodist Hospitals Southlake in Merrillville, takes the pain, length and nasty side effects out of the cancer-treatment equation.
Stereotactic Body Radiosurgery takes seven to 10 days to complete, has negligible side effects and is 90 percent effective in destroying certain types of tumors in the lungs, kidneys, liver and adrenal glands.
"This technique was designed for brain tumors in Sweden 40 years ago," said Dr. Robert Woodburn III, an oncologist with the Canter Treatment Group, which is affiliated with the Oncology Institute of The Methodist Hospitals.
"But because of computers, and the accuracy they provide, it's feasible to be doing this radiosurgery in the body."
Although the treatment is called radiosurgery, it involves no surgery, said Woodburn, who began studying radiosurgery four years ago while training at Indiana University, where clinicians were pioneering the technology. Already the only doctor in the Chicagoland area who performs radiosurgery, Woodburn said he hopes to be able to treat patients with prostate cancer soon at Methodist.
The therapy works by beaming high doses of radium, the radioactive chemical used in radiation therapy, directly into a tumor and obliterating it.
If a critical structure is near the tumor and the medical team misses its target, the effects could be very bad, Woodburn said.
But the time Woodburn and his staff of radiation therapists, physicists and dosimetrists spend measuring and analyzing their patients, checking numbers and images and re-checking those figures, it seems nearly impossible for anything to go wrong.
Patients like Mary Hill said she felt completely safe and provided for in the hands of Dr. Woodburn
"He definitely gave me a feeling of confidence that he knew what he was doing," said Hill, a Hobart resident.
Hill, 56, has been fighting renal cancer for two and a half years. She's had several surgeries to remove tumors from her adrenal gland, lymph nodes and she's had a cancerous kidney removed. In August of this year another tumor was discovered in her liver. Hill said she is running out of options and time.
This procedure buys her both.
"Time with my step-grandchildren, I look forward to spending time with them," Hill said.
In no time at all, she will be. Despite its effectiveness, radiosurgery is so noninvasive, she'll be able to go about her normal life between her three, 30-minute sessions.
"Because it is so targeted, we've seen patients tolerate it very well," Woodburn said.
"They go home after each treatment session and have very nominal side effects."
Beyond that, patients say the most uncomfortable parts of the therapy are holding their arms up during the sessions and having their abdomens restricted to control movement caused by breathing.
The treatments themselves take 30 to 40 minutes and involve beaming a series of seven doses of the radiation into its target. As patients lie on a table, a gigantic arm moves around them, and, aligned with pinpoint precision, send 30-second beams of radiation to the tumor.
Lasers, which have been calibrated through analyzing X-ray images obtained at an earlier planning session, keep the machines on target. Marks on the patients body -- tape marks and a tiny black tattoo -- tell the team members where to place certain machines.
Between each beam, team members manually re-check their measurements, make sure the patient hasn't moved from his or her position and, if necessary, re-align the machines.
The intense planning and precise calibration involved in radiosurgery is what spares virtually all healthy tissue, thereby eliminating side effects, Woodburn said.
Traditional radiation therapy, which is less precise, can result in damage to larger amounts of tissue.
Along with potentially painful side effects of traditional radiation, the eight weeks it takes to complete the therapy can be prohibitive, Woodburn said.
"Especially for someone who lives a distance away from the facility, it could be difficult if not impossible to complete the treatment," Woodburn said.
Whereas patients on traditional radiation still will be attending sessions two months after their first appointment, with radiosurgery, two months after the first session patients receive a CAT scan and will know if the therapy was effective.
In nine out of 10 cases, the targeted tumor has been eliminated, Woodburn said.
Hill said she was eager to undergo her three sessions, eager to see her results and learn if the treatment had given her more time to spend playing with her grandkids.
"When you have cancer, you like to think things will be done in a timely manner," Hill said.