Cancer treatment during COVID-19
Two months ago, our day-to-day lives changed, and much of what we knew became very uncertain. One thing that remained, Ackerman Cancer Center had patients that needed to keep moving forward with their cancer treatment. This situation played out at oncology centers around the world and left many oncologists thinking about what options they could offer their patients.
After we put strict screening protocols in place, the focus was placed on how to reduce the number of times a patient has to come into the clinic. This can be a challenge with radiation oncology, because typically radiation therapy requires a patient to come to the clinic for treatment several days in a row, for a total of 30 to 45 treatments. One way to reduce the number of treatments is by employing Stereotactic Radiosurgery (SRS), or stereotactic body radiotherapy (SBRT). These are two treatment techniques that deliver precise radiation doses to the tumor in five treatments or less. SRS is mainly used for lesions in the brain or central nervous system, while SBRT is simply the SRS technique used on parts of the body other than the brain.
Ackerman Cancer Center has been performing SRS and SBRT long before COVID-19 because it allows high doses of radiation to target a tumor precisely while sparing healthy tissue. This permits us to treat tumors in high-risk areas such as the brain, lungs near the heart, or other areas close to vital organs deep in the body. We are relieved to have this technology and knowledge in place already, and the added advantage of reducing the COVID-19 exposure risk to some of our most vulnerable patients is a genuine plus.
SRS is actually a non-surgical procedure even though surgery is in the name. It is a great alternative for patients that are not good surgical candidates, or have a tumor in an area where surgery would be too risky. SRS uses 3D computerized imaging to pinpoint an area to target with a high dose of radiation in as few as 1 session, but generally no more than 5 treatments.
SRS was developed as an alternative to whole-brain radiation by a team of neurosurgeons and physicists in Sweden about 50 years ago for the treatment of brain cancer, which could cause cognitive and intellectual decline. Of course the science is much more advanced now, as well as the imaging used to guide the beam to the tumor.
At Ackerman Cancer Center we have Gamma Knife technology to deliver our SRS Treatments, as well as our Versa Linear Accelerator. Some diagnosis that could benefit from SRS or SBRT are:
- Trigeminal neuralgia, a debilitating nerve condition near the ear that causes great pain
- Acoustic neuroma
- Pituitary tumors
- Brain tumors
- Early-stage non-small cell lung tumors
- Pancreatic cancer
- Liver cancer
- Some metastatic tumors
For patients that would benefit more from Proton Therapy, we can use a hypofractionated treatment plan when appropriate. Hypofractionation is delivering a higher dose of radiation in fewer treatments, in some cases reducing the number of treatments by half. This treatment schedule is something we have started doing more over the past year as more research points to favorable clinical results. It’s another example of how we are finding added benefits of a treatment technique we were already doing. Hypofractionation is not suitable for every diagnosis, and more research is needed before the widespread implementation of this technique. We are dedicated to staying up-to-date on the latest research, and we are currently participating in a clinical trial using hypofractionation for prostate cancer patients.
The medical world has discovered a lot during this pandemic. It has forced physicians to look at new ways to treat people through technology like telemedicine, or dive deeper into techniques that we frequently use such as SRS and SBRT to see if we can expand its use to other diagnoses. Regardless of what changes stick around after COVID-19 has passed, Ackerman Cancer Center will always provide the leading-edge cancer treatment founded on evidence-based research.