Press Releases
Targeting Cancer: New Trilogy Cancer Therapy Done in El Paso Center
Erica Molina Johnson
Publication: El Paso Times, El Paso
10/03/2009
When 80-year-old Connie Medrano received her fourth cancer diagnosis earlier this year, her doctor told her there was not much he could do. She needed a lobe removed from her right lung to ensure that the tumor growing there was wiped out. "He said he couldn't operate because my left lung is real bad," she said. Doctors had removed a cancerous tumor from her left lung in 2005.
"I was very grateful because -- when we came to see Dr. (Anuradha) Gupta, we had no hope other than just waiting, and she brought us hope," said Medrano's daughter, Sallie Medrano.
Gupta, a radiation oncologist at Texas Oncology-El Paso Cancer Treatment Center, saw Connie Medrano and told her she could be a candidate for treatment with her cancer care center's new Trilogy linear accelerator equipped with a smart computer called the BrainLAB.
The more-than-$2-million machine, which was installed at the center in June, is able to focus high doses of radiation precisely on tumors with minimal damage to healthy tissue around the mass.
The equipment allows Gupta to treat patients with certain tumors with far higher doses of radiation than traditional external radiation therapy.
The doses are delivered via beams of varying radiation strength that converge on the meticulously targeted area in a process called stereotactic radiation therapy for the body. Because more radiation is hitting the tumor, patients require fewer treatments.
Gupta said traditional radiation therapy requires patients to undergo daily radiation treatment for six to seven weeks.
The new machine cts that down to about two treatments a week for a total of about five treatments.
The difference, Gupta said, is that traditional radiation therapy treats tumors as well as about two-centimeter margins of healthy tissue to account for possible movement of the tumor.
"You're always treating the tumor, but the price you pay is you've got a two-centimeter margin all around of healthy lung that you're targeting also," she said.
The new technology enables Gupta to precisely target the tumor with only two-millimeter margins of healthy tissue.
Its multiple beams of radiation allow the patient to feel none of the traditional side effects of radiation therapy, such as skin irritation and pain or discomfort to other body structures that might have been affected during treatment.
The Trilogy equipment also can be used for image-guided radiosurgery for brain tumors. Special cones can be attached to shape the radiation beam to match the shape of the tumor.
Gupta said Connie Medrano was a good candidate to undergo the stereotactic treatment. She said that when considering treatment with the Trilogy linear accelerator with a BrainLAB component, doctors must first evaluate the tumor.
Good candidates, Gupta said, are small lung tumors located on the periphery of the organ and away from structures such as the heart or large blood vessels. Other good candidates for the treatment are liver tumors smaller than 5 centimeters, and brain tumors smaller than 3.5 centimeters. Some tumors of the spine and pancreas could also be eligible for the treatment.
"You have to really select your cases well. Not everyone can have this," Gupta said. "Everyone wants the newest and the best, but you have to pick your cases carefully."
For Connie Medrano, her previous radiation treatments for lung and breast cancer meant the Trilogy machine was the best option. She also had been previously treated for basal cell carcinoma, Susie Medrano said.
To begin, Gupta took a CT scan of Connie Medrano's lung and turned to the BrainLAB to plan her treatment. The specialized computer was used to plan the precise coordinates and intensities of the beams to be used in her treatment. When it was time for treatment, Connie Medrano's tumor was immobilized by fitting her with a special belt to minimize lung movement during breathing. Her entire body was then immobilized, and the Trilogy's On-Board Imager performed another CT scan.
The planning scan was overlapped by the new scan, and tiny adjustments were made before the treatment begins. The large machine then rotated to the appropriate position around the patient and began the treatment.
"I didn't feel anything. The rays go in and you don't feel anything," said Connie Me drano, who received her final treatment Sept. 25.
"What frightened me was that machine. It goes 'Grrrrrr! Grrrrrr!' It was like outer space. Once I got used to it, it didn't bother me."
Her 35 traditional radiation treatments in 2005 left her feeling exhausted, but she said she felt no effects from four rounds of treatment this time.
Gupta said Connie Medrano received radiation doses of 1,200 centigrade per visit, versus a daily traditional doses of 180 to 200 centigrade.
"The reason I had the guts to do it was the precision," Gupta said. "If you know this is exactly where you are and that's where you need to be, then you don't have the fear that you're doing something wrong."
Connie Medrano's tumor has already shrunk considerably and will continue to shrink for several weeks.
"I think I was very lucky. I think God helped so I was one of the first ones to take advantage of this new thing," she said. "Now I'm ready to dance and sing."
Since the machine was installed, Texas Oncology has treated three lungs, five brains and one liver.
One patient underwent treatment of a benign tumor on an optic nerve. Any other method would have left her blind, Gupta said.
She said these patients previously would have been referred to other cities for treatment.
"External radiation therapy has been available here for over 30 years. This brings external radiation therapy to its most precise form, stereotactic body radiation therapy," Gupta said. "The whole concept is to give a higher dose and kill the tumor and not give side effects to your patient."