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New weapons fight cancer Mail Tribune / Drew Fleming Laser beams help therapists align radiation beams to treat a patient at Providence Cancer Center. Providence Medford Medical Center has invested about $2.5 million over the past 18 months to install equipment that minimizes damage to healthy tissue. Medford hospitals� radiation machines focus beam on tumor, away from healthy tissue By Bill Kettler The treatment room looks like something from a sci-fi movie. A white-haired woman lies on a waist-high slab, her head shrouded in a ghostly wire-frame mask. An ominous-looking machine looms above her while a man in a lab coat punches numbers into a key pad. Ruby-red laser beams converge on the wire helmet as the technician leaves the room and a heavy door closes automatically behind him. It�s not a Hollywood set. It�s state-of-the-art cancer treatment in Southern Oregon at the beginning of the 21st century. Most cancer patients receive radiotherapy (radiation treatments) while they battle the disease. Medford�s two hospitals have invested millions of dollars in equipment that minimizes damage to healthy tissue and focuses the radiation on the tumors. Over the past 18 months, for example, Providence Medford Medical Center has spent about $2.5 million to install some of the most technologically advanced radiotherapy equipment on the West Coast. "You�d have to go to a university hospital to get what we have," said Providence�s Don Jacobs. Jacobs, a dosimetrist, works with doctors to deliver radiation most effectively to patients. Radiation-therapy equipment and computers are being designed to work together to concentrate radiation on tumors and limit damage to healthy cells. "In a sense, radiation is only as good as where you can deliver it," said Dr. Jere Sandefur, chairman of the committee of oncologists who practice at both Rogue Valley Medical Center and Providence. "It�s not like chemotherapy, which goes everywhere." Until about 1995, for example, radiation machines delivered radiation only in a square pattern. The rectangular beam of radiation damaged healthy cells around the tumor as well as the cancer cells. New radiation machines include thin metal "leaves" that can be adjusted to focus the radiation beam on cancer cells. "We can shape the field of treatment to match what the doctor wanted," said Jacobs. "It�s like having a suit of clothes tailor-made for you. We can tailor the radiation beams to conform to the tumor from almost any direction." Providence operates a 120-leaf "collimator," which can focus radiation beams down to about three-sixteenths of an inch. Rogue Valley Medical Center recently upgraded its 80-leaf collimator to a 120-leaf unit. Some of the newest equipment gives doctors and radiation therapists a better sense of how treatments are working. Therapists used to have to take individual X-rays of patients after each radiation session. Providence has installed a special camera that allows therapists to see images of the tumor during radiation treatments. "We�re getting a real image of the patients as they�re being treated," said Providence radiation therapist Cindy Hunter. Providence�s new "portal imaging system" records an image every 30 seconds, "without film and without chemistry," said radiation therapist Bruce Perkins. "It�s all electronic." The images can be stored in the patient�s computer record, giving physicians and therapists easy access to information. Providence also recently installed "record and verify" computer software to ensure that patients receive exactly the radiation treatments their doctors ordered. Physicians enter information into the computer about the kind of radiation a patient needs, where it should be applied and for how long. If the technicians who deliver the radiation set any of those parameters incorrectly, the computer will not allow the machine to operate. Entering each patient�s treatment plan into the computer also ensures that everyone involved in treatment � from physicians to radiation therapists � has the same information. "We don�t have all the hand transfer of data anymore," said Suzanne Schultz, Providence�s medical physicist. At Providence, all patient records are now stored electronically. Each patient�s record includes space for notes about the treatments. Therapists can record, for example, whether a female patient feels uncomfortable with just male therapists. To ensure that the electronic records are preserved, data on the computers are backed up nightly and stored in two separate computers. Paper copies can be printed whenever they are needed. Increasingly complex radiation treatments will become available as computers grow more sophisticated, says Sandufer, the cancer physician. Right now, doctors and therapists use computers to design radiation treatments that minimize damage to normal tissue. Within a year, computers could do most of the dosage planning that doctors and therapists now do themselves. Sandefur says this "intensity modulated radiation therapy" will, for example, allow him to tell a computer he wants to deliver 7,500 units of radiation to a prostate, and no more than 4,500 units to normal surrounding tissue. "I�ll define the doses," he says, "and the computer will tell me how to get there." Reach reporter Bill Kettler at 776-4492, or e-mail [email protected] Mail Tribune Home | Ottaway Newspapers, Inc. | Dow Jones & Co., Inc. | Privacy | Contact Us Copyright � 2000 Mail Tribune, Inc.