WEB REVIEW – Lung cancer survivor

A year ago, doctors told Suzan Shughart she had lung cancer and had only 18-24 months to live. But this month, she had an extra reason to celebrate her 60th birthday, as it was also her last day of lung cancer proton therapy treatment at MD Anderson.

When Suzan first received her cancer diagnosis, her doctors were stumped: the test results showed both large and small cell lung cancer, not in her lung but in her chest. Suzan headed directly to MD Anderson in Houston, where doctors spent a whole day examining her. Then, for the next 30 days, they performed different tests on her, trying to find the best way to defeat her cancer.

Eventually, she received her lung cancer diagnosis: a high-grade neuroendocrine carcinoma, an anterior mediastinal tumor attached to the pericardium, a double-walled sac that holds the heart and aorta. Her treatment included surgery, chemotherapy and radiation. After undergoing surgery, she returned home to Arizona to have her chemotherapy administered.

After completing chemotherapy, Suzan returned to MD Anderson to begin radiation therapy and again shocked her doctors: her cancer had returned. This time, doctors recommended a new type of treatment at a soon-to-open clinic: proton therapy. This would allow radiation to target Suzan’s cancer, but save the vital organs surrounding it, specifically her heart.

Every day for seven weeks, Suzan went to the clinic for treatment. “I was never sick a day,” Suzan says. But she did suffer other side effects. Her chest burned from the radiation treatment, and eating became difficult. Toward the end of her proton therapy treatment, a spoon of yogurt was a large meal for her. That is why she underwent esophageal dilation to make swallowing easier after her treatment.

“It was a small price to pay,” she says. “I’m alive, and that’s what counts.” When asked how she managed to get through her disease, she said: “My brain just said no. I’ve got four children. I’ve got grandchildren. I have a lot of living to do.”

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WEB REVIEW – Proton therapy for lung cancer

Lung cancer is the number one cancer killer in the U.S. This disease has just a 15% survival rate and causes more deaths worlwide than the next three most common cancers combined (colon, breast and prostate) : 1.3 million deaths every year. About $10.3 billion is spent annually in the U.S. on lung cancer treatment alone.

Physicians at The University of Texas MD Anderson Proton Therapy Center are leaders in the research and treatment of lung cancer and are pioneering the development of proton therapy for lung cancer patients.

Proton therapy presents an advanced image guidance and an ability to precisely target tumors in the lungs, as the powerful radiation of protons can be delivered with optimal accuracy.

Proton therapy’s advantage for many lung cancer patients is based on this feature, as it allows to spare critical nearby structures such as the esophagus, heart and spinal cord, reducing some of the side effects of traditional radiation and help patients maintain good quality of life. Furthermore, by minimizing the exposure of normal tissues, the tumor can be treated with a higher dose of radiation, which leads to better local control of the disease, higher survival rates and improved quality of life.

Proton therapy is currently available at only 11 centers in North America (13 centers are in development). MD Anderson has one of the largest and most technically advanced centers in the world, which offers a range of proton treatment options, including pencil beam proton therapy, a highly precise form of proton radiation also known as scanning beam, and intensity-modulated proton therapy (IMPT), the most advanced form of proton radiation. For patients with recurrent lung cancer, who have already received full doses of traditional radiation, pencil beam and intensity-modulated therapies may further limit or eliminate radiation to sensitive areas.

The Proton Therapy Center treats as many as 900 patients annually. Nearly 5,000 patients have been treated to date, accounting for 15 % of the total number of patients who have received proton treatment nationally. Approximately 1,000 of these patients have been treated for lung cancer. The best lung cancer candidates for proton radiation are those whose cancer is localized in the chest and can’t be removed surgically.

“We’re just beginning to see the potential benefits of proton therapy and as we move forward it looks more and more like an excellent treatment modality,” says Anne S. Tsao, M.D., associate professor in Thoracic/Head and Neck Medical Oncology. “As we learn more and gather evidence of these benefits, proton therapy will likely be extended to a broader patient population.”

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WEB REVIEW – Proton Therapy for lung cancer: decreased risk of secondary malignancies

In the treatment of cancer, it is challenging to deliver an adequate dose of radiation to the tumor while sparing nearby normal tissues. Proton therapy’s advantage for many lung cancer patients is based on this feature.

By minimizing the exposure of normal tissues, proton therapy allows to spare critical nearby structures such as the esophagus, heart and spinal cord, and shows tremendous advantages when compared with tradition radiation therapy : lower short and long-term side effects and better quality of life for the patient.

A study was conducted to compare non small cell lung cancer treatment (NSCLC) with IMRT (intensity modulated radiation therapy, an advanced form of traditional radiotherapy) and proton therapy to assess the radiation dose deposited on adjacent organs at risk (OARs).

NB: NSCLC includes adenocarcinoma, squamous-cell lung carcinoma, large-cell lung carcinoma, and represents most common types of lung cancer. No data was presented in this study for small cell lung cancer due to concerns that rapid tumor volume changes during proton therapy could lead to loss of plan validity and overdosing of OARs.

It was shown that proton therapy for NSCLC maintained an optimal tumor coverage while significantly reducing the radiation dose to adjacent organs at risk (heart, brachial plexus, oesophagus, etc), resulting in lower side effects and patient morbidity. The study underlined the advantages of PT over traditional radiation therapy, and recommended to investigate proton therapy for small cell lung cancer as well.

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WEB REVIEW – Teenager shaves her head for her cancer friend

Charlie Hemming, a 15 year old British teenager with bladder cancer, can really count on her best friend: yesterday, the young girl shaved her hair to raise funds so her friend can see her family this Christmas.

Charlie Hemming is being flown to Oklahoma, USA, to be treated with proton therapy (not yet available in the UK), but the NHS will only pay for her mom and another guest.

Faye, who has known Charlie for two-and-a-half years decided to raise money to help send her whole family to the US. Charlie, who can no longer attend school, was unable to make the event as she is undergoing chemotherapy three times a week. “It’s a quick way to raise money so that the rest of her family can wake up with her on Christmas morning”, said Faye. “Even if it’s just a little, it’s still going towards the full amount so hopefully a little can go a long way.”

Charlie’s teacher said: “You only have to look around at the number of children who are supporting the fundraiser for Faye to have her hair chopped to see that she is extremely popular among her peers. She has been so strong and I have no doubt that she will continue to be.”

Charlie is hoping to raise around £15K BY December to fly her Dad out to America for two weeks with her 4 brothers and sisters. “We are so grateful for the continued support to raise funds for Charlie to have this one wish come true”, her mom said. “From Charlie’s friends to the whole community and even strangers who have put their hands in their pockets, it’s overwhelming.”

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WEB REVIEW – Brain cancer kid needs help to get proton therapy in the US

13-year-old Jamie Green was diagnosed in July after being sick for weeks and being given anti-biotics by GPs. Then doctors found he had a brain tumor called medulloblastoma.

Revolutionary proton treatment could be the answer, as a less aggressive form of radiation, that will give him the chance to continue to live with little damage to his organs, tissue or bone structure.

Unfortunately, the use of proton therapy is relatively new, and while the NHS recognizes its benefits, the UK’s treatment centers are not due to be completed until at least 2016. Luckily, several proton treatment facilities in the USA could take care of Jamie, but as such treatment must be paid for in advance and the NHS is unable to fund it, Jamie’s family needs to raise enough money to be able to send him there and save his life.

Jamie’s dad, Steve Purvey, said: “The treatment comes in like a sword. So where they radiate the spine and the brain, it actually has collateral damage on every other organ. Whereas proton, when it comes into the body, it stops within two millimetres. So it actually irradiates the whole of the target area but has no collateral damage”

The family need to raise almost £250,000 for the treatment alone and will fly out on 25th October. Steve says the response has been amazing: “We had somebody drop a cheque through the door last night of a thousand pounds and it restores your faith in humanity in the way that people has actually responded and turned around.”

Kids‘n’Cancer has given the family a donation of £50,000 and altogether £107,000 has been raised so far. However, the family hopes to raise enough money to give back the money donated by Kids‘n’Cancer so it can benefit another cancer sufferer in the future.

You can find out more about Jamie’s story and donate by going to his website here: http://www.jamiesfund.com/

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Some types of breast cancer suited for protons after surgery

With their ability to target cancer while minimizing radiation harm to the heart and lungs, protons hold great promise in the treatment of breast cancer. But not all breast cancer patients will benefit from protons.

In fact, a leading radiation oncologist currently sees just four types of breast cancer where protons will be preferable to photon radiation — and all as follow-up to breast cancer surgery.

“I expect we’ll see a survival benefit from protons with those patients with a risk of lymph node cancer, those with left-sided breast cancer, those patients with cardiac health issues or a family history of cardiac mortality, and those with difficult anatomy,” said Nancy Mendenhall, MD, clinical director at the University of Florida Proton Therapy Institute.

This year, more than 230,000 American women will be diagnosed with invasive breast cancer, the American Cancer Society estimates. Carcinoma in situ of the breast, the earliest form of breast cancer, will be identified in another 64,000 American women.

“I think there are a large number of breast cancer patients who may not benefit from protons,” Mendenhall said. Partial breast irradiation, for example, may be treated as well with conventional radiation treatments as protons, she noted. “One of our goals is identifying who will benefit most from protons.”

Cancer doctors know that photon radiation following breast cancer surgery can very effectively control cancer, despite some of the challenges posed by photons. “We see a survival benefit from photon radiation, even though we frequently don’t get optimal doses to the target and we’re causing some cardiac mortality,” Mendenhall said.

“Our findings with protons show better targeting while sparing the heart and lungs from high radiation doses,” she said. “And over time, we expect a higher cancer survival rate with lower prospects of cardiac death.”

While tremendous clinical progress has been made in the use of protons to treat head and neck cancers, childhood cancers, and prostate cancer, proton therapy for breast cancer has moved more slowly. “Breast cancer is much more technically difficult to treat with protons than prostate cancer,” Mendenhall said.

In recent years, proton treatment techniques have been refined, enabling treatment of women with breast cancers, Mendenhall said.

The continuous improvements made to three-dimensional, real-time imaging and proton beam delivery may expand the types of breast cancer treated with protons.

Mendenhall pointed to the advances made in pencil beam scanning as an example. Pencil beam scanning, she said, may decrease the radiation dose to the skin and tissues deep to the breast cancer, further improving proton therapy outcomes.

WEB REVIEW – Fund for little girl battling cancer

Maddie Hems was just eight years old when she was diagnosed with Ewing’s Sarcoma in April last year. Her family has launched Maddie’s Fighting Fund to raise money to help her battle this rare form of bone cancer.

Maddie had been suffering from pain down her left arm when doctors discovered an inoperable fist-sized tumor underneath her collarbone. Her dad said : “When we got confirmation from the doctor, I knew it wasn’t great. Especially when I knew where it was from an anatomical point of view and it did turn out to be totally inoperable.”

Now aged nine, Maddie started a course of chemotherapy in May last year before the NHS funded a three-and-a-half-month trip to America for proton therapy at ProCure cancer treatment centre in Oklahoma.

The chemotherapy left Maddie vulnerable to infections, and she lost a third of her body weight during the trip after catching a serious chest and throat infection. But since they’ve been back in the UK, the family have had their first bit of positive news : an ‘unchanged’ scan. “It doesn’t mean we’re in the clear. Maddie’s type of tumor is highly aggressive and could come back anywhere and at any time. But she takes everything in her flow. She’s a fighter”, her mom said.

“With this in mind we have set up this fund to help make Maddie’s life a little easier and also support her if further treatment is needed in the UK or the United States, so that it can start immediately.”

For more information or to donate, email Maddiesfightingfund@gmail.com or follow Maddie’s Fighting Fund on Facebook.

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WEB REVIEW – 150th prostate cancer patient at Procure Proton Therapy Center in New Jersey

The ProCure Proton Therapy Center in Somerset, New Jersey announced that 150 prostate cancer patients have successfully completed their proton therapy treatment.

Since Procure opened the New Jersey facility in March 2012, physicians have noted that a majority of prostate patients have learned about proton therapy through family, friends and independent research rather than via their primary physicians and urologists.

Victor Lawson for example first discovered proton therapy as a potential prostate cancer treatment option while watching a cable sports program. He happened to hear the coach speak about his successful experience with proton therapy in treating his prostate cancer. Victor began to research the therapy and facilities that offer the treatment and discovered the ProCure Center in Somerset.

Another patient, Monte W. from NY, learned about proton therapy through his brother-in-law, who had been previously treated with proton therapy in Boston. Monte’s urologist had recommended standard radiation therapy, but his own independent research as well as his brother-in-law’s strong recommendations led him to opt for proton therapy treatment at ProCure.

“What appealed to Victor and Monte, as well as other prostate patients, was that proton therapy would enable them to avoid invasive surgery as well as help minimize risk to surrounding healthy tissue, compared to standard radiation therapy,” explained Dr. Brian Chon, radiation oncologist and physician at ProCure Somerset.

“My own experience taught me how important it is for individuals at risk of prostate cancer to be educated about their treatment options and to be motivated to make informed decisions,” said patient Victor Lawson. To help others who may be searching for a better understanding of what treatment options are available, Victor along with other prostate cancer patients actively reach out to patients to share their personal experiences. Their stories have even appeared in publications and aired on several broadcast programs.

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WEB REVIEW – Joe Landry, prostate cancer survivor

When Joe Landry’s younger brother was diagnosed with prostate cancer, his time and attention turned to helping his brother find the best care and treatment for the cancer. His research and resourcefulness paid off, as Joe was diagnosed with prostate cancer a year later.

Joe, a retiree, had spent 37 years with an oil and gas company and, with the exception of periodic bouts with prostatitis and kidney stones, he’d enjoyed 70 years in pretty good health. However, he knew from previous annual exams that his prostate-specific antigen (PSA) levels were steadily increasing each year.

During a regular annual visit with his urologist, Joe’s PSA level alarmed doctors and a biopsy confirmed their suspicions. He was diagnosed with early stage prostate cancer and was given the option of three months of “watchful waiting” to consult with doctors and consider his options for treatment.

While he weighed his options – radical surgery and various forms of radiation therapy – Joe  ran into a friend he hadn’t seen in about seven years. “He had been diagnosed with prostate cancer and been treated at a proton therapy center. He had nothing but positive results and experiences to report. “A radiation vacation is what he called it”, Joe remembers.

Shortly afterward, Joe self-referred to MD Anderson’s Proton Therapy Center. After discussing his options, Joe determined that proton therapy would offer him the fewest side effects, if any. However, what struck him most was care he received during treatment.

Joe received 42 treatments over the course of 8½ weeks. Other than minor urinary irritation, he had no problems and was so pleased with the process and his subsequent results that he formed ProtonPals, a support and outreach group for Proton Therapy Center patients. He wanted to stay in touch with the new friends he’d made during treatment and to provide education and support to the newly diagnosed.

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