Part 5 – In the search for the best cancer therapy option, “knowledge is power”

The radiation treatment options for their daughter Georgia’s cancer were still being sorted out by Becca and Nick at their Manila home.

They were getting conflicting advice from members of the medical team. One advised IMRT. Another SRS. They were awaiting word from London about Proton Therapy. And out of nowhere another option appeared.

In early October, Becca wrote on her blog, The Helping Georgia Fund: “Today we went to Makati Med [another hospital in Makati City] and met with a radiation oncologist who uses Tomotherapy. We found him to be very informative and helpful. He has only had the machine since March and is really impressed with it. Basically from what we can understand it is different from IMRT because it is helical and can turn 360 degrees around the tumor whereas IMRT delivers a straight line of radiation.

“We did not even know that this option was available in the Philippines until last week when our radiation oncologist mentioned that she had spoken to this doctor and would we like to meet with him.

“Sometimes this process seems so random how we find things out and it is only by constantly pushing and questioning that we go on to find out more information. So the next step is to email the UK with this information and then see what they suggest. Once we have done G’s PET scan we will also pass this on to the Doc at Makati Med and get a full assessment off him.

“We were very struck with the difference between Makati Med and St. Luke’s. Makati Med was so busy and we really felt like we were in a hospital. It was full of noise, people and activity going on all around us. Whereas St. Luke’s has the feel of a hotel and is very quiet and pleasant with a pianist playing in the lobby!

“I think we have been lucky so far as we really like our Oncologist here and it is thanks to her that we learned about the P53 gene therapy. But now we have hit a wall as St. Luke’s just don’t have what G needs when it comes to radiosurgery.

“To know that Tomotherapy is available at Makati Med is reassuring but still we have to constantly question what is the safest option for G. The doctor today said definitely Tomotherapy over IMRT and he did not agree with giving one high dose of radiation. He pointed out that with pediatrics they try and keep the dose low because of the side effects. The higher the dose the higher the risk of side effects.

“I did ask both radiation oncologists what they would do if given a choice as to the best treatment for G and they both said Proton would be their first choice but also pointed out that it is not available to many people.

“The Makati Med doctor also said that if Proton is not available then Tomotherapy over IMRT or SRS. So now we wait and see what the UK and Germany suggest.

“I know the UK is not always a great advocate of Proton as it is not offered on the NHS. But in some cases they do recommend patients for Proton. As far as safety goes, Proton is good as there is — no exit dose. The radiation goes in and then drops off into the tumor and does not exit the body in any other place.

“With Tomotherapy there will be an exit dose but it is low. Is that safe enough considering where G’s tumor is? It is so near to many vital organs and of course her spinal cord.

“My head hurts from thinking about it all. We have to do the best we can for G but how do we raise funds for Proton in such a short time if that is what is needed? It was also pointed out that they don’t actually have the clinical research yet to show that Proton is in fact safer as there have not been enough patients to gather this sort of evidence. With Tomotherapy and IMRT, the chance of a secondary cancer due to radiation is apparently 6 percent. So, it is pretty low.

“So we keep going. We keep asking questions and researching and I hope soon that we are given some concrete options to work with.”