By Dave Gardner
Cancer treatment is rapidly evolving as technology and the human element combines forces in organizations such as the Northeast Radiation Oncology Centers (NROC), based in Dunmore and Milford.
Treating cancer with various forms of radiation involves a very heavy capital investment as the needed equipment changes with technological breakthroughs. In addition, a modern oncology team that treats patients with radiation includes scientists, technicians, therapists and nurses in its base.
Christopher Peters, M.D., NROC medical director, described how radiation oncology in the Scranton area can be traced back to the 1970s. Partnerships among this specialty and medical oncology soon followed, and by 2004 NROC had evolved from its roots in Mercy Hospital to today’s independent organization.
The current staff has virtually no turnover, but staying current with rapidly advancing global technology has become a challenge.
“In fact, proficiency with accrued science, safety and technology are the key facets of our mission,” Peters said. “A love of science is one reason we all went into this and the close proximity of the faculty and students at the Geisinger Commonwealth School of Medicine has become a real blessing.”
Despite the wealth of scientific technology used in radiation oncology, the mission involves people. NROC philosophy has it that a patient’s experience includes the organization’s entire staff and while only a physician can start a course of radiation treatment, any employee including a receptionist can stop it if a problem is detected.
“Patients also are more informed than in the past due to internet access,” Peters said. “Increasingly, they are active partners in their treatment choices.”
He referred to the overall concept of fighting cancer with radiation as very effective but potentially dangerous, requiring great efforts with safety and a team approach with quality control. Despite ongoing technological advancements great differences among patient outlooks are still the norm, and if a grim prognosis surfaces, new treatment options may be enlisted.
“This is really a wonderful time in medicine, because great advances are being made to understand what makes cancer tick at the molecular level,” Peters said.
A wide variety of high-tech equipment lines the halls at NROC. This includes the TomoTherapy Hi-ART system, which can provide 3D imaging of a tumor immediately prior to treatment and subsequent delivery of radiation from 360 degrees. This technology allows for a more accurate identification and treatment of cancerous tumors and reduces exposure of healthy tissue to radiation.
External beam radiation therapy, the most common type of radiation therapy used for treating cancer, utilizes a concentrated beam of energy delivered from a linear accelerator into a tumor site. In addition, intensity-modulated radiation therapy can deliver a maximum dose of radiation to the tumor site with minimum damage to the surrounding healthy tissue, thereby creating few if any unwanted side effects.
Brachytherapy, a specialized form of radiation treatment, is also drawing attention. This specialty delivers an intense form of radiation over a short distance through small needles or catheters directly into the tumor site, or near the area, to destroy cancer cells.
Radiation oncology may also involve treatment with advanced pharmacology. Xofigo, an intravenous injection of the radioactive material radium 223, can be used to treat metastatic prostate cancer that is resistant to treatment.
What is especially interesting about Xofigo is the way it mimics the body’s natural calcium. The patient’s bones therefore absorb the drug and as low-energy particles are emitted the cancer cells are destroyed.
“We also are advancing rapidly with organ preserving therapies, such as saving a patient’s larynx and tongue,” Peters said.
Science is also advancing on the cancer diagnostic front. Peters and his peers are excited about the escalating use of biomarkers, which are measurable substances within a patient that indicate the existence of specific diseases.
Immunotherapy is also offering great promise. This scientific specialty uses the body’s own immune system to fight cancer and while real breakthroughs have been made, tremendous advancements still lie ahead.
Additionally, breakthroughs are stacking up fast with the “reading” of the human DNA code. Science is learning how to spot individual segments of this recipe that can guide a patient’s cells to be more susceptible to specific cancers, thereby making intervention and prevention a reality.
As oncology reaps the bounty of advancing science, the human element is never far behind. Burnout by oncology staffs remains a real problem as providers often draw close to their patients and “assume” the suffering that often occurs.
“Success keeps you going in these situations,” Peters said. “We all must have a passion for this.”
The face of modern radiation oncology is a familiar one to Sr. Ruth Neely, 72, a nurse practitioner and member of the Sisters of Mercy, who lives in Dallas. Neely’s medical ministry is associated with The Wright Center for Graduate Medical Education and she specializes in the treatment of HIV-positive patients.
Neely is also what she calls a cancer “double-dipper” — she battled breast cancer in 2006 and 2015. Her treatments have included lumpectomy, chemotherapy and radiation and she is firm that her radiation treatments, the second of which were administered by NROC, were routine with no external tissue damage.
“During both courses of treatment I never missed a day of work or had any nasty side effects,” Neely said. “The treatments were amazing and effective.”
Neely’s specific comments about her battles with cancer offer an interesting twist, considering the fact that she is a health care provider that functions within the world of modern technology. As she describes her ordeals, she rarely focuses on the technology that saved her life and instead comments about the human side of the providers, including the staff at NROC.
“They delivered compassion, presence and reassurance, which are core values that I prize,” Neely said. “They were efficient and considerate, which are very important to me as a spiritual medical provider.”