Dr. Mark Ranck understands his oncology patients' fear.
“When you hear 'cancer,' you just want to cure it at all costs,” he said Thursday.
Thanks to new technology at the Lutheran Cancer Center, treating breast cancer no longer has to mean exposing the patient's heart to potentially damaging levels of radiation, Ranck said.
Lutheran Health Network officials invited the media in for a demonstration of the TrueBeam Radiotherapy System made by Varian. Ranck, who practices with Radiation Oncology Associates, explained the technology.
The equipment, which sells for about $4 million, delivers radiation to carefully selected areas to stop cancer from coming back after a tumor has already been removed surgically. Those areas can include lymph nodes.
Chemotherapy, by contrast, flows through the entire body.
One downside of other breast cancer radiation treatments is that the heart and lungs can receive an unnecessarily high dose of radiation. Studies have found that every unit of radiation translates into a 7 percent risk of a future heart attack, Ranck said.
But medical scans show that when someone takes a deep breath, the inflated lungs push the heart out of the way of radiation beams aimed at the breast.
TrueBeam allows two specially trained therapists to monitor a patient's exact position and breathing patterns. Radiation is administered only when every one of seven indicators shows green for go.
“We have to be very careful with radiation because you can't see it, you can't take it back,” Ranck said.
As soon as a patient breaths, coughs, sneezes or moves, tracking technology detects it and the machine automatically stops the radiation beam.
Each patient must be under the beam for two to five minutes total. It can take eight to 15 minutes of stopping and starting the beam to reach that accumulated dosage.
The American Cancer Society explains radiation therapy this way: High-energy particles or waves, such as electron beams, are used to destroy or damage cancer cells.
“Your cells normally grow and divide to form new cells. But cancer cells grow and divide faster than most normal cells,” according to the nonprofit's website.
“Radiation works by making small breaks in the DNA inside cells. These breaks keep cancer cells from growing and dividing and cause them to die. Nearby normal cells can also be affected by radiation, but most recover and go back to working the way they should.”
Ranck's patients receive TrueBeam treatments Monday through Friday every day for three to six weeks. About 15 patients are treated each day.
Only patients who can hold their breath for at least 20 seconds are capable of undergoing this treatment, he added.
Although the TrueBeam machine has been in place for about two years, it's only been used for about the last six months, following various software upgrades and staff training, Ranck said.
The Parkview Cancer Institute, which opens to patients Tuesday, has two new TrueBeam linear accelerators, spokeswoman Jessica Miller said in an email.
TrueBeam can also perform radiosurgery, which involves delivering a very high dose of radiation to a small area to completely destroy a growth that can't be removed surgically, such as a small lung tumor, Ranck said.
He added, however, that TrueBeam isn't right for every patient. The Lutheran Cancer Center and the Parkview Cancer Institute have spent millions on equipment and technology to treat cancer patients.
Because of advances in medicine, cancer patients are living much longer, Ranck said. Previously, radiation damage done to a patient's heart or lungs wasn't a worry because the patient tended to die of cancer complications, he said.
But better outcomes mean that oncologists want to reduce the risk that treatments might hurt patients in the long run.
“You can never promise no harm with anything in medicine,” he said. “There's always that potential.”