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Emerging Role of Stereotactic Body Radiotherapy in the Treatment of Pancreatic Cancer

Emerging Role of Stereotactic Body Radiotherapy in the Treatment of Pancreatic Cancer

Abstract

The management of pancreatic cancer continues to be challenging. Despite surgical, genetic and molecular advances, its overall prognosis remains poor. Surgical resection is the only modality that offers a chance for a cure, with an overall survival rate of 10–20% at 5 years. However, only 20% of the patients are surgical candidates because of locally advanced disease or systemic stage at presentation. Conventional radiotherapy, with or without chemotherapy, has been used to treat patients with advanced-stage pancreatic cancer, an approach with high rates of local recurrence. Stereotactic body radiation therapy, also known as stereotactic ablative radiotherapy has emerged as a treatment modality that allows the precise delivery of a large ablative radiation dose to a tumor volume while sparing surrounding organs and tissues. Phase I and II studies have shown good rates of local control of the disease but rates of distant metastasis remain significant. Strategies to combine novel systemic therapy and stereotactic body radiation therapy are to be explored.

Click here to read the full article (you must have a MedScape account).

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The Cancer Support Community in Pasadena

Our Medical Director, Dr. Albert Mak, was invited to speak at the Cancer Support Community in Pasadena (formerly known as the Wellness Community) yesterday.  He gave a presentation on the “CyberKnife Radiosurgery Treatment” and a brief overview of “How to Manage Side Effects”.

The attendees learned about the difference between radiation therapy and radiosurgery, different types of radiosurgery treatments available, an introduction of the CyberKnife treatment, and how to manage side effects.  Most of the attendees have not heard of the CyberKnife treatment before and after listening to the presentation, they were all very impressed with what the CyberKnife could offer.  The presentation went very well and we want to thank everyone for attending.  It’s very nice meeting each of you and we wish you all the best of luck and happiness for the future! =)

Dr. Mak speaking at the Cancer Support Community workshop

We would also like to once again thank Jill at the Cancer Support Community Pasadena for giving us the opportunity to speak at their workshop.  The Cancer Support Community is a great place for people who are affected by cancer to get psychological and social support.  Their mission is to help those affected by cancer enhance their health and well-being through participation in a professional program of emotional support, education and hope.  They provide professionally-led programs of support to people with cancer and their loved ones no matter what kind of cancer or where they are on their cancer journey.  Participants can choose to participate in a variety of programs designed to help them learn more about cancer and its treatment, as well as connecting with and learning from others as you face cancer together.  In addition to educational workshops like the one we just did, they also offer “mind and body” classes ranging from yoga, tai chi to painting and knitting.  All the workshops and classes at the Cancer Support Community are provided free of charge!  Remember, you don’t have to fight cancer alone, there are resources available in the community that aim to help those affected by cancer.  For more information on the Cancer Support Community, please visit their website at www.cscpasadena.org.

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Do you want to learn more about the CyberKnife treatment?

The Food and Drug Administration (FDA) cleared the CyberKnife system for the treatment of tumors in the head, neck and cervicothoracic spine in 1999.  In August 2001, the CyberKnife system received clearance for treatment of tumors in any location of the body.

Although the CyberKnife system has been around for quite sometime now, not many people are familiar with this technology.  A few months ago, our Medical Director, Dr. Albert Mak, was invited to appear on the Healthline Show to talk about the CyberKnife Radiosurgery System and explain how it works.  Please take a look at the following YouTube video clips to learn more about the CyberKnife treatment available at our center.

Healthline – CyberKnife (Part I)

http://youtu.be/pgFUff–rK0

Healthline – CyberKnife (Part II)

http://youtu.be/QIuE7y_Z-po

Healthline – CyberKnife (Part III)

http://youtu.be/e9BdEnZPoTs

Healthline – CyberKnife (Part IV)

http://youtu.be/nq7Pbf9vCi0

Healthline – CyberKnife (Part V)

http://youtu.be/Ac3I8T4Jljw

Healthline – CyberKnife (Part VI)

http://youtu.be/xCQ6Be4f-74

We hope you find the video clips helpful and informative.  We would also like to take this opportunity to thank our patient, Jackie, for sharing her story on the show.  If you would like more information on the CyberKnife treatment, please don’t hesitate to contact the Pasadena CyberKnife Center at 626-768-1021.

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Happy Friday! Another Happy Case!

Happy Friday!  What better way to start the weekend than sharing with you a recent case we successfully treated at our center?

J.S.,a 61-year-old lady, who was diagnosed with metastatic breast cancer and received palliative external radiation treatment in November 2009.  A few weeks ago, she started having a sudden onset of double vision and was referred to our center for evaluation.  We ordered a set of MRI and CT scans for her to find out what was causing the problem.  MRI of the brain revealed a 2.5cm tumor in the skull base (the central portion of her brain) and the CT scan showed bony destruction.  The result of the scans was consistent with a solitary brain metastasis.

After examination by our neurosurgeon Dr. Fineman, he confirmed that her double vision problem was due to a paralysis of the muscles that move the right eye.  J.S. decided to wear an eye patch to help relieve her double vision.  To lighten up her unfortunate situation, she called herself a “pirate” and even carried a fake parrot on her shoulder.

Fortunately, J.S. was determined to be a perfect candidate for the CyberKnife radiosurgery treatment and she agreed to undergo the treatment.  She received 3 fractions of treatment (3 days of treatment) and each treatment took about 30 minutes.  The CyberKnife treatment is painless and is done in an outpatient setting.  J.S. tolerated the short course of treatment very well without any side effect.

One week after the treatment, her eye muscles have been restored.  She can now control and move her right eye.  What about her double vision?  It is GONE, and so is the eye patch!  She is so happy that she can drive again.  What about her parrot?  J.S. is so grateful for what we at Pasadena Cyberknife Center have done for her and since she is no longer a “pirate”, she decided to give her parrot to Dr. Mak as a gift =).  By the way, we have yet given the parrot a name, do you have any suggestion?

The CyberKnife radiosurgery is an excellent treatment for brain metastases.  It delivers high dose of radiation targeted to the metastatic lesions in one to five fractions.  The tumor control is around 80-85%, which is much higher than conventional radiation or IMRT (Intensity modulated radiation therapy).  Because of that, patients live longer and do not suffer from treatment related complications.

There is no better feeling than knowing you have made a positive impact on another person’s life.  We are so happy to be able to treat J.S. and to be a part of her healthcare team.

Dear J.S.:  We wish you the very best in every aspect of your recovery and don’t worry, we will take good care of your parrot =)

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Treating Trigeminal Neuralgia with CyberKnife

Did you know that the CyberKnife Radiosurgery is another treatment option for Trigeminal Neuralgia besides the Gamma Knife?  We recently treated a patient diagnosed with Trigeminal Neuralgia who suffered from right-sided facial pain for over a year.  She lost 65 lbs because she was not able to chew or eat due to the pain.  Two weeks after her CyberKnife treatment, she reported 90% reduction in facial pain.  It has now been almost 4 months since her treatment, she is now pain-free and more importantly, can enjoy eating her favorite meal again.

Below is her testimonial:

“I am very satisfied with the CyberKnife radiosurgery.  I had not been able to eat and sometimes not even been able to talk over the past 16 months of having TN.  I lost 65 lbs, not because I wanted to, but because I couldn’t eat. I can eat now after a couple of weeks post-treatment and have put on 5 lbs.  I could hardly walk very far before and now I can walk just fine.  I couldn’t wear my bottom dentures before and now I can.  All is going just fine.” ~ B 

Trigeminal Neuralgia is a chronic condition that causes a stabbing or electric-shock-like pain in parts of the face.  It usually affects older adults but may affect anyone at any age.  Symptoms of Trigeminal Neuralgia include:

  • Very painful, sharp electric-like spasms that usually last a few seconds or minutes, but can become constant
  • Pain is usually only on one side of the face, often around the eye, cheek, and lower part of the face
  • Pain may be triggered by touch or sounds
  • Painful attacks can be triggered by common, everyday activities, such as brushing teeth, chewing, drinking, eating, lightly touching the face and shaving
It is often easy to mistake the pain of Trigeminal Neuralgia for a toothache or a headache.  If you suffer from facial pain, please consult your physician.
Resource:  PubMed Health http://www.ncbi.nlm.nih.gov/pubmedhealth/


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