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Zeroing in on cancer

New machine targets tumors with greater precision, power

External-beam radiation – a cancer treatment using high-energy X-rays – has taken a giant stride at Mercy Regional Medical Center.

The hospital has acquired a $2.5 million Trilogy linear accelerator to treat liver, lung, prostate and brain cancer.

The Trilogy is the second high-tech instrument used in cancer treatment to arrive at Mercy in six months. In September, the medical center welcomed a surgeon-controlled robot called the da Vinci that is used in prostatectomies. The da Vinci is used elsewhere for heart repair and hysterectomies.

The Trilogy, manufactured by Varian Medical Systems, is up to three times faster than the 2006 model it replaced and directs its beam with more accuracy. These attributes reduce the amount of time the patient is exposed to radiation and spares possible damage to healthy tissue or organs near the target area.

External-beam radiation serves patients who aren’t good candidates for invasive surgery whether it be for age reasons, other health risks or because they have a hard-to-reach tumor.

Jay Lally, a Pagosa Springs resident, can appreciate the improved quality of the Trilogy. Lally, who works in a ski shop in the winter and logs in the summer, is being treated for third-stage esophageal cancer.

Lally was prescribed six weeks of treatment, which consists of five days of radiation and one day of chemo. At the end of the six weeks, Lally will rest for six weeks to prepare for surgery.

“The prognosis isn’t the best, but I’m optimistic,” Lally said. “It’s giving me more time, and the people here are one of the most important parts of the treatment.”

Radiation oncologists Dr. Jonathan Clark and Dr. Steven Bush and other team members at the Durango Cancer Center use the Trilogy’s three-dimensional imaging to guide their work.

Every time a patient arrives for treatment, a 3-D CT scan is made. The image is used by an oncologist to map the anatomy of the patient around the tumor and by dosimetrists, who calculate the angles at which radiation should be applied. Therapists in an adjoining control room, press the buttons that operate the gantry, which rotates around the patient, who lies on a bed. The bed itself swivels through an arc of 180 degrees.

While radiation is being applied, the therapists in the control room monitor the procedure via a pair of three-dimensional CT scanners that protrude like wings from the middle of the gantry. They can alert the oncologist of anything out of the ordinary.

The angle from which radiation is delivered can be changed as the gantry rotates around the patient.

Clark, who came to Mercy 15 months ago, received his medical degree and did his internship and residency at Loma Linda University in Loma Linda, California.

“The Trilogy is state of the art,” Clark said. “It will be good for 10 to 15 years.”

The high-energy radiation delivered by the Trilogy doesn’t remove tumors, but damages their DNA, leaving them unable to reproduce, Clark said. After treatment, malignant tumors tend to shrink quickly, while benign tumors take 18 months to two years to shrink.

High-energy radiation has been used in the United States to treat cancers since the early 1960s.

Mercy is leasing the Trilogy with the option to buy. The Mercy Health Foundation is developing a campaign to raise $3.3 million to upgrade cancer treatment equipment.

Proceeds are earmarked for the Trilogy, a new three-dimensional mammography machine, a new endoscopic ultrasound device for imaging through the walls of airways, patient assistance for lung cancer screening, lodging assistance for cancer patients and a new outdoor garden visible from the chemotherapy infusion room.

daler@durangoherald.com

This story was changed from its original publication to reflect that prostate cancer isn’t treated with stereotatic body radiotherapy, but the linear accelerataor is used to treat the cancer. The job titles of Mark Hayes and Jennifer Wright were misstated in a photo caption. He is chief radiation therapist and she is a radiation therapist.



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