Can­cer cen­ter uses sur­gi­cal strikes to at­tack some ma­lig­nan­cies

‘Blood­less surgery’ for tu­mors avail­able in Wal­dorf, Char­lotte Hall treat­ment clin­ics

Maryland Independent - - Business - By DAR­WIN WEIGEL dweigel@somd­ Twit­ter: @somd_bized­i­tor

Ra­di­a­tion treat­ment for can­cer­ous tu­mors isn’t new but ad­vance­ments in the last three decades or so have trans­formed it into a sur­gi­cal strike rather than a “car­pet bomb­ing.” One South­ern Mary­land can­cer cen­ter is lead­ing the charge to bring the lat­est treat­ment tech­niques closer to home.

“We have the two cen­ters and every­thing is up to date, you get the same treat­ment here as you would get in the city,” said Dr. Simul Parikh, a ra­di­a­tion ther­apy spe­cial­ist with Ch­e­sa­peake Po­tomac Re­gional Can­cer Cen­ter, which has clin­ics in Wal­dorf and Char­lotte Hall.

“One of the spe­cial­ties we do here is what’s called stereo­tac­tic ra­dio surgery and stereo­tac­tic body ra­dio ther­apy,” he said. “Es­sen­tially, ra­di­a­tion is X-ray treat­ment of can­cer, that’s the sim­ple way to put it. We us fancy X-rays to treat can­cer pa­tients.”

The ad­vent of more so­phis­ti­cated imag­ing such as mag­netic res­o­nance imag­ing (MRI) and com­put­er­ized to­mog­ra­phy (CT) scan­ning, along with im­prove­ments in ra­di­a­tion beam con­trol, have trans­formed the use of ra­di­a­tion into a form of “blood­less surgery” for some types of can­cer, Parikh said.

“The old tech­niques, you could say, were very un­guided — sort of like car­pet bomb­ing,” he said, sit­ting in his of­fice in Wal­dorf. “We were able to treat the can­cer but the nor­mal body sur­round­ing it took a lot of hits from it. As the [imag­ing] tech­nol­ogy got bet­ter — it’s one of the fields of medicine so tied into com­put­ers and imag­ing, CTs and MRIs — as those im­proved we were able to see what we were treat­ing and able to block out the nor­mal tis­sues while hit­ting the tar­get.”

The can­cer cen­ter has spent the last two years en­ter­ing what Parikh called “al­most the fi­nal fron­tier of what you can do with mod­ern ra­di­a­tion” — stereo­tac­tic ra­dio surgery.

“That’s able to do very, very fine beam-lets [of ra­di­a­tion],” he said. “You use many fine beams and they cross­fire from many dif­fer­ent an­gles.” The re­sult is con­cen­trat­ing high doses of ra­di­a­tion on a tu­mor while keep­ing the sur­round­ing tis­sue from re­ceiv­ing much at all, he said.

That’s done pri­mar­ily with the aid of CT scans, though MRIs are also used dur­ing the plan­ning stages. A CT scan­ner is built into the ra­di­a­tion treat­ment ma­chine to keep tabs of the tu­mor as treat­ment is tak­ing place.

The cen­ter in­vested around $800,000 in hard­ware and soft­ware to bring its ma­chines up to date for the more pre­cise ca­pa­bil­i­ties and is steadily build­ing up ex­pe­ri­ence and train­ing to at­tack a wider num­ber of can­cers, Parikh said.

Parikh came to the cen­ter six years ago af­ter five years of train­ing and res­i­dency ex­pe­ri­ence in treat­ing can­cer with ra­di­a­tion at the Univer­sity of Pitts­burgh Med­i­cal Cen­ter, which op­er­ates hos­pi­tals all over Penn­syl­va­nia and can­cer clin­ics around the world. Since com­ing to South­ern Mary­land, he’s headed up the ef­fort to bring in the lat­est treat­ment tech­nol­ogy.

“We do brain. We do lung,” he said. “We’ve treated a pa­tient with ovar­ian can­cer that had a spot in the pelvis. We’re start­ing a spine pro­gram now, where you have tu­mors very close to the spinal cord and we’re able to give it a very high dose and pro­tect the spinal cord at the same time.”

“We’re slowly ramp­ing up. It was one [pa­tient] a month [for the new treat­ments] and we’re now up to about two a month,” he said. “Part of it is [re­fer­ring doc­tors] not know­ing we have the ca­pa­bil­ity. We try to talk to our re­fer­ring physi­cians, but they’re just so use to send­ing them to Ge­orge­town or send­ing them to Anne Arundel Hospi­tal Cen­ter.”

One re­cent pa­tient, Eu­gene Wal­ton of Hunt­ing­town, had a spot on his brain near the op­tic chi­asma, which is where the op­tic nerves cross. “This area is very sen­si­tive to ra­di­a­tion,” Parikh said. “If we want to treat this area we’re right up against that. If we used old tech­niques there was no way we could pro­tect that.”

Af­ter care­fully work­ing up a treat­ment plan, Wal­ton was given three ra­di­a­tion treat­ments. Nearly four months later, the spot is gone.

“Two months later we bring him in and its gone,” Parikh said. “He’s asymp­to­matic. He’s got no prob­lems, no com­pli­ca­tions. We just wouldn’t have been able to give it the full dose treat­ment with­out this tech­nique. We would have been treat­ing every­thing, and over the course of two weeks. We were able to give the same dose in just two or three days.”

“I’m a very lucky man,” Wal­ton said in a re­cent tele­phone in­ter­view. “They only di­ag­nosed this last Oc­to­ber. I’ve been a very healthy per­son and have had very few sick days in my life.”

Wal­ton re­cently had colon can­cer re­moved — “I’m 100 per­cent clean” — through surgery at The Johns Hop­kins Hospi­tal in Bal­ti­more and he’s un­der­go­ing chemo­ther­apy for spots on his lungs and liver at Calvert Me­mo­rial Hospi­tal in Prince Fred­er­ick.

“The spe­cial­ist at Johns Hop­kins rec­om­mend the same thing,” Wal­ton said of the treat­ment he un­der­went for the brain spot. “So I guess they know what they’re do­ing.”

“I’m just proud of this cen­ter,” Parikh said. “We’re do­ing pretty cool stuff in a small, mostly ru­ral area.”


Dr. Simul Parikh of the Ch­e­sa­peake Po­tomac Re­gional Can­cer Cen­ter poses with the ra­di­a­tion treat­ment ma­chine/CT scan­ner at the Wal­dorf clinic.

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