Archbold Pioneering Treatment
for Lung Cancer
Tuesday, August 9, 2011
Physicians at Archbold Memorial Hospital are being recognized as the first in the state and second worldwide to revolutionize surgical treatment for lung cancer using mesh brachytherapy and the daVinci Robot.
Archbold general and thoracic surgeon Edward Hall, MD, and radiation oncologist Steven Johnson, MD, of Archbold’s Lewis Hall Singletary Oncology Center recently performed Georgia’s first implant of Cesium-131 mesh brachytherapy in an early stage lung cancer patient using the daVinci Surgical System.
The innovative technique performed by Hall and Johnson offers a less radical surgical treatment for a large group of patients, who until now had limited hope of finding a cure for their disease.
"Archbold doctors now have another aggressive, effective treatment option for patients—one that has a direct impact on patient survivability that comes with improved quality of life,” said CEO Dwight Babcock of Isoray Medical (ISR), manufacturer of Cesium-131. “Archbold physicians marked several milestones with this procedure—representing another crucial leap forward in cancer treatment. Archbold became the first hospital in Georgia, and the second worldwide, to implant the fastest, most aggressive mesh brachytherapy isotope available, Cesium-131, in a patient using the daVinci Robot. The importance of this new development cannot be understated.”
For many patients with stage one lung cancer, treatment options are severely limited. Poor pulmonary function and other health problems have historically prevented many patients with an early stage lung cancer diagnosis from undergoing major surgery.
“Surgery is the preferred treatment to cure lung cancer,” said Hall. “However, due to the potential for serious complications, patients with compromised lung function have, until now, been excluded from traditional surgery options used to treat lung cancer.”
Hall explained that traditional surgery options such as “open” surgery are performed through a large incision and involve splitting muscles and actually spreading the patient’s ribs in order to remove cancerous lung tissue. Because this type of surgery is very tough on the patient, it is not recommended for those who already have severely compromised lung function.
Archbold physicians have performed minimally invasive lung surgery, also known as video-assisted thoracoscopic surgery (VATS), as an alternative to “open surgery,” for nearly three decades.
While minimally invasive surgery provides significant advantages over ‘open’ surgery, the advantages are even greater when lung surgery is performed using daVinci robotics.
“Robotic surgery is a viable surgical option that allows us to offer treatment to patients who otherwise would be left without feasible treatment options,” said Hall. “DaVinci’s high definition 3D vision system provides a highly accurate, increased level of depth perception. The dexterity of the robotic arms enables us to perform complex surgical maneuvers easier. Using daVinci we can actually remove tumors in patients who otherwise would’ve been denied surgical treatment,” said Hall.
Unlike conventional lung surgeries, surgery with daVinci requires very little muscle to be cut and the rib cage does not need to be spread. In addition, patients experience many minimally invasive surgical advantages such as reduced length of stay in the hospital, less pain and quicker recoveries.
“We generally prefer surgery when possible to treat lung cancer,” said Johnson.
According to Johnson, nearly half of all cancer patients receive radiation therapy to treat their cancer or relieve symptoms. Radiation treatment can be performed two ways—internal and external. External beam radiation means that the radiation is aimed only at a specific part of the patient’s body. For example, a patient with lung cancer will get radiation to the chest only and not the rest of the body. Most patients get external beam radiation therapy once a day, five days a week, and depending on the type of cancer, treatment can last from 2 to 10 weeks.
Internal radiation—also known as brachytherapy—is a type of radiation therapy in which radioactive material sealed in needles, seeds, wires or catheters is placed directly into or near a tumor. Depending on the type of implant a patient receives, the radiation source may stay in place for minutes, hours or days. Or if a patient receives a permanent implant, it will not be taken out.
Different forms of brachytherapy have served for many years as effective treatment of cancers such as skin, cervical, breast and prostate. Mesh brachytherapy, the newest form of targeted radiation delivered via the robotic surgical approach, offers promising treatment options for patients with any type of tumor in close margin to the chest or abdomen, historically considered to be inoperable areas.
“Since the surgeon is already doing a surgical procedure to remove the tumor, targeted radiation done at the time of surgery is preferred,” said Johnson. “Application of a radioactive mesh treats the ‘at risk tissue’ directly while maximally sparing normal tissue. It also eliminates many weeks of treatment that is required with traditional external radiation.”
|Archbold is the first hospital in Georgia and the second worldwide to implant the fastest, most aggressive mesh brachytherapy isotope available, Cesium-131, in a patient using the daVinci Robot. Archbold general and thoracic surgeon Edward Hall, MD, and radiation oncologist Steven Johnson, MD, used the daVinci to deliver mesh-like, moldable cloth— woven with braided strands that contained radioactive seeds—near the cancerous tissue.|
The goal of brachytherapy is to directly target radiation exposure to the tumor, from inside the body, where it is most needed. Johnson explained the new technique allows the surgeon to place the radioactive source directly on cancer tissues, further reducing radiation exposure for physicians and adding a new level of safety for patients, who also reap benefits from the minimally invasive surgical approach.
“With mesh brachytherapy, patients benefit from getting the most targeted radiation possible, which decreases the chance of the cancer recurring and decreases the amount of potential lung damage,” said Johnson.
Johnson explained that once the tumor was surgically removed from the patient’s lung a piece of extremely fine moldable cloth, embedded with Cesium-131 (an isotope of Cesium) was applied to the suture line.
“Our innovation of placing Cesium, a radioactive chemical element used for treating cancer, over the suture line reduces the risk of cancer recurrence in patients to 10 percent or less,” said Johnson.
Other hospitals in the state use older isotopes for lung brachytherapy—isotopes that have longer half-lives and take longer to deliver the radiation, resulting in slower treatment for the patient.
“Archbold has an outstanding reputation for being early with technology,” said Johnson. “This is another state-of-the art tool that complements our existing services, including advanced forms of radiation therapy, such as Archbold’s Gamma Knife—the only non-invasive brain surgery technology of its kind south of Augusta— and Trilogy—Archbold’s newest linear accelerator that treat tumors of the body with similar precision to that of Gamma Knife. This is another example of how cutting edge Archbold is. Our physicians are innovators. We are interested in taking patient care to the next level.”