March 2008

In January, PAMF became the first health care organization in the world with a new high-definition multileaf collimator (HD 120 MLC), an ultra-fine device for radiosurgery that shapes each treatment beam to match the exact contour of a tumor or other target. This technology allows doctors to treat brain tumors and cancer in all parts of the body with unsurpassed accuracy – all with fewer side effects, greater patient comfort and improved outcomes.

Radiosurgery is a non-invasive medical procedure in which high-energy X-rays are delivered to a target area within the body from a machine outside the body. With the HD120 MLC, which is part of PAMF’s Novalis Tx® radiosurgery system from Varian Medical Systems and BrainLab, patients receive an ultra-precise dose of high-intensity radiation – accurate within fractions of a centimeter – while avoiding the pain and complications associated with conventional “open” surgery.

“This next-generation technology improves the precision of the treatment beam significantly, allowing us to treat a wide spectrum of conditions, including tumors and cancers that were once thought to be untreatable because of their location close to vital organs, delicate body structures and other soft tissues,” said Gordon Ray, M.D., head of PAMF’s Department of Radiation Oncology, who added that PAMF is continuing with quality assurance testing of the system and will begin offering the treatment this spring.

To ensure pinpoint accuracy, the radiosurgery system’s software calculates the ideal areas of the body in which to access the treatment target, and the ultra-fine beam-shaping device molds to the target’s contours. This ensures that even irregularly shaped targets receive an exact dose of radiation individually tailored to the medical needs of the patient. It also helps reduce side effects, as the radiosurgery system zeros in on the target and avoids exposing nearby healthy tissues to the treatment beam.

“One of the greatest benefits of radiosurgery as performed with the Novalis TX is faster treatment times,” said Pauling Chang, M.D., a PAMF radiation oncologist and head of the Stanley and Carolyn Hiller Radiosurgical Center at PAMF. Dr. Chang also heads the brain and spine tumors portion of the radiosurgical program with PAMF neurosurgeon Paul Jackson, M.D.

“Previously, when receiving radiosurgical treatment, a patient would have to lie as still as possible for up to one hour or more,” said Dr. Chang. “Not only was this uncomfortable for patients, but longer treatment times also make patient movement more likely, which can impact treatment accuracy. With this radiosurgery system, treatment takes only minutes and can often be performed in a single session. The system also continuously monitors the patient, allowing for adjustment of the patient’s position, if necessary.”

A History of State-of-the-Art Care

Utilizing the latest technology to provide patients with the highest quality care and most effective treatment is nothing new to PAMF, said Dr. Ray. For years, PAMF has been using Varian’s On-Board Imager and cone beam computed tomography (CT) system to verify patient positioning prior to treatment, thereby improving the effectiveness of cancer treatments. These technologies give physicians a clear picture of a patient’s anatomy, which allows them to deliver treatment more precisely while reducing side effects. According to Dr. Chang, PAMF’s new radiosurgery system will combine all of these imaging and treatment modalities.

“We have always been committed to providing patients with the most advanced treatment options available in a convenient, comfortable outpatient environment,” said Dr. Chang, who added that PAMF is one of only a handful of outpatient facilities in the country to offer radiosurgery.

Comprehensive, Integrated Cancer Care

Patients undergoing treatment for cancer, including radiosurgery, are part of PAMF’s comprehensive Cancer Care Center. “What sets PAMF’s Cancer Care Center apart is our commitment to our patients and our integrated care process,” said Theresa Manley, R.N., PAMF’s director of clinical operations. “From the moment patients are diagnosed with cancer, we are at their side, providing the latest treatment along with the support patients need to face the many physical and emotional challenges that cancer presents.”

A clinical care coordinator guides patients through the entire care process, working with the patient’s entire health care team to establish appointments, laboratory tests and other procedures. Together with the clinical care coordinator, the Center’s nursing staff helps patients understand the different treatment options and plan next steps in the treatment process.

“We are dedicated to providing care to the entire patient – mind, body and spirit,” said Manley. “We don’t just treat the cancer. We provide the complete array of care and support that patients need to be their healthiest – during cancer treatment and beyond.”