John,* a 70-year-old former smoker from Sunnyvale, Calif., has battled lung cancer for the past decade. His first cancer, a small-cell cancer on his left lung, was diagnosed and successfully treated with aggressive chemotherapy and large-field radiation therapy in 2000, but then nine years later, a new type of lung cancer surfaced on his right side. For that cancer, John was again treated, with surgery (a wedge resection to remove the tumor) and external radiation therapy. Unfortunately, in the fall of 2010, yet another new cancer appeared, this time on his left lung again.
Given that this was John's third lung-cancer diagnosis, his physicians realized that they would need to try a new approach to try to stop the cancer from coming back.
Dr. Deepak Khuntia, El Camino's newest radiation oncologist and an expert in radiation treatment for cancers of the lungs, head and neck, and brain, suggested "mesh brachytherapy," a technique in which a piece of mesh embedded with radioactive seeds is sewn directly onto the surface of the lung (after surgical removal of the tumor).
Mesh brachytherapy is one of the newest forms of targeted radiation and one of the most exciting developments in oncology today. With mesh brachytherapy, patients have the benefit of getting the most targeted radiation possible, increasing their chances of keeping the cancer from recurring and decreasing the amount of damage done to their normal lungs. Targeted radiation also does not involve the many weeks of treatment required in traditional external radiation; it can be done at the time of surgery and does not involve return trips to the hospital, except for routine follow-up visits.
With Lung Brachytherapy, El Camino Hospital Marks Several Firsts
With John's treatment, performed on January 7, 2011, El Camino Hospital hit several milestones:
- John is the first patient to receive mesh brachytherapy for lung cancer at El Camino Hospital, therefore launching the start of an exciting new service for early-stage lung cancer patients in Silicon Valley and beyond (El Camino already uses brachytherapy techniques for many breast cancer and prostate cancer patients).
- By using one of the newest radioisotopes (Cesium 131, which was FDA-approved in 2003) to deliver the radiation, El Camino also became the first hospital in California to use the fastest, most aggressive mesh brachytherapy isotope available today for lung cancer treatment (other hospitals in the state use older isotopes to for lung brachytherapy--isotopes that have longer half-lives and take longer to deliver the radiation, resulting in slower treatment for the patient).
- By using the da Vinci robotic surgery system in John's procedure, El Camino Hospital also became the first hospital in the world to use a robot to implant the Cesium 131 isotope in a lung patient, according to the isotope's manufacturer, IsoRay Medical Inc. Using a robot to implant the radioisotope is not only safer for physicians (less exposure to radiation), it is also safer for patients (smaller incision, quicker recovery).
Impact on Patient Care
According to Dr. Robert Sinha, director of Radiation Oncology for El Camino Hospital, "The launch of mesh brachytherapy treatment further enhances our hospital's ability to treat all lung cancer patients, regardless of their stage. Brachytherapy is a terrific tool that complements our existing services, which include all advanced forms of radiation therapy, such as the CyberKnife system. When it comes to state-of-the-art lung-cancer treatment, we now have all surgical, chemotherapy and target radiation options available for our patients."
Adds Dr. Khuntia, "Mesh brachytherapy can dramatically reduce the recurrence rate for early-stage lung-cancer patients. In John's case, with surgery alone, there would have been about a 20 percent chance that his cancer would come back locally. With brachytherapy, recurrence is just one percent. That's a significant difference."
By choosing brachytherapy treatment, John was also able to return home a day after his surgery and will be able to avoid the five-to-six-week process of daily treatments, as would have been required with conventional radiation therapy.
Brachytherapy treatment is only available to early-stage lung-cancer patients who meet the current treatment guidelines. To find out more about the treatment, contact the El Camino Hospital Center for Advanced Radiotherapy and CyberKnife Radiosurgery at 650-940-7280.
* Name changed for patient privacy