Patients with cancer of the chest region often require complex medical approaches that combine surgery, chemotherapy, and radiation and often require therapy and procedures not offered at a local hospital.
John Buatti, MD, head of Radiation Oncology, and the deputy director of Clinical Cancer Care, Holden Comprehensive Cancer Center at UI Hospitals and Clinics, talks about cancers of the lung and esophagus:
Often patients are diagnosed with cancer at their local hospital. Why is that initial diagnoses of cancer important in the course of their treatment plan?
That initial diagnosis is the starting point to get them in for a full evaluation of what can be done best to care for that cancer.
It's critical in that there are advanced staging methodologies, such as PET imaging for lung cancer or MRI imaging, that can sometimes distinguish between whether a cancer has spread in certain locations or not.
In addition, there are methods like endoscopic ultrasound that can go into the esophagus and actually tell whether these areas are thickened and involved, or conversely, not involved.
These advanced imaging approaches are critical in the decision-making as to whether the best treatment is a combination of surgery or radiation and chemotherapy or all three.
So the decision-making in the setting of doing all of that staging with experts specializing in that area provides the ability to make the best recommendation for that patient.
The Holden Comprehensive Cancer Center holds an NCI designation. What role does that play in cancer diagnoses and treatment?
The National Cancer Institute designation means that our cancer center has the national seal of approval in terms of being an advanced center for research for patients, particularly in the area of translational research that implies the latest advances for treating all of these individual cancers.
It also implies there's the ability to have very well established interdisciplinary groups working on many different types of cancers; so the destination is comprehensive, which the Holden Comprehensive Cancer Center has. It also means that we have all of those options available for every patient that comes to our center.
Why is it important that newly diagnosed cancer patients consider getting that second opinion from an NCI-designated center before their treatment begins?
I believe the biggest difference is that at NCI-designated centers, the physicians have the opportunity to sub-specialize in their given area of cancer, so we have physicians that specialize in lung cancer and esophageal cancer and spend the majority of their careers taking care of patients with these problems.
That gives them an ability to see many more patients with that type of cancer and understand some of the finer details. In addition, there are some advanced methods that are available to the patient in terms of different kinds of surgery and diagnostic studies. And finally, and very importantly, there are trials—both national trials that compare one treatment to another treatment, or there are new methods being trialed that the patient benefits from knowing about it and may want to participate in such studies.
Does Holden Comprehensive Cancer Center offer unique treatment to lung and esophageal cancer patients?
Absolutely, there are very significant abilities here. Particularly 4-dimensional radiation therapy, where we can look at the tumor and track how it's moving.
If you think about radiation as a beam of light targeted toward a given tumor, if it's in the lung or the esophagus, you can imagine that as you breathe, these things can move. By getting scans in a special way, we can develop a movie as to how it moves, and then when we give the radiation, we can track that and only turn the beam on when that tumor is in the right position. That lets us not treat as much normal tissue and give these areas a higher dose.
In addition, some advanced diagnostic studies, such as endoscopic ultrasound and things like that, require some special expertise that isn't available everywhere.
From a surgery standpoint, there are some less invasive methods to go in and do it—types of scopes that enable people to recover quicker. We have some highly skilled surgeons who specialize in these less invasive approaches for certain cancers offering the patient the absolute best outcome for the cancer, as well as less toxicity or less side effects from it. |
