Monthly Archives

March 2016

Cancer diagnosis? Don’t skip exercise

By | Breast Cancer, Cancer, Exercise & Nutrition, Survivors, Uncategorized | No Comments

Starting an exercise program after a cancer diagnosis can be very beneficial and result in patients emerging from treatment stronger mentally and physically!

This has been proven by research. One study out of the University of Alberta, led by Kerry Courneya demonstrated increased stamina, increased functional capacity, more strength, improved self-esteem, improved treatment tolerance, decreased pain and an overall better quality of life! Psychological improvements included a decrease in mood disturbances and depression and fewer sleep problems.

The specific exercise “dose” varies from patient to patient depending on if they were exercisers prior to diagnosis and their general physical abilities. The specific cancer diagnosis, treatment regimen, cancer type and how they are responding to treatment also have a part of play. Lymphedema, swelling that can happen as a side effect of breast cancer surgery, can also affect exercise choices but can have significant benefits as well. One size does not fit all! It is important to consult with a Cancer Exercise Specialist and, if necessary, a Lymphedema Specialist to help get started with a program that is right for you.

Following cancer surgery, exercise plays a vital role in helping one return to the fitness level and strength that was maintained prior to surgery. In some cases, surgery, compounded by reconstruction and radiation, has impacts on posture that can be drastically improved through a combination of stretching and strengthening muscles. These can affect everyday functioning like cooking, reaching for things in your cabinet, sitting at a desk, or holding a baby. These muscle imbalances can create a chain reaction leading to neck, back, knee or ankle pain. A thorough assessment can help determine what areas need to be stretched and what muscles need to be strengthened.

It’s also important not to forget the improvements made through cardiovascular conditioning. Exercises like biking, walking, swimming, running, etc. show an increase in endorphins that will give patients a boost emotionally as well as much-needed energy. Not only can a combination of stretching and strengthening improve a cancer survivor’s quality of life during and after treatment, there is a lower rate of recurrence when patients are involved in an ongoing exercise program after treatment is complete. [i]

 

[i] Leonard, Andrea BA, C.S.C.S., C.P.T., CES with Dr. Gero, Genn B., Cancer Exercise Specialist Handbook, (Cancer Exercise Training Institute, 2013)

Dosimetrists focus on finding perfect proton path

By | Cancer, Innovation, lung cancer, Proton Therapy, Technology, Uncategorized | No Comments

Not too long ago, radiation prescribed for cancer treatment was calculated by physical measurement and mathematic formulas worked out by hand.

Now computers do much of that detail work, but the job of a dosimetrist is as important as ever in making sure patients receive the right dose of radiation in exactly the right place. And thanks to advancements in the field—the development of proton therapy and advanced application technologies such as pencil-beam scanning, sophisticated software modeling platforms and high tech imaging capabilities—patients receive precise, customized therapy that’s the best in the world.

Kevin Kirby is one of six dosimetrists who work at Provision Center for Proton Therapy. These experts in the delivery of radiation for treatment of cancer work with radiation oncologist and physicists to determine the best treatment plan and then ensure its successful delivery, says Kirby, who spoke recently at a patient chat, held each Wednesday at the proton therapy center. The talks provide information on a variety of topics of interest to patients and their families.

“Our job is to create (proton therapy) dosage that focuses just in the tumor,” Kirby says. “We figure out the best way to position the patient so we can minimize any radiation to excess tissue.”

With the pencil beam application ability, calculations must be made to determine the direction and length of path for the protons being channeled to the tumor. In some cases, treatment can be made challenging by the location of the tumor, on the lung, for instance, in which radiation must be administered while the patient is breathing.

“We are able to predict the motion of the lungs by using four-dimensional CT scans to develop the treatment plans,” he says.

A laundry list of equipment and programs are involved in coming up with the unique plan for each patient. In the case of the lung cancer patient, for example, a respiratory device helps plan for treatment between breaths. Medcam marries patient x-rays with CT scans to aid dosimetrists, physicians and physicists in creating the treatment protocol. A software package called “Matrix” serves as quality assurance for treatment before it starts, even sending protons into the nozzle through which they’ll be delivered to the patient. Treatment planning software serves as a “flight simulator, which also allows for changes in the treatment plan based on shifts inside a patients body during the course of therapy. Another program, Mosaiq, records the treatment itself, creating a unique therapy chart for every patient.

Among the team of caregivers, physicians prescribe and monitor treatment, physicists manage the entire process on both the equipment and treatment delivery side and therapists interact directly with patients who are receiving therapy. Dosimetrists, says Kirby, focus specifically on the way radiation—in this case, proton therapy—targets the cancer in the patient’s body.

“We take the prescription the doctor gives and determine how to deliver it,” he says.

Cancer patient finds help post-treatment

By | Events, Exercise & Nutrition, Provision Health and Performance, Survivors, Uncategorized | No Comments

Staying healthy after cancer treatment is an important part of long-term survival and crucial in helping patients resume normal lives.

Sometimes, patients want to learn how to make healthy life changes following the restrictions on exercise and diet during cancer treatment. Sometimes they’re grappling with the results of treatment on their bodies.

Like Toni Doody.

A breast cancer survivor, she sought physical therapy from Kathy Kearse with Provision Physical Therapy  when suffering from lymphedema after her bilateral mastectomy. After receiving treatment there for several months, she learned about a new class Kearse and cancer exercise specialist Kathleen Bullock Provision Health and Performance,  were launching, designed specifically for the needs of cancer survivors.

“I thought it would be a good fit, and it was,” says Doody. “I just wanted to be able to do the exercise that would help my body and improve flexibility.”

After attending the first round of classes last year, Doody signed up for the second set of classes in January. The bi-weekly classes each feature an exercise session and an educational seminar on a variety of topics ranging from the risk of lymphedema, hydration, nutrition, foam rolling, relaxation and restoration.

“I really like Kathleen. She’s very positive and motivating,” says Doody. :It’s always easier to do it with someone else.”

In addition to educational sessions, the program consists of stretching, strengthening, and cardiovascular conditioning exercises targeted at the needs of men and women following recovery from cancer treatments who are ready to take the next step toward better health.

A new “Small Group Training for Cancer Survivors” will be held April 19-May 12, from 8:15-9:15 a.m. Tuesdays and Thursdays. More times will be made available as needed.

The class is open to both men and women who have completed treatment for cancer. A medical release from an oncologist or primary care physician is preferred in order to ensure participants are ready for exercise.

Groups will consist of 4-8 participants. Cost is $160 for eight sessions. For more information or to sign up, call 865-232-1414.

French doctor high on Provision, ProNova

By | Cancer, Dr. Marcio Fagundes, Innovation, Market, Niek Schreuder, Proton Therapy, research, Technology, Uncategorized | No Comments

Georges Noël’s interest in proton therapy hearkens back to the time when he met Provision Chief Medical Physicist Niek Schreuder in 1997 at a conference in Paris.

Georges, a radiation oncologist and widely published author, wrote a paper in 2005 declaring, “proton is the future.”

“That is not a new idea for me,” said Noël, director of the radiobiological lab at Centre Paul Strauss, a cancer treatment and research facility, in Strasbourg, France. Last year, he took a sabbatical from his position, to research proton therapy with plans to set up a center there.

He came to the U.S. to research protons, starting with a six month stint in Boston. He then decided to expand his experiences to other centers, taking jaunts to Jacksonville, Philadelphia, New York, Chicago, Shreveport and San Diego. He spent the last two months of his year-long tour observing and writing his report at Provision Center for Proton Therapy.

He already was familiar with Provision. In addition to his long-time relationship with Schreuder, journal articles by Medical Director Dr. Marcio Fagundes were regular reference points. He also came to learn about ProNova Solutions and the new proton therapy machines being developed here.

“I came to compare machines from different companies and show in my report what is the best one,” he says.

After his time here, Noël says he is absolutely sold on the ProNova product.

“It’s a device to treat patients and to treat patients better,” he said. “I think ProNova is at least five years ahead of the competition. I think this company is the future of protons.”

Noël said he appreciated the close collaboration among clinicians and ProNova development staff as well as the attention paid to the comfort of both the patients and the technicians in the proton therapy equipment’s design.

And, at Provision and ProNova, everyone has the same goal, he said.

“To think that what the physician wants, the physicist wants, what the technician wants is for proton therapy to work better,” he said.

That mindset makes ProNova machines attractive for an institution that is focused on innovation as well as treatment. Noël said he believes the equipment will be most compatible with whatever research track he might want to take, whether testing better treatments, developing databases or coming up with a dose calculation system. ProNova’s entrepreneurial approach to making a new and better machine makes it ideal for making advancements in the field of proton therapy.

“To create a company from nothing,” he said, “that’s always marvelous to me.”