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Provision Healthcare Announces National Survey Results

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Provision Healthcare Announces National Survey Results
Men treated for prostate cancer using proton therapy reported significantly better quality of life than other therapy options

Knoxville, TN (September 27, 2016)— A national survey released today reported that men treated for prostate cancer who received proton therapy reported significantly better quality of life during and after treatment than those treated with brachytherapy, surgery or traditional x-ray therapy.  The survey carried out via phone and online, by Bryant Research profiled 755 men, ages 50-75, who were surveyed at least 12 months after treatment.

Patients who received proton therapy reported the best outcomes for overall quality of life, urinary function, digestive function, sexual function, ability to remain active during treatment, and living life the way they wanted to after treatment.  Notably, more than 70% of proton therapy patients reported that treatment did not interfere at all with their overall quality of life.

“These survey results confirm proton therapy’s ability to target radiation to the cancer site without damaging surrounding healthy tissue,” says Scott Warwick, Vice President of Provision Healthcare.  “With proton therapy, patients feel better during treatment and have a better quality of life afterward.”

Other notable results included:

  • The proportion of proton therapy patients reporting that their treatment had no impact on their sexual function was almost double that of the next best scoring treatment in this survey.
  • Ninety-seven (97%) percent of proton therapy patients said they would recommend their treatment to other men with prostate cancer, significantly higher than the other treatment options.
  • Ninety-seven (97%) percent of proton therapy patients said they would select this same treatment option should they have to make the decision today compared to brachytherapy (68%), conventional radiation therapy (66%), and surgery (58%) patients.

Proton therapy is an advanced form of radiation therapy that uses a beam of high-energy protons to treat various forms of cancer.  Unlike conventional radiation therapy, in which x-ray beams deposit most of their energy into the healthy tissue prior to entry and upon exit of the tumor site, the protons can be better controlled, allowing most of the energy to be deposited directly into the tumor and thus reducing damage to nearby healthy tissue.

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About Provision Healthcare, LLC

Provision Healthcare, LLC, (Provision) was formed in 2005 with the purpose of developing innovative healthcare solutions focused on improving patient care and clinical outcomes and developing support for research, educational, and charitable causes. Provision has developed a unique, comprehensive expertise in proton therapy that distinguishes it from other equipment suppliers and proton and cancer center developers and operators that have a much narrower focus. The combination of a unique expertise and innovative, entrepreneurial approach continues to propel Provision towards a position of industry leadership with respect to both cancer care and proton therapy.

Contact

Nancy Howard
nancy.howard@provisionproton.com
(865) 603-0865

Provision Center for Proton Therapy Treats 1,000th Patient

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Provision Center for Proton Therapy Treats 1,000th Patient

Knoxville, TN (June 7, 2016)—

Today, 1,000 patients have graduated from the Provision Center for Proton Therapy, completing their course of proton therapy as part of their journey to defeating cancer. The 1000th patient marks an important milestone in the proton center’s development into a critical component of the comprehensive cancer campus at Dowell Springs and as a community resource in East Tennessee.

The center launched operations on January 20, 2014, with one treatment room. Three patients underwent therapy the center’s first day of business. Today the center is treating more than 90 patients per day in three treatment rooms. Each patient closes out his or her round of treatment by ringing the “victory bell” in the proton therapy center lobby, part of Provision’s unique “Culture of Care” experience.

The center has treated cancer affecting 53 sites in the body including head and neck, lung, esophageal, endocrine, prostate, breast, brain, bladder, sarcoma, tongue, lymph nodes, sinuses, bladder, eye and colon cancers as well as pediatric cancers.

Patients have come to Knoxville from 29 states and eight countries including the Netherlands, Taiwan, Mexico, Brazil and China. Thirty-four percent of patients travel to Provision Center for Proton Therapy from out of town, making East Tennessee home during their four-to-eight-week treatment while they experience our local and regional hospitality. More than 10,000 hotel room nights have been contributed to the Knoxville area since the center opened, greatly impacting the local and state economy.

Nearly 600 patients who graduated from treatment have now become Ambassadors—champions for Provision and proton therapy.

“With 1,000 patients successfully treated, we have established our reputation for excellence in medical treatment and customer care,” says Tom Welch, president of Provision Center for Proton Therapy. “Since we’ve opened our doors, many of the area physicians have seen the benefits of proton therapy for their patients and have continued to grow their support and involvement in our center. We are proud to have been the 13th proton center operating in the United States and excited to see that number grow to 22 in less than three years. Knoxville is very fortunate to be able to access this wonderful, proven treatment for cancer patients.”

Unlike conventional radiation therapy, which uses x-rays, protons deposit their energy in a specified location, treating the cancer and sparing the patient.  Provision features state-of-the-art technology including pencil beam scanning, which allows more precise targeting of the cancer, sophisticated treatment planning and management software and innovations such as SpaceOAR gel, which further protects vulnerable organs from radiation in prostate cancer patients.

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About Provision Center for Proton Therapy

Provision Center for Proton Therapy is the first cancer treatment center of its kind in Tennessee and only the third in the Southeastern United States.  Open to all credentialed physicians and health systems in the region, the Provision Center for Proton Therapy has three treatment rooms and is able to treat up to 900 cancer patients annually. The center utilizes intensity modulated pencil beam scanning, the most accurate proton beam therapy in the world. This advanced cancer treatment capability is available in only a handful of cities. Provision Center for Proton Therapy is one of only 17 proton therapy centers in the nation and 50 in the world.

Provision medical director speaks at ASTRO on benefits of SpaceOAR gel product

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Knoxville, TN (Oct. 19, 2015)—ASTRO Booth #250—Marcio Fagundes, M.D., medical director of Provision Center for Proton Therapy, will speak today in San Antonio, Texas, at the 57th annual meeting of the American Society for Radiation Oncology (ASTRO) on the results of using a product that helps protect prostate cancer patients from radiation exposure.

Six months after being the first proton therapy center to use SpaceOAR, more than 100 Provision patients have received the spacer, which fills the gap between the prostate and rectal wall, protecting the rectum from any minimal radiation exposure that may be incurred during treatment.

The injection replaces the familiar balloon once inserted into the rectum of men before being treated for prostate cancer. The one-time gel injection prevents irritation and injury that can occur with the daily balloon placement in addition to preventing longer-term impacts of treatment such as prostatitis. Following treatment, the gel simply is absorbed into the body and discharged in the patient’s urine.

Manufactured by Augmenix, Inc., SpaceOAR is the first product in the United States FDA-approved to protect the rectum in men undergoing prostate cancer radiotherapy. Provision Center for Proton Therapy began using SpaceOAR just a week after FDA approval. Provision now serves as a training center where the product manufacturer, Augmenix, brings physicians from other centers to learn the injection technique.

“We were the first center, and I was the first physician to be certified to use SpaceOAR in external beam therapy, once the product was released by the FDA” said Fagundes, a board certified radiation oncologist. “We were a pioneer in introducing this and it has proven to be highly effective for our patients.”

Seventy-year-old Frank Potts from Columbia, SC, the 100th patient to receive the spacer, said he was pleased Provision is using the hydrogel in lieu of the daily balloon procedure.

“I’m really, really pleased with the spacer,” Potts said. “I’ve had no discomfort, no problems. And to the extent that it’s a medical improvement over the balloon, I can’t imagine not doing it.”

About Provision Center for Proton Therapy

Provision Center for Proton Therapy is the first cancer treatment center of its kind in Tennessee and only the third in the Southeastern United States.  Open to all credentialed physicians and health systems in the region, the Provision Center for Proton Therapy has three treatment rooms and is able to treat up to 900 cancer patients annually. The center utilizes intensity modulated pencil beam scanning, the most accurate proton beam therapy in the world. This advanced cancer treatment capability is available in only a handful of cities. Provision Center for Proton Therapy is one of only 17 proton therapy centers in the nation and 50 in the world.

Provision and RaySearch partner on RayStation proton therapy training

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Provision and RaySearch partner on RayStation proton therapy training

KNOXVILLE, Tenn. (Oct. 18, 2015)—ASTRO Booth #250—Provision Healthcare is partnering with leading treatment planning software developer, RaySearch Laboratories AB, to offer new user education at the Provison Center for Proton Therapy’s state-of-the-art treatment and training facilities.

Provision was the first proton therapy center to adopt the company’s system, called RayStation, and has worked collaboratively with RaySearch since the launch of the Provision Center for Proton Therapy in January 2014.

“Over the past nearly two years, we have put RayStation through its paces, and we are pleased with the results. The physicists and medical dosimetrists who come for training will have a chance to learn from our clinical staff and see RayStation in action at a working medical center,” said Niek Schreuder, chief medical physicist for Provision Center for Proton Therapy. “Our world-class proton therapy facility plus a modern, fully-equipped training center will provide both classroom and hands-on instruction for the staff who will be working with patients and physicians in treatment planning.”

Trainers from Provision and RaySearch will conduct five-day training sessions, starting in January 2016, in both basic and advanced proton therapy planning.

“Although RaySearch provides planning training for our customers in our training center in New York, having a clinical site that can provide the entire spectrum of knowledge and experience is very valuable – especially a site like Provision that has been so successful in their implementation,” said Marc Mlyn, President of RaySearch Americas, the American subsidiary of RaySearch Laboratories AB.  “We are pleased to partner with the Knoxville team to offer such a high level of training.”

Because proton therapy is applied so precisely to a tumor, careful planning is essential to ensure the protons hit their target and to minimize damage of non-cancerous surrounding tissue. RayStation allows for detailed planning, while accounting for potential changes and needed adjustments over the weeks a patient undergoes treatment. Provision has experience in treating a range of tumor types and disease sites and will provide instruction in patient data management, patient modeling, planning and optimization, automated planning techniques and adaptive planning.

About Provision Healthcare
Provision Healthcare is a comprehensive healthcare group in the United States integrating clinical services, R&D, manufacturing, investment and a charitable foundation.  With an emphasis in cancer, Provision Healthcare is committed to providing cutting edge treatment, early detection and personalized care for cancer patients around the world.

About Provision Center for Proton Therapy
Provision Center for Proton Therapy is the first cancer treatment center of its kind in Tennessee and only the third in the Southeastern United States.  Open to all credentialed physicians and health systems in the region, the Provision Center for Proton Therapy has three treatment rooms and is able to treat up to 900 cancer patients annually. The center utilizes intensity modulated pencil beam scanning, the most accurate proton beam therapy in the world. This advanced cancer treatment capability is available in only a handful of cities. Provision Center for Proton Therapy is one of only 17 proton therapy centers in the nation and 50 in the world.

About RaySearch

RaySearch Laboratories AB (publ) is a medical technology company that develops advanced software solutions for improved radiation therapy of cancer. RaySearch markets the RayStation® treatment planning system to clinics all over the world. In addition, RaySearch’s products are distributed through licensing agreements with leading medical technology companies. RaySearch’s software solutions are used by over 2,500 clinics in more than 65 countries. RaySearch was founded in 2000 as a spin-off from Karolinska Institutet in Stockholm and the company is listed in the Small Cap segment on NASDAQ OMX Stockholm.

Eddie Check aims to honor a dad and save lives

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Kevin Kirkland was a high school senior on the football practice field when he learned his father, Eddie, had been diagnosed with late-stage prostate cancer. Four years later, his dad died from the disease. Kirkland doesn’t want anyone else to go through that experience.

Eddie Kirkland’s diagnosis was particularly difficult for Kevin because his mother had died a year before from breast cancer. Breast cancer was just gaining the public’s attention, while prostate cancer lurked in the shadows.

“Back in 1972, you didn’t hear people talk about prostate health, you didn’t hear people talk about PSA tests because there were no PSA tests,” he says. “I always said one day I wanted to do something that impacted men’s health like breast cancer awareness has impacted women’s health.”

More than 30 years later, Eddie Check was born. The program pairs free PSA tests for men with a Medic blood drive. The fi rst event in 2004 had  one Medic bus and did 50 PSA tests and collected 50 units of blood. At its beginnings, the initiative was called the Eddie Kirkland Memorial Blood Drive and Free PSA Testing Event Radio talk show host Phil Williams said ‘come get your Eddie Check’ on the air one year and the name stuck. The event is coordinated by Nisus Corp., where Kirkland now serves as president and CEO.

A year later, there was a second event, expanded to a second location. This year, there will be Eddie Check drives in 10 locations throughout eight East Tennessee counties. The initiative involves live radio shows on location  with partners including News Talk 98.7, WIVK and WNML and an annual blood drive contest with football fans at the University of Florida. Last year, the program collected 1,200 units of blood with more than 1,000 PSA tests conducted.

“All of a sudden it really started gaining its own strength and its own personality,” Kirkland says. “We’ve had tremendous support from the hospital community over the years. And then when Provision Center for Proton Therapy opened, they became our medical sponsor, and they’ve been an absolutely wonderful advocate and partner. And the Provision CARES Foundation now pays for all of the PSA tests.”

The event allows men, many of whom are hesitant to set up an annual physical exam, to get the PSA test for free while also performing a community service.

“Men don’t really like to go to the doctor, let’s just face it, they don’t,” Kirkland says. “With Eddie Check they can just stop by and get a free PSA test.”

For Kevin Wathen of Maryville, getting a PSA test through Eddie Check revealed what a recent trip to his doctor had not: an elevated PSA level. A follow-up biopsy with a urologist revealed that nine of the 12 samples tested positive for cancer.

“There were no symptoms to tell me there was a problem,” Wathen says. “If I hadn’t had the test done I wouldn’t have given it any thought.”

As a result of Eddie Check, Wathen learned of his diagnosis and became an early patient at Provision Center for Proton Therapy. There, his prostate cancer was treated with protons, a type of radiation that pinpoints a tumor and spares much of the healthy tissue around it. This reduces side effects such as incontinence and impotency as well as discomfort during the time of treatment. Wathen was one of the fi rst to receive hypofractionated proton therapy treatments at the center, a shortened, more intense course that allows therapy duration to be cut in half.

“It still doesn’t feel like I ever had cancer,” he says.

Wathen says he would recommend men of all ages taking advantage of the free annual PSA test, at least to establish a baseline for further testing.

“Especially with Eddie Check being available at no charge,” Wathen says. “I’d do it every year.”

As Eddie Check has grown and expanded, Kirkland says more men locally are becoming familiar with the risk of prostate cancer and how to keep tabs on their health. After 11 years of the Eddie Check program, men often approach him to discuss early detection.

“I think the education and the promotion we put out for prostate health have really resonated,” he says, adding that other programs coordinated by local hospitals and advocacy organizations have provided a boost to the most common of men’s cancers. “I think all of that has really improved education on prostate health. It has made us proud to be a small part of that.”

Provision | Scott Hamilton at Tedx KC

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Provision | Scott Hamilton at Tedx KC

KANSAS CITY, Mo. – He’s gone for gold and been the go-to in figure skating commentary, but now Olympian Scott Hamilton is trading in his ice skates for center stage.

“This technology right now needs a friend, a public friend that is going to stand up and talk about it,” said Hamilton.

Hamilton is a cancer survivor turned proton therapy advocate. In fact, he’s so passionate about the lifesaving cancer treatment that it’ll be what he talks about at his TEDxKC talk  Saturday.

WATCH: See Hamilton and 10 other speakers live at 5:30 p.m. Sat., Aug. 28

“When I’m doing a TED talk on a very scientific discussion, it’s kind of like I better stay in my lane here,” Hamilton joked. “Don’t wander off the path, don’t spend any time in the weeds; just stay on the path and go from A to B.”

In its seventh year, Kansas City’s TEDx is the largest in the country. Mike Lundgren, the creator of TEDxKC, said that’s for good reason.

“There’s a bit of a Renaissance that’s been going on here for a couple of years with arts and technology,” said Lundgren. “It’s a point of pride for Kansas City to have this thing that’s all about ideas and innovation, technology, some of the greatest things that are happening in the world. One of the largest events that happens in the world happened right here in Kansas City.”

And while the topics are as varied as the speakers, Lundgren said nearly everyone who attends leaves with new ideas that spark conversations.

“It’s the world’s doers and thinkers all coming together to talk about the things they are working on,” said Lundgren. “That’s really what TED is all about. It makes the world a little bit better place.”

The TEDxKC event in Kansas City is completely sold out, but that doesn’t mean you have to miss out. Watch it live at TEDxKC.org .

Lenoir City single mother fundraising after insurance won’t pay for proton therapy cancer treatment

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LENOIR CITY (WATE) – A single mother with four kids says she is at a crossroads after her insurance provider refused to cover her treatment.

Marla Cortez, 42, has an aggressive form of breast cancer, located right next to her heart and lung. Her oncology team prescribed proton radiation therapy, but unfortunately her insurance won’t cover the treatment. Cortez said she has appealed Aetna Insurance four times, but her only recourse is to pay $75,000 out of pocket.

“It’s very frustrating. You talk to everyone and they say tell you this is what you need. Then this insurance company, this big conglomerate, says no you don’t need it,” Marla said.

In March, a state Senate committee refused to act on a bill that would require health insurance companies to cover proton therapy treatment for cancer at the same levels it covers other radiation therapies. Knoxville’s Provision Center for Proton Therapy was behind the bill, but the insurance industry lobbied against the bill. That decision has left Cortez with very few options.

“We’ve been in this battle for a while even though proton therapy has been around for a long time. It’s probably more political than the technology itself,” explained Bill Hansen with the Provision Center for Proton Therapy, about how patients like Marla struggle to get covered by insurance providers.

“What we tend to see is that we treat a lot of children and older adults because Medicare covers it. So it’s been the people in the middle being denied this treatment,” he added.

The Lenoir City community has come together to help the single-mother raise money for treatment. Di’lishi, a new yogurt bar in Lenoir City created “Marvelous Marla Monday.” On Monday proceeds from yogurt purchased will benefit Cortez.

A friend of Cortez has also set up a GoFundMe page. The page has already received over $7,000 in donations.

“This is pretty overwhelming,” Marla said, about the community support.

Hansen says they’re pushing another bill in 2016 that would cover proton therapy for cancer patients.

Kentucky Family Seeks Out Proton Therapy in Knoxville

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As with all of her  children, it was when Linda Ferrell saw  the  first image  of her tiny daughter that it felt like she was really hers. That initial connection came not through a sonogram but a photograph of her fourth child, Emma, who made her entrance into the family from China a few months later.

“The picture is what’s pretty amazing,” says Linda Ferrell. “It was love at first sight.” Fifteen-month-old Emma joined a seven-year-old sister, also from China, plus two older brothers, Linda and husband David’s  biological children, to complete the family.  And life was good as Emma excelled in school, played softball, grew up.

Then in the spring of 2014 she got sick. There were headaches. She lost her voice. She lost 10 percent of her body weight. Her pediatrician kept insisting it was a virus. “That went on almost a month,” Linda says. When Emma was finally admitted to the hospital, an MRI showed a brain tumor encasing her entire left ventricle and making its way toward the right.

“You immediately think of the future — a future possibly without her,” Linda says. “But that is so brief. We’re a family that wants to find solutions, and we’re not going to waste our time crying. We’re going to find out how to help her. She didn’t deserve anything less than that.” Emma’s doctors didn’t mention proton therapy, but Linda did her research online and discovered it as a treatment option particularly ideal for pediatric patients. Unlike conventional radiation, protons deposit their energy directly at a tumor target, sparing much of the surrounding, healthy tissue — especially important for a growing, developing brain. Originally planning to travel to Seattle from Kentucky, she called Provision Proton Therapy Center and spoke with Dr. Matt Ladra about Emma’s tumor, which she describes as “relatively rare and very aggressive. One of the biggest reasons we chose Provision is that Dr. Ladra really did his due diligence,” Ferrell says. “He spent a lot of  time talking to experts who knew about Emma’s cancer.” He concluded she was a candidate for proton therapy.

First, there was surgery — which removed a “good portion” of the tumor. Six rounds of chemotherapy, followed with a subsequent highdose round in an attempt to further reduce the cancer cells remaining in her body. Then there was a stem cell transplant to boost recovery of her white blood cells. After this physical onslaught, including months spent in and out of the hospital, Emma and her Mom made the five-hour journey to Knoxville where they stayed for seven weeks of proton therapy  treatment at Provision Proton Therapy Center. Treatment at Provision provided welcome relief. Emma responded well to proton therapy, experienced only minor fatigue and retained a good appetite most of the time, gaining weight she had lost during chemo.

“It was pretty wonderful,” Linda says. “Emma’s been through quite a bit over the last year. With the treatment at Provision, it was pretty easy. I’m a huge advocate for proton therapy.” The Hospitality Department at Provision helped the Ferrells arrange their travel plans, suggested activities around town such as the Knoxville Zoo, and was there for them every step of the way during their stay in Knoxville. “The guidance that we received from everyone at Provision made the hardship of being away from home a little bit easier,” said Linda.

The road to recovery is not over yet. Emma still struggles with her appetite. This year she goes back to school, a process Linda knows will be challenging as she battles the lingering effects of chemo and a year practically lost because of her illness. But she has endured amazingly so far. “She’s stoic, she’s stubborn, and that’s really what got her through it,” Linda says. Unselfconscious over her scar and hair loss, through the surgery, chemo and physical challenges, ‘she never shed a tear,’ she says. The experience has brought the family closer, especially Emma and her older sister, Sarah, now 19 and a junior pre-med student. Since Emma got sick, Linda says, Sarah has decided to specialize in pediatric cancer.

With a diagnosis like Emma’s, “your whole life changes,”  says Linda. “It doesn’t end once you’re treated. We don’t know what the future’s going to bring. “But we’re so thankful to have her.”

Provision center perfect destination for doctor and his young patients

When Matt Ladra learned of the opportunity to practice radiation oncology at Provision Healthcare in Knoxville, Tenn., he was a bit skeptical. “I had been thinking about California,” his home state, Ladra said. But the avid outdoorsman, who’d never visited East Tennessee, didn’t realize how well it would suit him — both personally and professionally. “Provision is a pretty unique model for proton centers,” says Ladra, who came from a Pediatric Proton fellowship at Massachusetts General Hospital/Harvard Medical School. His experience also includes a master’s degree in public health and a research fellowship with St. Jude Children’s Research Hospital at a project in Rabat, Morocco. In 2005 he received the Arnold P. Gold Humanism in Medicine Award at Tulane School of Medicine for students who embody ideas and attitudes lending to humanism in medicine. Provision’s innovative approach to cancer care appealed to Ladra, whose experience includes a number of articles in peer-reviewed medical journals, particularly focusing on pediatric cancers. Proton therapy is recognized as a uniquely ideal alternative to conventional radiation for pediatric cancer, in which the goal is to spare as much of the child’s growing, developing body as possible from damage caused by the treatment. Protons, unlike x-rays, can be specifically targeted to a tumor, resulting in no exit dose of radiation to the patient and a reduction of the impact on healthy surrounding tissues and organs.

Ladra works with a patient’s primary care physician and pertinent specialists to obtain records and learn about the case. Then he takes time with each patient and his or her family to determine the best route of treatment. Ladra was the leading radiation oncologist in the care of Ehkam Dhanjal, a pediatric patient who traveled from England to Knoxville for proton therapy treatment of his brain tumor. In Dhanjal’s case, the consultation was done via Skype to limit the amount of travel time required for his family.

“We walked around the center with the computer so they could see everything,” Ladra says.

For pediatric patients in particular, Provision works closely with partner health care providers to ensure that all of their needs are met. Pediatric endocrinologists, medical oncologists, nephrologists and anesthesiologists are among those who become involved in children’s care.

“There’s a much more multi-disciplined approach with pediatric cases,” he says. Depending on the rarity of the cancer, he will consult with experts across the country to determine the best course of treatment for a particular patient. And, as it turned out, Ladra found Tennessee a pretty nice place to live, too. He enjoys weekends hiking and fly-fishing in the nearby Smoky Mountains, as well as the life-style of Knoxville’s vibrant downtown. He says patients appreciate Knoxville as an ideal place to come for treatment. For out-of-towners, it is easy to navigate and offers many options for recreation and relaxation when patients aren’t in treatment. When they are, he says, the ambience and friendliness of a smaller health care cam pus helps patients and their families feel at home. “Everyone makes them feel like they’re part of our family,” he says. “You can’t beat that.”

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Provision’s proton center treats 500th patient

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When Lou Lovingood, a 63-year-old grandmother from Sweetwater, was diagnosed with breast cancer earlier this year, she didn’t shed a tear.

Those came, she said, after receiving the first letter from her insurance company denying coverage for proton therapy, a type of radiation treatment that targets a specific location while minimizing damage to surrounding tissue and organs.

“It was the first time I had cried after all of this, after I got my first denial,” said Lovingood, who has now been denied twice and is appealing to her insurer again.

Lovington had lumpectomies in both breasts after her diagnosis, and completed her 33rd and final proton treatment Thursday at the Provision Center for Proton Therapy. She was the center’s 500th patient, and used the spotlight during a special celebration to share her insurance story.

“My diagnosis today could be yours tomorrow,” she said. “We want the best level of care for everybody. If there is something better that’s out there, we should have the right to it. We have to stand up and use our voice to say, ‘You can’t treat us this way.'”

Lovingood, co-owner of Sweetwater Insurance Agency, used savings put up for retirement to pay for the treatment. Others, she said, may not be so fortunate.

For the past two years, Provision has unsuccessfully prodded the state Legislature to get involved in getting proton therapy covered. The most recent bill called for proton to be covered by insurers at the same levels it covers other radiation therapies.

Insurers have argued that the more-expensive treatment isn’t cost effective and is not necessarily better than traditional radiation therapies.

Provision opened in January 2014 and is treating about 80 patients a day with proton therapy. More than 44 different cancers in various locations have been treated.

It also now has pencil beam scanning in all three of its treatment rooms, giving physicians more-precise capability, said Bill Hansen, vice president of business and strategic development at Provision Health Partners.

Looking ahead, Provision plans to continue to expand into different disease sites and offer more trials with some other newer treatment techniques.

Lovingood, for example, is the first person the center has treated for bilateral breast cancer.

“We’re trying to treat as much cancer as we can as noninvasive as possible,” Hansen said. “More time and energy is going to be spent in early detection, free screenings and finding programs that can match up.”

 

Men should have open dialogue about screening, treatment for prostate cancer

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Image by: Thomas Wells | Buy at photos.djournal.com

Prostate cancer survivor Dick Guyton anticipates he’ll be taking care of business for a long time. The 75-year-old executive director of the Elvis Presley Birthplace will mark the one-year anniversary of completion of his cancer treatment next week.

“It was scary, and it scared me,” Guyton said.

But after being diagnosed in May 2013, Guyton found a way to get past his fear and find the best treatment option for him. After careful research and consultation with physicians, he chose proton therapy, a type of radiation therapy at a Knoxville, Tennessee center.

“This was my first experience with cancer,” Guyton said. “It’s important to gather all the options from multiple sources.”

After skin cancer, prostate cancer is the most common cancer among U.S. men. The American Cancer Society estimates more than 220,000 new cases of prostate cancer will be diagnosed in 2015, and it will kill nearly 28,000 U.S. men. The walnut-size gland that makes a component of semen is located just underneath the bladder. If prostate cancer is found before it spreads to distant parts of the body, the five-year survival rate is nearly 100 percent. It’s extremely rare for men under 40 to develop prostate cancer, but the risk increases substantially as men age. African-American men and men whose fathers or brothers developed prostate cancer are at increased risk.

“It’s more common after the age of 50,” said Tupelo urologist Dr. Hughes Milam. “It’s most common in men in their 60s.”

Screening Debate

Universal prostate cancer screening recommendations – which apply to men with no symptoms of prostate problems – continue to be a topic of much debate. The American Urological Association, American Cancer Society and Mayo Clinic continue to recommend screening with prostate specific antigen test, commonly referred to as the PSA, and a physical exam. The urological association guidelines call for men to be screened between ages 55 and 70 if they have more than a 10-year life expectancy. Screening for people at higher risk should be individualized. The U.S. Centers for Disease Control currently recommends screening only for men at high risk for developing prostate cancer. U.S. Preventive Services Task Force discourages the use of PSA screening in the general population, and men and their physicians should go forward with screening only after a comprehensive discussion. The PSA blood test is very good at detecting changes in an antigen associated with prostate problems; however, it can’t distinguish between cancer and other prostate conditions.

“It’s a simple test,” Milam said. “It’s a complicated analysis when it comes with what to do with the results.”

The blood test can’t differentiate between aggressive and slow-moving malignancies; that requires a biopsy. Urologists usually look closely at how the PSA results have changed over time when considering a biopsy. If the biopsy finds cancer, it can be difficult for patients to opt for watchful waiting, even if the results indicate a slow-growing tumor.

“When I tell a patient they have cancer, it’s like telling them they are on fire,” Milam said. “They want a fire extinguisher.”

Even though the PSA has limitations, Milam feels screening is saving lives.

“In the 1980s, we didn’t have prostate cancer screening,” Milam said. “When patients did present, they usually had metastatic disease, and there wasn’t much we could do for them.”

With the advent of the PSA blood test in the 1990s, cancers were found earlier and the survival rates shot up dramatically. However, because prostate cancer often moves very slowly, concerns about overtreatment of cancers that would have remained silent have led some public health organizations to change their recommendations on universal screening.

Treatment Options

Once prostate cancer is diagnosed, men and their physicians have a number of tools to consider. Generally, men who are diagnosed at the earliest stages have the most options.

“We try to customize the treatment plan to the patient,” Milam said.

Watchful waiting: Depending on the results of the biopsy, watching to see how the prostate cancer develops may be the recommended course of action. Some prostate cancers grow so slowly they will never cause any symptoms in a man’s lifetime. Usually, men are followed with a PSA and exam every three to four months, Milam said.

  • Pros: None of the complications or side effects connected with other treatments.
  • Cons: May need a repeat biopsy; long-term worry over cancer.

Surgery to remove prostate gland: Men can opt for an open procedure or a laparoscopic surgery using a surgical robot. It’s very effective at removing localized cancer. There is a shorter hospitalization and less bleeding with the minimally invasive procedure, but otherwise, the outcomes and complication rates are similar, Milam said.

  • Pros: Cancer is definitively removed.
  • Cons: Irritation of the nerves can cause incontinence and erectile dysfunction that may take from weeks to months to improve.

External beam radiation: This is one of the most common choices for treatment, especially for men in their 70s and 80s. A linear accelerator is used to target the tumor.

  • Pros: Cure rates similar to surgical treatment.
  • Cons: Radiation usually requires 30 treatments, usually done five days a week. It can irritate the bladder and the rectum, although those side effects are typically not permanent. Erectile dysfunction can develop gradually after the treatment.

Internal therapy: This allows physicians to treat prostate cancer from the inside. Brachytherapy uses radioactive seeds inserted with needles to deliver radiation inside the prostate. Cryotherapy uses a similar technique to brachytherapy but delivers very cold gases to freeze the tissue in the prostate.

  • Pros: Less invasive than surgery.
  • Cons: These procedures are typically reserved for men with smaller prostates. Requires spinal or general anesthesia. Can cause problems with bladder and rectum. Cryotherapy has a higher rate of erectile dysfunction than surgery.

 

Guyton’s Experience

Guyton settled on proton therapy – a form of radiation therapy – after consulting with his Tupelo urologist and a Birmingham surgeon and doing extensive research.

“I knew I didn’t want surgery,” Guyton said, because of the rates of problems with incontinence and erectile dysfunction.

Proton therapy is delivered in a similar way to external beam radiation, but the protons don’t release their energy until they reach the target, minimizing damage to healthy tissue. Proton therapy was first used to treat cancer 25 years ago, but it is still a relatively new option for prostate cancer. Currently, there are fewer than 20 centers offering proton therapy around the country. The research is still ongoing to see how proton therapy compares to traditional treatments for prostate cancer, Milam said. It remains much more expensive than other treatments and patients must travel to receive it. For Guyton, Medicare and his supplement covered the cost of the procedure. Because his brother lives in Knoxville, he didn’t have the extra living expenses others would face. The procedure was a success for Guyton. He had no side effects and his PSA levels are essentially zero.

“It’s an eerie feeling to know I had cancer and that 12 months later, I don’t have it,” Guyton said.

After his experience, Guyton is an advocate for annual screening and for wider access to proton therapy.

“I would like to see more conversations about proton therapy,” he said.

 

 

This article is from the Northeast Mississippi Daily Journal in Tupelo, MS.