The Best Up and Coming Radiation Therapy / Cancer Treatment Centers

Imaging Technology News has published a list of the top 10 Radiation Therapy Centers “To Watch” in its July/August 2009 issue. While some radiation therapy centers (such as M.D. Anderson, Memorial Sloan-Kettering, Mayo Clinic) are well-known, well-established leaders and probably not soon to be overtaken in rank, this list of radiation therapy facilities proves that some lesser known and/or smaller centers are both thriving and ambitious–providing first-rate patient care with cutting-edge technology. Rankings were made based on “forward-thinking” (i.e. centers that are using advanced techniques and technology in patient care), innovation, operational efficiency, patient service and teamwork as well as reader nominations. The list of 10 radiation therapy centers is not ranked, however, but instead presented in alphabetical order and divided into two groups–with one group being labeled “Honorable Mention.”

Here are the centers that made the list:

1. Allegheny General Hospital (Pittsburgh, PA)
2. Barnes-Jewish Hospital (St. Louis, MO)
3. Booker Cancer Center (Red Bank, NJ)
4. Emory Department of Radiation Oncology, The Emory Clinic (Atlanta, GA)
5. Wake Forest University Department of Radiation Oncology (Winston-Salem, NC)

Honorable Mention:

1. Barbara Ann Karmanos Cancer Center (Detroit, MI)
2. Decatur Memorial Hospital (Decatur, IL)
3. CentraState Medical Center (Freehold, NJ)
4. Lynn Cancer Institute of Boca Raton Community Hospital (Boca Raton, FL) 
5. Renown Institute for Center (Reno, NV)

For descriptions of each therapy center and why they made the list, check out the full article at http://www.itnonline.net/node/33519/

Recent NRC News Stresses Importance of Radiation Safety Officer Duties

If you are a medical physicist who is also serving as the Radiation Safety Officer for your institution, it’s a good idea to take your responsibility as the RSO seriously and to give a higher priority to your duties as an RSO over your other responsibilitites as a medical physicist. “The NRC must be able to rely on individuals assigned to performing key safety functions at NRC-licensed facilities,” said Mark Satorius, Regional Administrator of the NRC Region 3 office in Lisle, Illinois. He continues: “A radiation safety officer is in the front line of ensuring the safe use of nuclear materials. It is a big responsibility and needs to be taken seriously.” These statements were published in a recent NRC press release dated July 31, 2009. The Nuclear Regulatory Commission staff has issued a confirmatory order to a radiation safety officer at the Department of Veterans Affairs Center in Lexington, Ky for failing to implement the radiation safety program in accordance with federal regulations. For details on the story you can click on this link:

http://www.nrc.gov/reading-rm/doc-collections/news/2009/09-024.iii.html

Medical Physicist Jobs Board Now Functional

Just a quick note to let you know the mdphysics job board for medical physics jobs is now functional and will be updated several times a week. The job board includes not only medical physicist jobs, but also health physics and dosimetry positions. Feel free to post jobs to the board using the link at the bottom of the job board page (the link is located below all the listings). Please pass along the link to anyone you know who is hiring medical physicists and would like to post their listing.

NRC: Recent Gamma Knife Misadministration

On July 27, 2009, the NRC reported that there has been a medical event at the Gamma Knife Center of the Pacific in Honolulu, Hawaii in which a patient received more than the prescribed dose of gamma radiation to two areas of the brain. Next week, the NRC is conducting a thorough inspection of the medical event, and the full report of the inspection will be available in about 1-2 months.

When the inspection report is completed and issued, it will be interesting to learn the licensee’s root cause and not only what steps were taken by the licensee to prevent such an incident from recurring, but also whether such steps are deemed adequate by the NRC. 

While news of misadministration is always scary and unfortunate, there is always a lesson to be learned by everyone to prevent a similar event from happening at any treatment center.

You can read the official NRC press release here:
http://www.nrc.gov/reading-rm/doc-collections/news/2009/09-027.iv.html

A link to the final inspection report as well as a follow-up post will be on this site when the NRC releases the report.

Prostate Seed Implant, IMRT or SBRT for Prostate Cancer Treatment?

Recently, a dear friend of mine, a scientist, called and told me he had been diagnosed with early stage prostate cancer and needs to undergo radiation therapy for his treatment. His physician had gave him three options: prostate seed implant (PSI), Intensity Modulated Radiation Therapy (IMRT), and Stereotactic Body Radiation Therapy (SBRT) via Cyberknife. He asked me for advice. I gave him my thoughts, but didn’t recommend one particular option over another; I told him he should make his final decision with his physician. Regarding PSI versus IMRT, I referred him to my post on mdphysics.com without getting into the specifics over the phone. I also brought up the same point left by a recent commenter (medphysphd) that uncertainty in treatment planning exists with all the treatment modalities. However, the human error will be higher in PSI than other modalities. Regarding choosing IMRT over SBRT/Cyberknife (or vice-versa), below is a summary of what I told my friend. I am also posting this here as a response to the recent comment left by a reader inquiring about this very issue: Read more

Medical Physics Calendar / Events

Just a quick post to let you know that there is now a medical physics events calendar on this site marking important dates (for conferences, annual meetings, workshops, symposiums, continuing education, training, etc). The link to the calendar is in the navigation bar at the top of the site. You can also access the medical physics calendar by clicking on the link below:

Medical Physics Calendar of Events

Medical and Graduate School Are Not the Same!

A little fun for the weekend…Have you ever wondered what if would be like (or what it would have been like, for some of us older medical physicists) if you had gone to medical school (pursued an MD) rather than graduate school to get a PhD? I know I have–more than once! That’s why I found the following blog post rather interesting (and entertaining). If you want to know the difference from someone who’s been through both grad school and medical school, go to this link and find out!

http://www.mudphudder.com/2009/07/an-apt-comparison/

Wireless Dose Verification System for Cancer Patients

The DVS-HFT (Dose Verification System) is the first wireless and implantable dosimeter system. The device was developed by Sicel Technologies, Inc. In March 2009, Sicel Technologies, Inc announced that it had received clearance from the U.S. Food and Drug Administration to begin marketing the DVS-HFT for measuring actual radiation dose at the tumor site when treating breast and prostate cancer patients undergoing external beam radiation therapy. The company also makes and markets OneDose, patient dosimetry verification systems specifically designed for radiation oncology therapy (we use them in our cancer center). DVS-HFT is specifically used for higher radiation doses over fewer treatments. This technique is called Hypo-Fractionated Therapy (HFT) and is highly effective in treating certain tumors.

“The DVS-HFT is an important advance in hypo-fractionated therapy, because physicians can now confidently determine the prescribed dose has been accurately delivered throughout the course of treatment, which is a key determinant in the long-term successful treatment of a tumor,” said Arnold Malcolm, MD, Associate Professor Vanderbilt Center for Radiation Oncology. “This device may actually accelerate the use of hypo-fractionated protocols, like those being adopted for treatment of prostate cancer, which may offer benefits across the healthcare spectrum.”

For further clinical use, technical understanding, reimbursement information, etc. go to:
http://www.siceltech.com/DVSSmartMarker/index.html

Photos from HealthyLiving (Summer 2009) published by the Boca Raton Community Hospital

IMRT – IGRT – SBRT

IMRT – IGRT – SBRT: Advances in the Treatment Planning and Delivery of Radiotherapy (published by Karger in 2007 and edited by John L. Meyer) is Volume 40 of the Frontiers of Radiation Therapy and Oncology series. Recently, I had the opportunity to review this book and found it to be an excellent reference that offers a guide to the new technologies of radiotherapy and their major applications in the modern radiotherapy clinic. Whether you are a newcomer to the profession of medical physics or a seasoned veteran of the field, reading this book–whether in part or in entirety–would be an asset for your professional advancement since many modern radiation oncology facilities offer the technologies covered in this book for cancer treatment.

The book is a practical resource and its scope encompasses several areas of concurrent development that have advanced in the field. It covers not only explanations and discussions of the techniques and technologies (IMRT and IGRT), but also applications of these technologies in the clinical setting (such as in the treatment of breast, head and neck, and prostate cancers) as well as guidelines for their current clinical use. The last section, 75 pages, is devoted solely to SBRT (Stereotactic Body Radiation Therapy)–from basic concepts to clinical application. The book is expensive but comparable to other high quality educational and/or clinical reference texts available on the market.

Also, just FYI, as of a few minutes ago, Amazon.com was indicating that there are only 3 more copies of IMRT, IGRT, SBRT: Advances in the Treatment Planning and Delivery of Radiotherapy left in stock (but with more on the way!).

For further information on this or other volumes of books in the Frontiers of Radiation Therapy and Oncology series, go to www.kargar.com/frato.

NYT on Prostate Seed Implants

There was an interesting article in the June 20, 2009 issue of the New York Times on Prostate Seed Implants gone wrong at the V.A hospital in Philadelphia. I had expressed concern over the potential inaccuracy of implant placements in a previous article on MDPhysics, but never imagined the degree of error that occurred at this particular brachytherapy program. I cannot fathom how a team of professionals can make such disastrous errors (over and over again). You can read the full article here.

Also, it’s worth mentioning the NYT had a neat graphical “tutorial” on prostate seed implants for the layperson who wanted to know how the procedure is performed. Check it out here.

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