Patient Care: Feature
Annual Report - 2005-2006
Innovations in Patient Care
As their research colleagues are working to develop therapeutic drugs on the molecular level, M. D. Anderson physicians also are using something bigger than genes and molecules to treat patients with cancer.
They are using technology. In just one year, M. D. Anderson brought online the most advanced form of radiation therapy and surgical instrumentation, which will help physicians deliver safer, more efficient care and improve the outlook for patients.
Protons — tiny, but powerful
M. D. Anderson’s new Proton Therapy Center began treating its first patients in spring 2006. The most precise form of radiation therapy, proton therapy uses a pencil-beam nozzle for scanning the proton beam throughout a tumor. To date, it has proven most effective for treating cancers of the prostate, eye, lung, brain, head and neck, and cancers in children.
“With proton therapy, we’re able to increase doses of radiation, preserve healthy tissue and treat more patients much more successfully,” says James Cox, M.D., head of the Division of Radiation Oncology.
Protons differ from traditional X-ray treatment because they deposit the highest dose of energy when they come to a stop at a target in the body, yet have a very low dose of energy when they enter, and have no dose at all beyond the target. In addition, patients don’t feel anything during proton therapy treatment, and because of the minimal effect on healthy tissues, they experience few, if any, side effects.
“This differentiation gives radiation oncologists greater control and effectiveness in directing and depositing high levels of destructive energies at a tumor,” Cox says. “There’s a broad range of patients who will be treated with proton therapy. They’ll be selected very carefully, based on the criteria that their tumor needs a high dose and it’s close to sensitive normal organs.”
However, conventional radiation therapy remains a proven and vital cancer treatment and most often will still be the preferred radiation treatment, adds Cox, who is grateful for the generous philanthropic support of the Proton Therapy Center, including commitments of $500,000 or more from The Baldwin Sanders Moore Family Fund, The Brown Foundation, Inc., and The Hamill Foundation.
A deluxe suite
M. D. Anderson’s new BrainSuite offers one of the world’s most advanced technologies, integrating the latest surgical and diagnostic tools in one operating room.
“It brings together in one place everything it takes to maximize our ability to remove a brain tumor,” says Raymond Sawaya, M.D., chair of the Department of Neurosurgery.
The high-tech operating room combines intraoperative magnetic resonance imaging with image-guided surgical systems and data management technologies to give neurosurgeons better information during surgery for the safe and precise removal of brain tumors. This includes ceiling-mounted cameras that provide the surgeon with updated images on huge video display panels.
“It’s another great tool to use in our battle against brain tumors,” according to Jeffrey Weinberg, M.D., assistant professor in the Department of Neurosurgery. “This technology helps surgeons home in on the tumor while avoiding critical brain structures, thus reducing the kinds of neurological deficits that lead to impaired quality of life.”
Patients with large, deep-seated skull base tumors will benefit most from the precision offered by the BrainSuite.
With the help of a $500,000 gift from Mr. and Mrs. William J. Dorè Sr., Sawaya says the BrainSuite will break new ground in brain tumor treatment and research. “This is a very smart, very well-designed system that will enable us to help many patients and increase our teaching and clinical research capabilities.”
In 2006, M. D. Anderson began MINTOS, or Minimally Invasive and New Technology in Oncologic Surgery. Led by Surena Matin, M.D., associate professor in the Department of Urology, the program’s first installation of technology was the da Vinci Robotic Surgical System.
This new technology allows a robot to perform surgery while the surgeon sits in the same room at a remote console, guiding the robot’s actions. The console has an opening for the surgeon’s face to view the surgical field through three-dimensional imaging.
At the console, the surgeon places his or her hands into loops — one for the thumb and one for the index finger. Then, as the surgeon’s human hands move, the very tiny robotic “hands”mimic the action on a smaller scale inside the patient.
The robot, placed at the patient’s side, has four arms: three instruments to grasp, lift, cut and sear tissue, and one for the camera. Each arm is inserted in the patient through a small incision or port. Assistants stand by to change instruments on the arms and make adjustments throughout the procedure.
The robot can’t be programmed and requires that every surgical movement be performed with direct input from the surgeon.
Advantages of the system for the surgeon include the three-dimensional images that the camera provides, along with seven degrees of movement and no risk of hand tremors. Patient benefits may include less risk of infection, blood loss, scarring and pain, as well as shorter hospital stays and recovery time.
While the system initially will be used for urologic procedures, there are plans for its use in treating gynecologic, thoracic and head and neck cancers.