Stereotactic body radiation therapy (SBRT), also known as stereotactic ablative radiotherapy, or stereotactic ablative body radiation (SABR) precisely targets tumors with very high doses of radiation.
SBRT is used to treat smaller tumors. Among these are many types of primary tumors, often prostate cancer, lung cancer and kidney cancer.
In addition, doctors use SBRT to treat tumors that have spread, or metastasized, from another site. This includes oligometastatic disease, in which a patient has just a few metastatic spots. In these cases, SBRT may halt further spread of metastatic disease.
Patients may choose SBRT instead of surgery in some cases. This lets them avoid a hospital stay, a recovery period and other aspects of a surgical procedure. The treatment also may be an option for those who are not healthy enough for surgery.
One common side effect of SBRT is fatigue. Other possible side effects depend on the tumor’s location. For example, a patient with an abdominal tumor may have SBRT-related gastrointestinal problems. A patient with a tumor near a bone could experience bone damage.
How does SBRT work?
SBRT uses several radiation beams of various intensities aimed at the tumor from different angles.
This requires one or more sessions of treatment planning. During these sessions, the patient will undergo a CT, MRI and/or other advanced imaging techniques. Doctors use these images to precisely map the position and shape of the tumor. They then create a customized treatment plan that determines beam angles and intensities.
If the tumor is in or near the lungs the care team will also make a time-lapsed video of the patient breathing. The doctor will use the video to factor motion into the treatment plan. Patients may be asked to hold their breath for short periods while the video is being created and during treatment.
The care team will also create a mold of the patient’s body near the tumor site. The mold places the patient in a position that makes treatment most effective. It also holds the patient still during treatment, ensuring the tumor gets the full dose of radiation while sparing nearby healthy tissue.
After planning, patients undergo between one and five SBRT sessions. Sessions take place either once a day or once every other day. Most sessions last about one hour.
I started using cigarettes in the early 1970s, when I was just 16. I smoked a pack a day for more than 35 years. I didn’t quit until my granddaughter was born in 2009. Even so, somehow I never thought I’d get lung cancer. When you’re young, you feel invincible. And later, you think it’s never going to happen to you.
I don’t think that way anymore. Because I’ve been diagnosed with stage I lung cancer three separate times since I stopped smoking. The first time, I had a golf ball-sized tumor in my right lung. The last two, I had tiny nodules in my left lung.
The only treatment I’ve ever had for any of them is a kind of radiation therapy called stereotactic body radiation therapy (SBRT). But it’s done the trick every time. And MD Anderson has kept me going with that therapy alone for more than seven years.
My first lung cancer diagnosis
The first time I learned I had lung cancer was in the summer of 2013. I’d started feeling some weird chest pains. I knew something was wrong, because up until then, I’d been pretty healthy. A local nurse practitioner who is also a family friend ordered an X-ray. That’s when I found out I had lung cancer.
I’ve lived in the greater Houston area all my life, so I was aware of MD Anderson’s reputation. I knew I wanted to go there for my lung cancer treatment. That was especially true after a doctor near my home in Beaumont suggested the complete removal of my right lung as my best option. That just sounded crazy to me, so I made an appointment at MD Anderson. A few days later, I made the hour-and-a-half-long drive to the Texas Medical Center.
My lung cancer treatment: Stereotactic Body Radiation Therapy (SBRT)
At MD Anderson, I met with thoracic surgeon Dr. Reza Mehran. After confirming my diagnosis, he discussed the best possible treatment options for me with some of his colleagues, including a thoracic radiation oncologist. Initially, they thought I might need surgery. But finally, they decided SBRT would be a better fit. It focuses the radiation directly on the tumor itself, to minimize damage to any healthy tissue around it.
As it turns out, my doctors were right. I had four days of SBRT starting on Sept. 12, 2013. And it worked so well, I didn’t need surgery, chemotherapy or anything else.
The first SBRT treatment kept me cancer-free until 2016. Then, doctors found another tiny nodule in my left lung during a routine checkup. I had another four days of SBRT to treat it, and was cancer-free until this past January. My doctors, who now include radiation oncologist Dr. Joe Chang, prescribed another four-day round of SBRT to treat the new nodule.
It wasn’t until I had a routine CT scan just before starting the next round of SBRT treatment that I learned I also had COVID-19. Dr. Chang thought the images looked suspicious for the coronavirus, so I was sent for an emergency COVID-19 test. My diagnosis was confirmed the next day. My case was so unique that Dr. Chang reported it to the Journal of Thoracic Oncology.
MD Anderson helped me recover from COVID-19 and lung cancer
I never dreamed that whatever I had going on was COVID-19. It sapped my energy and appetite for a few days, but aside from that, it felt just like the allergies I’d had my whole life. Looking back, I probably caught the coronavirus at a concert back in mid-March. We didn’t know the importance of social distancing and wearing masks at that point.
The safety precautions MD Anderson took not only helped me to recover fully. They also protected other patients and employees from COVID-19. That was a real comfort to me.
Life after COVID-19 and lung cancer
Today, I just feel extremely lucky. Not only because I survived COVID-19, but because I’m still here, even after three bouts of lung cancer.
I still have about 10 more tiny nodules in my lungs that my doctors are watching. But those spots haven’t changed in years. And my doctors assure me that even if those nodules turn into cancer someday, I still have plenty of treatment options. So, I can’t complain.
My doctors at MD Anderson are the experts. I trust their judgment. And that gives me a lot of confidence.
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