Headlines

As reported by Hartford Magazine, July 2010.

Targeted Radiation

By Carol Latter

Two years ago, UConn men’s basketball coach Jim Calhoun learned from his doctors at UConn Health Center in Farmington that one of the lymph nodes in his neck was cancerous. It was a dangerous situation, since cancer can spread quickly once it reaches the lymph nodes.

A decade ago, he may have been forced to undergo chemotherapy or radiation, and endure the debilitating and lingering side effects — nausea, stiffness, fatigue, loss of sensation, and even permanent damage to his saliva glands.

Instead, Calhoun underwent surgery to remove the tumor, which left him with 68 stitches from his ear to his Adam’s apple. Then UConn medical staff used TomoTherapy, a machine that targets radiation treatments to very precise locations, minimizing damage to surrounding, healthy tissues.

Calhoun, who visited the hospital five days a week for a total of 36 treatments, would lie inside the machine for 35 to 40 minutes, wearing a mask to protect his face. Now, he is cancer-free. If standard radiation had been used, he said, “there would have been much more damage to the saliva glands, throat and other parts of my body.” After the treatment, “I couldn’t taste very well, but I didn’t walk out feeling as if I had been fried.”

Dr. Robert Dowsett, the hospital’s division chief of Radiation and Oncology, said a traditional radiation machine radiates around the patient, with the person in a fixed position. Designers of TomoTherapy “decided it would be desirable to attack the tumor from every angle,” with a computer able to change the shape, intensity or angle of the beam at any second. That approach has made it possible to thoroughly treat the tumor, while avoiding nearby bodily structures.

Because the radiation technology is built within a CAT scan frame, “the machine can go into CAT scan mode before every treatment” to help determine precisely which area needs to be treated.

While viewing the CAT scan onscreen, doctors can click the image to tell the computer to move the platform inside the machine as little as a couple of millimeters in order to line the patient up perfectly. “Then the machine cranks millions of permutations to determine what strength and angle [of radiation beam] will do the job.”

He said TomoTherapy may not necessarily be any more comfortable for the patient than traditional radiation treatments, “but it’s better for long-term recovery and functioning. In the case of head and throat cancer, there are fewer effects on the swallowing musculature, and in prostate cancer, the bladder and rectal irritation is now minimal. In brain cancer cases, it helps us in trying to avoid the brain stem and optic nerves, which are critical structures.”

He acknowledged that a number of the newer, high-end conventional radiation machines have improved to the point where medical staff can shape the beam and vary the intensity— and some have appendages allowing CAT scans to be performed. But compared to TomoTherapy, he believes, “nothing is as good.”

Dr. Dowsett, who completed his medical training in 1991, said he considers the TomoTherapy machine “an amazing engineering feat. Never in my wildest dreams did I think I’d be doing something like this.”