Posts Tagged ‘Oncology’
HOPE
The Randolph Cancer Center has been awarded the Hematology & Oncology Practice Excellence (HOPE) Award for Expense Control by Hematology & Oncology News & Issues magazine.
This award signifies Randolph Cancer Center as a leader, both administratively and clinically, among the cancer center practices of its size in the country.
The HOPE Awards recognize and advance excellence, and help practices gauge its success. In cooperation with corporate partners and sponsors, the awards are a part of a three-year initiative designed to encourage the development of practice standards of excellence in community-based cancer treatment centers.
The three main goals of the initiative are to identify measurable business standards, quantify a set of criteria within each standard that can be applied across practices and recognize the practices that exhibit excellence among its peers.
Randolph Cancer Center received this award for its focus on Electronic Medical Records (EMR) implementation, workflow analysis and staff accountability. Adoption of EMR and moving toward a paperless system has been common among HOPE award winning facilities.
EMR calculates the medicine dosage, length of time given and provides alerts for medical conflicts. While chemo volumes increased by 36 percent during the first three months of operation at Randolph Cancer Center, EMR had a large impact on decreasing nurse charting time.
Volume increases also led to the need for a workflow analysis, or the process by which patients were scheduled. After examining the EMR system, they determined most patients could bypass check out.
“Our new process eliminated patient wait time, which increased patient satisfaction and allowed us to maintain one staff position for scheduling,” said Stacey Bannister, executive director of Randolph Cancer Center. “This year we decided to hold each person on the team accountable for finding at least one cost saving idea. We didn’t focus on the amount of savings but rather getting 100 percent to participate in seeking ways to reduce expenses.”
To read the remainder of this article, please continue to: http://www.randolphguide.com/business/local_story_205091706.html
Live Premiere: Cancer Treated with Radiation Therapy
James J. Urbanic, M.D., a radiation oncologist, and Carnell J. Hampton, Ph.D., a physicist at the Comprehensive Cancer Center at Wake Forest University Baptist Medical Center, will use the most advanced linear accelerator to treat lung cancer.
Elekta Axesse™ image guided linear accelerator offers highly-accurate targeting of tumors and lesions virtually anywhere in the body. Typically requiring only one to five treatments, it achieves excellent results in fewer treatments than required by standard radiotherapy.
“Axesse raises our technological and treatment capabilities to an even higher level,” said Urbanic, lead physician on the Axesse team. “We are able to deliver higher and more conformal doses of radiation to the target in fewer fractions than with conventional radiation therapy techniques.”
For patients, that means more convenience and a faster return to their daily activities.
The Axesse combines three-dimensional image guidance with highly conformal beam shaping and robotic 6D patient positioning to deliver fast, effective and accurate treatments.
“Even the slightest patient misalignment can impact the accuracy of a dose,” said Urbanic.
With Axesse, the unit’s built-in CT imaging can allow for targeting accuracy within just a couple of millimeters. This ability to precisely conform the dose to the size and shape of the target offers clinicians the confidence to treat targets more aggressively while avoiding healthy tissue and critical structures.
Radiation therapy with these techniques is a treatment modality for a wide range of cancers including lung, prostate, head and neck, esophageal, spinal cord, pancreatic, liver metastases, recurrent gynecologic cancers, bone metastasis and adrenal cancer.
Very few areas of medicine are changing faster than cancer care and Seattle physicians and researchers are leading the way.
A patient with pancreatic cancer at the Swedish Cancer Institute (SCI) recently became the first person in the United States to be treated with a new technology known as Volumetric intensity Modulated Arc Therapy (VMAT). VMAT cuts radiation treatment times by one-half to two-thirds through delivering a higher and more targeted dose to cancerous tumors, without compromising patient safety. To date, more than 10 patients have been treated with VMAT at the Swedish Cancer Institute. They have included patients with tumors of the brain, abdomen and pelvis.
“VMAT allows the delivery of higher radiation doses with greater precision. We will kill more cancer and patients will have fewer side effects,” said Vivek Mehta, M.D., director of SCI’s Center for Advanced Targeted Radiation Therapies.
Faster treatment times often mean improved comfort for patients, making it easier for them to remain still during the process. For the first VMAT patient, total treatment time was less than 10 minutes. More important, Dr. Mehta’s team was able to greatly reduce the radiation exposure to surrounding sensitive areas – including the spinal cord, left and right kidneys and the liver.
Dr. Mehta is the principal investigator on a VMAT clinical study that will last approximately six months and involve at least 20 separate patients. Part of the study’s purpose is to prove definitively that VMAT is both faster and safer than the existing treatment approach.
With VMAT, Swedish clinicians are able to treat more patients with complex cancers than they could in the past. That includes those who have had radiation therapy previously with limited success and patients with tumors adjacent to critical structures in the body. Also, the technology should benefit patients who find it difficult to lie completely still for the typical 30 or more minutes of treatment time.
Dr. Mehta estimates that 10 percent to 15 percent of people now treated at the Swedish Cancer Institute will be good candidates for VMAT.
Swedish clinicians are working closely with VMAT developer Elekta. “I believe we were chosen as the first North American site because Swedish has a proven track record of innovation in cancer care,” Dr. Mehta said. “Medical manufacturers often come to SCI’s Center for Advanced Targeted Radiotherapy with novel ideas and we select the technologies that have the greatest potential to improve treatment and save lives.”
What’s on the horizon?
Dr. Mehta believes the next innovation will be some form of adaptive radiotherapy. By borrowing software from other disciplines, clinicians may be able to see the results of the radiation therapy within 30 to 60 seconds and adapt their treatment plans instantly. Instead of viewing an image of the tumor in week one of treatment and not again for the typical six weeks, physicians could make near real-time corrections to both radiation targeting and dosage.
“We can cure about half of the patients we see, many of whom have very serious cancers. That is far better than a generation ago, but we need to keep improving outcomes for the other 50 percent,” said Dr. Mehta. “As the largest and most comprehensive cancer treatment program in the Pacific Northwest, that is our sole mission.”
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Oncologist – A doctor who specializes in the treatment and prognosis of cancer. Oncologists may be specialists in particular areas such as chemotherapy, radiation or surgery.
Oncology – The study of diseases that cause cancer.
MOSAIQ Oncology EMR
EMR brings to the practice. Does the EMR yield a return that provides equal or greater value to the business? An oncology executive describes how a nine-physician comprehensive oncology care center implemented an oncology-specific EMR and achieved significant positive ROI.
This guide contains information on frequently asked questions and information on the treatment process. While this information will not necessarily correspond to the exact process adopted by an individual hospital, we hope it will provide general background information and an indication of a typical treatment process.
Who will be looking after me?
A specialist cancer doctor is known as a radiotherapist or radiation oncologist. In this guide we will refer to him/her as an radiation oncologist. The radiation oncologist will plan and oversee your treatment, which will be carried out by radiation therapists. In addition, the team looking after you may include nurses, health care assistants, specialist nurses, counsellors and dietitians, according to your needs during your treatment.
What is radiation therapy?
Radiation Therapy is the treatment of cancer with radiation. This can be done in a variety of ways, depending on the nature of your cancer. The most commonly used method is called external beam therapy (from a machine outside the body), which directs radiation at your tumor.
How does radiation therapy work?
Radiation Therapy Treatment Process
Although the radiation affects both cancer and normal cells, it has a greater effect on the cancer cells. Treatment aimed at cure will give the highest possible dose of radiation to the cancer area (within safe limits) to attempt to kill all the cancer cells. Sometimes smaller doses are used, where the aim is to reduce the size of a tumor and/or relieve symptoms.
How is the treatment planned?
Every course of radiation therapy is designed to suit the particular needs of the person receiving it, so you will usually be asked to make a preliminary visit to the treatment center to have your course of treatment planned. The radiation oncologist and radiation therapists will do this (in conjunction with x-rays and scans, using a machine called a simulator). Your skin will be marked with coloured pens to define where you will have your treatment. In addition, some minute permanent marks will be made using a special dye and a tiny pin prick.
These marks will enable the radiation therapists to identify exactly the right area at every treatment session. If a head shell has been made for you the guidance marks will be put on the shell rather than on your skin.
If you are having radiation therapy to your mouth and/or throat you will need a dental assessment at this stage as you may require some dental treatment before you start your radiation therapy.
How is radiation therapy given?
Radiation therapy is given using either a machine called a linear accelerator or, for some skin tumors, a superficial x-ray unit. To receive the radiation therapy, you will lie on a couch under the machine, and be asked to remain still during the actual treatment.
Will the radiation therapy hurt?
Radiation Therapy Treatment Process
No. The treatment is completely painless. Radiation cannot be seen or felt while it is being given.
Will the treatment make me radioactive?
No. There is no possibility of this whatsoever.
How long will the course of treatment last?
Your radiation oncologist will tell you this once the appropriate treatment for you has been decided. A course can last for anything from a single treatment to five treatments a week for six weeks depending on a number of factors, e.g. the part of your body being treated and the aim of the treatment. Most treatments are carried out daily between Monday and Friday.
How long is each treatment session?
This varies from machine to machine. Some machines operate at a faster rate than others, and it also depends on the plan worked out for you. The length of a treatment session can be anything from five minutes to fifteen minutes. Occasionally a session may take longer, but this will be explained on an individual basis. When you come for your first treatment your radiation therapist will tell you how long each session will take.
Do I have to stay in hospital?
If you are able to travel to the hospital for treatment there is usually no need for you to be admitted during the course. Most people are treated as outpatients, but your radiation oncologist will tell you if it would be better for you to be admitted.
Will I have any tests during treatment?
Radiation Therapy Treatment Process
During your course of treatment, you may need to have occasional blood test and/or urine test, depending on the part of your body being treated. Some people also have X-rays and/or scans during their course of treatment, which is part of the routine and nothing to worry about.
Are there particular things I should or should not do during my course of treatment?
As far as possible throughout your treatment, try to lead a normal life – try to think of the radiation therapy as an interruption to your daily routine rather than as the most important part of your day. However, the following tips might help:
Do
* Drink plenty of fluids every day during treatment, e.g. tea, coffee, milk, fruit juice, water or fizzy drinks (ideally sugar-free).
* Eat regularly and try to keep a balanced diet. If you don’t feel like big meals, try eating little and often. The dietitian can help to plan a diet for you if necessary.
* Wash, shower or bath as normal during treatment using a simple or baby soap taking care to pat dry the area being treated, rather than rubbing it.
Do Not
* Drink spirits, eat spicy food or very hot or very cold food if you are having treatment to your mouth, neck or chest, but ask the radiographers if you would like more information.
* Expose the treated area to the sun during a radiation therapy treatment course, as the treated area will burn more easily and take some time to heal. In the future it is advisable always to apply sunscreen to avoid sunburn.
* Put creams or deodorants on the treated area as these may worsen your skin reaction.
Am I likely to have any side effects?
Radiation therapy is a localized treatment, which means that any side effects will depend on the part of the body being treated. Although many people have few, if any, side effects, everyone reacts differently and during your treatment you may experience one or more of the following:
* Tiredness:
Radiation Therapy Treatment Process
You may feel tired and lethargic during your treatment and especially towards the end of the course and after it has finished. This is very common, and can last a variable length of time. If it happens to you, pace yourself and rest as much as you feel you need to and gradually the tiredness will pass, although it may take a long while.
* Tender skin:
During your treatment and especially towards the end of your course, your skin in the area being treated may turn red, like mild sunburn, and tenderness and redness may even increase for a week or two after your treatment has finished (this is because the tissues continue to be affected by the x-rays for several weeks after treatment.). It will gradually recover, but the nurse or radiation therapist treating you will explain exactly how you should look after your skin, during and after your course of treatment.
* Sickness:
Depending on the part of your body being treated you may feel nauseous or be sick during your course of treatment. This does not happen to everyone. If you do feel sick, please tell your radiation therapist or nurse as it can be controlled by tablets or diet.
* Diarrhoea:
Again, depending on the part of your body being treated, you may experience some diarrhoea. Please tell your radiation therapist or nurse if this happens to you as you may need diarrhoea-relieving medication.The dietitian will also be pleased to advise you and help you with an eating plan if necessary.
* Frequency when passing urine:
If you are having treatment to your lower abdomen/pelvis you may find that you pass urine more often and may experience discomfort when doing so. Drinking extra fluids will help, but try to avoid alcohol, tea and coffee as these can irritate your bladder. If this happens to you please tell the staff treating you, so that your urine can be tested for any infection,which could then be treated with appropriate medication.
* Sore mouth and throat:
This only happens if you are having treatment to this part of your body. If it is likely to be a problem your radiation therapist or nurse will explain how to look after your mouth and throat, or give you advice on chewing and swallowing difficulties. This only happens if you are having treatment to this area. If it is likely to be a problem, your radiation therapist or nurse will explain to you how to look after your mouth and throat during treatment.
* Hair loss:
Hair loss only occurs where treatment is given. For example you will only lose the hair on your head if your head is being treated, and if your chest is being treated, then you will only lose your chest hair. Whether or not it grows again will depend on how much radiation you have been given. Your oncologist will explain what this means for you. If your hair is expected to grow again, this should happen within a few months of the end of your treatment.
Can I carry on working?
If you feel you wish to carry on working, as long as your radiation oncologist reason why you should not continue with your normal daily course of treatment. However do ask if you need advice.
What will happen when the treatment is finished?
Radiation Therapy Treatment Process
The immediate side effects of the treatment described above will start to ease off within a week or two of the end of your course. Because of the way radiation therapy works, the full benefit of the course of treatment is not usually reached until some weeks after the last treatment session.
Will I have any check-ups after my treatment?
After your treatment, you will be seen again at the hospital you first attended or be referred back to your Family Doctor. The first follow-up is often about 4 to 6 weeks after the course has finished, and this appointment will be discussed with you before you finish at the treatment center. However, follow-up arrangements can vary from person to person and from centre to centre. Your radiation oncologist will explain to you how and where your follow-up appointments will be arranged.
Can radiation therapy cause permanent damage?
Radiation therapy treatment is planned and delivered with the utmost care, but sometimes sensitive parts of the body are damaged. This is because to treat the cancer effectively, it is sometimes necessary to use high doses of radiation, close to the limits that normal tissues can withstand. The bowel, bladder and nervous system are particularly sensitive, but other parts of the body can suffer long term changes.
If you are having radiation therapy aimed at killing your cancer cells, there is about a 5% possibility of side-effects which may seriously affect your lifestyle. However, it is important to balance this against the much higher potential risks to your life, from the cancer getting worse or recurring without the treatment. On the other hand, if you are having radiation therapy to shrink the tumour and/or relieve symptoms, then the much lower doses of radiation used are unlikely to cause any permanent damage.
If the radiation therapy treatment includes the gonads (ovaries in women, testicles in men) this will affect fertility and hormone function. It is important to discuss this with your oncologist before treatment begins.
If you do have any difficulties at any time in the future which you feel may be connected with your radiation therapy, then do not hesitate to contact your oncologist or GP. If there are any special risks or problems in your case then your oncologist will discuss this with you. Bear in mind that you are being offered radiation therapy because the benefits greatly outweigh the risks.
Acknowledgments
This guide is taken from a booklet produced by the Lynda Jackson Macmillan Centre for Cancer Support and Information in collaboration with Mount Vernon radiation oncologists, other health care professionals, patients and carers. Elekta wish to thank the Lynda Jackson Macmillan Centre for Cancer Support and Information for their kind permission to reproduce this information.
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Twitters from Elekta – News and Twitters from the Oncology and Neuroscience World
Leading cancer centers in Moscow and Siberia to receive Russia’s most advanced stereotactic radiotherapy system.
Two of Russia’s leading research centers, The Meshalkin Research Institute of Circulation Pathology (NRIBCP, Novosibirsk, Russia) and the Hertzen Moscow Oncology Research Institute (MORI, Moscow, Russia), have purchased Elekta Axesse™ systems which will, for the first time in Russia, allow clinicians to treat cancer tumors throughout the body with ultra-high precision while minimizing damage to surrounding healthy tissue.
Elekta Axesse will help us to build the one of the most advanced cancer centers in Russia,” says Professor Alexander M. Karaskov, Director of the Meshalkin Research Institute. “The system combines speed and accuracy with the ability to target tumors throughout the body.”
Elekta Axesse will be delivered with the latest technology, Elekta VMAT (Volumetric Modulated Arc Therapy), which enables faster treatment time and more accurate targeting of the dose. Hertzen MORI will be the first clinic in Russia to provide this technology to patients.
“The system will enable us to attain very-high precision and accuracy for every patient, in many cases sub-millimeter. This is specifically important in treatment of difficult sites such as lung or liver,” commented Professor Anna Boyko from MORI. “The advanced 3D imaging capabilities of Elekta Axesse facilitate rapid, precise targeting of tumors, and the highly-conformal radiation delivery system effectively treats tumors while minimizing damage to a patient’s healthy tissue.”
This advanced technology is delivered with MOSAIQ®, the most advanced integrated suite of Electronic Medical Record (EMR) software in oncology; which enhances workflow, improves productivity and simplifies medical record accessibility throughout the department.
“Software support for efficient workflow is a key component in a treatment system and MOSAIQ, along with the entire software package supplied by Elekta, is second to none. In a clinical setting, the system manages documents, patient and user schedules and imports treatment plans into the EMR as well as verifies and records the treatment delivered, all handled from one integrated user environment. This definitely helps to streamline clinicians’ workflow, ultimately saving precious time,” says Dr. Olga Efimova, NRIBCP’s Head of Radiosurgery.
Generally, on the opinion of Professor Andrey Chernichenko, President of the Russian Association of the Therapeutic Radiation Oncologist (RATRO), “such sophisticated equipment will open new era for all Russian oncology – high precision, super effective irradiation for many ‘social important’ tumors.”
Elekta Axesse - world’s most complete portfolio of stereotactic treatment solutions for the treatment of cancer and diseases of the brain, spine and body.
- Largest Neurosurgical Center in Russia Acquires Elekta’s Leksell Gamma Knife Perfexion February 6, 2012Russia’s first Leksell Gamma Knife® Perfexion™ system has found a home at the renowned N.N. Burdenko Neurosurgical Institute, just a five-minute car ride from Moscow’s Red Square. On June 2, 2011, a 59-year-old woman was the first Perfexion patient, receiving Gamma Knife® radiosurgery to treat tumor tissue that remained following open surgery. Now, eight mon […]
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