by
Gus Iversen, Editor in Chief | April 03, 2015
From the March 2015 issue of HealthCare Business News magazine
Getting started, he says they were unsure what their patient population was going to look like and what disease sites they would be treating most frequently. As those patterns have emerged, other concerns have been happily put to rest.
“We were wondering: Is the machine going to operate at full capacity? And do we have a patient load and referring physicians to keep it in use?” says Bradley, “The answer to both was ‘yes.’”
Experience has also informed the way they utilize radiation therapy using X-rays and protons. “I recently treated a patient with a mediastinal tumor directly behind the sternum, and I decided to mix X-ray and protons so that I could reduce the skin surface dose and reduce the chance that the patient would have skin burns,” says Bradley. Bradley says that technique can be credited to his accumulating hands-on experience, and also applies to head and neck patients. “Their tumors are right beneath the skin surface and so sometimes we’re using mixed beam combinations to reduce the skin surface dose a bit,” he says.
Protons in an X-ray world
The benefits, and unobtrusive nature, of proton therapy may be remarkable news to many candidates for treatment, but for physicians like Bradley they’re fairly well understood. For them, the mysteries around proton therapy may primarily be of a logistical nature.
“I know a lot more about the ins-and-outs of dealing with each individual insurance company with respect to proton therapy than I did before,” says Bradley. In some cases, he and his colleagues draft two different patient plans, one utilizing X-rays and another utilizing protons, to illustrate the benefits to payors. “It doesn’t always work, but it is a means that we use to show that the patient would benefit from protons.”
Within Bradley’s radiology network they perform radiation therapy on 14 linear accelerators, and the importance of those systems is not undermined by the addition of the MEVION S250. “We have a Gamma Knife unit for brain cases, we have linear accelerator for lung and liver stereotactic radiosurgery — and that hasn’t changed,” says Bradley.
He says having only one proton room, (traditional proton centers have multiple) makes his facility extra selective when determining which patients will be treated with it. “We’re getting children referred from all over the region who would have been treated closer to home with X-ray therapy,” says Bradley, who emphasizes the importance of utilizing the system where it can provide the greatest clinical benefits.
