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Departmental News & Highlights

 

July 2, 2004:

New Technology Brings Hope To

Patients with Inoperable Tumors

 

OMAHA, Neb. – The diagnosis of an inoperable brain tumor doesn’t have to mean certain death.  A spinal tumor does not have to mean paralysis and a tumor that pushes on the auditory nerve doesn’t have to mean a life of silence.  Instead, patients like 41-year-old Doug Reedy are finding options in technology, and hope at The Nebraska Medical Center. 

         

When he first heard he had a large brain tumor, Reedy said he “just shut down.” He was told his only chance was an invasive and dangerous brain surgery that could lead to a stroke, blindness and possibly a coma. 

 

A second opinion led Reedy to The Nebraska Medical Center and where he found a second option in the Novalis radiation therapy system, which became available to patients in May. 

 

“There’s always got to be an option,” Reedy said.  The Novalis system is a good one for Reedy who says he has not suffered any side effects from the therapy.

 

“Novalis uses multi-directional radiation beams that shape a three-dimensional volume of radiation dose around the tumor while avoiding critical structures that may surround it such as the optic nerve in Mr. Reedy’s case,” said Robert Thompson, M.D. medical director of radiation oncology at The Nebraska Medical Center, which is one of only 21 Novalis treatment sites in the country and the only place in the region to offer this state-of-the-art technology.

 

Dr. Thompson says Reedy has probably had the tumor for as long as 20 years and while it is not cancerous, it is dangerous.

“The tumor is about the size of a large egg. It is compressing the hypothalamus and threatening his vision as well as the brain’s blood supply,” said Arun-Angelo Patil, M.D., neurosurgeon at The Nebraska Medical Center.

 

Reedy has lost sight in his left eye and the vision in his right eye is impaired. But since starting treatment about a month ago, he says he is seeing some signs of improvement.

Another patient, Chrisie Butler, was being tested for multiple sclerosis when doctors found the unexpected.

 

“There is a walnut-sized tumor at the base of Chrisie’s skull,” said Britt Thedinger, M.D., an otologist-neurotologist at The Nebraska Medical Center.  “Surgery to remove the benign tumor carries serious risks like injury to the nerves controlling hearing, balance, voice, swallowing and shoulder movement.”   

      

In Chrisie’s mind those risks were too high.  Reluctantly, she scheduled the surgery still hoping for another option.  Then she got a call from neurosurgeon George Green, M.D., telling her to cancel the surgery, he found a better option while training on the Novalis at UCLA.

 

“Novalis offers several different options for shaping the radiation dose.  The ability to deliver the treatment in several fractions (treatments) instead of a single one can very significantly reduce the risk of side effects in many cases,” said Charles Enke, M.D., Chairman of radiation oncology for the University of Nebraska Medical Center. With Novalis Chrisie has experienced sporadic headaches and an occasional metallic taste in her mouth.

 

“This is a piece of cake compared to surgery,” Chrisie said.  She has a better than 70% chance that the tumor will stop growing and even shrink without damaging her cranial nerves.  Those are odds she’ll gladly take, “if it works, I don’t have to have that surgery,” she says.

 

The Novalis system by Brain Lab is the most innovative and advanced option available to treat tumors of the brain, head, neck, spine, liver, lung and prostate without harming surrounding healthy tissue.  This sophisticated approach to stereotactic radiosurgery and radiotherapy is quickly becoming the standard of care for advanced cancer treatment. 

 

“Gamma knife has been available for decades as a way of delivering focused radiation in a single treatment,” Dr. Enke explained. “Novalis can treat any clinical problem that the gamma knife can treat, but the converse is not true.  For example, Novalis can treat areas in the skull base that gamma knife cannot reach. It can deliver a single fraction dose when appropriate but also has the ability to deliver fractionated treatment which may be desirable in certain clinical applications. In addition, Novalis is FDA approved to treat locations anywhere in the body while gamma knife is strictly limited to the brain and skull,” he said.  

 

What makes it so appealing to patients is the non-invasive delivery of a precise dose of high-energy radiation, which can shrink or control the growth of a tumor by killing tumor cells or interfering with their ability to grow.  It is virtually painless; the patient remains awake throughout the procedure, which is usually performed on an outpatient basis.

 

Reedy said he was thrilled when he heard about this option.  “I was walking on air when I left the hospital that day,” Reedy recalled.  His wife Stacy said, “It was like music – it was too good to be true.  I thought it can’t be this easy!”

 

Both Chrisie Butler and Doug Reedy have been able to continue working full-time and enjoying their homes and families.  Both are thrilled to have an option that wasn’t available to them a couple of months ago. They say the fact that they are among the first patients in the region to undergo Novalis radiation therapy can only be described as “a God thing.”

 

January 21, 2002:  NHS Week Publication; Volume 3, edition 42:

"Radiation Oncologists Make Patients Wish Come True" 

At a time of year when most of us wanted to be home with our families, shopping, baking or celebrating with friends, members of the NHS Radiation Oncology team were here, trying to make a difference in someone’s life by making his Christmas wish come true.  The person with the wish was Patrick Meehan. On Sept. 18, 2001, Meehan a corporate attorney from St. Petersburg, Fla. was diagnosed with head and neck cancer after a routine dental check-up. To tackle the cancer, he had surgery at the University of Southern Florida, Moffett Cancer Center and then investigated his options for radiation treatment.  He was consulted for radiation oncology at both the Moffett Cancer Center and at the University of Florida, Gainseville before he decided to come to NHS for Intensity Modulated Radiation Therapy (IMRT). NHS is the only facility in Nebraska and one of only a few in the Midwest to offer patients IMRT, a highly sophisticated new technology of radiotherapy. IMRT enables the radiation oncologist to improve radiation targeting of tumors regardless of their size or shape. This improved targeting technique allows the radiation to attack the cancer without damaging nearby healthy tissue and organs.  Meehan had discovered that NHS had the state-of-the-art technology and that Weining Zhen, M.D., is an expert in head and neck radiation oncology. His decision was simple.

 

He wanted the best treatment and he has family in Omaha, so NHS was the place for him. “I talked to Dr. Zhen and was impressed that he made himself accessible to me,” Meehan says. Meehan and Dr. Zhen, assistant professor of Radiation Oncology and Otolaryngology—Head and Neck Surgery, then met to compare traditional radiation treatment with IMRT treatment. “IMRT is more comprehensive and is seemed like a clear choice to me,” Meehan says.  Meehan arrived in Omaha on Oct. 25 and began his treatments. While he was here receiving a course of 35 radiation treatments his wife who stayed in Florida, was diagnosed with breast cancer. Although Meehan wasn’t scheduled to finish his radiation treatment until after Christmas, he desperately wanted to be home for Christmas to be with his wife and children. Dr. Zhen and the Radiation Oncology staff decided that with some adjustments, his treatment could be completed by Christmas. Dr. Zhen and radiation therapists, Tanya Custer, Kellie Ferguson and Roxane Tangeman came to work on three consecutive Saturday’s especially to give Meehan his treatment. “As far as finishing his treatment before Christmas, that was the least I could do to help him,” says Dr. Zhen. “I’m glad he tolerated this treatment.”   With their extra efforts, Meehan was able to make it home for the holidays. Meehan made it home on Dec. 24.  This is an exemplary example of NHS employees “being there” for a patient.  “It makes me proud to have these people as part of our staff,” says Ann Yager, manager, Radiation Oncology. “We deal with cancer patients all day long every day and they each have a heartbreaking story behind them. We have to teach ourselves to not get too personal and yet, when there is truly something we can do to make a difference, everyone is in line to volunteer to do so.”    Dr. Zhen agrees. “I’d like to praise the radiotherapists here at the NHS,” Dr. Zhen says.

 

“They’re truly wonderful and highly appreciated by my patients. They provide our patients with comforts, dignity and hopes. They always go above and beyond.”  Meehan feels the same way about NHS and the Radiation Oncology staff.

 

“I would absolutely recommend NHS to others needing this kind of treatment,” says Meehan. “I was very impressed with the caring nature, professionalism and humanity of the staff. Dr. Zhen is just out-of-this-world and has outstanding bedside manner. He took the time to listen. He doesn’t dictate his patients, he listens.”  Although it was a lot to take at one time, Meehan leaned on his parents who live in Omaha and “we got through it,” he says. He’ s now at home and feeling better and is taking medication for the pain. He recently started back on solid foods. His wife had a mastectomy and is doing well. “There wasn’t any spreading of the cancer to her lymph nodes so she doesn’t need further treatment,” Meehan says. “We’re very blessed.”  “I sometimes take this kind of special performance for granted because I feel the entire Radiation Oncology staff has made this type of action the normal standard of care,” Yager says. “I truly work with an extraordinary group of people.”   

 

November 29, 2000 :  NHS/UNMC Press Release:  New Weapon in the Fight Against Cancer Brings Nebraska Health System Patients New Hope.  Click here for IMRT News Information.

 

August 4, 2000:  Attached is the AAPM write-up for Dr. Komanduri for his Fellowship Recognition: 

 

    "Komanduri Ayyangar received his Ph.D. degree in Nuclear Physics from Andhra University, India in 1965.  He became an NIH fellow and worked with Dr. Gordon Brownell at Massachusetts General Hospital.  He received his Clinical Medical Physics training at Thomas Jefferson University Hospital in 1975 and was board certified in Radiological Physics in 1978.  He is currently a Professor at the University of Nebraska Medical Center.  He has been active in teaching graduate students in Medical Physics.  Dr. Ayyangar's achievements are in the areas of 3D pencil beam modeling for electron beams and the development of Monte Carlo based treatment planning for Stereotactic Radiosurgery.  He participated in TG23, TG37 and the Rules Committee of the AAPM.  He is a Physics Advisory Editor of Medical Dosimetry and an associate editor of Indian Journal of Medical Physics.  Dr. Ayyangar has published over 62 papers in peer reviewed journals and 30 papers in proceedings and book chapters"

 

We congratulate Dr. Komanduri on this fellowship award and recognition..

 

July 10, 2000:  The Department of Radiation Oncology welcomed Dr. Weining (Ken) Zhen and Darren Gearheart (Medical Physicist) to UNMC/NHS.  Dr. Zhen has extensive experience in Head & Neck cancers and is very knowledgeable in IMRT applications and treatments.  Darren joins the physics section after recently graduating from the University of Kentucky, with a masters degree in Medical Physics.  Both additions are representative of the high quality of expertise the Radiation Oncology Department has on hand.

 

May 5, 2000:  Ayyangar Komanduri, Ph.D. Medical Physicist has been elected as a Fellow of the American Association of Physicists in Medicine (AAPM).  This recognition is for his accomplishments to the medical physics field in radiation oncology.  Dr. Komanduri will be presented with his Fellowship Award at the AAPM Meeting in Chicago on July 25, 2000.

 

February 1, 2000:  Charles A. Enke, M.D. has formally been named Professor and Chairman of the Department of Radiation Oncology.  Dr. Enke's interim status has been changed with this formal appointment.

 

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