Ultrasound-Based Radiation Treatment Provides Exciting,
New Alternative for Prostate Cancer Patients
An ultrasound-based radiation treatment now being used at the University
of Nebraska Medical Center/Nebraska Health System offers prostate cancer
patients a new treatment option which could increase the cure rate for
patients with advanced disease by up to 30 percent by allowing for safe
delivery of higher therapy doses.
Called BAT (B-Mode Acquisition and Targeting), the new system allows
the radiation oncologist to use ultrasound to precisely target prostate
cancer tumors and thus deliver higher doses of radiation to the tumor with
less risk of damaging healthy surrounding tissues. The BAT unit, which
is located at NHS Clarkson Hospital, is one of only 15 such units in the
country and the only one in Nebraska.
“This is a major breakthrough for prostate cancer patients,” said Charles
Enke, M.D., professor and chairman of the Radiation Oncology Department
at UNMC and an NHS physician. “This is new technology that can help many
men diagnosed with prostate cancer.”
With BAT, the patient is positioned on his back on the treatment table,
which is the same position used for treatment. The physician or trained
therapist scans the patient’s lower abdomen using an ultrasound probe to
locate the prostate. This provides a three-dimensional view that will show
the therapy staff the exact location of the prostate gland. The BAT then
calculates and communicates this location to the treatment machine for
the necessary adjustments to more precisely target the prostate.
“The location of the prostate gland changes each day, depending on how
full the patient’s bladder and rectum are,” Dr. Enke said. “By giving us
the exact location of the prostate on a daily basis, BAT allows us to do
a more precise radiation treatment.”
By being better able to target the tumor, the radiation oncologist can
increase the radiation dose, Dr. Enke said, which results in improved cancer
control. The standard dose for treating prostate cancer is 6800 to 7000
centigray. With BAT, the radiation oncologist can safely deliver 7500 centigray
of radiation.
“Best of all, you can deliver this additional radiation without causing
injury to the rectal or bladder tissue that is in close proximity to the
prostate,” Dr. Enke said. AWithout BAT, you are putting the patient at
greater potential risk for a variety of health problems such as bladder
and rectal injury.”
The best candidates for being treated with the aid of BAT are patients
with the more aggressive form of disease, whose cancer has spread just
beyond the prostate or who have a Prostate Specific Antigen (PSA) level
of 10 nanograms per milliliter or higher or a Gleason’s score of 7 to 10.
“For these patients, a 20 to 30 percent improvement in the PSA relapse
free survival rate has been observed with doses of 7500 centigray or higher,”
Dr. Enke said. ABAT allows us to reach those doses with greater safety.”
Prostate cancer is the most common type of cancer found in American
men, other than skin cancer. The American Cancer Society predicts there
will be about 180,400 new cases of prostate cancer in the U.S. in 2000.
About 31,900 men will die of the disease this year. More than eight out
of 10 men with prostate cancer are over the age of 65.
“BAT is very patient friendly,” Dr. Enke said. AEach BAT localization
takes 5 to 7 minutes, which is immediately followed by the radiation treatment.
Patients will experience minimal — if any — discomfort.” Patients typically
receive daily treatments on weekdays over the course of an eight-week period.
Dr. Enke stressed that the ultrasound procedure is done on the lower
abdomen and doesn’t involve the use of a rectal probe, which can cause
discomfort for patients. For more information on the BAT procedure, call
the UNMC/NHS Radiation Oncology Department at (402) 552-3844.
The BAT system was purchased with funds from the Charles W. and Margre
H. Durham Excellence in Medicine Fund, which was established in 1998 when
the Durhams made one of the largest gifts ever to benefit UNMC and its
College of Medicine. It provides the financial support needed to expand
research and education programs in three key areas B prostate cancer, arthritis
and minimally invasive surgery.
UNMC is the only public academic health science center in the state.
Through its commitment to research, education, outreach and patient care,
UNMC has established itself as one of the country’s leading centers for
cancer research and treatment, solid organ transplantation and arthritis.
During the past year, nearly $31 million in research grants and contracts
were awarded to UNMC scientists, and UNMC’s funding from the National Institutes
of Health increased by 28 percent, going from $16.2 million to $20.7 million.
UNMC’s educational programs are responsible for training more health professionals
practicing in Nebraska than any other institution.
NHS is the partnership of the former Clarkson Hospital, the first hospital
in Nebraska, and the former University Hospital, the primary teaching facility
for UNMC. The combined hospital is a 685-bed facility and serves approximately
25 percent of the Omaha-area market. NHS operates clinics and health care
centers serving Omaha, Plattsmouth and Auburn in Nebraska; and Council
Bluffs and Shenandoah in Iowa. In addition, NHS physicians operate more
than 300 outpatient clinics in 100 communities in four states. NHS provides
access to tertiary and primary care including world-class specialized treatment
such as solid organ transplantation, burn care, wound care, geriatrics,
bone marrow (stem cell) transplantation and other cancer treatments.