Berks County Medical Society Medical Record Fall 2019 - 24

m E d i C a l r E C o r d F E at u r E

Advances in

Oncology
Care
by Marc A. Rovito, M.D.
Penn State Health St. Joseph Cancer Center

A

effects.

S we move forward in our care of cancer patients, new
technologies and treatments are becoming available that
offer our patients better outcomes with potentially fewer side

We have come a long way from Dr. Farber's lab in Boston in the
'40s, Hallstead's surgeries at the turn of the century, and cobalt used
to treat with radiation. Our surgeries are more refined, as we have
found that less is more in certain circumstances. Radiation now is
delivered with such focus that in many cases the surrounding tissues
are spared and such high doses can be achieved per treatment that
the number of treatments can be reduced from 30-40 down to 3-5.
Chemotherapy conceptually hasn't changed much, but the drugs are
more effective, combinations are of drugs more active, and toxicities
are more manageable.
We typically think of the 3 pillars of cancer care...surgery,
radiation and chemo. There now is a fourth. Immunotherapy has
joined the therapeutic armamentarium, and I don't remember a time
when a single drug has gain such rapid approval for such a large
array of tumors as Keytruda has in its relatively short lifetime.
Berks County has the benefit of having two sophisticated
health systems, Tower and Penn State Health St. Joseph, that
have incorporated many of the advances necessary to offer to our
community the state of the art care that it deserves...to stay at home
and to be treated at home.

24

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Radiation
The advances in radiation oncology that have occurred in the last
year include implementation and utilization of the Varian Tru Beam
system. The advantage of this Tru Beam is that it is Varian's most
advanced system. It includes respiratory gaiting, which allows for
motion relative to breathing and so limits the dose to surrounding
tissues. It has the Rapid Arc system, which reduces the time for
the patient to be on the table. In addition, it works in conjunction
with the Calypso system. This system is primarily used for prostate
cancer treatment. It relies on a radio wave emitting beacon inserted
by ultrasound guidance into the prostate. The Calypso system uses
essentially a GPS to locate the position of the prostate, irrespective
of slight motion, to guide therapy...again with the intention of
pinpointing the tumor to deliver radiation more specifically to the
tumor. It integrates with the Tru Beam and together they make
a formidable therapy for prostate cancer. Of course, the system
includes the Stereotactic Body Radiotherapy capabilities, which
allow pinpoint treatment and therefore less treatment to a tumor.
In addition, it has the capability of performing Stereo Radiosurgery,
which allows the same technique to be used for the brain lesions that
occur commonly in cancer patients.


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Berks County Medical Society Medical Record Fall 2019

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