Revolutionary technologies have not only changed our everyday world, they are also transforming the lives of cancer patients at Greater Baltimore Medical Center's Sandra & Malcolm Berman Cancer Institute.
New methods of screening and diagnosis are providing earlier and more accurate detection. And breakthroughs in treatment have eliminated much of the negative impact earlier procedures once had on patients' health and well-being.
"In the past, the goal was to attack the tumor no matter what, because you were trying to save somebody's life," said Michael Stein, executive director of oncology services at GBMC. "The technologies now are also concerned with the patient's quality of life during treatment and afterward."
State-of-the-art screening and diagnosis
At GBMC, cancer care starts with innovative new tools for early detection. "The goal is to diagnose the cancer as early and as accurately as possible," Stein said. "Then physicians can better match the therapy to the patient."
One of the most exciting diagnostic developments is breast tomosynthesis, better known as 3-D mammography. It provides images in multiple 1-millimeter "slices," where traditional mammography gives only front and side views. 3-D imaging identifies tumors and their locations more precisely, reducing the number of false alarms. There's an added bonus: Advanced ergonomic design gives women a more comfortable experience.
A greater level of accuracy in colorectal cancer screening and diagnosis is now possible with high-definition endoscopy and narrow-band imaging. The enhanced detail of the images provides earlier detection and allows surgeons to remove lesions and polyps before they become malignant.
Another excellent tool is low-dose computed tomography, or CT scan, of the lung for people at risk for lung cancer, such as heavy smokers or those who have been exposed to asbestos. Though the technology itself isn't new, low-dose CT scans to screen for lung nodules have just been approved under the Affordable Care Act and Medicare. While many hospitals are scrambling to put a low-dose CT lung screening program in place, Stein said, GBMC has been providing these scans for almost a decade.
What's revolutionary about the new generation of radiation tools is the precision with which they target a malignancy while sparing the healthy tissue around it. This is especially important for patients with cancer in delicate areas like the genitourinary tract, where earlier treatments sometimes damaged essential tissue.
One of these new-generation treatments is the SmartBeam IMRT (intensity-modulated radiation therapy). It uses computer-generated images to target radiation to the exact shape and depth of a tumor, without affecting the nonmalignant tissue surrounding it.
The RapidArc linear accelerator, as the name suggests, moves in a fast arc around the patient, directing precise radiation at the tumor from many different angles. It's often used to treat patients with neck and throat cancer, where it can spare the salivary glands, which often had to be sacrificed with older treatments.
For eligible patients, one of the most exciting new developments, intra-operative radiation therapy, applies a concentrated dose of radiation to the tumor during surgery. This reduces the time needed for post-surgery treatment and may also help kill microscopic malignancies.
The human hand is not always the most appropriate instrument for surgery. When a procedure is especially delicate, surgeons at GBMC sometimes use a "third hand," the da Vinci SI Surgical System. This robotic surgeon has a greater range of motion than its human counterpart. And its "eyes" provide high-definition 3-D imaging for a clear picture and greater depth perception. At the same time, the human surgeon is always in control of the procedure.
Personalized cancer care
Though technology has revolutionized cancer treatment, the primary concern at GBMC is always the person being treated. Every patient has access to GBMC's multi-disciplinary Oncology Support Services team that helps with the issues cancer patients and their families or caregivers may face.
Addressing the emotional, spiritual, financial and physical challenges presented following a cancer diagnosis, the team's services range from counseling and referrals to community resources for transportation to nutrition advice, education and financial help for services and medications.
And when patients complete their treatment, GBMC's Survivorship Program is available to help address specific issues facing cancer survivors, easing their fears and enhancing their quality of life.
"GBMC is focusing on the care of the individual as opposed to just the cancer," Stein said. "It's care that considers the mind, body and the spirit of the patient as well as their family."
—Maxine Nunes, Content Solutions Writer