The Beam: New radiation tech coming to the proton therapy facility; thoughtful gifts for cancer patients; meet a new radiation oncologist

New X-ray radiation tech coming to the proton therapy facility at UW Medical Center – Northwest campus

Within the next month, providers at Fred Hutch – Proton Therapy will be able to offer advanced X-ray radiation, called TrueBeam photon radiation, to those patients who will benefit from this modality.

The state-of-the-art photon accelerator, or Linac, currently being installed should be operational by January.

“The move to add the sophisticated TrueBeam linear accelerator was part of our strategy to develop a radiation oncology hub on the campus of UW Medical Center – Northwest,” said Medical Director Annemarie Shepherd, MD.  

Shepherd said cancer patients get the best outcomes when they’re treated by providers who are specialists in their field, since general practice providers may have trouble staying up to date on all the new treatments and technologies. The radiation oncology hub allows Fred Hutch and UW Medicine specialist providers to treat in one place and have access to all modalities.

That also includes Gamma Knife technology, which recently moved to UW Medical Center – Northwest, where it’s being used to treat patients with central nervous system tumors. Gamma Knife is operated through UW Medicine.

“As a radiation oncologists specializing in taking care of patients with brain and spinal cord tumors, I am fortunate to have different technologies to deliver radiation therapy in one area,” said Lia Halasz, MD, who frequently treats patients at the proton therapy facility. “Every time I meet a patient, I recommend what I think is best for them based on their individual situation.”

Fred Hutch continuously updates treatment machinery to the latest and most advanced models, including the dual energy CT machines at both the proton therapy facility and the radiation facility at UW Medical Center – Northwest, as well as cone-beam and surface scanning technology in the gantry.

The new Linac is top-of-the-line, and an identical model will be installed the radiation facility at UW Medical Center – Northwest to make it easier to treat patients at both locations. It also means simulations before treatment can be done at either location.

 “The Linac comes with all the advanced technology we’re installing for protons already incorporated,” Shepherd said. “Though protons are an excellent treatment option, not everyone is an appropriate candidate for proton therapy, and with the TrueBeam we can offer other targeted therapies, such as stereotactic body radiation therapy (SBRT), which delivers a higher dose in a short period of time — five days at most instead of weeks.”

Providers at the proton therapy facility said having the Linac available in one facility allows them to do additional treatment comparison plans to further ensure they’re offering the best individualized treatment for each patient.

Childhood cancer expert Ralph Ermoian, MD, said he’s excited about the opportunity to use the new Linac for Volumetric Modulated Arc Therapy  (VMAT) total body irradiation, which is used in both adults and pediatric bone marrow transplant patients who have blood  cancers such as leukemia, which cannot be treated with protons. VMAT is a type of intensity-modulated radiation therapy.

A benefit to TrueBeam is that patients can lie down for total body irradiation — not the case with older technology — which makes the experience much easier on the patient.

The Linac may also be used to boost a patient’s proton therapy treatment when necessary and can be a better treatment option when a patient’s tumor is rapidly changing during treatment. Some patients also require treatment of multiple tumor sites, some of which may be better treated with protons and others with photons. Having both at the same location makes these treatments more convenient for all.

What are the best gifts for cancer patients? A few suggestions from patient proton therapy grads

Editor’s Note: some patients prefer to use first names only.

During the holidays, gift giving is often at the top of many people’s minds, so we asked our patients who’ve graduated from proton therapy about the gifts that are most appreciated while dealing with cancer. We hope their feedback will inspire you when looking for gifts for your own loved ones undergoing cancer treatment this holiday season, a time of year when many feel extra vulnerable or alone. They also provided feedback on the kinds of gifts that were not as useful. Read on for their suggestions.

“Just the other day I received a card from a college friend’s mother-in-law in Ireland who wanted to let me know that she and all of her friends prayed for me regularly,” Monin said. “It’s nice to feel that people care about you and are thinking of you.”

In terms of comfort items, warm (but stylish) jackets, blankets and — for kids — stuffed animals, are popular gifts. Socks are also a great choice.

“Nice socks are not only good for at home but also when you’re getting treatment,” said Ed, a patient who went through proton therapy for his lung cancer. “You are always wearing warm socks when all you have on is a gown in those cold treatment rooms.”

“The absolute best gifts were from a friend who had gone through breast cancer treatment the year before,” Monin said. “She sent me a whole chemo care package with ginger candy and special mouthwash and a hat to cover my bald spot. She sent her kids’ favorite books for me to read with my children.”

Several patients also mentioned they enjoyed getting books, especially uplifting, light reading material, including magazines which help patients take their mind off cancer.

Ed also mentioned that books relating to a person’s hobby can be a good distraction.

“Books are number one,” Kaitlyn said. “Without fail, books kept Ava chill and happy.”

Gifts to avoid

Unwelcome gifts included primarily scented items: bath bombs, essential oils, even strong-smelling lotions and candles.

Though the sentiment is lovely, strong smells can make cancer patients, especially those undergoing chemotherapy or radiation, nauseated. Radiation also can make skin too sensitive for non-clinical creams or bath materials.

In addition, gifts that require any kind of work, even such innocuous things as flowers — which require water changes — are best avoided.

“The gifts I appreciated the least were things like books about how to eat for cancer or a gratitude journal,” Monin said. “It took a while before I was in a place to feel grateful for anything and I didn’t tell my children my brain tumor was cancer, so I didn’t want books about cancer laying around for them to see.”

One more piece of advice?

Don’t feel upset if the cancer patient in your life doesn’t get back to you. Treatment is often a full-time job. Showing that you care — through time, outreach or gifts — is very much appreciated by the patient, even if they don’t respond right away.

“I did a terrible job of sending thank you notes for all the amazing, thoughtful, wonderful gifts sent to me,” Monin said. “I wish I had been in a better emotional and mental state to send lovely cards of gratitude to everyone, but I just wasn’t.” 

Meet gynecologic, genitourinary and prostate cancer expert, Dr. Jim Leng

Expanding cancer treatment and resources to parts of the world that lack access to care is a major interest of Fred Hutch’s new prostate cancer physician, Jim Leng, MD.

Leng’s grandmother in rural China died when he was young because she lacked access to cancer treatment. It left a strong impression on him and subsequently inspired him to help people with cancer receive the treatment they need at the right time.

“It’s our moral imperative,” he said.

Every year, Leng travels to Tanzania via an ongoing collaboration with Duke University where he works with partners to improve brachytherapy for patients with cervical and other gynecologic cancers. These cancers are more prevalent due to limited access to HPV vaccinations and cervical cancer screening.

Leng also uses brachytherapy to treat gynecologic cancers at Fred Hutch – South Lake Union. He also treats prostate and genitourinary cancers at the proton therapy facility.

“My mentors from Duke and the Global Health Institute were very influential,” Leng said. “One faculty member spends half her year caring for childhood cancer patients in Tanzania, making sure they have access to treatment and survivorship care, as well as food and a place to live throughout treatment.”

Leng chose medicine with the express purpose of becoming an oncologist, he said, because “there’s nothing quite like the relationships you develop with cancer patients over time.”

“In radiation oncology, we have access to targeted and frankly incredible technology that allows us to create personalized treatment plans and think very thoughtfully about that,” he said. “We prioritize time with patients and have a chance to really engage and make treatment decisions together.”

Leng is also pleased to have proton therapy as part of the prostate cancer treatment arsenal.

“It’s exciting to have this advanced technology to offer to the right patient who might benefit,” he said. “To have these conversations and guide patients through what the best course is for their cancer is exciting. It allows us to tailor treatment to individual needs and also improve outcomes.”

Leng moved to Seattle with his wife, who also joined Fred Hutch as a palliative care physician. He said he’s looking forward to hiking and backpacking in the Cascades and Olympics. He and his wife also love to explore performances and shows in town and are already regulars at the Paramount.  

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