Treatments benefit from IGRT and other ARC technologies such as Respiratory Gating and IMRT by taking the breathing motion into consideration, and decreasing doses to the underlying sensitive tissues and organs, such as the lungs and heart. Lung Cancers are tracked using Respiratory Gating, a form of IGRT that tracks a tumor using 4-Dimensions, allowing ARC’s physicians to know the location of the lung tumor despite its constant moment-to-moment movement. IGRT can ensure that the head and neck position is so precise that doses to the spinal cord and vital organs can be significantly reduced or eliminated.
Proton therapy is a type of external beam radiation where a proton beam is used to deliver the radiation. Up until just a few years ago, there were only two locations in the US, and only a handful in the world, where proton therapy was being used because a very large accelerator was required to create the proton beam. It required a facility that was larger than a football field. These facilities were typically part of a scientific and academic university setting. Protons have an interesting inherent property in that they can be stopped at basically any depth within the body. This made it an excellent
treatment for certain tumors, mostly those affecting children or certain tumors of the eye.
Several things have happened in the last few years that have seen a renewed interest in using proton therapy for prostate cancer therapy. The advances in computer technology catapulted x-ray radiation therapy into being a true curative cancer therapy. Newer technologies such as Intensity Modulated Radiation Therapy, or IMRT, and Image Guided Radiation Therapy, or IGRT, paved the road for using radiation, and not surgery for example, as a primary, less invasive treatment for prostate cancer in the last 10 years. In doing so, the overall market for prostate radiation has grown. This growth has attracted the venture capital community, which has billions of dollars to invest – and what better place to invest than in a $200-million proton therapy facility… and is there a better type of cancer to target a business plan toward than prostate cancer?…since it is the most common cancer in men… probably not. So now with Wall Street behind it, several more proton centers have opened, and there are now plans for at least 15 new proton facilities to be built in the next few years.
The problem with this explosion of proton facilities is that there is no longer a benefit to proton therapy when compared to the newer x-ray technologies of IMRT and IGRT. This “smoke and mirrors,” which is fueling the proton therapy business has been the subject of many investigative reports in the New York Times and other print media, as well as medical journals (see our website for the articles), which clearly state that there is no benefit to protons over photons, and at the expense of the taxpayer, Wall Street is pushing a high cost therapy when a much more cost-effective, and equally effective therapy exists in IGRT. The other real problem is that there is only one significant study using proton therapy in the treatment of prostate cancer, compared to hundreds and hundreds of studies of IMRT and IGRT. Until such studies exist, and many believe those studies may never happen for lack of funding, since the groups backing the funding of the proton facilities may not want to be stuck with the bill if the studies show that protons are NOT as good as IGRT, the jury is still out as to the efficacy of protons as a treatment for prostate cancer.
Calypso is a technology which allows the
Radiation Oncologist to locate
the prostate before treatment occurs. Similarly, Calypso uses markers in
the prostate that send out a signal, which is read by a computer located next to the patient before treatment. The signals help pinpoint
the prostate much like the Gold-Markers do in the Gold-Marker IGRT treatments performed at Advanced
Radiation Centers, but that’s where the similarities between the systems end.
Calypso is typically used by Radiation Oncology facilities with older radiation accelerators, which cannot be upgraded to the latest imaging devices like the On-Board Imager (OBI). Only accelerators that are 10-15 years old cannot be fitted with an OBI, like we have at Advanced Radiation Centers. Calypso was created just for these older machines so facilities would not have to upgrade their existing equipment. Any facility that has a Calypso, you will know also has an older machine. Older machine = older technology. The Calypso is a stand-alone unit that can be used alongside the older non-upgradable linear accelerator.
Unlike the Gold Marker IGRT Technology , which is very visual and easy to read, Calypso provides NO images. It only provides numbers on a screen. The Calypso also provides no prostate, rectum or bladder volumes, and does not have the ability to use images to make specific changes in targeting. Since there is no image or view of the actual anatomy at any given moment, Calypso is at a major disadvantage compared to the linear accelerator-based technologies. Calypso is only good if the facility only has an older linear accelerator.
With On-Board Imaging (OBI) technology the prostate itself, along with the bladder and rectum, are actually viewed prior to every treatment to ensure that the anatomy perfectly lines up with the treatment. This is a much better gauge than lining up numbers on a computer, as the Calypso provides.