Dr. Michael Ray, MD, PhD

ThedaCare treats 100th prostrate cancer patient

ThedaCare Regional Can-cer Center recently reached a new milestone, treating its 100th prostate cancer patient with high-dose rate (HDR) brachytherapy. This important treatment option is not available at many community cancer centers, as it demands specialized expertise, equipment and experience. Until recently, the treatment was only available at Wisconsin’s academic centers. Many years of brachytherapy experience and dedication to building a high-volume brachytherapy program, have enabled the prostate cancer leaders at ThedaCare to offer this program where HDR brachytherapy can be used to help patients.

“Once we had HDR brachytherapy available, I quickly saw it had advantages for treating prostate cancer. I began working toward getting a prostate cancer treatment program started,” said Michael Ray, MD, PhD, radiation oncologist at the Regional Cancer Center. “Today I think we have one of the most experienced, established and successful HDR brachytherapy programs for prostate cancer in the state.”

Brachytherapy–placing radioactive materials inside a patient’s cancerous tumor to help control the disease–has existed for many years to treat a variety of cancers. HDR brachytherapy is a relatively new option for the treatment of prostate cancer. ThedaCare Regional Cancer Center started its prostate treatment program in 2012, shortly after HDR brachytherapy became available at the Center. “There are advantages to delivering radiation internally from implanted sources because the radiation doesn’t pass through other surrounding normal organs,” said Dr. Ray.

In treating prostate cancer with HDR brachytherapy, a prescribed dose of radioactive source material is delivered directly to the cancerous tumor(s) in the prostate gland. The entire HDR brachytherapy procedure typically lasts about four hours, during which the patient is mildly sedated and receives a spinal block to anesthetize him from the waist down.

“In terms of a surgical procedure, it’s actually a minor outpatient procedure,” Dr. Ray said.

According to Dr. Ray, the potential benefits of HDR brachytherapy for prostate cancer are multiple, including: It often leads to better cure rates, either as a treatment by itself for milder cancers or in combination with a short course of external radiation for more aggressive prostate cancers; it’s possible to deliver a higher dose of radioactive therapy directly to tumors, resulting in better cancer control; complication rates and side effects are often lower than other protocols previously used. For example, there is less possibility of damage to nearby organs such as the bladder or rectum.

Putting a HDR brachytherapy prostate treatment program together takes cooperation among a number of specialties. Anne Christopher, RN, and brachytherapy coordinator for the Regional Cancer Center manages that activity. She is responsible for arranging medical counseling for the patient and getting all the specialists in the right place at the right time.

“We put the patient’s needs first,” said Christopher. “Therefore, we coordinate schedules to ensure caregivers work seamlessly together during the procedure.   

In addition to Christopher and Dr. Ray, the HDR brachytherapy team for prostate cancer treatment includes urologists from the Wisconsin Institute of Urology. Dr. Ray particularly commended the participation of Dr. Robert Vlach and Dr. Scott Kolbeck for the expansion of the HDR treatment program. Dr. Ray added that the medical physicist is among the most critical members of the treatment team.

“The medical physicists are a critical part of the planning and delivery of the radioactive material” explained Dr. Ray. “They develop individualized treatment plans, program the machine and verify each patient plan. They make sure each piece of equipment is performing to specification and verify that the treatments are delivered properly and safely.”

“The HDR brachytherapy program is an example of what can happen when there is true collaboration among healthcare professionals in a community setting, with the patient at the center of concern,” said Kim Schwab, manager of ThedaCare Cancer Care Radiation Oncology. “The care team, including medical physicists, anesthesiologists, nurses and operating room technicians, works together to ensure the best outcomes for patients.”

“It’s a real achievement for ThedaCare as a health system to put this treatment program together,” said Dr. Ray. “It’s a unique program; one you would more likely find in a university academic medical center than a regional cancer treatment center. And it’s all for the benefit of the patient.”