Cancer News | March April 2023

ISSUE 2

Fighting Cancer with an EDGE

When it comes to fighting cancer with radiation, patients want the latest technology available. That’s offered today in Lincoln at Cancer Partners of Nebraska. The Varian Edge is an advanced linear accelerator (LINAC) that uses focused radiation beams to treat a wide range of cancers, including brain, spine, neck, chest, lung, prostate, pancreas and liver.

The Edge offers patients fewer, less invasive treatments. Radiosurgery delivers higher doses of radiation faster with no anesthesia, cutting or a hospital stay. It uses extreme precision that targets tumors with sub-millimeter accuracy (450 microns). Its real-time surface tracking, like GPS for the body, reduces damage to surrounding tissue and minimizes side effects.

Radiosurgery opens the door for patients who may not have other options. For example, they may not be candidates for traditional surgery or even conventional radiotherapy. Radiosurgery gives medical professionals new tools to treat more types of cancer and other conditions.

Treatments on the Edge system are fast and precise, about 15-20 minutes. Shorter treatment time leads to less interruption of patients’ daily lives. The Edge linear accelerator will move to the April Sampson Cancer Center late this year.

Radiosurgery Case Study

Male, 54, glioblastoma

• Full resection of visible tumor at Bryan West Campus

• Case presented to Bryan Neuro Tumor Board to collaborate on treatment plan

• Medical and radiation oncologist care

• Completed oral chemo and radiation therapy

• Prescribed Optune tumor treating fields device

Recurrence of two new, 4 mm tumors outside initial radiation treatment area

• Not a candidate for second resection surgery due to multifocal tumors

• Chose radiosurgery, maintained quality of life

• On follow-up MRI, tumors were resolved

Key Benefits of Radiosurgery

• Non-invasive cancer “surgery,” without a knife

• Most accurate and precise radiation treatment

• Less impact on surrounding tissue

• Shorter and fewer treatment sessions

• No hospital stays

Types of Radiosurgery

Gamma Knife® – Bryan Medical Center

• Uses focused gamma rays

• Treats small- to medium-sized lesions, usually in and around the brain

• Equipment does not move

Varian Edge™ – Cancer Partners of Nebraska

• Uses high-energy radiation

• Treats lesions in brain and other areas

• Machinery moves around patient

To find out if your patient is a candidate for radiosurgery or to place a referral, call: Bryan Cancer Program, 402-481-7900

Cancer Partners of Nebraska, 402-420-7000

Bryan Tumor Boards work to find best treatment plans

How do you provide the best possible cancer treatment? Bring all the experts into a room to brainstorm and formulate a plan.

A variety of physicians and specialists comprise each Tumor Board and meet regularly in person or virtually.

Specialists include:

• Medical oncologists

• Radiation oncologists

• Surgeons

• Pathologists

• Radiologists

• Interventional radiologists

• Physical and occupational therapists

• Genetics counselors

• Research/clinical trial specialists

• Oncology nurse navigators

Depending on the case additional providers may join, such as plastic surgeons, palliative care, wound/ostomy nurses or other specialized physicians and surgeons.

“The collaboration of multiple specialties at our tumor boards allows for improved patient care and open communication when developing a plan. This provides the ability to quickly move forward with the patient in a coordinated manner. With more complicated cases, we are able to brainstorm difficult situations together.”

Each person is as unique as their tumor

The Tumor Board’s goal is to determine the best possible cancer treatment and care plan for each person. A provider who knows the patient shares relevant details with the group and any barriers to care. Everyone reviews the case together. They may look at images taken (CT, MRI, PET) and talk about pathology findings or molecular testing. They may discuss other tests needed. They also talk about possible treatments (like surgery, chemotherapy, immunotherapy, radiation, clinical trials). Each specialist shares their views so they can find the best treatment plan for the patient.

Scheduled tumor board meetings specify cancer areas to ensure the right specialists attend. However, they will discuss any disease site at one of the following meetings:

• Breast and gynecologic, 3 times a month

• Gastrointestinal, twice a month

• Thoracic, twice a month

• Genitourinary/urology, once a month

• Neurologic, once a month

- Nathan Green, DO Medical Oncologist, Cancer Partners of Nebraska

Left to right: Neurosurgeon Dr. Steven Gogela; Oncology Nurse Navigator Jill Geschke; Cancer Center Coordinator Laura Spurlock; Radiologist Dr. Jonathan Fullner; Neurosurgeons Dr. Jeremy Hosein, Dr. Andrew Livingston and Dr. J. Chris Hawkins; Radiation Oncologist Dr. Mark Stavas

Any provider can submit any kind of tumor for review. To submit a case to a Bryan Tumor Board, call 402-481-7900.

Being able to collaborate with a multidisciplinary board improves our ability to comprehensively care for our patients.

- Andrew Livingston, MD Neurosurgeon, Neurological and Spinal Surgery

Doctors discuss a patient’s case at a Bryan Neuro Tumor Board. Specialists named in photo above, plus: bottom, Radiation Oncologist Dr. Jacqueline Kelly, and top right, Medical Oncologist Dr. Stacey Knox.

Genetic Counseling and Testing

Do you have patients with a family history of cancer? Or concerned about their risk? A genetic consultation may help.

We offer genetic counseling and testing to:

• Find inherited DNA variations associated with increased risk of cancer

• Help determine the best course of action for patients already diagnosed with cancer

Our unique approach goes beyond a lab test and report. Specially trained genetic counselors meet with each patient to explain the results and what they mean for them and their family.

Maddie Kaltenberger, MGC, CGC Bryan Health since 2021

Master of Science in Genetic Counseling from the University of Nebraska Medical Center

maddie.kaltenberger@bryanhealth.org

402-481-6305

Bronson Riley, MS, CGC, CCRP Cancer Partners of Nebraska since 2006

Master of Science Genetic Counseling from Case Western Reserve University in Cleveland, Ohio

genetics@cancerpartners.com

402-420-7000

What is the difference between genetic testing and counseling?

Genetic testing is the examination of genetic material (or DNA) to determine if someone has an altered copy of a certain gene. This change in a gene (or a mutation) prevents the gene from working properly. If this happens in a cancer susceptibility gene, it could mean someone is at an increased risk to develop cancer in their lifetime.

Genetic counselors are medical professionals who guide patients through the genetic testing process. We analyze family history to determine what testing is appropriate, provide cancer risk assessment, interpret results and help patients understand the implications.

Who should get genetic testing?

The best way to know if genetic testing would be beneficial is by gathering and reviewing family history. A genetic counselor can analyze this information and determine what testing would be most appropriate.

Some clues that cancer may be inherited are if it occurs:

• At a young age (i.e., less than 50)

• In both of a paired organ (such as both breasts)

• In a pattern within a family

What if the patient already has cancer?

Can genetic testing help?

Genetic counseling and testing could provide more information about someone’s risk to develop a second primary cancer, influence options for cancer treatment and alter recommendations for cancer surveillance for the future. It also can be beneficial information for their family members to clarify their own risk of developing cancer in the future.

To learn more or make a referral, please call 402-481-7900.

Donor Corner

April Sampson Cancer Center is grateful for generous donors in our community, such as:

The University of Nebraska - Lincoln Interfraternity Council (IFC). The governing body for 25 fraternities at UNL is helping fund the café in the April Sampson Cancer Center The café will feature cancer fighting foods and drinks, grab-and-go items and cooking demonstrations.

This philanthropic group committed to a $150,000 donation toward this gathering space as one of the many ways they give back to our community.

Address Service Requested

Cancer News will keep you up-to-date on comprehensive cancer services available now and in the future. April Sampson Cancer Center will open late in 2023.

Shop Our Cancer Patient Amazon Wish List

Create care packages for cancer patients facing surgery, radiation, long appointments and infusions. Our team has hand selected “wish list” items to meet cancer patients’ unique needs. These items promote comfort and relaxation and ease anxiety.

Ship items to Bryan Volunteers to place in customized gift bags for cancer patients.

Lung Nodule Program

Early detection of lung cancer leads to significantly better survival rate, so Bryan has created a new multidisciplinary lung nodule program.

Our Lung Nodule Review Board is comprised of:

• Pulmonologist (Nebraska Pulmonary Specialties)

• Interventional radiologist (Advanced Radiology)

• Oncology nurse navigators

• Cancer program coordinator

The group meets weekly to review CT scans where lung nodules have been identified. If necessary, they make recommendations to the patient and their primary doctor for further screening and treatment.

To refer a patient for lung nodule review, call 402-481-7900.

Shop our wish list by scanning the QR code:

402-481-7900

We’re here for you and your patients

If you have a patient who is diagnosed with cancer, call us first. We will:

• Contact your patient within 24 hours (Monday-Friday)

• Connect them with an oncology nurse navigator

• Help them find the doctor to meet their needs

• Coordinate care to get them from diagnosis to treatment faster

• Explain treatment options and side effects

• Collaborate with you and other physicians involved in their care

• Walk with them every step of the way

NEW! Referral to Bryan Cancer Program now available in Epic. Thank you for entrusting us with your patients’ cancer care.