He chose radiation treatment for his prostate cancer

JAN ROBERTS WASN’T SURE WHAT TO EXPECT when he received radiation treatments for prostate cancer at the Upstate Cancer Center.

A disabled Vietnam veteran, he receives primary care at the Syracuse VA Medical Center, where he was diagnosed after an elevated test result for his PSA, or prostate-specific antigen. It would have been a lengthy drive from his home in Cazenovia to Albany, the nearest VA offering treatment. The Veterans Choice Program, however, allowed him to receive treatment at Upstate.

Offered the choice of surgical removal of the prostate or radiation treatment, Roberts chose a non-invasive approach with focused radiotherapy. He became a patient of Jeffrey Bogart, MD, the head of radiation oncology.

“I went for radiation, and I was a little apprehensive, but once I got into the hospital, what I thought was going to be an unpleasant scenario turned out to be a very good scenario, all things considered,” says Roberts, 73, who also deals with the effects of wartime wounds, exposure to the herbicide Agent Orange and post-traumatic stress disorder. He is retired from his family business of selling highway equipment, such as sanders and snowplows.

His treatments were given on the state-of-the-art Vero radiation system. Instead of traditional radiation treatments, which can take up to 45 daily sessions over nine weeks, the precision and accuracy of the image-guided radiation technology allowed treatment to be completed over 28 sessions in fewer than six weeks. He finished his treatments at the beginning of November 2018.

“I usually had the same staff every day. They made me feel wonderful, as though I was the only person in the hospital. They were all very kind, very good, and what could have been an unpleasant experience was pleasant,” Roberts says.

His routine involved stripping from the waist down, lying on a table with a custom body mold, his hands on two grips over his head. The machine, guided by daily integrated imaging of the precise location of the prostate, would revolve around him as it focused radiation on the cancer cells.

This is the Upstate Cancer Center's stereotactic radiotherapy system, the Vero.

“It’s not a very long process. You’re in the room maybe 15 to 20 minutes.”

He didn’t feel anything during the procedure, but he would afterward.

“I got very fatigued as the treatment went on,” he says. He drove himself to the treatments every weekday, and he found himself sleeping more. He also had some bladder and bowel troubles that were cleared up with medication.

He noted the camaraderie that developed among fellow patients awaiting treatment. “We all talked about our different problems as we were being radiated,” he recalls.

After his course of radiation, he had a follow-up visit with Bogart, and his PSA levels will be monitored to see if they return to a lower number.

The fatigue is wearing off, and he pushes himself to keep busy each day. His activities include working with veterans at the Syracuse VA Medical Center as well as the group Combat Veterans Anonymous, where he helps fellow vets cope with the many aspects of PTSD.

“I have nothing but good things to say about Upstate, and not just the people radiating me,” Roberts says. “As soon as I walked in the front door, they said, ‘Good morning,’ and they always had a smile, and I never had to wait for anything.

“You got the feeling that only person who counted wasyou, and they made everybody feel that way,” Roberts said. ●

VERO OFFERS LATEST IN RADIATION TECHNOLOGY

When doctors recommend radiation therapy for a tumor in the lungs, the chest or another spot in the body, they must figure out how to target that tumor while minimizing damage to healthy tissue around it.

They also consider that even if the patient lies still during treatment, his or her digestion, heartbeats and breathing will cause the tumor to move.

One solution is a powerful stereotactic radiotherapy system called Vero, a 9-ton circular machine that was anchored into the ground floor of the Upstate Cancer Center when it opened.

Vero is designed to deliver concentrated and precise doses of high-power X-ray beams from almost any angle, and amid the normal anatomical movements of the body. Vero has unique capabilities in being able to both image and treat complex tumors, unlike other radiotherapy technology. That is because Vero can move around the patient, using a first-of-its-kind robotic O-ring gantry pivot (see photo).

Vero “integrates several state-of-the-art capabilities and technologies into one machine,” explains Jeffrey Bogart, MD, who leads Upstate’s department of radiation oncology and is also the interim director of the cancer center. “This includes the ability to deliver radiation treatment at unique angles that may better protect surrounding structures, such as minimizing radiation to the rectum and bladder in the case of prostate cancer. Vero also has a unique tracking feature that facilitates treatment of moving tumors, such as those in the lung, liver, and other tumors.”

The enhanced precision means patients may undergo more intense treatments in a fewer number of visits. Such customized care provides hope for greater cure rates — and fewer side effects.