Northwestern Lake Forest Hospital Using Ultrasound Technology to Treat Prostate, Breast Cancers

By Robert Channick | Special to the Tribune
April 22, 2009


Ultrasound now helping target cancers as well


Long a window into the womb for expectant mothers, ultrasound technology is being used at a north suburban hospital to improve treatment for prostate and breast cancer patients.

Three-dimensional images from a new ultrasound machine at Northwestern Lake Forest Hospital allow doctors to target tumors more precisely during radiation therapy and minimize side effects.

"I can't tell you it's revolutionized the way I do my prostate treatments, but I can say that I would not feel comfortable treating a prostate without it," said Dr. Marc Posner, a radiation oncologist at Northwestern Lake Forest Hospital, one of the first in the nation to purchase a $300,000 Clarity ultrasound system.

Treatments for breast cancer and prostate cancer require a daily dose of radiation, but pinpointing where to target the radiation traditionally has been inexact. Doctors typically develop a treatment plan using an initial CT scan, but the prostate gland shifts daily, and the cavity left when a breast lump is removed shrinks over time.

"It was basically law of averages, but that was the best technology we had at the time," Posner said.

The ultrasound system, acquired last year, offers a real-time view that takes much of the guesswork out of prostate treatment, doctors say.

Much as with the ultrasound machines used in obstetrics, a wand attached to a monitor is moved across the abdomen, locating the prostate gland. The image then is overlaid on the initial CT scan, allowing a computer to make minute adjustments to the patient's position before radiation.

The technology is promising but needs additional testing, said Dr. Jonathan Simons, president of the Prostate Cancer Foundation, a non-profit organization in Santa Monica , Calif., that has funded more than 1,500 research projects worldwide.

"Common sense says this could be a very good step, but it will take several thousand patients very carefully studied with this technology to see how large the benefit is," Simons said. More than 2 million men are living with prostate cancer in the U.S. , according to the foundation.

Radiation therapy is a common treatment option, usually delivered on an outpatient basis in 40 sessions over eight weeks. Side effects can include urinary problems and sexual dysfunction, which Posner hopes will be minimized using ultrasound.

"If I have a better picture of exactly where the prostate is, then my targeting is going to be more accurate, and less normal tissues will be treated," he said.

About 182,000 cases of breast cancer were diagnosed last year, according to the National Cancer Institute. Most patients undergo a lumpectomy to remove the tumor, followed by outpatient radiation. After five weeks of treatment for the breast, patients often receive a 11/2-week course of radiation focused on the lumpectomy cavity, the most likely site of cancer recurrence.

"We are now capable of focusing on these areas in a much more confident way and sparing the surrounding underlying tissues, which in the case of the breasts would be the lung or the heart," said Dr. Joseph Imperato, director of radiation oncology at Northwestern Lake Forest Hospital.

Undergoing radiation therapy for recently diagnosed prostate cancer, Ed Jaronik, 61, a securities broker from Beach Park, said he appreciated the new equipment.

"It's a very scary process going through this whole thing, but knowing that they have the most advanced tools that they can use, and with this added tool, makes it that much better," he said. "Hopefully, everything will work."

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