Oregon Health & Science University Knight Cancer Institute physicians will share the results of 15 studies at the 52nd annual conference for the American Society for Radiation Oncology (ASTRO).

The research to be presented covers a wide range of patient-care issues from how radiation treatments influence well-being and spirituality to how hormone therapies impact the placement of transponders that direct radiation to prostate tumors to how radiation should be used following a mastectomy when the patient’s tumor was small. ASTRO’s annual meeting, which will be held in San Diego through Nov. 4, is the premier, international conference for radiation oncologists and attracts about 10,000 attendees.

“The number of studies presented reflects the breadth of research in radiation oncology under way at the OHSU Knight Cancer Institute,” said Charles Thomas Jr., M.D., chairman of the Department of Radiation Medicine.

The studies include relatively new areas of exploration, such as how radiation affects all areas of patients’ quality of life including their spirituality.

Spirituality and patient well-being

An OHSU Knight Cancer Institute study found that patients’ spiritual well-being, along with their social, family and functional well-being, did not change after they received radiation treatment.

In fact, while physical well-being worsened during radiation treatments, most patients’ emotional well-being improved. However, in an exploratory subgroup analysis, women’s scores for faith rose significantly though their sense of meaning and peace did not show a substantive increase.

“Patients’ quality of life and spirituality should be included in clinical trials involving radiation in order to better understand the true impact,” said Erik K. Fromme, M.D., who specializes in palliative medicine for cancer patients.

“Supporting and inquiring about a patient’s quality of life is part of providing whole-person care,” Fromme added. “This study invites health care providers to think about whether they should do more to support patients’ spirituality during a course of intensive treatment. It might improve the patient’s overall experience.”

Other OHSU Knight Cancer Institute researchers who contributed to the study were Thomas; Tasha McDonald, M.D.; Joseph Waller, M.D.; Clifton Fuller, M.D.; as well as Department of Radiation Medicine medical student Bethany Tara Samuelson.

Use of radiation after mastectomy

Another study looked at whether radiation treatments following mastectomy improves the final outcome for breast cancer patients with smaller tumors.
 
Post-mastectomy radiation has been shown to improve overall survival for patients with tumors that are greater than 5 centimeters or with four or more involved lymph nodes.  

In patients with smaller tumors, which are less than 5 centimeters, and one to three positive lymph nodes under the arm, the role of post-mastectomy radiation is controversial.  

The OHSU Knight Cancer Institute study, which used the SEER database, showed improved survival in this group of patients after radiation. However, radiation did not benefit patients with very low risk features, such as a tumor that was less than 2 centimeters and had a low histologic grade, and when less than 15 percent of sampled lymph nodes were positive. These patients can be spared from post-mastectomy radiotherapy.

“Our findings are helpful in developing a prediction model for clinical decision making,” Charlotte Kubicky, M.D., said.

Other OHSU Knight Cancer Institute physicians who worked on this study were Carol Marquez, M.D., and Sam Wang, M.D.

Hormone therapy’s impact on transponders

Finally, the impact of hormone treatments on prostate cancer patients who are receiving radiation treatments using the Calypso Medical system will also be presented at ASTRO.

Calypso uses two to three electromagnetic transponders that are implanted in the prostate to direct radiation treatments on the cancerous tissue, reducing the potential that healthy tissue and organs are impacted. There were concerns that shrinking the prostate gland with hormone therapy could change the position of these transponders, which, in turn, would compromise the Calpyso system’s ability to target the right area during radiation.

Eight cancer patients were included in the study. Six were undergoing hormone therapy when the transponders were implanted and two were not. The largest changes in the position of the transponders occurred during the first two weeks following implantation. However, the study found that there was no difference in the stability of the transponders whether the patients were on hormone therapy or not.

Though the concurrent hormone therapy appears to have no affect on the stability of the transponders, more patients are needed for additional investigation, explained Arthur Hung, M.D.

Other OHSU Knight Cancer Institute researchers who contributed to the study were Tony T. He, Ph.D.; James Tanyi, Ph.D.; and Wolfram Laub, Ph.D. Calypso Medical printed the poster for the presentation of the study.

About the OHSU Knight Cancer Institute
With the latest treatments, technologies, hundreds of research studies and approximately 400 clinical trials, the OHSU Knight Cancer Institute is the only National Cancer Institute-designated Cancer Center between Sacramento and Seattle— an honor earned only by the nation's top cancer centers. The honor is shared among the more than 650 doctors, nurses, scientists and staff who work together at the OHSU Knight Cancer Institute to reduce the impact of cancer. Visit www.ohsuhealth.com/cancer or www.facebook.com/OHSUKnight.

About OHSU
The Oregon Health & Science University is the state's only health and research university, and Oregon's only academic health center. OHSU is Portland's largest employer and the fourth largest in Oregon (excluding government). OHSU’s size contributes to its ability to provide many services and community support activities not found anywhere else in the state. OHSU serves patients from every corner of the state, and is a conduit for learning for more than 3,400 students and trainees. OHSU is the source of more than 200 community outreach programs that bring health and education services to every county in the state.

About ASTRO
ASTRO is the largest radiation oncology society in the world, with more than 10,000 members who specialize in treating patients with radiation therapies. As the leading organization in radiation oncology, biology and physics, the Society is dedicated to improving patient care through education, clinical practice, advancement of science and advocacy. For more information on radiation therapy, visit www.rtanswers.org. To learn more about ASTRO, visit www.astro.org.