UCLA Journal of Radiation Oncology January 1, 2022 - Flipbook - Page 28
UCLA RADIATION ONCOLOGY JOURNAL
“It can be quite long,” he said. “Imagine if you're a working person, or even if you're
not a working individual, you have other responsibilities, other things to do.”
That could explain why radiation treatment for prostate cancer patients is generally
underutilized in the United States, Dr. Kishan said.
“Patients are not referred for radiation or they're not interested in radiation or
they're scared of the radiation. All kinds of reasons exist for that,” he said. “But even
if they get a chance to hear about radiation, the length of the treatment course can
disincentivize a lot of men. Overall, the underutilization is a big problem, because
radiation is a major curative treatment in someone that has a rising PSA after
surgery.”
One of the machines researchers are using is the MRIdian Linac, which has a builtin MRI to guide radiation treatment. UCLA Health is one of the few health systems
in the country with this machine, which also is being used in clinical studies for
treating pancreatic cancer and sarcomas.
For study participant John Babcock, who first was diagnosed with prostate cancer in
2004 at age 52, the intensive treatment at UCLA Health has given him hope.
Babcock’s PSA had been rising for years after his initial surgery. UCLA Health was
not Babcock’s first stop for care, however, due to insurance contracting. Doctors at
another health system told him he could not be cured and he would have to be on
hormone therapy indefinitely. This caused problems, including “man-opause,” with
hot flashes, Babcock said.
Babcock came to UCLA Health after a change in insurance and was referred to Dr.
Kishan to discuss SCIMITAR. He was able to stop hormonal therapy and receive
radiation.
“It’s been a little over a year now and my PSA is barely measurable,” Babcock said.
“Dr. Kishan’s work and advanced research provided relief where there had been no
hope before. His brilliant work is certainly going to help a great number of people. I
am just one example.”
Another paradigm-changing study that Dr. Kishan and the UCLA Health research
team is running is the GARUDA trial, which involves taking a cheek swab of a
patient considering radiation (specifically, considering SBRT) to see if they have
a genetic biomarker that predicts for a higher chance of late radiation toxicity
to the genitourinary system after SBRT. If they do have this biomarker, they are
encouraged to pursue an alternative, longer form of radiotherapy.
Patient Hiram McCall, 68, was one of the first patients enrolled in this study. He
praised UCLA’s effort as “far more evolved.” Treatment doesn't compare with what it
was like even 30 years ago, he says, noting the seemingly non-personalized nature
of some standard treatments.
McCall was one of the rare patients found to be more sensitive to radiation, so his
treatment plan was altered, and he is doing well, with minimal side effects after
radiation therapy. ☐
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