St. Vincent’s Comprehensive Cancer Center has installed the RapidArc radiotherapy system, an innovative radiotherapy technology that will provide patients with faster, more precise radiation treaments. St. Vincent’s Comprehensive Cancer Center is the first in Manhattan to offer RapidArc treatment. The new technology can shorten each treatment by up to 80%, particularly for complex treatments such as head and neck and prostate cancer.

The RapidArc therapy system delivers image-guided IMRT (intensity-modulated radiation therapy) in a single 360-degree rotation around the patient. During a RapidArc treatment the radiation beam is continually shaped and reshaped according to the size, shape, and position of the tumor within the body. As a result, the delivery of radiation is dramatically faster; treatments that once took twenty minutes can take as little as four minutes.

“RapidArc will be much easier on the patient,” said John Rescigno, M.D., Radiation Oncologist at St. Vincent’s Comprehensive Cancer Center. “It’s difficult for the patient to hold still for long periods of time and by delivering the dose more quickly and accurately, we can simultaneously improve the quality of care and make our patients more comfortable.” RapidArc treatment creates sophisticated treatment plans, generated by computer on the basis of each patient’s unique anatomy and tumor size, shape, and position within the body, to guide the treatments.

“We’re very pleased to be able to offer patients this exciting new treatment option,” added Dr. Rescigno. “RapidArc technology is enabling us to target some types of cancer very accurately while sparing healthy tissue. It is a powerful additional weapon in the cancer fighting arsenal, and will enable selected patients to receive image-guided precision much more quickly than was possible before.”

Cancer of the head and neck refers to a collection of cancers that begin within the head and neck region. The head and neck region consists of five basic areas:

• Oral cavity, which includes the mouth and tongue, the gingiva and the hard palate
• Pharynx, which includes the regions around the tonsils, the base of the tongue, and the soft palate
• Larynx, which includes the vocal cords
• Nasal cavity and sinuses
• Salivary glands, including the parotids

The majority of patients (85%) with cancer of the head and neck have squamous cell cancers, and the rest have primarily adenocarcinomas. Smoking and excess alcohol consumption are habits that increase the risk of developing cancer of the head and neck.

The treatment of patients with cancers of the head and neck is highly complex because of the anatomy of the head and neck region and the importance of maintaining the ability to taste, chew, swallow and speak. Because of this complexity, patients with cancer of the head and neck are best treated by a coordinated team of specialists, like the multidisciplinary team at St. Vincent’s. The treatment plan may include surgery, radiation and chemotherapy alone or in combinations designed to address the individual characteristics of a patient’s cancer. There have been recent improvements in surgery, the delivery of radiation (see RapidArc) and in chemotherapy with targeted agents (see Clinical Trials for Head and Neck Cancers) that may have fewer side effects. SVCCC also has supportive care services, including nutrition services, to help patients manage any side effects of treatment.

From St.Vincent’s Registered Dietitian Shayne Robinson

You may not always have control over which foods are served at holiday gatherings. But you can still enjoy a healthy holiday if you’re sensible and use moderation. Here are some tips to help you eat well during the holidays:

• Be realistic about maintaining or losing weight during the holiday.
• If you’ve been working hard on weight loss for months and you know the holidays will be tough, lower your expectations.
• Celebrate the holidays on a handful of special days rather than the entire season, which can last for 6 weeks or longer.
• Don’t give up the family favorites, but enjoy them in moderation. Have a few cookies or your favorite treat periodically, but not every day. Ask yourself if you really need that second or third treat.
• Choose your foods wisely at buffets and dinner parties. Raw fruits and vegetables, with a small amount of dip, are good choices. Boiled shrimp with cocktail sauce or lemon is also a good option. Limit the number of high-calorie foods — such as rich desserts or fried appetizers. Select only a few items that you really want and enjoy a small portion. To curb your appetite and avoid overeating, eat a small, low-calorie snack before starting on the buffet or dinner.
• Set a limit of one to two alcoholic drinks per occasion. Calories from alcohol can add up quickly, so when you’ve reached your limit, switch to calorie-free sparkling water, diet soda or plain water with a twist of lemon or lime.
• Balance out the added calories with extra exercise. Join your neighbor for a brisk walk. Ride an exercise bike or walk on a treadmill while watching TV. Walk up the stairs instead of taking the elevator. Short doses of exercise add up!
• Enlist your family’s support for a healthier holiday by taking food off center stage. Think of non food ways to celebrate, such as sledding, skating, singing or watching a movie.

St. Vincent’s offers patients the opportunity to participate in clinical trials. Medical Oncologist, Dr. Zujun Li is currently the primary investigator on a clinical trial for people with cancers of the head and neck. “Many new drugs have been developed to treat cancer in the last few years including targeted therapies such as Cetuximab and Iressa^®” says Dr. Li. Cetuximab (Eritux^®) is a monoclonal antibody that targets the epidermal growth factor receptor on cancer cells and is FDA approved in combination with radiation therapy for the treatment of locally or regionally advanced squamous cell cancer of the head and neck. Cisplatin and Docetaxel are chemotherapy drugs used to treat cancer of the head and neck. “We are now trying to find the best combination of these therapies to provide the most benefits for patients with head and neck cancer,” added Dr. Li.

One of the clinical trials open at the cancer center:

RTOG 0522: A Randomized Phase III Trial of Concurrent Accelerated Radiation and Cisplatin Versus Concurrent Accelerated Radiation, Cisplatin, and Cetuximab (C225) [followed by Surgery for Selected Patients] for Stage III and IV Head and Neck Carcinomas

• The purpose of this study is to compare the effects, good and/or bad, of radiation therapy and chemotherapy (cisplatin) with radiation therapy, chemotherapy, and cetuximab (C225) on advanced head and neck cancer to find out which is better.