How Advancing Technologies are Helping Produce Better Patient Outcomes
By Marika Loveless, MHA, RN, OCN, Executive Director Mission Cancer Program, Mission Health
“You just lie there listening to music and looking at the stars on the ceiling while this amazing robot works, and then in 15 minutes or so it’s over,” said prostate cancer patient Dennis Gingras. After his cancer diagnosis, Gingras was presented with two options for treatment and he chose the CyberKnife in order to reduce the number of visits as his drive back and forth for treatment was considerable.
It’s the patient stories that tell the tale of why advancing technology is so important. Their personal lives and what is affecting them day-to-day beyond their healthcare gives those in the medical field the constant impetus to do better, be better and strive to have on hand the latest technology that offers the best outcome.
Here’s a look at just some of the technology offered at Mission Health in Asheville, North Carolina, that helps us care for our patients in the best possible way, with the best possible outcomes.
“Unlike the traditional linear accelerator, the CyberKnife is an accelerator at the end of the robotic arm,” said Eric Kuehn, MD, a radiation oncologist with Mission Cancer Care. “So rather than the radiation treatment delivery restricted to one plane, the robotic arm allows the team to choose almost any angle to deliver the beam. When multiple beam angles are utilized, the radiation is given to a tightly focused area.”
As part of the preparation to begin prostate cancer treatments, Mission replaced its original machine with this newest version of the technology to allow delivery of the radiation even more efficiently than before.
The biggest benefit of CyberKnife is that it drastically shortens a patient’s treatment period from 40 treatments over the course of 8 weeks to five treatments within a week and a half. Dr. Kuehn said this patient-friendly feature is particularly important in western North Carolina, where patients sometimes drive long distances to receive treatment.
MRI Ultrasound Fusion Target Prostate Biopsy (UroNav®)
An MRI of the prostate can detect areas suspicious for cancer that are not felt on exam or detected on prior biopsy of the prostate. If areas suspicious for prostate cancer are seen on an MRI, then a UroNav®- targeted biopsy may be indicated.
Mission Hospital has recently started using the UroNav® technology, which takes the images from a prostate MRI and an ultrasound, fusing them together to target specific areas for biopsy. This technology provides a valuable tool in the imaging of the prostate and diagnosis of prostate cancer.
The procedure is usually performed in the operating room, but sometimes can be done in a procedure room. The images are processed by the UroNav® machine, which has the MRI images preloaded, and a 3D map of the prostate is generated that assists the urologist in targeting the suspicious areas. Targeted biopsies of the prostate are then taken as well as additional samples.
Whole Breast Ultrasound—ABUS
According to Helen Sandven, MD, a radiologist with Asheville Radiology and the Director of Breast Imaging for Mission Health, “12 percent of women in the United States will have breast cancer in their lifetime.”
Whole Breast Ultrasound, otherwise known as ABUS, enables radiologists to look through hundreds of image slices to find breast cancers that might be missed on a regular mammogram.
Mission Breast Center was the first to introduce ABUS to the area. “We have our finger on the pulse of technology, and Mission Health has been very proactive about investing in cutting-edge equipment when it becomes available,”said Dr. Sandven.
This technology uses non-ionizing soundwaves and substantially increases the chances of diagnosing breast cancer at an earlier, more treatable stage.
Savi Scout: Wire-free Reflector Placement
Mission Hospital recently started using Savi Scout to pinpoint the precise location of a tumor and make surgery less invasive. Prior to breast surgery, providers place a “reflector” (a tiny device about the size of a grain of rice) into the tumor. The reflector is completely passive until activated in the operating room. At the time of the surgery, safe radar waves will be used to detect the location of the reflector within the breast. Your surgeon will use real-time audible and visual indicators to locate and remove both the tumor and the reflector during your surgery.
To make the day of surgery less complicated, patients have the reflector placed on a separate day in advance of their scheduled surgery day. During the placement, your provider will:
• Confirm the location of the tumor using imaging (mammography or ultrasound)
• Use a local anesthetic to numb the targeted area of the breast
• Introduce the reflector through a small needle under image guidance
• Confirm the placement of the reflector
Patients will not see or feel the reflector after it has been placed, and they can resume normal activity.
During surgery, a radar system is used to detect the location of the reflector within the breast, allowing your surgeon to plan the best path to the tumor. Real-time guidance is used during surgery to confirm the exact location. Finally, the system confirms that the reflector has been removed along with the targeted tissue.
To help patients who have received a cancer diagnosis through their journey, Mission employs several Nurse Navigators.
As a Nurse Navigator with multiple certifications in oncology and breast healthcare, Janet Magruder, RN, works closely with patients by providing education, coordination, resources, emotional support and advocacy through each phase of diagnosis, treatment and survivorship. Magruder guides patients through the healthcare system, and she helps get their questions answered.
“We work as one part of the team with nurses, social workers and physicians to help that patient,” said Magruder. “We work to help get treatment started.”
Examples of these services include: assistance with coordination of care, individualized education to help patients understand the information they have received about their breast diagnosis and treatment options; provide patients with information and connect them with resources offered by Mission and throughout the community. Additionally, Nurse Navigators offer emotional support to each of their patients during a sometimes difficult and confusing time.
Breast cancer is the top diagnosis at Mission following lung cancer. On a clinical day, Magruder can have anywhere from 10 to 12 patients, and each of those patient’s needs are different.