Thirty years ago, oncology radiologists believed the then-state-of-the-art cancer treatment options were beyond reproach. However, as with everything else, time marches on.
“If I treated people with those therapies today,” explains Dr. Edward Soffen, “I would be considered a third-world radiation oncologist.”
He is anything but.
In fact, Soffen has been practicing radiation oncology for almost three decades, 25 years of which were at CentraState Medical Center in Freehold.
“There will always be ways we can improve treatments that will maximize tumor response, minimize side effects and increase the likelihood of cure,” he said. “That’s our goal. Until we have 100 percent cure or complete prevention, we know there are ways to improve.”
“However, at this moment in time, the innovative radiation treatments we are using are incredibly efficacious.”
Three radiation treatment therapies, hypofractionation, brachytherapy and SpaceOAR (organs at risk), are now being prescribed regularly by Soffen and members of his oncology team at CentraState and are nothing shy of revolutionary. To understand why, it’s important to understand the “what.”
Cancer is viewed by the medical community as both a local disease as well as a systemic one. The latter means that, at diagnosis, the cancerous cells are metastasizing into other places in the body.
Chemotherapy treats systemic cancer, while radiation, Soffen explained, treats local disease.
“These days, patients can avoid large, complicated surgeries because of innovations in radiation treatment,” he said. “Fewer mastectomies are necessary now. Often, we can preserve the prostate, the larynx and the tongue in some head and neck cancers. We don’t have to have the anatomically destroying surgeries we once did, now that we have precise radiation therapies.”
Through hypofractionation, radiation oncologists are able to move patients through treatment faster, with the same cure rate as traditional radiation. Soffen explained with this treatment plan, patients receive the same total amount of radiation but in larger doses and less time.
“The traditional treatment was 30-33 days, five days per week for close to seven weeks. Now it is completed in half the time.” The cure rates between hypofractionation and traditional treatment are equally successful, he said.
“Hypofractionation put less burden on the patient and their family,” Soffen said. “They are able to return to work faster and get back to their lives more quickly.”
A recent study of hypofractionation in prostate cancer treatment showed efficacy in treating patients for five to six weeks instead of nine weeks. Inoperable lung cancers can typically be treated with five treatments over 10 days, instead of the usually prescribed 30 treatments of six weeks, Soffen confirmed.
In the past, hypofractionation of radiation was used for terminal patients, “when we wanted to get them through treatment fast and not force them to spend the rest of their days in treatment,” Soffen recalled. “Today, hypofractionation is becoming the optimal therapy for several different local cancers.”
Through this radiation delivery technique, radiation oncologists deliver an optimal dosage of radiotherapy using a sealed source of radiation placed next to the site of the origin of the cancer. It is used successfully, Soffen said, for breast, prostate, cervical and skin cancers, as well as many other types of tumors throughout the body.
“Through brachytherapy we are essentially irradiating the body from within,” he said. “This procedure can elimin ate five to nine weeks of treatment because we are able to put the radiation right next to the cancer and eradicate it faster.”
In the case of radiation to treat prostate cancer, which generally has a high incidence of erectile dysfunction as an unfortunate side effect, brachytherapy (treatment without the need for surgery) has proven incredibly successful. While the likelihood of preserving erection capability stands at 70 percent traditional external beam radiation, brachytherapy improves the likelihood considerably, Soffen said.
He added “Brachytherapy has added to our ability to treat skin cancer, with just seven, quick visits and no surgery, and little, if any, scarring.”
Used in prostate cancer treatment, SpaceOAR hydrogel further improves the likelihood of preserving erection capabilities. Soffen and CentraState worked together as one of the clinical trial leaders, one of only 20 sites in the country who participated in the trial that demonstrated safety and efficacy.
SpaceOAR is an FDA-approved gel that is injected before the start of radiation in the small space between the front wall of the rectum and prostate. The gel will dissolve by itself in three months. SpaceOAR it is extremely successful, Soffen said, in moving the rectum away from the prostate during any kind of radiation treatment.
“SpaceOAR acts as a spacer between the rectum and the prostate, making it much less likely that the rectum will be exposed to radiation,” he said, noting the rectum wall and prostate are practically touching each other. “It acts as a barrier to significantly decrease the rectal toxicity.”
“The cure for cancer is not something that is going to happen overnight. We know this,” Soffen concluded. “It will occur over time, through small steps. Every small increment of advancement improves survival rates or reduces side effects. Every time we improve the technology, we are one step closer to a cure.”
To schedule a consultation with Dr. Edward Soffen, contact his office at CentraState Medical Center at (866) CENTRA7. Visit www.centrastate.com/cancer-center for more information on The Statesir Cancer Center at CentraState.