New Hyde Park, N.Y.-based Northwell Health’s Greenlawn and Lake Success radiation therapy centers are among the first in their area to offer adaptive radiation therapy.
Varian Ethos radiation therapy utilizes AI-powered imaging technology and enables physicians to make adjustments in real time, minimizing both side effects and table time for patients, according to a March 5 news release from Northwell.
Heather Zinkin, MD, chief of radiation oncology at Northwell Health’s Huntington (N.Y.) Hospital, spoke to Becker’s about the technology and what she sees for the future of cancer treatment.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: Can you explain how adaptive radiation therapy differs from traditional radiation therapy methods?
Dr. Heather Zinkin: What makes the Ethos Hypersight so unique is that, first, it incorporates AI to produce the fastest and highest-quality imaging technology. Patients can be imaged in as quick as six seconds. When we turn the beam on, we can really treat patients much more precisely than we ever were able to before.
The technology also allows us to account for daily changes in anatomy such as changes in tumor size or movement in the surrounding tissues. With adaptive radiation therapy, we can adjust the plan to account for these changes. In a matter of the patient table time, it takes maybe 30 minutes tops for imaging, creating a new plan and delivering treatment.
There’s been a strong focus in oncology care on not just in curing the patient, but on the patient’s quality of life. When looking at quality of life measures, you really have to think about both acute and long-term side effects from radiation. This technology, which will hopefully be studied over the course of years, will reduce radiation for normal tissues and should result in fewer long-term side effects.
Q: From an operational standpoint, what should health systems consider when evaluating similar investments?
HZ: Having the high imaging quality and the ability to deliver radiation on one machine is advantageous. Looking into the future, this may allow us to plan and treat a case on the same machine, which would be an economic savings.
Having such a fast machine also allows for much higher patient output. We can treat many more patients on one machine, so it should be a cost savings.
Q: How does the integrated care model improve the patient experience, and do you see it becoming a standard in cancer care?
HZ: Cancer care really involves the collaboration of many different specialists, and to have patients traveling to all different locations is highly inconvenient, stressful and inefficient. Looking at a model where patients can get all of their care housed in one location and one site is better for physicians, because they can coordinate care, and better for the patients.
Having some of the ancillary services that are really vital to patients — speech and swallow therapy, nutrition, rehabilitative medicine to help mobility issues, to help pain, having physical therapy — all in one campus is really advantageous to cancer care.
We’re really learning that traveling an hour each way for a 10-minute radiation treatment just makes no sense, and it’s just not necessary. Bringing these technologies and services out into patients’ communities will be the standard moving forward.
Q: What emerging trends or innovations in radiation oncology do you anticipate seeing in the next five to 10 years?
HZ: Instead of overtreating patients, we are recognizing that sometimes offering them less treatment is preferable. All aspects of oncology care are beginning to really focus on a theme I call “less is more”: less chemotherapy, less radiation, less surgery, but without compromising outcomes.
My passion is really including integrative services into cancer care. I’m fortunate in that we have a holistic nurse in our office a full day every week. Being able to offer patients services such as yoga, reflexology and acupuncture is really an important component of their care. I tell my patients it’s not just what I do, but what you do that matters as well.
Empowering patients to have some control over their prognosis, outcomes and quality of life is very impactful.
