Transcription:

Deborah Howell (host): Hello and welcome to the show. You are listening to Weekly Dose of Wellness. It’s brought to you by MemorialCare Health System. I’m Deborah Howell, and today’s guest is Dr. Asif Harsolia. Dr. Harsolia is a board certified cancer specialist in Radiation Oncology. He completed his residency at William Beaumont Hospital in Royal Oak, Michigan, where he trained with some of the world’s top specialist in the field of radiation oncology and established highly specialized skills and advanced radiation techniques, such as brachytherapy, image guidance, radio surgery and intensity modulated radiation therapy. Today, we’ll discuss neurological oncology with emphasis on a multi-disciplinary approach to treatment. Welcome, Dr. Harsolia. Dr. Asif Harsolia (guest): Thank you for having me. Deborah: Let’s get right into it. What are some of the latest advancements in treating brain and spine tumors? Dr. Harsolia: Well, I think one of the most exciting developments in recent years has been the advancement in the technique known as radiosurgery and utilizing systems such as the cyberknife. While the word knife and surgery brings up images of cutting in an operating room, radiosurgery is actually a virtual type of surgery where there’s no real cutting involved. It’s a painless non-invasive way of treating brain and spine tumors without anesthesia or hospital admission. Deborah: Incredible. It’s like a Johnny Quest world, isn’t it? Dr. Harsolia: Yes. Deborah: Did you ever think we’d make these advancements? Dr. Harsolia: I think 10 to 15 years ago, some of these things were the topics of science fiction, but the advancements in robotics and computer technology has really opened up brand new avenues that we’ve never had before. Deborah: Right. Now, it’s a great age to be a patient, of course, because of these advancements. How does cyberknife help in the treatment of this type of cancers? Dr. Harsolia: That’s a great question. In the past, to give you an example of a patient presented with a brain tumor in a critical location, let’s say near the optic nerves, which are the nerves that control vision in the brain. It’s a very sensitive area to operate on and it could be a risky operation. It could potentially results to blindness for the patient. Normally, when you’re doing that type of an operation, the neurosurgeon would have the nurse shave the patient’s head, have the skull open and then remove the tumor. The patient would be admitted to the Intensive Care Unit and have many days of recovery in the hospital. Now, there’s an alternative option for patients who present in these types of situations. They can have this outpatient cyberknife procedure done, where they can wear their street clothes, they're lying at a table for about an hour and a half, there’s no anesthesia, no cutting, and we’re able to, in most cases, ablate the tumor safely with a relatively small risk of toxicity and the patients usually are able to go home the same day. Deborah: Absolutely incredible. It just blows my mind. Let’s get more specific now. What is cyberknife and why is it such an important piece of technology? Dr. Harsolia: Cyber knife is sort of an advancement over some of the prior radiosurgery systems. Essentially, it’s a robotics system. It was actually pioneered by a neurosurgeon from Stanford and it’s based off of actually automotive robots and what it is, is a miniaturized linear accelerator that’s mounted on this robot and it allows the ability to deliver hundreds of beams of radiation from multiple different directions and it allows almost basically the precision to treat. You can almost treat something on the head of a pen; it’s that precise. And so, you’re able to carve radiation around critical structure, pinpoint the tumors with a high degree of precision and accuracy. Deborah: So, it is robotics surgery. It’s just a very specific type. Dr. Harsolia: Right, exactly, except there’s no cutting or there’s no actual incision. It’s actually x-ray beams that are focused that have a single point with high energy. Within a few millimeters away, you’re able to unintelligible regular healthy tissue. Deborah: In Men in Black, they have – I forgot what it’s called but it’s the thing they point at people and it just kind of zaps. The neuralizer, I think, it was called. I’m just trying to put it in layman’s term. So, you basically neuralize the tumor. Dr. Harsolia: Right. It’s sort of like that. It’s beams that go through the body and because each beam is divided by 1/100, when they intersect, it’s a lot more powerful, but each individual beam doesn’t hurt the body. So, yes, I guess you could sort of think of it that way. Deborah: All right. Now, can you also use a cyberknife for repair in terms of, say, the optic nerve—we’re back to the optic nerve—you couldn’t reconnect and put in a new optic nerve using a cyberknife. It’s really used for more or less demolishing something that’s foreign to the body. Dr. Harsolia: That’s exactly correct, yes. So, you can destroy or ablate tumors that are in critical locations, whether it’s in the spine or in the brain, but you can't actually repair or reconnect the nerves or things like that. Deborah: Do you think there will be a time in the future when we’ll be able to do things like that? Dr. Harsolia: Possibly. Probably not using this type of technology, but I think this type of technology is very useful in treating cancerous tumors or unintelligible tumors or things that should not be in the body. But there are uses besides cancer. People have used it for treating – for example, there’s a disease called trigeminal neuralgia which is a painful condition of the nerve, and you can ablate nerve with it, or even benign tumors such as meningioma which is a small tumor that is not malignant but nonetheless can be very uncomfortable for patients. Deborah: What about fibroids? Dr. Harsolia: It hasn’t been used for fibroids yet but that’s an interesting thought. Deborah: A lot of women would be glad to hear that. Dr. Harsolia: I’m sure. Deborah: All right. What can a patient expect from their physician team when being treated for this and other types of cancers? Dr. Harsolia: I think the most important thing is while we have this very advanced futuristic technology and cutting-edge type of equipment, we always try to keep in mind the actual patient’s condition and the overall clinical picture. Additionally, we try to select our teams such that they are able to balance this technology with compassion and with good bedside manner, as well as customize each of the patient’s treatment plans to their individual condition. Deborah: Fantastic. How is MemorialCare leading the way in the treatment of neurological cancers? Dr. Harsolia: MemorialCare has been very, very supportive. I think their investments in advanced technologies and putting together a multi-disciplinary team of specialists, because this was never a one-man type of a thing. We work very closely with neurosurgeons, with neuroradiologists, with pathologists, medical oncologists and many other members of the team. MemorialCare has actually put together a multi-disciplinary neuro-oncology tumor board to help with more complex cases. I think that really sets MemorialCare apart in terms of pioneering the treatment path in terms of neurologic cancers. Deborah: It’s really one of those things. It’s about the team, and if egos get in the way, it can really harm the patient’s prognosis. So, it’s wonderful when you see a team really working together. Dr. Harsolia: Absolutely. I completely agree with you on that. Deborah: Certainly, if you’re a patient, that’s what you would want. Dr. Harsolia: Absolutely. It’s very important. Deborah: What other developments are we looking at in terms of cybersurgery? Dr. Harsolia: Even though it was initially pioneered for the brain, there’s been tremendous advancement for treatment of lung cancers with cyberknife, pancreatic tumors, liver cancers and prostate cancers. The preliminary data for all of these techniques have been very promising, so we’re very excited about the future of this technology and this procedure. Deborah: What about wound control? I’ve heard that there are some places looking into putting these machines around a wound that is non-healing and actually healing the wound from the perimeter of it. Dr. Harsolia: Yes. I think that is something that is being looked into with another type of technology, but the cyberknife itself wouldn’t be used for something like that. It mainly affects the DNA and it prevents any type of cell in the body that’s replicating very abnormally. It prevents that replication from happening. So, with wound healing, it would be a different issue. Deborah: All right. Well, we want to thank you very much for your time. It’s a very exciting time in medicine. We look forward to further advancements coming out, out of your corner. Dr. Harsolia: Thank you so much and it was very nice talking to you today. Deborah: Dr. Harsolia finding the time to talk to us about the cyberknife and the multidisciplinary approach to neurological oncology. It’s a lot of big words but it’s a very good thing if you are a patient. It’s been a total pleasure to speak with you today. We learned a lot. I’m Deborah Howell. Please do join us again next time as we explore another Weekly Dose of Wellness, brought to you by MemorialCare Health System. Have a lovely and healthy day, everybody.