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December 17, 2007 - 2:01PM

New cancer tool shows promise in Scottsdale

Edward Gately, Tribune

Ray Simms has prostate cancer, but he fully expects to live at least another 20 years free of the disease. The 78-year-old resident of Tyrone, N.M., is undergoing radiation treatment at the Arizona Cancer Institute in Scottsdale. He’s confident the treatment will remove all of the cancer from his prostate, and that he’ll know for sure that it’s gone.

Of course, the radiation treatment Simms is receiving is unlike any treatment available throughout the Southwest. In fact, it’s only available at 25 locations across the globe.

The Calypso 4D Localization System is the state-of-the-art tool for treating prostate cancer, said Dr. Scott Tropper, radiation oncologist and the institute’s medical director.

“If you locate the tumor better, you’re better able to direct the radiation at the tumor,” he said.

Simms said the one factor that convinced him to go with the Calypso system is it provides proof that the cancer is gone.

“My wife had several types of cancer over the years and she finally died as a result of the cancers,” he said. “Even though the doctors thought they had eliminated it a couple of times, they hadn’t. It had progressed to other areas of the body. So it was very important to me that (Tropper) can prove it.”

Dr. Jonathan Ashman, a radiation oncologist with Arizona Oncology Services at St. Joseph’s Hospital, said improving technology is allowing prostate cancer patients to more safely receive higher doses of radiation, and therefore achieve higher cure rates.

“Calypso is but one type of technology that can accomplish that,” he said. “There are several types and no one has been shown to be better. This is all relatively new territory.”

Hard target

There’s no system in the world that only irradiates cancerous tissue and avoids all normal tissue, but there’s been vast improvements in directing radiation at the cancer and avoiding as much normal tissue as possible, Tropper said.

The prostate gland is the size of a walnut, located below the bladder. In the early 1990s, treatment involved irradiating an area the size of a grapefruit surrounding the prostate, Tropper said.

Since then, there has been steady progress in directing the radiation more toward the cancer and away from normal tissue, he said.

“Six years ago ... we started doing image-guided radiation treatments with an ultrasound system for prostate cancer,” Tropper said. “The idea is you could really avoid a lot of the surrounding tissue because you use the ultrasound image to direct the radiation specifically to the prostate gland.”

Next, Tropper advanced to implanting markers inside the prostate, and then locating them via x-ray to better track the exact location of the prostate.

Problem is, the prostate constantly moves, even during treatment, and neither the ultrasound nor the markers allowed the position of the prostate to be tracked during treatment.

“Now comes Calypso,” Tropper said. “It’s actually a series of markers, but ... they’re actually beacon transponders. Basically it’s a Global Positioning System.”

The Calypso system allows the position of the prostate to be tracked during treatment. The physician knows where the tumor is at all times, so all necessary radiation gets to the tumor while avoiding the bladder and rectum, he said.

Corporate backing

Tropper couldn’t afford the multi-million-dollar price tag to purchase the Calypso system and the accompanying Trilogy image-guided radiotherapy system on his own. So he partnered with 21st Century Oncology, a publicly traded company and the largest provider of radiation oncology.

“This meant millions of dollars, so I was able to do this because of the public company I partnered with,” he said.

Calypso is only approved by the federal Food and Drug Administration for treating the prostate, but it eventually will be used for treating other types of cancer, such as breast, liver and lung tumors, Tropper said. Those are other examples of tumors that are hard to track because the breast, liver and lungs are constantly moving, he said.

Tropper plans to use the Calypso to treat one of his patient’s liver tumor.

“A year from now, Calypso will be utilized for other things,” he said. “But we’re ahead of the curve.”

Patients welcome

Prostate cancer patients from all over the Valley and Arizona come to the institute for radiation treatment with the Calypso system, and Tropper said he’s not limited in the number of patients he can treat.

He recently moved the institute to a larger office, on Thomas Road east of Scottsdale Road, and will be opening a second location next month in the west Valley.

“A year from now, we’re going to have a center in Gilbert near Mercy Gilbert Medical Center,” Tropper said. “There’s no radiation there currently and it’s a significant growth area. There’s a need for it in terms of the population growth there, and it just makes sense to actually put one there.”

The key to prostate cancer is there are multiple “excellent” treatments during the early stage, Ashman said.

“All patients should (consider) both surgery and radiation before deciding,” he said. “Prostate cancer tends to be a slow-growing disease where there is time to decide the best treatment option.”


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