For Melody Smith, the timing could not have been much worse. A busy young third-grade teacher, she was planning the most important event in her life—her wedding on June 25, 2005—when she began experiencing headaches and sharp pains.
In June 2002, Melody had undergone a sixteen-hour surgery to remove a large, difficult meningioma—a non-cancerous tumor that grows on the dura, the fibrous sheath surrounding and protecting the brain. Now, it was back.
But this time would be different. Dr. Troy Middleton, Melody’s neurosurgeon, told her about a new treatment option available at Providence Hospital. The new Trilogy™ stereotactic radiosurgery system allows highly trained physicians at Providence to perform non-invasive brain treatments without an incision, with minimal pain and oftentimes, with no hospitalization. Providence Hospital worked closely with Dr. Middleton’s practice, Coastal Neurological Institute, PC (CNI) to be among the first in the nation to deploy this new technology.
Trilogy is the most powerful and versatile cancer treatment technology available, offering image-guided radiotherapy (IGRT), stereotactic treatment and conformal radiotherapy (CRT) in one system. The system delivers a wide range of precise treatments making it easier to treat difficult conditions including cancer and other neurological conditions.
“This technology brings us to a new level, significantly improving on precision and shortening the duration of these types of treatments,” observed Robert Gilbert, MD, radiation oncologist. “That means more accurate targeting along with greater patient comfort, since patients spend less time on the treatment table.” For Melody, Trilogy’s precision was especially critical, since the tumor was very close to her optic nerve. She had five treatments, of about one hour each, on an outpatient basis. Because of preparatory procedures, Melody was off work two days for the first treatment, but missed no work due to the subsequent treatments. “I was nervous about getting radiation, but it was not painful and I had no side effects,” she said. “They said I might have some hair loss, and with the wedding coming up, I was worried, but even that did not happen! Dr. Gilbert and the entire staff were wonderful. They made me feel very comfortable and relaxed.”
"As a community hospital, Providence was in the unique position to associate with CNI to provide Trilogy treatment to patients in the region, bringing new hope to many,” said Clark P. Christianson, president and CEO of Providence Hospital. “We will continue to team with our Ascension Health partner Sacred Heart Health System of Pensacola, Fla. to expand cancer care along the Gulf Coast. Trilogy treatment provides our patients with treatment that has only just now become available. There are only a handful of other cities offering the treatment, and most of those are only available at teaching and research hospitals," he said. According to Dr. Gilbert, if Trilogy had not been available at Providence, Melody would have had to travel several hours to another city and stay there two weeks for treatment.
At the core of the Trilogy system is a high-powered medical linear accelerator, a machine that rotates around the patient to deliver radiation treatments from nearly any angle. The system focuses on the tumor or lesion so that radiation is delivered directly to the target while minimizing the exposure of normal, healthy tissues. The system also incorporates a multi-leaf collimator for shaping the radiation beam to match the three-dimensional shape of the tumor, and a built-in X-ray imaging device for fast, accurate, real-time tumor tracking and automated patient positioning.
The Trilogy technology can be used to deliver all forms of external beam radiotherapy, including 3-D conformal (3D-CRT), intensity-modulated radiotherapy (IMRT), image-guided radiotherapy (IGRT), and image-guided radiosurgery (IGRS). Clinicians at Providence Hospital plan to use the Trilogy stereotactic system primarily to treat brain cancer and functional disorders. “It will also be used to target tumors that lie extremely close to critical structures or organs like the spinal cord or, in the case of head and neck cancer, the eyes or the salivary glands,” Dr. Gilbert said.
“Trilogy is a state-of-the-art system designed to enable clinicians to treat patients with the most advanced radiotherapy techniques, using clinically efficient processes,” said Richard Levy, chairman and CEO of Varian Medical Systems, manufacturer of the Trilogy device. “Our goal, with this technology, is to raise the standard of care while lowering the cost of treatment. We’re extremely gratified to see this happening in forward-looking community hospitals like Providence Hospital.”
Melody Smith is happy to again be focusing on her students and her wedding. “The headaches and the sharp pains are gone,” she said. “I feel great. I go back in September for an MRI scan to make sure the tumor is gone, but I am praying and believing that it is.”
