A Cutting-Edge Clinical Trial at Boston Medical Center Gives Boston Man a New Lease on Life

When Roy Davis found himself in Boston Medical Center’s Emergency Department, nothing could have prepared him for what doctors discovered. A large tumor in his rectum was obstructing his large intestine and critically endangering his life. However, when the pathology report confirmed the tumor to be rectal cancer, the diagnosis was absolutely shocking to the 72-year-old, who only months before had started to feel vaguely under the weather.

Still reeling from the shock, Roy was faced with the difficult task of choosing a treatment option that would not only cure his cancer but also preserve as much of his gastrointestinal tract as possible. A national multidisciplinary clinical trial at BMC provided hope. Based on research performed by the Chair of BMC’s Department of Radiation Oncology, Lisa Kachnic, MD, and BMC’s Department of Radiation Oncology Chief of Physics John Willins, PhD, the treatment focused on reducing the tumor through intensity-modulated radiation therapy and the combined administration of the chemotherapy drugs oxaliplatin and capecitabine.

“I was told that it was a cutting-edge protocol. I had a second opinion, and I learned that that was true because the other leading hospital did not have a protocol to match it,” remembered Roy.

Chemoradiation has been a preoperative strategy for patients with locally advanced rectal cancer over the last decade. Dr. Kachnic, who is a national leader in the treatment and research for colorectal, anal and other GI cancers, is working to perfect the accuracy of radiation administration through a cutting-edge technique called dose-painted intensity-modulated radiation therapy that effectively targets tumor cells, while sparing normal surrounding structures.

The new type of radiation therapy offers a customized approach to treatment based on biological information gathered from a patient’s positron emission tomography (PET) scans. PET scans reveal abnormal cells by their reactions to a harmless chemical, called a radiotracer, which is injected into the patient’s bloodstream. A scanner follows the radiotracer and sends three-dimensional images to a computer screen.

Armed with this information, physicians are able to use higher dose levels by "painting" beams of radiation where they need to go, point by point, skipping over healthy tissue. No other treatment method has this capability, and the method left Roy optimistic that despite his large-sized tumor, his bowel function could be fully restored.

Roy agreed to participate in BMC’s clinical trial and embarked on a six-week course of intense chemotherapy and radiation before surgery to remove the tumor in the fall of 2005.

“They were able to take out the area that had his tumor and, surprisingly to all of us, this really large and advanced-stage tumor turned out to have only one microscopic foci of tumor remaining,” explained Dr. Kachnic.

Today, Roy has been cancer free for eight years. Moreover, he has remained pain free after his treatment and surgery, which is a testament to the care he received at BMC. He remains active in his BMC cancer survivorship support group, which he claims is as vital as medicine for helping him cope after his traumatic illness.

“Dr. Kachnic is my angel. Going to Boston Medical Center was the best choice of my life,” he remarked.

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