He still goes in every three months for CT scans, and his tumors are shrinking and disappearing. He is now looking forward to celebrating his 50th birthday.
DALLAS — Brian Hacker is tough, sharp and straightforward. He builds custom vehicles for a living.
Three years ago on his birthday, he experienced unshakable pain.
“I ended up going into the hospital,” Hacker said.
At the time, he thought it was kidney stones, but it wasn’t.
“Facing your own mortality will absolutely change you to your core,” Hacker said, describing what it felt like to be diagnosed with Stage 4 Renal Cell Carcinoma.
Kidney cancer that has spread to both lungs. He was 47 years old.
“There are words that will completely shift your gravity,” Hacker recalled. “Stage 4 cancer. No cure. Terminal.”
Treatment options at that disease stage were limited, and surgeons removed one kidney. But instead of starting chemotherapy, doctors at UT Southwestern Medical Center tried a different approach.
“We wanted to try something new,” said Dr. Raquibul Hannan, Chief of Genitourinary Radiation at UT Southwestern.
They enrolled Hacker in a small clinical trial to treat his tumors with pinpoint radiation technology, which was developed and available only at Simmons Cancer Center.
“It’s the technology that really allows us to make it more focused,” Dr. Hannan explained.
Hacker got fitted for a custom mold and lined up in a machine to receive ultra-focused radiation: three rounds, one hour at a time, with weeks between treatments. Doctors tackle one tumor at a time, but target multiple tumors in one visit.
“We got rid of those few spots in his lungs,” said Dr. Hannan. “For some patients, we will be able to cure them, and for others, we will be able to give them a good quality of life for a certain period of time.”
Over 90% of patients in this phase 2 study are cancer-free after one year, and there is another huge benefit in that patients report experiencing minimal side effects from this type of radiation.
“Most of our patients doing the stereotactic radiation come in during their lunch break, get radiation, and go back to work the same day,” Dr. Hannan said.
Hacker said his quality of life was uninterrupted. He still goes in every three months for CT scans, and his tumors are shrinking and disappearing. He is now looking forward to celebrating his 50th birthday.
“I didn’t want to waste away in a hospital bed,” Hacker said. “I didn’t want my mom to have to bury her son.”
Hannan said this type of radiation is not for people with rapidly-progressing cancer. It can be used for solid cancers only, but anywhere in the body.
The level of accuracy doctors can achieve is unprecedented. They use the same electromagnetic or gamma rays as one would use in other forms of radiation you’ve heard of, but combined with adaptive radiation, healthy tissues surrounding tumors get a far less dose of radiation.
Adaptive radiation allows experts to use CatScan or MRI technology during radiation treatment, and change the field – or direction – of radiation based on the tumor response.
For instance, Hacker’s tumors included one that was 16 millimeters. Some tumors were dangerously close to his esophagus and trachea. Dr. Hannan said because of the location and proximity of the tumors, old technology wouldn’t allow them to treat those without significant side effects that would impact Hacker’s breathing and swallowing mechanisms.
Now, they can … even while Hacker is on the table, with tumors in his lungs – which were moving as he was breathing.
“That’s the level of accuracy we can get to,” Dr. Hannan said.
Researchers at UT Southwestern got approval to do a larger Phase 3 Trial, which will look at whether this type of stereotactic radiation gives patients a head start, should they need chemotherapy years down the road if there is any sign of microscopic disease not removed by radiation.
The hope behind this type of radiation is that it could change the standard of care for people like Hacker.
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