By MARGARET DWIGGINS
An invitation to speak to the Findlay Rotary Club about cancer care presented a challenge to Dr. Stephen Lutz, a radiation oncologist at Findlay’s Cancer Care Center, as it’s difficult to condense such information into a brief presentation.
Lutz, who spoke to the club at its weekly meeting Tuesday, opted to light on several topics, zeroing in more closely on those that elicited questions from his audience.
Lutz discussed the changes in medicine and how life expectancies have changed because of technological advances and the ability to control infection. By 2030, 19 percent of the population will be older than 65, making current medical models unsustainable. Dying represents the most expensive component of health care costs, and these costs will increase as the population ages, Lutz said.
According to the Centers for Disease Control and Prevention, cancer is the second leading cause of death in the United States behind heart disease, and over 500,000 Americans die of cancer each year.
Lutz in frequently consulted on palliative oncology care, which addresses the treatments of people with life-ending illnesses, some of which allow a patient to live for many years. It has been difficult to establish guidelines for such care, and cancer care in general, he said.
Lutz said sifting through the latest guidelines for cancer care is becoming an increasingly large part of his job and that he deals with “a tidal wave of guidelines” every day. He has become nationally and internationally involved in determining these ever-changing guidelines, serving as the incoming chair of the Guidelines Committee for the American Society for Radiation Oncology and as chair of the Cancer Steering Committee for the National Quality Forum, a nonprofit organization that works toward improvements in health care.
He has seen, too often, how recommendations he has worked on have been ignored or passed too quickly without proper review or revision.
Lutz said Blanchard Valley Hospital continues to develop Findlay as a regional cancer care center, providing radiation, chemotherapy and support at one place.
“It is the right way to maximize care for people going through the hardest time in their life,” Lutz said. He noted the center is attracting patients from throughout the state and Michigan.
Lutz said Findlay’s cancer center had state-of-the-art radiation equipment when it was built 10 years ago, but changing technologies necessitated the purchase of new equipment about a year ago. The center now has two TrueBeam linear accelerators, which provide “stunningly” precise radiation treatment.
The machines deliver more concentrated doses of radiation which allow for fewer treatments, he said. Treatments are quickly and painlessly administered and are often effective enough that surgery can be skipped altogether, or to allow surgeries to be less invasive, giving the patient a better lifestyle.
“We can position someone down to the millimeter,” Lutz said, explaining that the radiation wraps itself around a tumor “like a blanket.” The machines are so accurate that they can detect when a patient draws a breath during a treatment, stopping itself until the breath is completed. This is particularly valuable for patients with lung and breast cancers whose treatments are targeted near the lungs and heart where a breath can easily alter the machine’s accuracy.
One of the Rotarians noted that people here often opt to seek treatment in larger cities, and he asked Lutz if there is pressure from larger clinics for patients to have all their treatments there, as opposed to having surgery at an out-of-town clinic but regular follow-up treatments, such as radiation, at home. Lutz acknowledged that this is often the case, as it can be difficult to maintain relationships between physicians, but he said that Findlay’s cancer center can offer most treatments “as well or better” than other clinics and that people can be very comfortable with the care available here.
“That’s been one of our struggles, to let people know what to get where,” Lutz said.
Lutz was also asked how lifestyle affects the incidence of cancer. He noted that being overweight increases the risk of hormonally affected cancers, such as breast and prostate cancers, because fat cells produce hormones and secrete them into the bloodstream. Smoking greatly increases one’s risk of lung cancer and heart disease, although some people have genetic factors that also increase their risks.
Still, “if you quit smoking today, your risk for cancer and heart disease starts dropping tomorrow,” he said.
Lutz said he is also seeing a huge increase in throat cancers, which used to be primarily caused by excessive smoking and consumption of alcohol. Now, many of these cancers are attributed to the human papillomavirus, the same virus that causes cervical cancer.
The most prevalent cancer locally is breast cancer, he said.
Lutz said researchers have long worked toward the goal of curing cancer, but there are thousands of types of cancers to combat. The good news, he said, is that with immunotherapies and specific treatments, doctors are much more able to offer personalized cancer care for patients that, if not providing a cure, is at least giving patients greater longevity.
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