When the Artiste came to Baton Rouge General’s Pennington Cancer Center last year, a unique relationship started to unfold—techno-lover meets techno-wonder.
Dr. William Russell, the center’s medical director of radiation oncology, was among the first people in the world to work with Siemens’ computerized linear accelerator to provide radiation therapy, one of the most advanced cancer fighting technologies available.
The center took delivery of the first Artiste in the Americas in December 2007. The machine uses incredibly focused and powerful beams of radiation to kill cancerous tumors while sparing healthy tissue.
Russell, an unabashed Trekkie who’s been a radiation oncologist 16 years, revels over the machine, what its evolution likely will mean to cancer treatment and his work.
1. How is the Artiste working out?
We’ve really enjoyed having a lot of people from around the country come and see what we’re doing with it. It was the only one in the country so they could come here to see it from big and small cancer centers, which was also good for Baton Rouge. It certainly put our name on the map. It was fun to network with other cancer centers about Artiste, as well as about going paperless and the other things we’re doing. Other centers are thinking about adopting this kind of center. We’ve been able to share with them on how we did it, and there’s been a lot of good cross-pollination.
2. What is the Artiste’s most significant advancement in treatment?
The most significant advances have yet to be seen … the things it will do in the future as it continues to be tweaked. It’s been very good with the degree of precision we’ve been able to treat people. Until now, no one has been able to measure real dose in a patient using intensity modulation [a fancy treatment technique]. We’ll be able to measure in real time what we’ve done, which is huge in radiation oncology. The next phase is adaptive radiotherapy, which changes the treatment plan from day to day.
3. Why was Pennington Cancer Center chosen among the first three centers for the Artiste?
We had a long relationship with Siemens, and the president of Siemens Oncology was a friend of mine. We also had the ability to accommodate this machine. We agreed with Siemens that a good place to start this off was in a community setting because that is where the majority of cancer care occurs. It was a very good fit.
4. Why did you come to Pennington Cancer Center?
Eleven years ago, I was in private practice in North Carolina, and they called me to come down here to put in a 3-D treatment center. I saw the quality of care here was really good. When I met the physicians and discussed their vision it was very exciting. We treat people like family, and we serve God. The staff enjoys coming to work. They like to help people. That kind of culture is infectious and has its own life, and that’s what is cool about this center.
5. Why did you go into radiation oncology?
I was actually teaching internal medicine and had a friend who was a radiologist oncologist who was talking about how much he loved it. I thought that sounded neat, looked into it and changed careers. There’s a lot of technology and clear goals. I love technology. The compelling side is treating people in crisis. When you’re told you have cancer, the rubber hits the road in everything you believe. It’s neat to be there and to help if I can. It’s nice to wake up in the morning and look forward to work.
6. What’s next in radiation oncology?
We’re going to have shorter treatment courses and more focused therapy. As computing power improves, we’ll get an image, and a plan will be done spontaneously with the patient on the table. And every day the patient will get a new treatment. Cancers and organs are never quite the same every day. The future will be that the plan given to that patient won’t be close, it’ll be exact.
7. Why does Louisiana have a high cancer rate?
The rates are not out of line. There are a couple of pockets of abnormalities, but what Louisiana has are cancers presented at later stages. We have to continue to improve access to care and meaningful screening. It’s an issue everywhere.
8. But more so in Louisiana, right? Why is that?
It’s just not been a priority for Louisiana, which is way behind in the screening efforts. What’s important to know about Louisiana is screening is on the uptick. For people who have insurance, it’s just a matter of going to their doctor. But there’s a large percentage of uninsured population, and they don’t have screening. That’s where Louisiana falls down, but things are moving forward. Money is coming for screening. As we do more and more of it and it becomes more accepted, we’ll get cancers at an earlier stage and we’ll have fewer of them.
9. What are your thoughts about medical care in the U.S.?
I know our medical system is broken. I just don’t know what the solution is. I think that we’re having problems with expectations due to marketing and people all feel they should get these miracle treatments no matter what the issue. We’re also having problems in health care delivery and a very complicated third-party payer system.
10. Many people are calling for universal coverage. Is that the right response?
I don’t think a socialized system is the answer. We’re comparing our system to those with people who leave there to come here for care. The real issues that are harder to get at is who should we do what to and for. The majority of health care dollars are spent in the intensive care unit in the last days of peoples’ lives. Also, health care providers bill exorbitant amounts knowing their insurance company will only pay a fraction of that. People paying cash get slammed because they don‘t have contractual protection to keep the rates lower.
