Conditions and Treatments
Ablation is a minimally invasive procedure that uses heat to remove obstructions and open airways for patients with blocked and/or scarred airways. Cryoablation uses cold energy to destroy tumors and control airway bleeding. Each technique is used during bronchoscopy and can be combined with other treatment techniques and stenting.
Chemotherapy is a highly effective treatment for many types of cancer. Chemotherapy may be used alone or in combination with other treatments such as radiation therapy or surgery.
Chemotherapy is given:
- As a pill to swallow
- As an injection into the muscle or fat tissue
- Intravenously (directly into the bloodstream; also called IV or infusion)
- Topically (applied to the skin)
- Directly into a body cavity
Chemotherapy is a systemic treatment, meaning the cancer-fighting drugs travel to all parts of the body, not just to the cancer cells. As a result, some patients experience side effects.
- There are more than 50 chemotherapy drugs commonly used to treat cancer. Each person reacts differently to treatment, which is why side effects range from mild to severe. Some people experience no side effects at all.
- Talk with your cancer care team and learn about potential side effects before you begin treatment. Armed with this information, you and your caregivers will be better prepared to minimize, or even prevent, side effects.
- Side effects may include nausea, vomiting, confusion, headaches, sores in the mouth, redness or dryness of the mouth, diarrhea or constipation and hair loss.
Inova Schar Cancer Institute offers dedicated medical oncology units staffed by physicians and nurses with special expertise in oncology and cancer care. These professionals are highly experienced in administering chemotherapy and dealing with any side effects. Your medical oncologist also consults with other physicians involved in your treatment plan, including radiation therapists, surgeons and your primary doctor, to determine the appropriate medications and dosage for your situation.
Clinical Research Trials
Inova is deeply committed to finding better ways to prevent, detect, diagnose, and treat cancer.
For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.
Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive a standard treatment or they may be among those randomly selected to receive a new treatment.
Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward. Patients can enter clinical trials before, during, or after starting their cancer treatment. Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring or to reduce the side effects of cancer treatment.
Cryotherapy is a type of surgery that destroys cancer cells by freezing them. The surgeon takes care to try to keep healthy cells and tissue from being frozen along with the cancer cells.
Several different procedures can be used to freeze cancer cells. For instance, to treat skin cancer, cells are usually frozen using liquid nitrogen that may be sprayed or applied right on the skin. To treat tumors in the lung, a thin tube is put into the lung tumors. The tip of the tube applies intense cold to the tumor, destroying the cancer. This procedure is done under general anesthesia.
Cryotherapy may be used to treat cancers of the skin, liver, cervix, prostate, bone, lung and for various pediatric cancers.
CyberKnife® is cutting edge treatment without cutting. It is an exceptionally precise, non-invasive form of radiation therapy for cancer available at Inova Fairfax Hospital.
This non-surgical treatment alternative is used for many different kinds of cancer. Patients with cancer of the brain, spine, lung, prostate, liver, pancreas, head, kidney, neck and pelvis may be excellent candidates for CyberKnife radiosurgery.
The pain-free treatments are delivered on an outpatient basis with virtually no disruption to normal activities and in many fewer sessions than conventional radiation therapy.
Benefits of CyberKnife treatment
- Pain free
- No anesthesia required
- Exceptional accuracy that spares healthy tissue and organs
- No invasive body frame or holding your breath
- Offers an excellent non-surgical option for patients with inoperable or surgically complex tumors, or who are looking for an alternative to surgery
Esophageal cancer is cancer that develops in the esophagus, the muscular 10- to 13-inch tube that connects the throat to the stomach.
The esophagus is located just behind the trachea and allows food to enter the stomach for digestion. The wall of the esophagus is made up of several layers and cancers generally start from the inner layer and grow out.
Often there are no symptoms in the early stages of esophageal cancer. Symptoms do not appear until the disease is more advanced. The following are the most common symptoms of esophageal cancer. However, each individual may experience symptoms differently. Symptoms may include:
- Difficult or painful swallowing, known as dysphagia, is the most common symptom of esophageal cancer. Dysphagia gives a sensation of having food lodged in the chest.
- Pain in the throat or back, behind the breastbone or between the shoulder blades
- Severe weight loss due to the unintentional lack of not getting enough food
- Hoarseness or chronic cough that does not go away within two weeks
- Blood in stool or black-looking stools
Image Guided Radiation Therapy (IGRT)
The robotic-assisted da Vinci® surgical program at Inova is the state-of-the-art alternative to both traditional open surgery and conventional minimally invasive surgery. Your surgeon's hands are at the controls of a robotic platform so refined that even the most complex, delicate procedures can be performed through very small incisions with unmatched precision.
Intensity Modulated Radiation Therapy (IMRT)
Intensity-modulated radiation therapy (IMRT) is a type of 3-dimensional external radiation therapy that uses a computer to make pictures of the size and shape of the tumor. Thin beams of radiation have different intensities and are precisely aimed at the tumor from many angles. IMRT is often used to treat head and neck cancers.
IMRT can cause less damage to healthy tissue near the tumor. Dry mouth, a commonly reported side effect of traditional radiation therapy, can be less of an issue with IMRT patients.
Minimally invasive laparoscopic surgery allows a surgeon to remove cancerous tissue through a very small incision. Advantages include reduced scarring and quicker recovery time.
Laparoscopic surgery was the first available form of "minimally invasive" surgery and is still frequently performed today. When it first came on the scene in the 1980s, laparoscopic surgery was sometimes referred to as "keyhole" surgery. Small half-inch incisions are made and access ports are placed in the body. A camera is inserted in one port to look inside the body. The camera is connected to a monitor that displays the body's interior to the surgeon and the surgical team. Surgical tools on long thin instruments are placed inside the body through the ports and surgery is performed.
Laparoscopy requires smaller incisions and results in less blood loss, lower risk of transfusion, a shorter hospital stay, less need for pain medication, and a quicker recovery.
Laparoscopic surgery is a minimally invasive option that can be used to treat many different types of cancer, including:
- Gynecologic cancers
- Urologic cancers
- Colorectal cancer
- Lung and other thoracic cancers
Lung cancer usually starts in the lining of the bronchi (the main airways of the lungs), but can also begin in other areas of the respiratory system, including the trachea, bronchioles or alveoli. Lung cancers are believed to develop over a period of many years.
Nearly all lung cancers are carcinomas, a cancer that begins in the lining or covering tissues of an organ. The tumor cells of each type of lung cancer grow and spread differently, and each type requires different treatment.
Lung cancer usually does not cause symptoms when it first develops, but symptoms often become present after the tumor begins growing. A cough is the most common symptom of lung cancer. Other symptoms include:
- Constant chest pain
- Shortness of breath
- Recurring lung infections, such as pneumonia or bronchitis
- Bloody or rust-colored sputum
- A tumor that presses on large blood vessels near the lung can cause swelling of the neck and face
- A tumor that presses on certain nerves near the lung can cause pain and weakness in the shoulder, arm, or hand
- Fever for unknown reason
Like many other cancers, lung cancer can cause:
- Loss of appetite
- Loss of weight
- Pain in other parts of the body not affected by the cancer
- Bone fractures
Other symptoms can be caused by substances made by lung cancer cells – referred to as a paraneoplastic syndrome. For example, certain lung cancer cells produce a substance that causes a sharp drop in the level of sodium in the blood, which can cause many symptoms, including confusion and sometimes even coma.
None of these symptoms is a sure sign of lung cancer. Only a physician can tell whether a patient's symptoms are caused by cancer or by another problem.
Medical oncology is the specialty associated with administering chemotherapy, or cancer-fighting drugs, to treat cancerous cells. Chemotherapy is a very effective treatment and has been used for many years. The number and types of chemotherapy medications increase each year as research continues to find new and better ways to fight cancer and lessen the side effects associated with treatment.
Inova Cancer Institute offers dedicated medical oncology units staffed by physicians and nurses with special expertise in oncology and cancer care. These professionals are highly experienced in chemotherapy and its side effects, pain management and cancer education. Your medical oncologist consults with radiation therapists and surgeons about your overall treatment plan and determines the proper medications and dosage.
NanoKnife™ is a minimally invasive cancer treatment that precisely targets and kills hard-to-reach tumors. NanoKnife allows treatment of difficult-to-reach tumors that in the past would be virtually impossible for surgeons to remove.
NanoKnife, available only at Inova Alexandria Hospital, is a minimally invasive cancer treatment that uses irreversible electroporation technology to precisely target and kill hard-to-reach tumors at the cellular level. The precision of the NanoKnife™ allows our interventional radiologists to treat tumors that in the past would be virtually impossible for surgeons to operate on due to their location.
NanoKnife technology is especially effective on small tumors, typically less than five centimeters, which are considered inoperable or poor candidates for traditional treatments. NanoKnife can be used for both primary tumors or for tumors that have metastasized or spread to other parts or organs of the body.
Tumors in the liver, lungs, kidneys and pancreas can be treated with NanoKnife.
Our team was the first in the Washington, DC, metro area to use Nanoknife™ – a minimally invasive cancer treatment which implements technology known as irreversible electroporation to precisely target and kill hard-to-reach tumors at the cellular level.
NanoKnife™ services at Inova Alexandria Hospital are performed by Dimitrios Papadouris, MD.
How does it work?
NanoKnife technology applies a series of quick bursts of electrical energy through electrodes that are inserted directly into and around the tumor and destroy it – leaving the surrounding tissue, veins, nerves and ducts unaffected. Healthy cells and tissue can then grow back and regenerate within the area. NanoKnife is different from other treatments like cyberknife and traditional surgery in that it can be done quickly and painlessly, and success can be evaluated much more quickly.
What are the benefits of NanoKnife?
- Cutting-edge technology that treats tumors considered inoperable, or where radiation therapy is not an option
- Virtually painless treatment with patients receiving general anesthesia and generally experiencing few or no side effects
- Fast treatment that usually requires only an overnight hospital stay
- No stitches or staples, just a small bandage
Patients arrive one hour prior to the procedure to the Cardiovascular and Interventional Radiology Department (CVIR) where they are greeted by the oncology intervention team including the nurse, technologist and anesthesiologist. After meeting again with the interventional radiologist who will answer any questions, the nurse will place an IV line for medication and fluids.
The patient will receive anesthesia, or an intravenous medication to put them asleep, and will be moved to the procedure room. The procedure generally lasts between one hour to one and a half hours, and following this the patient will awaken in the anesthesia recovery unit. After a short stay here, the patient will be taken to their room until they are discharged, usually the next morning.
There are no stitches or sutures to remove, only a small bandage covering the procedure spot. That dressing can be removed the following day. The patient will not have any significant medical restrictions after discharge, and may resume activities as tolerated.
How do I learn more and find out if I am a candidate for NanoKnife™?
Inova Schar Cancer Institute offers state-of-the-art radiation oncology and proton therapy services for all types of cancers and benign conditions.
Radiation therapy is a unique treatment that uses different forms of radiation to target cancer cells. Many cancer patients will undergo some form of radiation either as a stand-alone treatment or in combination with surgery and chemotherapy.
Stereotactic radiosurgery is a form of radiation therapy that delivers a high dose radiation to a small, specific area. The treatment is also known as stereotactic radiation therapy.
Stereotactic radiosurgery uses high energy X-ray beams to shrink or manage the tumor by destroying the cells or by disrupting the cells from growing. This therapy is different from traditional radiation therapy as stereotactic radiation therapy more effectively excludes the surrounding healthy tissues and organs so that side effects are minimized.
Stereotactic radiosurgery is available at Inova Alexandria Hospital Cancer Center and Inova Fairfax Hospital Cancer Center.
Stereotactic radiosurgery can be used to treat:
- Brain cancer
- Lung cancer
- Liver cancer
Surgery encompasses an ever-growing list of procedures, many of them minimally invasive, to diagnose, remove or treat cancer in nearly every part of the body.
Surgery is both a common and effective treatment for many types of cancer, especially those that are detected early and have not spread. In more advanced cases, surgery is often combined with chemotherapy, radiation therapy or hormone therapy.
Surgeons at Inova utilize some of the most advanced technologies available, including:
- da Vinci® robotic-assisted surgery
- Laparoscopic surgery
- Video assisted thoracic surgery (VATS)
All anticancer drugs target tumors in some way. Most conventional treatments, however, attack healthy cells as well as cancer cells. As a result, there can be serious side effects from the treatment.
A newer approach to cancer treatment, molecularly targeted therapy, may help reduce side effects. The medication takes a more direct aim at cancer cells, and that means less damage to healthy cells.
Targeted therapies are designed to recognize a specific molecular change in a cancer cell that drives the growth and spread of a tumor. By zeroing in on its molecular target, these new medications destroy or slow the growth of cancer cells while avoiding normal, healthy cells. And because healthy tissues are spared, targeted therapies tend to bring about fewer and less severe side effects than conventional treatments.
Some targeted therapies hone in on tumors by seeking out molecules found only in cancer cells. Other targeted agents seek out molecules that are more abundant in cancer cells than in healthy cells. And still other treatments are focused on processes that are more important to the growth of cancer cells than normal cells.
Targeted therapy can be an effective treatment strategy for:
- Breast cancer
- Colorectal cancer
- Skin cancer
- Stomach cancer
- Lung cancer
- Pancreatic cancer
- Thyroid cancer
Trilogy™ is a new, state-of-the-art radiation therapy that treats cancer conditions more quickly and with unprecedented precision, reduces treatment times and side effects, and improves outcomes. The Trilogy system's linear accelerator rotates around the patient to precisely target tumors from nearly any angle and reduces radiation exposure to healthy tissues. The system shapes the radiation beam to match the three-dimensional form of the tumor and an On-Board Imager™ device delivers real-time tumor tracking and automated patient positioning.
A set of optical guidance cameras monitor and correct for a patient’s slight movements on the treatment table. Trilogy even adjusts to the subtle motion of breathing. An infrared monitoring device turns the radiation beam on and off during treatment to compensate for respiratory motion. This feature is especially useful for treating lung cancer, but it is also effective on several other types of cancer as well.
The advanced features of Trilogy™ make it an effective form of radiation therapy for these types of cancer:
- Breast cancer
- Lung cancer
- Prostate cancer
- Kidney cancer
- Liver cancer
- Colon cancer