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Published on September 01, 2015

Radiation Oncology: Recent Advances in Cancer Therapy

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Thomas Sheldon, MD

When he isn’t playing his beloved oboe with the Longwood Symphony Orchestra in Boston, Dr. Thomas Sheldon is immersed in the work of his profession. Dr. Sheldon has worked as a radiation oncologist for 34 years. A man at the top of his game with an enviable CV and a curious mind, Thomas Sheldon confesses that his entire career has been spent “trying to drive myself out of business”. His way of doing that has been to attract other top-notch medical practitioners in the field of cancer care and treatment to Concord Hospital Payson Center for Cancer Care, see to it that they have the best equipment available along with ideal working conditions and then collaborate with them to provide state-of-the-art cancer care and treatment for patients and their families right here in Concord.

Participating as part of Concord Hospital Trust’s popular “What’s Up Doc” lecture series designed to keep Hospital benefactors up to date on the status of various elements of Concord Hospital’s services as well as its needs, Dr. Sheldon described his recent testimony in front of the State of New Hampshire’s Certificate of Need (CON) Board.

According to Dr. Sheldon this type of regulation has been “wildly successful” in radiation oncology, insuring for instance that only institutions that can realistically project a specific market share in a service area will be granted the CON Board’s coveted Certificate of Need for the latest Linear Accelerator with Robotic Table, which promises greater speed and accuracy in targeting of radiation.

Changing Times

Dr. Sheldon shared several interesting stories with the “What’s Up Doc” audience. Of particular relevance is the story of Roscoe Ammon, an inventor, industrialist and community benefactor, from Manchester, N.H. In the 1960’s Ammon was diagnosed with cancer and was treated in Boston due to lack of up-to-date cancer treatment in the local area. Determined to bring the ultimate in cancer treatment facilities to New Hampshire, Roscoe Ammon donated great resources to Manchester’s Elliot Hospital specifically for that purpose. As if by magic, the fabulous equipment in turn attracted the best and the brightest radiation oncologists and technicians, turning the region into something of a mecca for cutting-edge cancer treatment. All this took place before enactment of the CON laws which, are due to sundown in 2016. The result was that the Elliot facility grew very big, very fast. As a result, Concord Hospital was temporarily and frustratingly delayed in obtaining some of that state-of-the-art equipment and the brilliant professionals who utilized it. However, once allowed to pursue its cancer care goals, Concord Hospital has performed in the most outstanding ways.

Currently Concord Hospital Payson Center for Cancer Care offers some of the most current comprehensive cancer care to be found anywhere in the country. Dr. Sheldon reports that the two very busy Linear Accelerators each average 5,000 treatments annually and that the long-standing Palliative Care Program, so often an afterthought in many hospitals, is a strong and vital part of cancer care at Concord Hospital. At the top of the Payson Center’s wish list is that a multi-million dollar Linear Accelerator with Robotic Table. With its greater targeting capability, accuracy and speed, Payson Center needs a modern-day Roscoe Ammon to provide the funding.

Ironically the trend in Radiation Oncology is for treatments each day for fewer total days, known as Hypofractionation, or specifically for breast cancer, Canadian Fractionation. Cancers, such as small lung cancers, previously treated daily over six weeks are being treated in 2-3 treatments. In New Hampshire, on average, machines that in 2004 performed 6,400 treatments performed 5,400 in 2012 - down 16 percent. This is not because there are fewer patients but because the treatment theory and practice has changed. One of Dr. Sheldon’s Harvard professors tried to steer him from radiation oncology to cardiology observing “Once they find a cure for cancer, you’ll be out of work”. Perhaps instead, his alternate route to more time with the oboe will be Hypofractionation.