Cancer Care Connections
Cancer Care Connections
Revolutionizing Cancer Care: Advances in Radiation Oncology
Experience the advances in cancer treatment with Dr. Michael Miller from Virginia Oncology Associates as he shares his inspiring journey into the field of medicine, rooted in the influence of his sister’s nursing career. Discover the game-changing technologies revolutionizing radiation oncology, such as the TrueBeam Varian Linear Accelerator. Dr. Miller provides an in-depth look at how these advancements are enhancing precision and improving patient outcomes, laying the groundwork for a new era in cancer care.
Explore the transformative strides in stereotactic radiation therapy, moving beyond traditional gamma knife treatments to cutting-edge techniques that prioritize patient comfort and accuracy. Learn how sophisticated machines like the Varian TrueBeam are revolutionizing lung tumor treatments using gating techniques that synchronize radiation delivery with patient breathing. This segment underscores the versatility and significance of stereotactic radiation therapy in modern medical practice, expanding its applications far beyond brain treatments.
Lastly, dive into the captivating realm of radiopharmaceuticals and brachytherapy. Dr. Miller discusses the evolution of treatments like Radium-223 and Lutetium-177 for prostate cancer and their potential to target other cancers. Get insights on HDR brachytherapy, which delivers high-dose radiation directly to tumors with minimal patient discomfort, particularly for skin cancer. Plus, get a sneak peek into our upcoming episode with Dr. Jacob Hall, who will explore the use of radiation therapy beyond cancer, including its applications for osteoarthritis. Join us on this enlightening journey through the forefront of radiation oncology!
Dr. Michael Miller graduated Magna Cum Laude from the University of Pittsburgh with a B.S. in Pharmacy. He received his doctorate from the Philadelphia College of Osteopathic Medicine where he was valedictorian and a member of the Sigma Alpha Omicron Honor Society. He completed a surgical internship at the Doctor's Hospital/Ohio Health.
His residency was completed at Eastern Virginia Medical School where he was Chief Resident. Dr. Miller was awarded the 2005 American Brachytherapy Society Prostate Fellowship Award at the Seattle Prostate Institute. Dr. Miller is board-certified by the American Board of Radiology as a specialist in Radiation Oncology.
Dr. Miller resides in Virginia Beach with his wife and sons and enjoys outdoor sports and other fitness activities.
Resources mentioned in this podcast
National Cancer Institute: https://www.cancer.gov/
American Cancer Society: https://www.cancer.org/
National Comprehensive Cancer Network (NCCN): https://www.nccn.org/
Thank you for listening! If you're interested in hearing more from Virginia Oncology Associates, make sure to subscribe to Cancer Care Connections on Apple Podcasts, Spotify, or anywhere podcasts are available, or listen online at cancercareconnections.buzzsprout.com.
Cancer Care Connections is the official podcast of Virginia Oncology Associates. For more information, visit us at VirginiaCancer.com. or find us on Facebook or Instagram at Virginia Oncology Associates.
Intro
00:05
Welcome to Cancer Care Connections. On this episode, Cheryl spoke with Dr Michael Miller, a radiation oncologist at Virginia Oncology Associates. Dr Miller discusses the incredible advancements in radiation oncology, especially the game-changing TrueBeam Varian Linear Accelerator, and how these innovations are enhancing treatment precision and patient outcomes. Through Dr Miller's insights, you'll learn how radiation oncology uses high-precision X-rays to treat tumors with unparalleled accuracy.
Cheryl
00:42
Dr Michael Miller has been with Virginia Oncology Associates since 2005. He is a radiation oncologist who treats all types of cancers, with a focus on head and neck cancer, thyroid cancer, and stereotactic radiation. He lives in Virginia Beach with his wife and three sons and enjoys outdoor sports and various other fitness activities. Dr Miller, thanks so much for talking with us today.
Dr. Michael Miller
01:06
Thank you for having me.
Cheryl
01:07
I want to get just a feel of what brought you to medicine. How did you get into this?
Dr. Michael Miller
01:14
My sister was a nurse and she was eight years older than me. And when I was young she used to teach me anatomy. So she's in nursing school, she's teaching me bones, she's teaching me muscles and teaching me arteries and I thought, man, this is really cool, I'd like to do this. But I thought, "I don't think I should be a nurse", and it was a long time ago, so there weren't many male nurses. And so I decided to get into the medical field. That's a long, twisted story, but that's kind of how it happened.
Cheryl
01:43
Oh, I love that. So in the family.
Dr. Michael Miller
01:46
Yeah, she retired from nursing after 40 years. So, yeah, her career is done, but I'm still trying.
Cheryl
01:52
Well, congratulations to her. And what a legacy, right? You're following in her footsteps and doing great things here.
Dr. Michael Miller
01:58
All right.
Cheryl
02:00
So today we want to talk about recent advances in radiation oncology. I know this is something close to your heart and I'd love to know what is responsible for most of the recent advances in this field.
Dr. Michael Miller
02:13
Yeah, I honestly think the reason we're better in this specialty now than we were 10 years, or 20 years ago, is simply the equipment. I don't think that the radiation beam is much different. I don't think the doctors are smarter. I think that the machines are very, very precise. They're very good. They're advanced and they allow us to do things that I really couldn't even dream of doing 20 years ago when I finished my residency.
Cheryl
02:39
I think the doctors probably have something to do with it.
Dr. Michael Miller
02:42
Maybe a little bit, maybe a little bit. Yeah, but the machines are fancy and the key is learning how to use that precision and advanced technology, and that's what we're doing.
Cheryl
02:52
So what do these advances mean to someone listening? And we have patients, and their families. We have other doctors who want to learn more about what this technology means for them.
Dr. Michael Miller
03:04
I think the place to start would be to talk about a linear accelerator, and that's a machine that delivers radiation. So someone comes to get a treatment. They lie on a fancy x-ray type of table. That table moves them into position and the machine that then treats them with radiation is called a linear accelerator. In our centers, we have linear accelerators made by Varian. There's a machine called a TrueBeam Varian. It's kind of what we consider state-of-the-art. It's very versatile. There are other machines that are more specific and made for particular tasks, but a TrueBeam is kind of what I think is a state-of-the-art machine that can treat patients with a lot of different modalities of radiation. We're going to talk about some of those; a lot of different modalities. And that's where it starts. The machine and the advances on that machine that have taken place over the years are impressive and, yeah, I think we'll get into that today.
Cheryl
04:06
Definitely. I want to go to the beginning if we could. What is radiation oncology?
Dr. Michael Miller
04:12
So radiation oncology is the specialty where you use radiation; and radiation, for the most part, is a fancy strong, precise X-ray to treat a tumor. Typically cancerous, although benign tumors are occasionally treated, and that x-ray is designed to shrink, obliterate, or kill that tumor. And that's the specialty in a nutshell.
Cheryl
04:37
Can I ask what is your specific role when you're working with patients?
Dr. Michael Miller
04:43
So my job if I were to try to tie it up quickly: I'm going to meet a patient. We're going to decide whether radiation therapy is the right thing. I'm going to prescribe how we should do that, how much, where we're going to treat, et cetera. We're going to take that patient to our fancy simulator CT machine. We're going to get those images. I don't run that machine, my board-certified therapists do. Now we're back to the point where I step in.
05:11
It's time to design some radiation beams. Me and my staff will use the images, contour or draw out what we want to be treated, how much needs to go there, what needs to be spared, and how much radiation can the normal tissues tolerate before a problem could occur. That's my job. Those beams are designed. We look at that plan. We approve that plan. We say we like it. Now we're going to hand it back off to our board-certified radiation therapists who are going to run the radiation machine for me. When a patient gets treatment, we're going to use, for example, a lung tumor. Every day, when they get that cone beam CT, I'm going to sign off that I agree with the accuracy of the treatment and that we're doing exactly what we designed and what we wanted to do. So I'm involved in every step, but I'm not running the machine. And they're so much better at running that machine than I am. Thank God we have them.
Cheryl
06:10
That's incredible, and I know we wanted to talk about four types of therapy, the first one being image-guided radiation therapy (IGRT). Can you talk more about that?
Dr. Michael Miller
06:21
Sure, IGRT or image-guided radiation therapy. What do we mean by that? It means that, as opposed to 20 years ago, we're going to have a patient on our fancy linear accelerator and every day when we treat them, we're going to take a picture of them. We're going to take a scan of them. We're going to be able to look at that tumor inside the body and then adjust our beams each day to be more accurate and more precise with our treatment.
It started years ago with some less impressive imaging and worked its way up to what we use today, which is called a cone beam CT. So there's a very small CT or CAT scan unit on the linear accelerator. The patient is lying in the treatment position. They're pretty comfortable. Our new cone beam CT rotates around the patient and takes a fancy image. You can look at the tumor. Then the treatment beams are adjusted. It could be a few millimeters, could be as big as a centimeter, but there are adjustments made pretty much every day to localize and make the treatment more effective and more accurate.
Cheryl
That is incredible.
07:35
It is incredible, and 20 years ago I never dreamt it could happen. Imagine in 20 more years.
Cheryl
07:41
What could happen then? And so, when you're looking at this picture, what does it tell you now? How does it help the patient?
Dr. Michael Miller
07:50
It does. Here's what happens. We're going to use lung cancer as an example. We have our patient in the treatment position. They're on our linear accelerator. Our cone beam CT is done. Now we're looking at the tumor. Now we adjust our beams. Now we're very, very accurate. But what does that mean? It means that 20 years ago if we were going to be accurate on that tumor, the beams, the treatment field, the area that needed to be treated, needed to be much bigger. Let's call it a five-centimeter lung tumor. And we think, okay, those lungs are moving, that patient's moving, he's breathing. How big does this field need to be to treat the patient? It needs to be a pretty good size, otherwise you're going to miss that target. Now we can be much more precise, so the treatment beams are smaller. What does that mean? Less side effects, and less toxicity. Also, it means that by using smaller beams and treating less normal tissues, you can give a higher dose. Now we have a better chance to cure people and protect them.
Cheryl
08:53
Way more targeted.
Dr. Michael Miller
08:55
Way more targeted.
Cheryl
way more targeted.
Dr. Michael Miller
Yeah.
Cheryl
08:57
So our next one is intensity-modulated radiation therapy (IMRT).
Dr. Michael Miller
09:02
And it's a good thing to talk about. And I would tell you it's not new, but it's better than ever. Intensity-modulated radiation therapy is this: when you develop your beam and your beam is, we're going to use our five-centimeter lung tumor again, your beam is designed to treat that tumor. But what happens is that there are different parts of the body; they have different sizes, different shapes, and different densities. That beam, if it is static or doesn't change, is not going to deliver a homogeneous dose of radiation. It would be very heterogeneous; higher or hotter in one area, cooler or lower in another. But if you can use a computer with leaves that can protect, shield, and block the radiation at certain times during the treatment, you can smooth that dose out very, very nicely. So now the beam is not static, meaning, stop, turn it on, let it go. It's a beam that, while it runs, changes in intensity at different places and spots throughout the treatment field.
Cheryl
10:10
The way it's supposed to in your mind.
Dr. Michael Miller
10:12
The way it's supposed to.
Cheryl
10:13
As the doctor says okay, it's got to be higher and lower here, right, and you tell the computer to do that and it does that.
Dr. Michael Miller
10:19
And now the computer can do that for us, so we can be more accurate and we can give higher doses and the doses we're given can be more smooth and homogeneous so that we're getting the outcome we need. So that's been around longer than what we just discussed the IGRT but it's still really paramount to what we do today and makes a big difference.
Cheryl
10:42
Well, back to a custom treatment, targeted treatment. This is part of that puzzle.
Dr. Michael Miller
10:48
That's correct.
Cheryl
10:49
Number three is stereotactic radiation therapy.
Dr. Michael Miller
10:53
Yeah, yeah. So stereotactic radiation is another one that isn't new, but the advances are how we've gotten from where we were to where we are now. So the first example of stereotactic radiation would probably be stereotactic radiosurgery, and the definition of that is using a very precise radiation beam to deliver a high dose of radiation in a single treatment to the brain. So stereotactic radiosurgery is only really a true definition utilized in the brain. The first time that was done in this country, started a little bit earlier in Europe, but the first time that was really done in this country was at the University of Pittsburgh using a device called the gamma knife, and the gamma knife is still a very accurate and excellent device.
One of the problems with the gamma knife was when patients had a gamma knife treatment to their brain. In order to be accurate, you had to use a frame and you had to bolt their head down to the treatment table. So there were four bolts that went into the skull. It immobilized the patient and it did that very nicely. No one moved, but it's not comfortable. When I was a resident we still did that. It wasn't comfortable but it worked. We've gotten from that kind of treatment to gamma knife, where maybe the frame wasn't quite as uncomfortable, to now, where you can do that type of procedure on high-end machines that we now have in our facilities and, honestly, a lot of facilities in the country. Gamma Knife was only in a few select facilities in the country and it was very accurate, very good, and excellent treatment. And people in the field knew we had to do better. This has to be offered to every community, every decent-sized town, not just at big institutions in big cities. So now on our linear accelerator, by Varian TrueBeam, we have the ability to do stereotactic radiosurgery and thankfully we don't need to bolt anyone's head down.
Cheryl
13:07
So I've got this picture in my head as you're describing it. What is the experience now for a patient with this particular therapy where they don't need to have their head bolted down?
Dr. Michael Miller
13:17
It doesn't hurt at all. We treat patients and they walk in and they walk right out. They're adjusting their hair and brushing their hair, but otherwise, they haven't felt a thing.
Fortunately, even gamma knife machines don't have to use the bolt. But it was a day-long procedure. You needed some anesthesia, of course, getting the bolts in and out, and it was quite an ordeal. And now the fact that we can offer this in the community to patients with the same clinical results is impressive.
Cheryl
That is incredible.
Dr. Michael Miller
It is cool. Yeah, it is very cool.
Cheryl
13:53
I'm thinking, as you're telling this, that you remember what it was like back then, and then now to have patients who have a much better experience, even though they still have to have the surgery or the procedure done. That's pretty cool to be able to see that.
Dr. Michael Miller
14:09
When I was a resident, one of my jobs was to stop the bleeding of the bolt hole,
Cheryl
Oh my goodness,
Dr. Michael Miller
Which didn't take that long.
Cheryl
Oh good.
Dr. Michael Miller
Fortunately, I don't have to do that anymore.
Cheryl
14:19
Yes, I think everyone's happy that you don't have to do that anymore. This last one is gating techniques.
Dr. Michael Miller
14:27
Yeah, gating techniques. So, gating techniques, and I'm going to describe this by using two different machines. We've already established we really like our Varian TrueBeam linear accelerator. But to get to that point and to get any patient to the point where we treat them with radiation, we first take them to the simulation machine or the simulator. And that is a fancy CT scan. The one that we use is by Siemens, and it's a fancy CT scan. We do our own scan, but this CT scan has the ability to do a four-dimensional scan since it can record motion.
I want to go back to our lung tumor, because lung tumors, move. We can do our scan, we can record the motion of our lung tumor, which can be just a little bit or quite a bit. Now we know this lung tumor moves, we're going to call it two centimeters, and it goes up and down and up and down with every breath. We design our fancy beams, we head over to our machine. We need to account for that motion and one of the ways we can do that, probably the best way to do that, is something called gating. The machine itself will only deliver the treatment when the tumor is in the treatment zone. If the breaths are pretty small and steady, we got it nailed down. As soon as the breathing gets a little bit erratic, the beams will turn off. The patient's breathing will settle down and come back into the treatment zone. Again, improve accuracy, and improve the conformal treatment that we're trying to deliver. So that's gating.
Cheryl
16:06
And I just sort of think that for the patient it means, as we were saying earlier, it's less of an impact on that person.
Dr. Michael Miller
16:12
Less of an impact. More normal tissues are spared, more radiation to where we need it, and gating is one way to handle this motion. It's interesting, we know so much more about tumor motion and patient motion and things now than we used to because of these fancy tools. And that's just one of the ways we deal with motion is gating and some other techniques, but that's a good one.
Cheryl
16:38
That's very cool.
Dr. Michael Miller
16:39
It's very cool.
Cheryl
16:40
We just talked about stereotactic treatment in the brain. Does that work for other parts of the body?
Dr. Michael Miller
16:46
It does and it's one of the things that I really enjoy. In fact, I consider it one of the best advances we've made in radiation therapy. When I described stereotactic radiosurgery, I defined it as a single treatment. When you use stereotactic radiation in the body, it's rarely a single treatment. In fact, it's typically three to five treatments, but the principles are very similar. We need to use a very focused beam. It's got to be a high dose, intense beam, but, importantly, it's got to be very, very accurate. It's called stereotactic body radiation therapy and I think the most common use and my favorite utilization is for early lung cancer.
We've been spending a lot of time talking about lung cancer, haven't we? And we've talked about this five-centimeter tumor that I was trying to treat. Now I want to talk about a stage one lung cancer; a small one, two, three-centimeter lung cancer that previously was almost always treated surgically or if the patient wasn't capable of having surgery, and that's a lot of patients with lung cancer, they got a more standard approach of radiation. Now we can utilize these techniques we've talked about and we can treat that patient with three to five radiation treatments. Very focal, very precise. Do you remember what we're going to use? We're going to use our gating and we're going to use our IGRT and we're going to use all our conformal techniques to treat this small tumor. Three to five treatments with really excellent results, and it's one of my favorite things to do.
Cheryl
18:27
I love how excited you are, which means the patients are too, to hear what this will mean. So maybe just to give a comparison 20 years ago, that patient would have been treated in a different way. How different is their treatment today, and how do they feel after?
Dr. Michael Miller
18:42
20 years ago, and I did this, 20 years ago for that two-centimeter lung tumor they came every day, Monday through Friday, five days per week. We treated them for six and a half weeks in a relatively small area and the success rate was low. It wasn't very good, but it was the best we had. Now they're treated every other day for three to five treatments, so either a week or a week and a half. The success rate, the control is much higher, and the side effects, toxicities, and tolerance are much better. So it's one of the biggest advances that I've seen.
Cheryl
That is amazing.
Dr. Michael Miller
Yeah, it's really fun, that's incredible.
Cheryl
19:23
One of the things we were talking about before and you're excited about this as well is radiopharmaceuticals. What are they and what is so amazing about them?
Dr. Michael Miller
19:34
We've spent our whole time talking about fancy machines. We can forget about the machines. No machines for this. No machines for a minute. So radiopharmaceuticals are radiation therapy that's administered into the body either orally with a pill or through an infusion, an injection.
Cheryl
19:54
Like a shot?
Dr. Michael Miller
19:56
Like a shot, yeah, or an IV. You know, you'd think, okay, I'm going to get an IV and I'm going to get my medicine into the vein and that's what this is. If I'm going to reflect on radiopharmaceuticals from a historical standpoint, the first one that I would mention would be radioactive iodine, and there's nothing new about radioactive iodine. It's been around a long time, but it is a pill. It's a pill that you swallow, it's a radioactive material, and that material, for various physiological reasons that we won't get into, goes exactly where we want it to go, which, for radioactive iodine, is thyroid, thyroid cancer, thyroid tissue. So now we have almost what we consider a "magic bullet" in medicine. Throughout time people take pills, and the pill goes throughout the body, the medicine's everywhere. If we only had a magic bullet, if it only went where it was supposed to go, radioactive iodine does that, and it was the first radiopharmaceutical. I've done a lot of that in my life. I've treated a lot of thyroid cancer and it's a great modality for that one cancer. Well, we ought to have more modalities for other cancers. That's what I'm thinking, right? So, lo and behold, we do, and through the years we've taken steps.
Probably the next important step with radiopharmaceuticals was a product called Radium-223. And it was specifically for prostate cancer and it was effective to treat prostate cancer that had spread to the bone, and it was excellent at improving pain and even improved survival. Patients with metastatic prostate cancer were going to live longer if they got this product because it had a "magic bullet" approach and went where it was supposed to go. That's been around at least 10 years, maybe a little bit longer. The next step was a new, improved version and it was called Pluvicto, and the radiopharmaceutical that's used there is called Lutetium, Lutetium 177. And this is even better than the radium because it's more specific to prostate tissue. It's a better "magic bullet" approach. I think it's a little bit easier to take with regards to side effects and things like that, and numerous studies have shown, that if we have metastatic prostate cancer, it's improving survival in patients. So we're helping people live longer and the treatment's pretty tolerable. So we don't need the machines for it anymore. Now we can just inject it right into the body. It's not going to ever replace machines, but it is something that's a small part of our practice and it is making an impact.
22:44
That lutetium is unique because, after the success that it had in prostate cancer, again smart people asked, can we do this for other tumors? And it isn't the lutetium part, it's the radioactive material. When it gets to the tumor, it gives radiation directly to the tumor. You need to have the proper molecule to get it there. So if you can develop a molecule to get it there, an antibody that wants to seek out a specific type of cancer, you can do that. The next type of cancer that was very successful and the data is still unraveling, but looks to be very successful, is neuroendocrine cancers. These are cancers that typically start in the digestive tract, the pancreas and the intestinal tract, and often spread to the liver, and this radiopharmaceutical can kind of seek those out and that seems to be a big advance for that malignancy. There are even studies right now ongoing for breast cancer developing the proper molecule. Get it to the tumor and let our radiopharmaceutical help. So I think it's exciting.
Cheryl
23:52
It is extremely exciting and as these developments occur and as you hear more about them and start using them, I'm sure you'll come back and share that with us.
Dr. Michael Miller
24:01
Yeah, I look forward to that.
Cheryl
24:02
Very exciting. I wanted to talk about one more topic, and then I have other questions, as I always do. But HDR brachytherapy what is that and why is that also something that you're excited about?
Dr. Michael Miller
24:15
Yeah, HDR-brachytherapy stands for high-dose-rate brachytherapy. So, to understand this you need to know what brachy means. Brachy in Latin means close. So what we want to do is we want to put a radioactive source, a high dose rate radioactive source, close to the tumor. What are we doing? We're taking a little radioactive seed and the seed is stored in a big lead tank. We call it a pig and it's connected to a computer and has a wire attached to it and that wire will go wherever we want. And what we do is we utilize that radioactive seed, attach an appropriate applicator to it, put the applicator by the tumor and when it's ready to do our treatment, we push a button. There goes the seed, it sits down in the applicator and now we have a radioactive source very, very close to the tumor.
The easiest one to do and the easiest one to conceptualize is skin cancer. If we have a relatively small skin cancer, basal cell carcinoma or squamous cell carcinoma would be the most common types of skin cancer that you would do this for. For a small skin cancer, the patient will be on the treatment table. It's really a stretcher, a gurney. It's comfortable. A small applicator is laid on them, gently taped to them, not technical, just gently taped to them. Radioactive seed comes out and delivers the treatment. It usually takes, three to five minutes, back into where it's supposed to be, and off you go. They'll typically have five to seven treatments to treat their skin cancer.
Cheryl
25:57
So they come in for the treatment and can leave in like it sounds like 10, 15 minutes.
Dr. Michael Miller
26:01
They're probably in and out in 20 minutes. Yeah, yeah, they are. Now it can be more elaborate brachytherapy. This can be used to treat gynecological cancers. Now, our applicator isn't simply taped on. It would be an intravaginal device. But the same principles apply. Our seed is placed up into the applicator. The seed can be moved to various places in the applicator to treat the area that needs to be treated. Out comes our seed, and the patient goes home. Yeah, it can even be done for breast cancer. Breast cancer takes a little bit more of an elaborate device. We need to have the help of a surgeon who places that device at the time of the breast surgery. But still, they come to our department. The applicator is in place, the wire is hooked up, the treatment is delivered, and off, they go. So those are examples of HDR brachytherapy and we offer that at our Brock Cancer Center and we do that every day.
Cheryl
27:05
With all of these treatments that you've shared with us, can you talk about the process you go through to figure out the best way to help a particular patient? And I know you work with all types of cancer patients, so every day is different. What is your process for determining which one works best for each person?
Dr. Michael Miller
27:24
Well, we'll sit down with the patient. We're going to look at the whole patient and certainly, every patient's different. It has a lot to do with their health status. It has a lot to do with their physical age and their physical condition, and it also has a lot to do with their mindset. And we're going to figure out how to navigate the options.
And sometimes there's a lot of options and, of course, when there's a lot of options, there's a lot of confusion. But if we can bring the facts about all of these options, help make it more clear, and help them make a decision, I think it's going to work pretty well. And sometimes there are very few options. We say we really only have one tool and we're up against it and this is what we need to do, and we can do that too. But a lot of times patients will have options and it's our job to help them navigate what's right. And sometimes that isn't radiation therapy, sometimes that's let's get you to a surgeon, sometimes it's let me get you to my medical oncology colleagues. So we're going to help them either way.
Cheryl
28:22
It's exciting because there are so many more options, as you've been talking about. What else is exciting for you, as you kind of look ahead?
Dr. Michael Miller
28:31
For the next few years, I think that the things that I've elaborated on are only going to get better. I think our machines are going to get fancier. I think our radiopharmaceuticals are going to expand to more and more tumors. But I'm also really excited about what my medical oncology colleagues do. Boy, do they have some neat tools coming down the line: very specific treatments, very targeted treatment, a treatment that's personalized to the individual and the tumor and the genetics within the tumor. So I think both of those fields are going to be very, very exciting. I look forward to it.
Cheryl
29:05
Yeah. For those listening, do you have any resources that they may go to if they want to hear more? They can also re-listen because you talked about so many things.
Dr. Michael Miller
29:14
Sure, sure, I would first tell you to talk to your doctor, and ask your doctor questions, but I do think cancer.gov would be an excellent website. I also think that the NCCN is an excellent website and they have resources for patients and physicians. You click one direction you're heading toward the patient site and one direction heading toward the physician site, so excellent resources. The American Cancer Society is always good too. Locally, talk to your physician and we have excellent resources here in Hampton Roads for you.
Cheryl
29:50
Yeah, I like what you said earlier, there are so many options, and sometimes that creates a little bit of confusion and a lot of thoughts in your head. But there are a lot of resources and certainly there are plenty here at Virginia Oncology Associates.
Dr. Michael Miller
30:03
I agree.
Cheryl
30:04
Dr. Miller, thank you so much for your time.
Dr. Michael Miller
30:06
Thank you for having me.
Exit
30:14
That's all for this episode of Cancer Care Connections. Today we discussed radiation therapy to treat patients with cancer. On our next episode, Cheryl will sit down with Dr. Jacob Hall, a radiation oncologist at Virginia Oncology Associates. Dr. Hall is going to discuss the use of radiation treatment outside of cancer, specifically for the treatment of osteoarthritis. Don't forget to subscribe to our podcast via Apple Podcast, Spotify or anywhere podcasts are available, or listen online at cancercareconnections.buzzsprout.com. Cancer Care Connections is the official podcast of Virginia Oncology Associates. For more information, visit us at virginiacancer.com or find us on Facebook or Instagram at Virginia Oncology Associates.