PRESQUE ISLE, Maine — A significant stride has been made in the progress of the new state-of-the-art cancer treatment center for The County at The Aroostook Medical Center that will provide the best, most comprehensive care possible for cancer patients in the region. A new Varian linear accelerator (LINAC) is being installed at TAMC’s A.R. Gould Memorial Hospital which will deliver tumor-shrinking radiation therapy to cancer patients across northern Maine.
While TAMC has had the only linear accelerator in northern Maine, the current machine is nearing the end of its lifespan and needs to be replaced. The new LINAC was delivered to the Presque Isle medical center June 20, but more work is needed before it will be fully operational for patient treatments. TAMC officials anticipate that the first cancer patients should be treated on the new equipment at the beginning of September.
A three-person rigging crew from Alabama unloaded the 30,000-pound machine. The crew worked for three days, using special equipment and rigging to move the accelerator from the delivery truck into the newly constructed concrete vault that will house it, assembling its big pieces and bolting the machine to an elaborate frame in the concrete floor.
An installation crew, led by a technician from Varian Medical Systems, is currently installing the smaller pieces, as well as the cabling and the computer that will run it. They will spend about a week getting it turned on and making necessary adjustments to the unit. Next, physicists employed by TAMC will complete first testing for safety before patients are treated. Following that will be the commissioning of the machine, when an independent company will come for one to two weeks to test the calibration as a further safety procedure.
July and August will be a busy time of testing equipment as well as training the TAMC staff on its operation and updated electronic medical record (EMR) procedures.
“In preparation for the new equipment and updated EMR, staff have been and will be attending specialized classes at Varian’s training facility as well as extensive onsite training provided by the Varian and the EMR vendor Elekta,” said Chris Miller, manager of imaging services at TAMC.
For the past eight months, a major construction project has been underway not only replace the aging linear accelerator, but to improve and expand treatment areas and to create a more home-like or private surrounding to accommodate medical and family needs. The project combines radiation therapy services and the existing medical oncology/ hematology practice within the Aroostook Cancer Care Center.
“It is incredibly satisfying to be at the final stages of this project, which we began planning for about a year and a half ago,” said Tim Doak, facility engineer at TAMC. “Once complete, this center will be a tremendous benefit to cancer patients in Aroostook County and their families.”
A linear accelerator speeds electrons toward a target to generate a radiation beam aimed at a patient’s tumor. Many patients at TAMC are treated using a technique called intensity modulated radiation therapy (IMRT). With the current equipment at TAMC, the beam is targeted through a series of solid brass molds, called compensators, custom-made for each patient’s tumor. A series of seven to nine compensators are created for each patient and are manually changed throughout each treatment to ensure the tumor is always targeted and not the healthy tissue near the tumor. While effective, this procedure is time-consuming.
With the new Varian linear accelerator, IMRT treatments are performed using a computer controlled mechanism called a multi-leaf collimator, which continually shapes the radiation beam and varies the intensity in real time, meaning improved care and convenience for patients.
“Even though the current manual process is effective, the multi-leaf collimator is faster and more precise,” said Randy Bacon, director of TAMC’s ancillary clinical support services. “It will allow patients to spend much less time on the treatment table. Instead of a therapist having to come into the room multiple times during treatment to change the compensator and adjust the positioning of the machine, the machine moves in a continuous sweep, changing and adjusting the shape and intensity of the beam throughout the treatment.”
The new linear accelerator will also be capable of advanced treatments such as image guided radiotherapy (IGRT), stereotactic body radiotherapy (SBRT) and stereotactic radiosurgery (SRS). These new capabilities mean more accurate treatments that can be accomplished in fewer visits, minimizing radiation damage to healthy tissue and improving patient outcomes, according to Bacon.
In addition, EMR and treatment planning systems will be fully integrated with the linear accelerator. The full integration of software and equipment will mean that once a treatment plan is made it will automatically communicate that plan to the linear accelerator, enabling a 100 percent accurate treatment. This software also aligns TAMC’s Aroostook Cancer Care Center to Eastern Maine Medical Center’s Lafayette Cancer Center in Brewer, allowing both facilities to use the same servers.
“What this means to patients, is that because we are sharing information and will be integrated, they could get some treatments here and some in Bangor if that is needed for some reason. We have never been able to do that before without them having to go through separate treatment planning at each location,” explained Doak.
The LINAC, along with the accompanying software, is a $2 million investment in patient care. Half of that cost was covered from the generous support of the Next Generation Foundation. The organization donated a total of $2 million, half toward the purchase of the LINAC and half toward a cancer patient support fund at the hospital. Additional funds came from community members through the Color Me Pink and Lights of Life fundraisers last year and general donations, with the remaining costs financed through TAMC.
Since the LINAC is being installed in the newly renovated Aroostook Cancer Care location, it means that there will be no disruption to patient treatments. Patients will be treated on the current linear accelerator right up until the new machine is ready to be put into use in September.
The public will be able to view the completed Center, including the new linear accelerator and a healing garden located outside of a new patient atrium during a ribbon cutting ceremony that is being planned in October.
