2018-19 Cancer Network Annual Report

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The Cyberknife system, pictured above, delivers radiotherapy in a more targeted, accurate manner than traditional radiotherapy.

Clinical Innovation & Advanced Technology

Early adoption of advanced technology

With our team of highly skilled physicians focused on bringing proven, state-of-the-art cancer treatments to our communities, the Sentara Cancer Network offers patients advanced and effective technologies and innovations to fight cancer. Our expertise is enhanced by partnerships with other medical centers. Together, we create one of the leading, cutting-edge cancer networks in the nation. To deliver the most effective care to our patients, we rely on a team of highly trained, board-certified radiologists, pathologists and other specialists to accurately diagnose cancer. Collaborating with a team of experts allows us to diagnose patients and develop a personalized care plan earlier than was possible just a few years ago.

Earlier detection: 3D mammography

Available at numerous sites throughout the network

In addition to standard mammography, 3D mammography has been proven to increase early detection rates by 35 percent. Because of the groundbreaking success in early detection, Sentara Cancer Network invested in making the 3D technology available throughout the network to give more women access close to home.

*June 2013 issue of the American Journal of Roentgenology (AJR)

3D mammography improves breast cancer detection rates by 35 percent.

A closer look: Breast-specific gamma imaging

Dorothy G. Hoefer Comprehensive Breast Center, Sentara RMH Medical Center

While mammography remains the primary method of early detection, diagnostic challenges can occur due to the complexity of the breast tissue. Breast-specific gamma imaging (BSGI) aids in diagnosis when a mammogram is inconclusive by revealing important information that can help more accurately determine if an area of concern is cancerous. During the procedure, a gamma camera takes images showing the metabolic activity of breast lesions. The high-resolution camera creates pictures so doctors can see cancers as small as 3 millimeters. It can detect early stage cancers, see lesions even in dense tissue and provide multiple angle views.

Emily Ritchie, M.D., Radiology, relies on gamma imaging to spot cancer as small as 3 millimeters.

A comprehensive combination: Positron emission tomography/computed tomography (PET/CT)

Available at numerous sites throughout the network

A PET scan and a CT scan are performed at the same time with the same machine, providing a more comprehensive image than each produces alone. Using nuclear medicine technology, PET scans take pictures of the function of the organs and tissues, while CTs create a 3D physical image using X-rays. A PET/CT scan is used often to image the heart, brain and liver. An oral contrast medium may be used to outline or highlight organs so that they can be seen more easily. The combined scan is one of the most effective ways to study cancer.

Combining PET and CT scans allows physicians to take a detailed, 3D look at how an organ functions.

Fewer procedures: Navigational bronchoscopy

Available at numerous sites throughout the network

An outpatient procedure called electromagnetic navigational bronchoscopy uses a navigation tool much like a GPS to provide a road map to better find, diagnose and mark spots on the lung for precision treatment later. Using this new system, Sentara Cancer Network pulmonologists thread a catheter through a patient’s nose and airways to reach some of the lungs’ deepest tissue. Once the questionable tissue is found, doctors rely on the fast work of specialized pathologists to determine if the spot is cancerous within minutes. Previously, patients would have required one or more procedures to receive a diagnosis.

Faster diagnosis, faster treatment: Endobronchial ultrasound

Available at numerous sites throughout the network

With a minimally invasive endobronchial ultrasound procedure known as EBUS, doctors are able to diagnose patients with lung cancers without surgery. This technological breakthrough helps patients with lung and lymph node tumors to be more accurately diagnosed and begin treatment sooner. The physician uses a bronchoscope equipped with an ultrasound device to work through the patient’s nose or mouth and into the lung’s airways.

A minimally invasive approach to staging: Endorectal ultrasound

Sentara Norfolk General Hospital, Sentara Virginia Beach General Hospital

The same technology that makes EBUS possible is used for endorectal ultrasounds to help pelvic and colorectal cancers. No incisions are needed, and the minimally invasive procedure enables doctors to see and stage cancers prior to surgery.

The daVinci® Surgical Robot allows surgeons to view cancerous sites through an advanced 3D high-definition vision system and to access the sites with highly manipulable instruments (pictured below) more flexible than a hand.

Genetics behind cancer: Our molecular testing lab

Personalized medicine is one of the many benefits for patients in our Sentara Cancer Network, and our molecular testing lab makes the personalization possible. Having an in-house molecular laboratory, staffed by a board-certified molecular genetic pathologist, allows critical test results to be made available quickly.

The future of cancer medicine is heavily reliant on a person’s genetics. Because cancer is complex, with numerous subtypes, molecular information can assist physicians in pinpointing and treating the disease. With nearly 70 percent of medical decisions based on lab results, it’s vital for doctors to have state-of-the-art labs.

Tabetha Sundin, Ph.D., Director, and the team in the molecular lab use next generation sequencing to help physicians learn more about the genetics involved in cancer.

Other healthcare providers may need to send their samples to a lab out of state, while our Sentara Cancer Network lab allows our providers to receive quicker results and, soon after, to provide appropriate therapies.

We anticipate even more in-depth details on patients’ cancer as we implement next generation molecular sequencing. This advanced analysis allows us to further explore multiple genes faster and more cost effectively. We also look to the future as we preserve tissue removed during diagnosis. Should the patient need additional tests, we have the tissue readily available preserved in paraffin. We may also use the tissue in retrospective studies to help future patients, while always preserving patients’ anonymity.