Wayne Kestler

Wayne Kestler, Sullivan, was one of two individuals to be the first in line to receive a new MRI-guided radiation therapy to treat cancer.

Longtime and 80-year-old Sullivan resident Wayne Kestler made a bit of history earlier this year when he became one of the first patients ever to receive a new type of radiation therapy in the fight against cancer.

Physicians at the Siteman Cancer Center at Barnes-Jewish Hospital and the Washington University School of Medicine in St. Louis have begun treating patients using the MRI-guided radiation therapy, and Kestler was one of two individuals to be the first in line to receive this latest advancement in treatment.

According to the Siteman Cancer Center, the new technology allows tumors to be visualized during treatment.

Magnetic resonance imaging and radiation therapy have been used separately for decades to treat people with cancer, information from the center stated. Until now, however, the technologies had not been integrated to provide real-time monitoring of tumors during treatment. Even if patients remain still, their breathing and the subtle movement of organs in the body can slightly skew the beams of radiation.

“Now we know precisely when a tumor shifts,” said Dr. Dennis Hallahan, chairman of radiation oncology and the Elizabeth H. and James S. McDonnell III distinguished professor of medicine. “This allows us to pause radiation with the goal of sparing healthy tissue, reducing side effects and improving a patient’s overall outcome. It’s one more advance in personalized cancer care.”

Kestler is a 40-plus-year cattle rancher in the Sullivan area and a 13-year lung cancer survivor. In fact, after his first day of receiving the new treatment, he was able to help birth calves in the snow and inclement weather on his ranch.

Kestler first was diagnosed with lung cancer more than 13 years ago and has had two prior lung surgeries, said Jim Goodwin, associate director of cancer news for the Siteman Center at Barnes-Jewish Hospital and the Washington University School of Medicine.

He had a third lung cancer treated a few years ago with stereotactic body radiation therapy.

“Mr. Kestler is an active person,” Goodwin told Senior LifeTimes. “He manages a farm and is out and about most of the day.

“More lung surgery is risky because a person needs enough lung left to stay off of supplemental oxygen and/or function normally. He developed this fourth lung cancer recently.

“Since he is not a surgical candidate, we are giving him another course of stereotactic radiation therapy with intent to eradicate this cancer.”

Information from the Siteman Center stated that radiation therapy is critical in the fight against cancer, and nearly two-thirds of patients receive radiation during their illnesses.

New System

Unlike other radiation therapy systems that rely on static images taken before or after treatment sessions, the new system uses real-time magnetic resonance images during radiation treatment to continuously track a tumor’s location. The technology is similar to the intraoperative MRI system neurosurgeons at a handful of centers, including Barnes-Jewish Hospital, use to obtain real-time images during delicate surgery.

Kestler and 67-year-old Larry Fleming of Ohio were the first in the world to undergo the radiation therapy with the new system.

“Before, we didn’t have the ability to know precisely what was happening during radiation treatment,” said Sasa Mutic, Ph.D., director of medical physics and professor of radiation oncology. “We now can answer questions we never could before.”

Washington University radiation oncologists and physicists have been instrumental in developing the MRI-guided system, which involved conducting clinical trials and which the U.S. Food and Drug Administration approved for use in 2012. The technology especially will be useful for treating cancer in the abdomen or pelvis, where other current imaging doesn’t allow physicians to see clearly, said radiation oncologist Parag Parikh, MD, who led the clinical trials.

“The majority of tumors we treat are in soft tissue,” he said. “With this new technology we not only can see exactly what we are treating, but we also can see subtle changes in the tumor that might call for changes to the radiation treatment plan.”

The radiation therapy system was developed and manufactured by ViewRay Inc., a privately held medical device company based in Bedford, Ohio. Jim Dempsey, Ph.D., a physicist who trained at Washington University, developed the technology and turned it over to Washington University radiation oncologists at Siteman for further testing and the development of treatment protocols.

Attempts to reach Kestler were unsuccessful.