Photo | University of South Alabama
To comprehend the level of cancer care available at the almost 2-year-old University of South Alabama Mitchell Cancer Institute Kilborn Clinic in Fairhope, you should have at least a cursory understanding of the Elekta Versa HD radiotherapy system.
Housed in a room with 7-foot-thick lead and boron walls, the part of the system most patients see is an inviting and open space with comforting lighting. Patients lie still on a table as the machine quietly maneuvers around them, a procedure that typically lasts just a few minutes.
What they don’t see is the plant room. Behind the treatment end of the system is a machine that resembles a deconstructed nuclear device. It’s all powered by a number of powerful servers driving the mechanical aspects of the system.
Essentially it’s a computer, but unlike the Mac or Windows device in your home study, it also houses a computed tomography (CT) scanner and can deliver a powerful and concentrated beam of protons to very precise areas of anatomy. When it hits its target — tumors in the bodies of cancer patients — it can affect treatment quicker and more effectively than prior methods.
“For small lung cancers, we used to give seven weeks of treatment for 50/50 effectiveness,” said Dr. Bill Hixson, staff radiation oncologist and associate professor of Interdisciplinary Clinical Oncology. “Now we can give as few as three treatments, focusing a lot of radiation therapy on just a small area very accurately, and it’s 90 percent effective.”
Practicing medicine since 1997, Hixson said: “Radiation oncology has progressed as computers have progressed. Now we have the ability to give more precise treatments, more treatments per day and shorten the course of treatment.”
But the system is not autonomous. Aside from Hixson, treatment at the clinic may also be mapped out and supervised by on-site staff that includes physicists, medical oncologists, hematologists and nurses. In Mobile, Mitchell Cancer Institute (MCI) employs at least three dosimetrists who plan the treatment in consultation with physicians at the Kilborn Clinic.
In the same facility, physicians and patients have access to nine exam rooms and 16 infusion recliners. When it opened in July 2017, the Kilborn Clinic doubled the space at MCI’s previous location in the Thomas Hospital complex and is expected to be “well equipped to keep pace with the demands of the rapidly growing Eastern Shore.”
Advanced as it is, the clinic’s radiotherapy system is not a cure-all. Some cancers respond better to immunotherapy, and sometimes the two can work together.
“There is a lot of interplay between immunotherapy and radiation therapy,” Hixson explained. “If someone has a cancer in their bones in 14 different spots, sometimes you can aggressively treat one of those spots with radiation therapy. What it does, for lack of a better term, is sort of pulverizes the cancer and exposes parts of the cancer that would not otherwise be exposed to the immune system. So you treat one spot and all of a sudden the immunotherapy works better and it works everywhere. The abscopal effect is [a theory that says] you do something in one spot and something happens in another, and that’s very exciting.”
The clinic is named after prominent area attorney Vince Kilborn, an established MCI donor who committed $1.5 million in support of the new facility.
“I’ve always been sort of a soldier against cancer,” Kilborn said last week. “My father died of pancreatic cancer, uncles have died of brain cancer … I always get on the side of folks who try to defeat that particular disease — it affects everyone.”
Indeed, Hixson said, patients in Baldwin County are affected by all types of cancers — breast, prostate and lung cancers are extremely common — but doctors are seeing “everything” including leukemias, pancreatic cancer, colon cancer and myelodysplastic syndrome, a rare disorder in which the body cannot produce enough healthy blood cells.
Hixson said providing comprehensive cancer services under one roof in a community like Baldwin County can encourage patients to seek treatment they may otherwise choose to ignore.
“People have written papers about how difficult it is for cancer patients to travel,” he said. “And how some people will choose not to seek treatment or not to get treatments in the time frame they need them because of the travel. So it’s important to be where the patients are, and I think it makes people feel comfortable knowing they don’t have to go to Mobile or beyond.”
“When you first get diagnosed with cancer you think [The University of Texas] MD Anderson [Cancer Center] or the Mayo Clinic (locations nationwide), but the matter is it’s much better for patients to be treated locally,” he said. “The Kilborn Clinic along with MCI offers the same treatment and expertise here and fills that huge gap that wasn’t filled before.”
When the clinic was initially proposed, the University of South Alabama (USA) Board of Trustees quickly committed its support, citing Baldwin County as the fastest-growing county in the state. Baldwin added 21,444 residents between 2010 and 2016, bringing its total population to 208,563, according to the U.S. Census Bureau. An estimated 19.2 percent of residents are 65 and older, an age that carries a greater risk for developing cancer, USA reported.
Dr. Bill Hixson, radiation oncologist, with Daniel Cameron, medical oncologist.
Kilborn, who remains engaged with the clinic and occasionally visits staff and patients while bringing along a shipment of Dew Drop Inn hot dogs, said it has been “slammed” since opening. “There were 409 patients last month with radiation and 300-something with chemotherapy,” he said. “It’s an obvious success.”
He praised both the staff and the technology at the clinic, calling the radiotherapy system “so accurate it can carve out a popcorn [kernel]-sized brain tumor without hurting any of the healthy tissue around it.”
Kilborn also noted there is support in place for those who may be struggling financially or emotionally with cancer treatment, including a person in-house who consults on options for those who may be suffering hair loss.
“Treatment doesn’t end on the table,” he said.
“Mr. Kilborn has not just given money to this place, but he’s been very involved from day one watching it go from nothing to something amazing,” Hixson said. “He really cares what goes on and is proud of what is happening here. Not everybody is willing to put their money into something but also their time and interest.”
More recently, USA began to offer urology services at the clinic. Down the road at the USA Physicians Group behind Thomas Hospital, doctors are currently seeing patients for colorectal surgery, maternal-fetal medicine, pediatric surgery and plastic surgery.
Each April, the clinic also hosts the Hope Grows Here fundraiser, a farm-to-table event with a silent auction where all proceeds benefit the MCI Kilborn Clinic Fund for Excellence.
Hixson said he practiced internal medicine before he became an oncologist, but he finds his present course of work much more rewarding.
“With oncology you know what the problem is,” he said. “It’s kind of nice to know what you’re dealing with and know what you’re going to do. When I did internal medicine, you may have had someone come in with chest pain and you’d try six different things and they would get better, but you may have never known what it was. With [oncology], you really know what you’re dealing with.
The patients really need you, and they can’t fake it. The patients are great to be around and I can get more out of it than I can ever give.”
It’s become a tradition for many patients in remission or cleared of cancer to ring a brass bell hanging in the hallway.
“To me that means you’ve finished this phase of whatever you’re doing,” Hixson said. “The bell doesn’t have to mean you’re cured — maybe you’ve finished a step or treatment. Some people don’t want to ring the bell and others don’t want to stop ringing it.”
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