WATERLOO - When Wayne Clough was battling prostate cancer in the late '90s, traditional radiation therapy was considered the most effective form of treatment for the disease.

The 10-year survivor has few complaints about the treatment he received, though a few persistent side effects nag him to this day. While radiation kills cancer, it can also damage normal tissue. This damage can lead to scarring that causes muscle shrinkage and permanent injury to overtreated muscles or even the spinal cord, which can cause paralysis.

"The alternative would have been worse," Clough said.

Though Clough was pleased with his treatment and the therapy is still considered the best option for many cancer patients, new technology is reducing the long-term side effects for specific cancer cases. Dr. Cassandra Foens, a radiation oncologist with Clinical Radiologists PC, said new image-guided radiation technology has proven just as successful in treating some cancers while reducing the amount of radiation entering healthy tissue and organs.

In July the Covenant Cancer Treatment Center began offering select patients the option of using new-image guided radiation therapy. The machine uses an internal CT scan to line up the radiation treatments daily. In addition to prostate cancer, the new technology is also used on spinal cord tumors and lung or mouth and throat cancers.

"Cancers do move, and we have to take into account the areas we are treating, which can give us some unusual shapes to treat. When you are treating an unusual shape near an organ that you don't want to mess with, like the spinal cord, this gives us better technology to aim at the areas we want to treat," Foens said. "It means more radiation is directed at the cancer and less at the healthy tissue."

Ultrasounds have been used to do similar guided therapies; however, the images do not show all kinds of cancer, Foens said.

The additional cost associated with the new technology does not make it the most reasonable therapy for every patient. Foens said they still will recommend traditional radiation therapy for patients who are using the treatments to alleviate pain, but it is unlikely they will be cured of the cancer.

"This is why it takes specialized physicians to use this. You have to count on us to know when are the right and wrong times to use this kind of technology," Foens said. "You don't want to use it just because you have it."

Though the on-board CT scans are good enough to locate the cancer for treatment, Foens said patients still will need a full CT scan when diagnosed.

Getting screened

Men over the age of 75 do not need yearly prostate screenings, according to new recommendations recently released by the U.S. Preventive Services Task Force.

The group is an independent panel of experts in primary care and prevention that regularly develop recommendations for the U.S. Department of Health and Human Services.

The American Cancer Society has taken a similar stance, but said that men over age 75 with a life expectancy of at least 10 more years should continue to be screened.

Dr. Cassandra Foens said the new recommendations show a shift in the way experts are looking at preventive screenings.

"We are really starting to look at screenings scientifically, and that is important," she said. "New medical treatments are always coming, but at some point you have to ask if it is the right thing for the right patient at the right time. Maybe my 97-year-old grandfather doesn't need to know he has early stage prostate cancer. Maybe no treatment and not having to deal with the side effects is better for him."

Because prostate cancer progresses slowly, Foens said it unlikely that an elderly man with other comorbidities will die from the cancer in a 10-year period.

Foens said it is recommended that all men get yearly screenings beginning at 50 unless they are at a higher risk for the disease, which includes black men and those with a family history.

Contact Emily Christensen at (319) 291-1570 or emily.christensen@wcfcourier.com.