High-tech revolution helps radiation oncology center target treatment areas
A tour of the Maddock Center for Radiation Oncology illustrates the evolution of cancer radiation treatment.
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In one room stands a 40-year-old X-ray machine, still used today for treating superficial cancers. In another room, a computer monitor pinpoints the location of a tumor using a 3-D model of a human throat.
Dr. Phillip G. Maddock, 60, founded the radiation facility in 1984. He has since seen the practice of radiation oncology advance from six-hour external beam radiation sessions to computer-assisted treatments that last 25 to 30 minutes.
The Maddock Center, which in May changed its name from Radiation Oncology Services of Rhode Island, is a free-standing cancer radiation facility that prides itself on blending the accessibility and comfort of a community doctor’s office with the latest radiation technology available.
“The big difference between modern radiation and what we were doing five years ago is, one, we can shape the (radiation) beam, two, we have an image-guided system so we know, in real-time, the patient’s anatomy during treatment,” Maddock said.
“And the third advance,” he said, “is we now use computers to shape those beams so we can get exact doses exactly where we want them.”
That third advance is called Intensity-Modulated Radiation Therapy (IMRT), which the Maddock Center began offering about a year and a half ago. Basically, IMRT delivers precise radiation doses customized by a 3-D computer-modeling program to fit the shape of a malignant tumor, Maddock explained. Its ability to customize the shape of radiation beams spares neighboring parts of a patient’s anatomy.
Maddock also employs more simple methods to treat patients, manipulating radiation doses by fitting beeswax over, for example, a patient’s hand where there is cancer.
The doctor’s reason for investing in the latest radiation treatment methods is as simple as beeswax.
“Basically,” Maddock said, “if we do not provide the best radiation oncology services, we simply cannot compete with other centers.”
Maddock said his facility is one of only three in the state – along with Rhode Island Hospital and Radiation Oncology Services Inc. in Providence – that offers IMRT. Yet the capital costs of the new equipment are growing much faster than health insurance reimbursements, which have actually decreased in recent years.
Still, the age of managed care has had less of an impact on Maddock’s practice than general medicine offices, to which insurance companies often don’t pay medical claims. It would be difficult to deny claims for radiation treatment, Maddock said, because patients are sent to his facility after being diagnosed with cancer.
Doctors such as Maddock who own private practices must juggle their time between clinical tasks and the administrative duties running a small business. He said he spends 75 percent of his time practicing medicine and 25 percent doing business.
“A lot like most physicians, I don’t like the administrative things, so that was left to the end of the day,” Maddock said.
Maddock currently employs a full-time director of administration, his daughter Lucy Maddock-Mark, who has taken on managing the business end of the treatment center. Though hiring his daughter has reduced his hours, he said he maintains the same 75-25 ratio in his work schedule.
Maddock opened his radiation center having spent 14 years in academic medicine, and has been a clinical associate professor of radiation therapy at Brown University since 1978. He and his medical partner, Dr. Steven C. Lane, also serve on tumor boards at five hospitals in the state.
The Maddock Center likes sending visitors home with a tube of SPF-15 sunscreen. Since the center opened about 20 years ago, Maddock has observed a “significant increase in skin cancer.”
In particular, the doctor said he notices numerous cases of skin cancer on ears – an often overlooked area when applying sunscreen.
Radiation oncologists go to great lengths to keep patients as comfortable as possible, and limit any pain caused by radiation treatment. Yet they realize that their ultimate goal must be to rout out tumors and save lives. “The worst side effect of radiation is not curing the patient,” Maddock said.
