Dr. Jean-Pierre Bissonnette   &   Dr. Alex Sun

A POTENTIAL GAME CHANGER

PET-Boosted Radiation for Lung Cancer

Drs. Jean-Pierre Bissonnette and Alex Sun noticed something peculiar while they were reviewing the results of a study on how positron emission tomography (PET) imaging, or nuclear medicine imaging, can be used to monitor patients with advanced lung cancer. On the images, they found the brightness of the cancer was not uniform. The cancer areas that were brightest could indicate where the disease was particularly active.

The Princess Margaret's Dr. Bissonnette, Senior Medical Physicist, and Dr. Sun, Radiation Oncologist, have spent much of their professional lives thinking about ways to fight lung cancer. Both of them believe that one of the best ways to do that is with focused radiation treatment.

“I always say to people that if you can give a high enough dose of radiation, you can cure all cancers,” says Dr. Sun. “The problem is that there are normal tissues in the way.”

Drs. Bissonnette and Sun realized PET imaging could be used to deliver higher doses of radiation treatment to the exact area affected, while protecting normal tissue from damage and minimizing side effects. PET imaging could also guide how an extra radiation dose could be delivered to cancer areas that were brightest on the PET images.

The PET clinical trial began in 2017 and involves cities across Canada. Half the patients receive a regular radiation dose and the other half get the PET-boosted dose.

While it will be two or three years before they see results, they are extremely optimistic and believe it could change practice.

“Ultimately, we want patients to survive longer. And if we can demonstrate that they are, it could change the way we deliver radiation to all of these patients,” says Dr. Sun.

Dr. Bissonnette says the first such practice change is for clinics around the country to use PET technology.

“One of the problems is that many clinics don't have access to PET imaging. So if we can demonstrate the value of this imaging modality, it will encourage clinics to get into that technology.”

For Dr. Bissonnette, however, the main goal is striking back against lung cancer, which in advanced stages kills about 75 per cent of patients.

“I'm convinced we can do better than what we do now.”

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