Patients at Riverside Cancer Institute in need of radiation therapy now have access to the most advanced treatment technology. The new Discovery RT radiotherapy system reduces treatment times while enabling each patient's care team to personalize oncology treatment plans with improved accuracy and radiation dosing safety.
Dr. Alex Herskovic discusses our advanced low-dose CT system and it’s use in the fight against cancer, as we strive to keep each patient's best interests at the forefront of progress.
Selected Podcast
Low-Dose CT for Use in Cancer Treatment
Featured Speaker:
Alex Herskovic, MD
After completing his undergraduate degree at Duke University, Alex Herskovic, MD received his Doctor of Medicine degree from Northwestern University Feinberg School of Medicine in Chicago, IL. He then completed his medical internship at Resurrection Medical Center in Chicago, IL and went on to complete a residency in radiation oncology at NewYork-Presbyterian Hospital/Weill Cornell Medicine in New York, NY. During his time at NewYork-Presbyterian Hospital, Dr. Herskovic served as chief resident. He has authored 18 peer-reviewed publications and presentations and contributed to numerous research programs. Transcription:
Low-Dose CT for Use in Cancer Treatment
Carl Maronich (Host): Today, we are talking to Alex Herskovic. Dr. Herskovic is a Radiation Oncologist at the Riverside Cancer Institute. Doctor, welcome to the podcast.
Dr. Alex Herskovic (Guest): Thanks, I’m happy to be here.
Carl: Now, let me start by asking a little bit about your background. Where are you originally from?
Dr. Herskovic: I’m originally from the Chicago area. I grew up in the western suburbs.
Carl: Ah, which suburb?
Dr. Herskovic: La Grange.
Carl: La Grange. Did you go to L.T.?
Dr. Herskovic: No, that’s where I would have gone. I actually went to a Catholic high school called Fenwick, which is in Oak Park.
Carl: Oh, Fenwick. Sure, very good. I went to Downers North, and L.T. was in our conference – big rival, so I’m glad to hear you didn’t go to L.T.
Dr. Herskovic: Oh, okay. [LAUGHING]. We weren’t rivals, yeah, yeah.
Carl: And then, for schooling where did you get your education?
Dr. Herskovic: So, I completed an undergraduate degree at Duke University in North Carolina. I went to Northwestern, in Chicago, for medical school. I completed my residency training at Weill Cornell Medicine, so that’s the Cornell University Medical Center -- which is actually in New York City, not in Ithaca -- and then I moved back to the Chicago area after residency.
Carl: Ah, very good, so you’ve been around the country, landed back in Kankakee, and Bourbonnais, and we’re glad for that. And Doctor, let me ask a little bit about why you chose Radiation Oncology?
Dr. Herskovic: As a Radiation Oncologist, I get to be there for people in a very difficult time in their lives, and I find that to be very rewarding. A lot of my job is just to listen, and sometimes be a shoulder to cry on, but also try to give people a hopeful outlook because there is a lot of great technology and a lot of great treatment we can do now. Radiation Oncology sort of combines that human aspect of medicine with a lot of advanced technology that we can use to very actively target tumors now while minimizing side-effects from radiation therapy.
Carl: Wow, and that’s specifically what we’re going to talk about today, the Discovery RT System, which is something that does just that. Why don’t you talk a little bit about what the Discovery RT System actually is?
Dr. Herskovic: Sure. I’m happy to have that new piece of equipment in our department. The Discovery RT System – the most important thing it does is it allows us to do a very accurate CT simulation. The CT simulation is the first part of treatment planning for radiation therapy. Patients get a CT scan with this machine in our department, and we use special molds to allow patients to lay in a very reproducible position. The Discovery RT System rebuilds images that it takes for our radiation treatment planning software and can give us a very accurate view of the tumor and allow us to design a plan that’s as safe as possible.
Carl: Wow, so as you said, being able to really pinpoint where that radiation is going during the treatment process really is a benefit to the patient.
Dr. Herskovic: Yeah, absolutely, and that’s all about what Radiation Oncology is about now, is maximizing dose to the tumor and minimizing dose to surrounding, healthy tissues as much as possible.
Carl: Wow, now are all patients candidates for this system or are there some patients with whom it does or doesn’t work better?
Dr. Herskovic: Pretty much all patients in radiation oncology get a CT simulation as part of their treatment planning now. There are a few situations – for example, for small skin cancers where you can see the tumor with your eyes. It’s skin cancer, so we don’t’ necessarily do a CT simulation for that. I would say that 99% of our patients would get a CT simulation with the Discovery RT System if they are seen in our department.
Carl: Now, the benefit of really pinpointing and not impacting the healthy tissue and organs around where the site of the cancer is, that’s the primary benefit. Are there additional benefits of the RT System?
Dr. Herskovic: Yeah, so it has some other, more advanced features than that – all prior equipment had. It’s a Wide-Bore CT scan – a pretty simple concept, but it’s just a wider opening in the CT scanner, which is not only more comfortable for the patient but allows us to do radiation setups where we can really minimize those beams passing through normal tissue. I’m particularly excited that this Discovery RT System allows me to offer Prone Breast Radiotherapy for more of our breast cancer patients, which really, really helps us to reduce radiation dose to the heart and lungs, which in the past was more of a problem in radiation oncology, but it’s something that we can really minimize now.
Carl: Wow, that sounds like a huge benefit, keeping the radiation away from the vital organs. Although I’m not a doctor, I know the heart is indeed a vital organ.
Dr. Herskovic: [LAUGHING] Yeah, it’s a pretty important one.
Carl: Even marketing guys know that’s the case.
Dr. Herskovic: Yeah, yeah. Yeah.
Carl: The idea of collaboration in oncology is probably an important one. I know you’ve got a great team here at the Riverside Cancer Institute. The collaboration between you and the other providers is something that’s an important part of the patients’ care journey, isn’t it?
Dr. Herskovic: Yeah, absolutely. Cancer care, by definition, is really multiple disciplinary. There are three main ways to treat cancer, surgery, radiation, chemotherapy. There’s a separate doctor for each. The chemotherapy doctors and medical oncologists they work right around the corner from me, so I can touch base with them on a daily basis on all of our patients.
Carl: Now, Doctor, you haven’t been out of school all that long, but I think it’s interesting that you’re already able to see some new technology that’s coming in from the time you started your schooling to now being a couple of years in practice. Have you seen indications that there are constant advancements that are going to be happening in cancer care?
Dr. Herskovic: Yeah, absolutely. That’s one of the things – and I’m glad you mentioned it – that drew me to oncology is that it’s something that always changes. It’s a really important battle to fight. Radiation oncology is about being at the cutting edge of that and really offering patients -- translating technology to the best cancer care possible.
Carl: I’ve had the pleasure of being able to hear Dr. Sipahi speak – one of the other oncologists there at the Institute. He’s had a long, wonderful career in oncology, and he talks about just how amazing the technology all around oncology care has advanced over the course of his career. I’m sure he’s excited to see someone like you come in and get those same advantages to see where cancer care is headed.
Dr. Herskovic: Yeah. Dr. Sipahi is a great oncologist. I think all of the medical oncologists are great, and I’m happy to work with them. They give me a great an example for me to follow in my own practice.
Carl: That’s great to hear. Now, just to recap about the Discovery RT System – this system, which is now in use at the Riverside Cancer Institute – really gives you an opportunity to focus that cancer treatment on the site and not affect healthy tissue and organs around. That’s really the key to this new technology.
Dr. Herskovic: Yeah, absolutely. That really helps us to maximize patient outcomes.
Carl: And Doctor, folks want to learn more about all that you have to offer there. Where can they go?
Dr. Herskovic: They can go to our website, which is RiversideHealthcare.org/Cancer, or they can call us at our General Oncology number and can reach all of our oncology providers that way. The number is (815) 933-9660.
Carl: Very good. Well, Doctor, thank you for all of the information that you shared.
Low-Dose CT for Use in Cancer Treatment
Carl Maronich (Host): Today, we are talking to Alex Herskovic. Dr. Herskovic is a Radiation Oncologist at the Riverside Cancer Institute. Doctor, welcome to the podcast.
Dr. Alex Herskovic (Guest): Thanks, I’m happy to be here.
Carl: Now, let me start by asking a little bit about your background. Where are you originally from?
Dr. Herskovic: I’m originally from the Chicago area. I grew up in the western suburbs.
Carl: Ah, which suburb?
Dr. Herskovic: La Grange.
Carl: La Grange. Did you go to L.T.?
Dr. Herskovic: No, that’s where I would have gone. I actually went to a Catholic high school called Fenwick, which is in Oak Park.
Carl: Oh, Fenwick. Sure, very good. I went to Downers North, and L.T. was in our conference – big rival, so I’m glad to hear you didn’t go to L.T.
Dr. Herskovic: Oh, okay. [LAUGHING]. We weren’t rivals, yeah, yeah.
Carl: And then, for schooling where did you get your education?
Dr. Herskovic: So, I completed an undergraduate degree at Duke University in North Carolina. I went to Northwestern, in Chicago, for medical school. I completed my residency training at Weill Cornell Medicine, so that’s the Cornell University Medical Center -- which is actually in New York City, not in Ithaca -- and then I moved back to the Chicago area after residency.
Carl: Ah, very good, so you’ve been around the country, landed back in Kankakee, and Bourbonnais, and we’re glad for that. And Doctor, let me ask a little bit about why you chose Radiation Oncology?
Dr. Herskovic: As a Radiation Oncologist, I get to be there for people in a very difficult time in their lives, and I find that to be very rewarding. A lot of my job is just to listen, and sometimes be a shoulder to cry on, but also try to give people a hopeful outlook because there is a lot of great technology and a lot of great treatment we can do now. Radiation Oncology sort of combines that human aspect of medicine with a lot of advanced technology that we can use to very actively target tumors now while minimizing side-effects from radiation therapy.
Carl: Wow, and that’s specifically what we’re going to talk about today, the Discovery RT System, which is something that does just that. Why don’t you talk a little bit about what the Discovery RT System actually is?
Dr. Herskovic: Sure. I’m happy to have that new piece of equipment in our department. The Discovery RT System – the most important thing it does is it allows us to do a very accurate CT simulation. The CT simulation is the first part of treatment planning for radiation therapy. Patients get a CT scan with this machine in our department, and we use special molds to allow patients to lay in a very reproducible position. The Discovery RT System rebuilds images that it takes for our radiation treatment planning software and can give us a very accurate view of the tumor and allow us to design a plan that’s as safe as possible.
Carl: Wow, so as you said, being able to really pinpoint where that radiation is going during the treatment process really is a benefit to the patient.
Dr. Herskovic: Yeah, absolutely, and that’s all about what Radiation Oncology is about now, is maximizing dose to the tumor and minimizing dose to surrounding, healthy tissues as much as possible.
Carl: Wow, now are all patients candidates for this system or are there some patients with whom it does or doesn’t work better?
Dr. Herskovic: Pretty much all patients in radiation oncology get a CT simulation as part of their treatment planning now. There are a few situations – for example, for small skin cancers where you can see the tumor with your eyes. It’s skin cancer, so we don’t’ necessarily do a CT simulation for that. I would say that 99% of our patients would get a CT simulation with the Discovery RT System if they are seen in our department.
Carl: Now, the benefit of really pinpointing and not impacting the healthy tissue and organs around where the site of the cancer is, that’s the primary benefit. Are there additional benefits of the RT System?
Dr. Herskovic: Yeah, so it has some other, more advanced features than that – all prior equipment had. It’s a Wide-Bore CT scan – a pretty simple concept, but it’s just a wider opening in the CT scanner, which is not only more comfortable for the patient but allows us to do radiation setups where we can really minimize those beams passing through normal tissue. I’m particularly excited that this Discovery RT System allows me to offer Prone Breast Radiotherapy for more of our breast cancer patients, which really, really helps us to reduce radiation dose to the heart and lungs, which in the past was more of a problem in radiation oncology, but it’s something that we can really minimize now.
Carl: Wow, that sounds like a huge benefit, keeping the radiation away from the vital organs. Although I’m not a doctor, I know the heart is indeed a vital organ.
Dr. Herskovic: [LAUGHING] Yeah, it’s a pretty important one.
Carl: Even marketing guys know that’s the case.
Dr. Herskovic: Yeah, yeah. Yeah.
Carl: The idea of collaboration in oncology is probably an important one. I know you’ve got a great team here at the Riverside Cancer Institute. The collaboration between you and the other providers is something that’s an important part of the patients’ care journey, isn’t it?
Dr. Herskovic: Yeah, absolutely. Cancer care, by definition, is really multiple disciplinary. There are three main ways to treat cancer, surgery, radiation, chemotherapy. There’s a separate doctor for each. The chemotherapy doctors and medical oncologists they work right around the corner from me, so I can touch base with them on a daily basis on all of our patients.
Carl: Now, Doctor, you haven’t been out of school all that long, but I think it’s interesting that you’re already able to see some new technology that’s coming in from the time you started your schooling to now being a couple of years in practice. Have you seen indications that there are constant advancements that are going to be happening in cancer care?
Dr. Herskovic: Yeah, absolutely. That’s one of the things – and I’m glad you mentioned it – that drew me to oncology is that it’s something that always changes. It’s a really important battle to fight. Radiation oncology is about being at the cutting edge of that and really offering patients -- translating technology to the best cancer care possible.
Carl: I’ve had the pleasure of being able to hear Dr. Sipahi speak – one of the other oncologists there at the Institute. He’s had a long, wonderful career in oncology, and he talks about just how amazing the technology all around oncology care has advanced over the course of his career. I’m sure he’s excited to see someone like you come in and get those same advantages to see where cancer care is headed.
Dr. Herskovic: Yeah. Dr. Sipahi is a great oncologist. I think all of the medical oncologists are great, and I’m happy to work with them. They give me a great an example for me to follow in my own practice.
Carl: That’s great to hear. Now, just to recap about the Discovery RT System – this system, which is now in use at the Riverside Cancer Institute – really gives you an opportunity to focus that cancer treatment on the site and not affect healthy tissue and organs around. That’s really the key to this new technology.
Dr. Herskovic: Yeah, absolutely. That really helps us to maximize patient outcomes.
Carl: And Doctor, folks want to learn more about all that you have to offer there. Where can they go?
Dr. Herskovic: They can go to our website, which is RiversideHealthcare.org/Cancer, or they can call us at our General Oncology number and can reach all of our oncology providers that way. The number is (815) 933-9660.
Carl: Very good. Well, Doctor, thank you for all of the information that you shared.