For patients with kidney cancer, it's OK to ask a medical oncologist about radiation threapy, an expert exerplained.

When it comes to radiation therapy, there is plenty for patients with kidney cancer to discuss with their care teams, as Susan Poteat, medical science liaison for KidneyCAN, explained to CURE®.

Poteat is a medical physicist specializing in radiation therapy, as was her husband, who died approximately 15 months ago after living with metastatic kidney cancer for 15 years. She spoke with CURE® about some of the things that patients need to keep in mind and conversations they should have with their care teams about radiation therapy.

Multiple Names for the Same Procedure

When discussing a study on stereotactic ablative body radiotherapy (SABR), Poteat noted that “there are multiple terms that get used to describe [the act of] using many, many beams of radiation to tightly focus on a small target and be able to give a large dose there,” stating that some may be more familiar, for example, with SBRT, or stereotactic body radiotherapy.

SABR is ‘Skill-Dependent’

“I do encourage patients to remember that it is skill-dependent — just like you wouldn't have a difficult surgery done at a community hospital, you shouldn't have SABR done at a community hospital in general,” she said. “... A lot of community hospitals have experience using SABR in lung [cancer] and there's usually nothing too delicate nearby, but when we start talking about in the abdomen, there are a lot of radiosensitive tissues there and a lot of special considerations. So, I think [patients] should talk to their oncologist in some cases about using SABR in their course of treatment, but they also should talk to their oncologist about where's the nearest academic center with an outstanding radiotherapy program.”

Used to Treat More Than a Primary Tumor

The use of SABR, Poteat said, has “a very, very clear space for patients who get just a few brain [metastases],” stating kidney cancer metastasizes to the brain for approximately 30% of patients.

Additionally, Poteat said, “we have a lot of patients who are doing very, very well on their drug treatment, and then there's this one spot that pops up, it's developed some sort of resistance, it's growing on multiple scans. If everything else is going well, the patient can very likely extend their time on that particular drug by ablating that single place that's the bad actor and is growing.”

“Community physicians may not bring that [strategy] up,” she said. “So, it's appropriate for patients to ask about that. And ask who they could ask for a referral to radiation therapy and go talk to someone who's knowledgeable about that.”

It’s OK to Ask About Radiation

“I do think, more than anything else, knowing that your medical oncologist may not think about whether radiation would help the current thing that just popped up for you [is important],” Poteat said. “And it's OK to ask, ‘Is there any point in me talking to a radiation oncologist about this?’ He's very likely going to refer you for a bone [metastasis] or brain [metastasis]. But there are other times in your care path [when] you might wonder [about radiation], and it's fine to ask.”

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