Dr. Justin Voog
Dr. Justin Voog, a radiation oncologist at the Ridley-Tree Cancer Center, has special expertise in advanced radiation techniques like stereotactic body radiation therapy, a high-accuracy treatment for prostate cancer. “The linear accelerators at Ridley-Tree Cancer Center are state-of-the-art devices, on par with what you’d find in larger institutions,” he says. (Ridley-Tree Cancer Center photo)

[Noozhawk’s note: Third in a series sponsored by the Hutton Parker Foundation. Click here for the first article, and click here for the second.]

Significant advancements are taking place in the world of medicine, and many of those innovations can be found right here in Santa Barbara.

The days of driving to Los Angeles for cancer care are no longer necessary as the Ridley-Tree Cancer Center, in partnership with the Cancer Foundation of Santa Barbara, rival larger national institutions in terms of patient care and cutting-edge advancements.

One example is a technique that Dr. Justin Voog, a radiation oncologist, is administering to patients with prostate cancer. Voog was instrumental in launching stereotactic body radiation therapy, a treatment that delivers curative doses of radiation at extremely high precision in short treatments.

What used to take eight weeks with conventional treatments is now accomplished in 10-15 minute daily sessions, over the course of five days, granting faster recovery time, with equivalent cure rates, toxicity profiles and side effects.

“We are able to provide this advanced level of care thanks to high quality staff and access to the technology,” Voog told Noozhawk. “The linear accelerators at Ridley-Tree Cancer Center are state-of-the-art devices, on par with what you’d find in larger institutions.”

In fact, it’s a technique that Voog used while working at a much larger institution, Memorial Sloan Kettering Cancer Center in New York. He was among the first to bring the technology to the Central Coast.

“Ridley-Tree Cancer Center is an early adopter of this technique,” he said.

Similarly, an advanced diagnostic tool that Voog relies on is PSMA Pet Scans, recently introduced by Ridley-Tree’s nuclear medicine department. These scans provide more accurate and earlier detection of prostate cancer than previous imaging methods.

Dr. Winifred Leung

Dr. Winifred Leung, a breast radiologist,  specializes in breast imaging, but praises the Ridley-Tree Cancer Center’s team approach to treatment. “We have all these specialists focused on diagnosing and treating breast cancer, which forces us to stay up to date on the most evidence-based diagnostic and treatment options,” she says. “It’s accountability as well as collaboration.” (Ridley-Tree Cancer Center photo)

The ability to detect cancer recurrence or spread at much earlier stages can significantly change the course of treatment for patients.

Radiation oncology patients at Ridley-Tree will soon benefit further from the center’s Clinical Research Department, which has recently announced increased involvement in radiation therapy focused clinical trials.

Dr. William Charles Conway, a surgical oncologist, is another Ridley-Tree physician who brought expertise from a larger institution to the area. As a gastrointestinal specialist, he worked at a high volume, liver and esophageal cancer center in New Orleans before relocating to Santa Barbara five years ago.

He is highly trained, with two additional fellowship years specialized in surgical oncology.

Conway’s focus is primarily upper GI, including liver, pancreas, esophagus and stomach cancers, and he said that more and more of these operations are being performed with minimally invasive techniques.

Patients recover faster without having large incisions, while the less invasive procedures have the same level of effectiveness and long-term cure probabilities as traditional surgeries. In partnership with Santa Barbara Cottage Hospital, Conway’s program reached high-volume pancreatic surgery status from The Leapfrog Group in 2018, the first year it was established.

“It’s certainly unique to Santa Barbara to have surgeries performed in this manner,” he said.

Dr. William Charles Conway

Dr. William Charles Conway, right, a Ridley-Tree Cancer Center surgical oncologist, specializes in cancers of the pancreas, liver and esophagus. “Cohabitating in the same building facilitates this level of care,” he says of the collaboration among specialists. (Ridley-Tree Cancer Center photo)

For similar approaches, patients would have to travel to Los Angeles or the Bay Area.

One of the minimally invasive advancements developed by Ridley-Tree’s nuclear medicine department is TheraSphere, used in the treatment of liver tumors. The procedure allows for precise delivery of high-dose radioactive spheres to targeted regions of liver tumors, and is effective at slowing tumor growth or even eliminating the tumor altogether in particular cases.

When determining how advanced a patient’s esophageal or pancreatic cancer is, Conway relies on endoscopic ultrasound. This form of imaging, available for the first time ever in Santa Barbara, closely examines the interior gastrointestinal tract.

While ultrasound technology has been around for a long time, using this concept with endoscopy allows for a greater level of detail in much less invasive ways than were previously available.

Many patients benefit from these advanced techniques, and they also benefit by having a cadre of experts collaborating on their care. A team of specialists, including medical, radiation, and surgical oncologists discuss complex cancer cases and the best course of treatment at weekly tumor board meetings.

“These tumor boards allow for detailed discussions from all subspecialities, providing a multidisciplinary approach to care that is in the best interests of the patient,” Conway explained. “What you end up with is a patient-centered treatment plan, as opposed to just getting one doctor’s opinion.

“Cohabitating in the same building facilitates this level of care.”

Dr. Winifred Leung, a breast radiologist, participates in a weekly breast cancer tumor board.

“It’s a meeting of the minds,” she said. “We have all these specialists focused on diagnosing and treating breast cancer, which forces us to stay up to date on the most evidence-based diagnostic and treatment options. It’s accountability as well as collaboration.”

One of the recent advancements in treatment for women with breast cancer is the introduction of a needle-free radar localization system known as SAVI Scout, used to identify the exact location of the cancerous breast tissue in lumpectomy procedures.

Until recently, surgeons relied on wire localization to mark a tumor’s location. This entailed inserting a thin, hooked wire into the breast, with a portion of the wire extending out from the skin. This wire needed to be placed the morning of surgery, requiring patients to undergo two procedures in one day, prolonging anxiety and discomfort.

The SAVI Scout procedure can occur weeks before lumpectomy, making it easier for the patient, and often resulting in better cosmetic outcomes since less unneeded tissue is removed. It offers surgeons greater precision in locating the tumor, while often saving time.

“Breast imaging has also made tremendous strides across the industry,” Leung said.

In early 2013, the Food & Drug Administration approved tomosynthesis, a digital X-ray mammogram that creates multidimensional pictures of the breast. Leung describes it as “looking through the breast like pages of a book.”

The important benefits are that it increases cancer detection rates, and decreases false positive rates.

“We have robust imaging services, which also includes ultrasound and MRI, and it’s all available right here,” Leung said.

Leung was one of the first fellowship-trained breast radiologists in Santa Barbara and she is thrilled to focus her practice solely on breast imaging, which she said allows her to gain a deep level of knowledge and expertise, while staying current on research in her field.

Sansum Clinic has plans to upgrade its breast imaging center, expanding the physical space and dedicating it solely to breast screening.

While Voog, Conway and Leung have distinct specialties, they share the strong sense of camaraderie at the Ridley-Tree Cancer Center, at 540 W. Pueblo St.

“In a community of this size, to have the collective nucleus of all the oncology providers in your cell contacts or on the floor above you is very unique,” Voog said.

Leung agreed.

“There’s a lot of collaboration that happens all under one roof and that is really unique to Ridley-Tree,” she said. “Once I detect the cancer through a confirmed biopsy, then it’s very easy for me to direct the patient to the proper provider in an expedient and thoughtful manner.”

Confronting a cancer diagnosis can be an extremely anxious, stress-filled time, and it’s reassuring to know that excellent care and the latest technological advancements are right here, in our own backyard.

Click here for more information about the Ridley-Tree Cancer Center. Click here to make an online donation.

— Ann Pieramici is a Noozhawk contributing writer. She can be reached at news@noozhawk.com.