When the OSF HealthCare Cancer Institute in Peoria, Illinois was being developed, plans included an enhanced brachytherapy suite. Since welcoming its first patients in early 2024, the OSF Cancer Institute has provided nearly 100 fractions (treatments) to 29 patients and continues to look for ways to bring the best treatment options to patients.

“Brachytherapy is a radiation treatment that we can use to get radiation right up into a tumor without having to go through a lot of extra normal tissues,” explains Mackenzie McGee, MD, radiation oncologist with OSF HealthCare. “(With) external radiation we're going to radiate somebody from the outside in so we're going through a lot of different normal tissues. The advantage of brachytherapy is we can get an applicator right up into the tumor to deliver radiation right where it needs to be and help really spare a lot of the normal surrounding tissues.”

Currently, prostate and gynecologic cancers, such as endometrial and cervical cancer, are what are primarily treated with brachytherapy.

“For patients with cervical cancer, brachytherapy is the gold standard. It does have superior control and survival rates as compared to other techniques that have been tried. When you look at good brachytherapy - so that's image guided brachytherapy, exactly what we're doing here - the control rates of the cervix are extremely high, well over 90% in most cases,” says Dr. McGee.

“The brachytherapy device - the bravos - has a single Iridium 192 source and what we can do is program the source to come out through cables that we attach to our applicator so it's all a closed system to the patient and we will tell it where to go and where to stop at different points along the applicator. What we can do then is it delivers almost like a little cloud of radiation just around the area and the dose getting further out from that source is really very low.”

Before treatment can begin, patients requiring advanced brachytherapy, such as cervix and prostate cancer patients, are taken to the brachytherapy suite in the OSF Cancer Institute to put the applicator in place while they are under mild anesthesia, which helps ease getting it in place and on target correctly. Because of the new set-up, the time between putting the applicator in place and treatment has been reduced by hours and the overall span of the two-dose treatment shortened to less than 24 hours in many cases. Since patients have to stay in the hospital with limited mobility while the applicator is in place, the goal is to continue to work to shorten that time.

The OSF Cancer Institute is in an elite group of the top brachytherapy treatment centers in the United States, and the only one in central Illinois to offer complex brachytherapy treatments. It is the first-ever cancer treatment center to offer GE’s CT Scan technology on tracks, which increases the precision of the treatment.

“This CT is really unique because it can actually come in and move over the patient while they're still under anesthesia and we can see if our applicator is in the exact right position. If we need to adjust that applicator or the needles, we can do that while the patient is still under sedation and very comfortable,” Dr. McGee explains.

 “The CT on rails is really a huge win because… what it’ll let us do down the road is actually introduce more applications for brachytherapy. There are studies out there about…being able to give a single dose of brachytherapy to a lung tumor to obliterate it. You can do that potentially with sarcomas as well so there's going to be other tumor types that we right now aren't able to offer but with the CT on rails we can work with our interventional radiology colleagues to help bring novel treatments to our patients that really aren't available widely across the country. This is a really unique opportunity for us to expand the brachytherapy that we offer.”

In addition to the state-of-the-art technology, the OSF Cancer Institute offers a multidisciplinary approach to care which includes nurse navigators to guide patients through their treatments, supportive services like a dietitian and a financial navigator, and even a pelvic floor therapist who can help with any needs patients have down the road.

For Dr. McGee, it’s all about doing what’s best for her patients.

“Having the opportunity to think through what my patients go through when they're having these brachytherapy techniques. It's a scary time, there's a lot of unknowns, there is sometimes some discomfort with it. Being able to really push our team to offer the best possible patient experience that also offers them the same opportunity for cure and reduced toxicities is really exciting. I always want my patients to feel that we are doing everything we can to help them feel loved and cared for and one way we can do that is really respecting how much time they have to have some discomfort and so every opportunity we can take to improve that, I think this really allows us to do that.”

Learn more about all of the treatments and services offered at the OSF HealthCare Cancer Institute.

Mackenzie McGee, MD - OSF HealthCare Radiation Oncologist interview clips

OSF Cancer Institute Brachytherapy suite Broll

As we begin a new year at OSF HealthCare, we’re reflecting on 2024 and the major strides in digital transformation to make access to care and health information seamless for our patients. At OSF, we continue to collaborate with our academic and business partners to leverage collective expertise and to responsibly use the power of artificial intelligence, always taking care to use guiding principles of what is fair, appropriate, valid, effective and safe (FAVES).

The efforts are highlighted here in our Top 10 Digital Health and Innovation stories of 2024 in no particular order.

1. OSF Unveils new 55+ primary care service in south suburban Chicago: Called OSF Complete Care 55+, this is a unique collaboration between OSF HealthCare Little Company of Mary Medical Center and OSF OnCall, the digital arm of the health care Ministry. When launched in early 2025, this primary care program will incorporate in-person visits, plus a mix of virtual care, digital health monitoring tools and 24/7 access to a care team focusing on those with chronic conditions.

2. Building an AI prepared workforce: OSF HealthCare leaders took just six weeks to develop mandatory training about generative AI for all 24,000 OSF Mission Partners (employees) because tools were already publicly available. Melissa Knuth, Vice President of Planning, outlines that to rise to the challenge, she worked with OSF Innovation to use mixed media to keep the content interesting and tapped generative AI tools to assist with the content creation.

3. OSF Digital Hospital patients in Rockford area say it’s the best medicine: OSF OnCall expands its digital hospital program to Rockford and receives rave reviews from some of its first patients. In addition, a well-known farm broadcaster shares her story about receiving acute-level care from the comfort of her own home and urges others who are eligible to consider the option.

4. OSF Innovation sets the table for solution to prevent cancelled surgeries: Two OSF HealthCare nurses turned to the OSF Innovation Studio team to help improve their Device Table software that serves as a database for implanted medical devices – offering information needed for surgical teams to reference for safety in surgery planning. We also reported on the creation of a spin-off company, OpenSurg, which will license and promote widespread sales of Device Table and related support features.

5. OSF HealthCare experts: ‘Establish guiding principles when developing digital care strategy’: OSF OnCall was a spotlight vendor and presenter at this year’s American Telemedicine Association’s annual Nexus conference in Phoenix, Arizona. OSF OnCall Senior Vice President Jennifer Junis advised during her presentation that health systems use guiding principles when developing their approach to digital health and to involve clinicians and patients when piloting new programs and digital tools. OSF HealthCare has also become a founding member of an ATA Digital Center of Excellence.

6. Mapping the future for early diagnosis of rare diseases: A Jump ARCHES grant-funded project with the University of Illinois Urbana-Champaign is using generative AI and knowledge graphs that map symptoms to detect rare diseases. Adam Cross, MD, who leads the OSF Children's Innovation Lab in Peoria, Illinois, wants to create a point-of-care tool for primary care providers to help patients get an early diagnosis of a rare disease.

7. Health economist: Connectivity and trust can expand telehealth: OSF OnCall hosted its first-ever digital health symposium which drew nearly 150 clinicians and vendors. Keynote speaker health economist and advisor Jane Sarasohn-Kahn stressed evidence-based digital technologies can improve health outcomes, but health systems need to build trust and expand community partnerships to increase engagements.

8. Fast-Tracking Hope: Rapid Intake at the OSF Cancer Institute: OSF HealthCare began 2024 with the opening of its new comprehensive Cancer Institute, offering advanced radiation therapy such as brachytherapy and proton beam therapy.  It also launched a new rapid intake system, developed by OSF OnCall and OSF Innovation to offer a single point of contact through OSF-HOPE (844- 673-4467) so cancer patients can be immediately connected to treatment and support services.

9. Piloting a smarter colonoscopy: OSF HealthCare St. Joseph Medical Center piloted artificial intelligence-backed colonoscopies, using a company called GI Genius, to improve detection of precancerous polyps. During the pilot, the adenoma detection rate (ADR) averages increased among all patients involved to as high as 12%, while individual physician ADR increased as high as 32.8%. The technology is now being implemented across the OSF Ministry.

10. Testing the path to better concussion diagnosis: An OSF Innovation lab-designed FlightPath app is now being tested by athletes at Illinois State, Bradley and Illinois Wesleyan Universities. The app only takes about two minutes to collect more than a million data points as a person tries to catch a hummingbird within a 3D space on a screen. The clinical trial could last two years. 

In the past decade, breakthrough treatments for cancer have emerged requiring a personalized approach.  The new OSF HealthCare Cancer Institute on the campus of OSF HealthCare Saint Francis Medical Center in Peoria, Illinois, will offer access to a variety of treatments under one roof when it welcomes its first patients next month.

A lesser discussed treatment that will be available is brachytherapy or implant radiation. Unlike external beam radiation, this treatment is delivered from inside the tumor and can deliver more intense doses of radiation at the tumor site. Brachytherapy is most commonly used to treat cancers of the female pelvis, prostate, breast, eye and skin. 

James McGee, MD, radiation oncologist at OSF HealthCare Saint Francis Medical Center has sub-specialized in brachytherapy. It is the most targeted radiation treatment type and preserves healthy tissue. 

“Placing a radiation source directly into the patient’s tumor allows for many advantages. In this way, the radiation is not going through normal tissues and has much less normal tissue effect.  At the same time, it creates the need to be very individualized and very creative.” 

The radiation is given with high dose delivery rates usually with a very small radiation source in a cable moving through an applicator or even a series of needles to the core of the malignancy. The devices are called temporary implants that are removed after the dose is delivered. Brachytherapy implants may be short-term (temporary) or long-lasting (permanent). The result is a higher cure rate for certain cancers than with external beam radiation alone says Dr. McGee.  

The OSF Cancer Institute will have a state-of-the-art brachytherapy surgical suite, fitted with a GE CT scanner on rails, specifically designed for the space. It will allow patients to stay under anesthesia during CT-guided applicator or implant insertion. A new MRI scanner is located directly outside the suite, creating efficient transfer for the patient, when MRI imaging will help, improving their overall experience. 

Better preparation through 3D models 

Dr. McGee sits in front of a 3D model made for a woman who had cervical cancer. It was developed using translucent silicone molding and graphite material to represent tumor growth. He explains that because of the need for precision application of the radioactive material, OSF HealthCare enlisted engineers at Jump Trading Simulation & Education Center to create patient-specific models for complex cancer cases. 

“We've actually been taking MRI scans from patients and in preparation for their treatment and we've created models that represent their normal anatomy and the anatomy of their cancer. Usually this is after initial treatment with chemotherapy radiation, probably for about five weeks.”

The use of brachytherapy reduces recovery time and side effects, and is often a shorter, more cost-effective treatment than traditional external beam radiation. There are many types of brachytherapy.  These can be categorized by the duration of the dose delivery - high dose rate, low dose rate, and permanent. They are also categorized by the technique used such as interstitial (in between cells of cancerous tissue), intracavity and surface application. 

 Dr. McGee looks forward to being able to enhance brachytherapy procedures by having the operating room, imaging, and treatment delivery system integrated in the same space at the OSF Cancer Institute. 

Video Clips with Dr. James McGee courtesy of WTVP-PBS

B-roll of Brachytherapy-Courtesy WTVP-PBS