Raquibul Hannan, M.D., Ph.D. Answers Questions On: Radiation Oncology

External beam radiation therapy in the treatment of GU cancers, more specifically prostate cancer, is a standard of care because we have over 15 years of mature data from large clinical trials demonstrating its efficacy and safety. In addition, with the development of advanced forms of external beam radiation therapy such as IMRT and IGRT, the precision with which we can target the tumors has increased significantly and this simultaneously allows us to decrease the dose to the normal tissues around the tumors and thereby substantially reduce the treatment side effects.

Here at UT Southwestern Medical Center, we have state-of-the-art technology including Trilogy, Rapid Arc, CyberKnife, Gamma Knife, TrueBeam. The significance of having the most advanced technology simply means better, more precise, and higher dose delivery to the target tumor with reduced radiation dose to the normal tissues, which eventually translates into better outcomes for our patients both in terms of curing the cancer and decreasing the side effects.

Patient autonomy. I believe that as a patient’s advocate, it is a physician’s duty to neutrally inform and educate the patient about his/her cancer, all the available treatment options, their outcomes, and side effects. A physician should then help guide the patient in selecting the best treatment option that is personally suitable for him or her. 

The body’s immune system is a great natural tool that, when educated, can eradicate tumors including those hidden in metastatic sites, effectively and without any side effect – the so called “magic bullet” against cancer. There is significant preclinical evidence that radiation therapy acts as an in-situ tumor vaccine in presenting tumor antigens to the immune system and initiating an immune response to cancer cells. The focus of my research is to decipher the mechanisms of this immune stimulation by radiation and thereby allowing us to rationally combine immunotherapy with radiation therapy, not only for GU cancers but for all sites of cancers where radiation is a treatment option.

The insight gained by learning the immune-stimulatory effects of radiation therapy allows us to better strategize in designing successful combinations of immunotherapy and radiation therapy. Two such clinical trials are currently in the design for metastatic prostate cancer and renal cell cancer patients. We hope to start patient enrollment soon.