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‘Game-Changing’ Adaptive Radiation Therapy Program Will Enhance Treatments for Cancer Patients at ChristianaCare

Revolutionary treatment boosts precision and effectiveness

Oct 21, 2024

3 min

Patients undergoing radiation therapy for certain types of cancer at ChristianaCare’s Helen F. Graham Cancer Center & Research Institute will be the first in Delaware to benefit from a cutting-edge treatment system that increases accuracy and precision, enhances patient comfort and minimizes side effects.


ChristianaCare expects to begin scheduling patients in early 2026 to receive treatment with the Varian Ethos™ system equipped with HyperSight. The innovative radiotherapy system leverages artificial intelligence and the fastest on-table imaging in the field to enhance precision and increase the likelihood of effectively treating tumors.



“As leaders in cancer treatment and care, we continually strive to stay at the forefront of medicine for our patients, and this new technology is a game-changer,” said Thomas Schwaab, M.D., Ph.D., Bank of America endowed medical director of ChristianaCare’s Helen F. Graham Cancer Center and Research Institute. “Adaptive radiation therapy enables members of the patient’s treatment team to create a new treatment plan every day in real-time based on the patient’s needs and anatomy in that moment as well as any changes observed during their therapy.”


In traditional radiotherapy, a plan is established at the beginning of treatment and followed through the treatment course. Adaptive radiotherapy allows for real-time modifications to the plan based on periodic assessments while the patient is on the radiation table.


Human anatomy changes quickly through normal bodily function even during treatment. In the context of radiation therapy, even slight shifts or alterations in the body while being treated can significantly impact effectiveness.


The advanced technology in the system enables real-time imaging on the radiation table to be completed in seconds, rather than minutes – a dramatic improvement that transforms targeting accuracy and patient comfort.


“This advancement will allow us to deliver personalized treatments, enabling radiation oncologists to make necessary treatment decisions even more quickly and accurately,” said Lindsay Romak, M.D., radiation oncologist at the Graham Cancer Center. “This will provide clinically meaningful benefits for patients who require radiotherapy for a wide range of cancers, including those of the prostate, bladder, abdomen and head and neck.”


Artificial intelligence powers patient treatments


Leveraging the power of artificial intelligence to capture and analyze rapid images in real time, the technology quickly detects changes in the patient’s anatomy and tumor size, shape or position. Using real-time imaging data, the system automatically suggests adjustments to the treatment plan to account for these changes, which is key to achieving better patient outcomes.


The system also uses artificial intelligence when determining the distribution of the radiation dose, ensuring the tumor receives the optimal amount of radiation. This streamlines the workflow making the entire process of adaptive radiotherapy more efficient.


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"The integration of artificial intelligence into our treatment processes underscores our dedication to incorporating the most innovative treatments for our patients. With this technology, our patients can anticipate shorter treatment times and potentially fewer sessions, significantly enhancing their overall experience,” Laura Doyle, Ph.D., chief clinical physicist at the Graham Cancer Center said.

Adaptive radiation therapy is covered by Medicare and most insurance carriers.


The system will be located in the radiation oncology suite at the Graham Cancer Center.


Equipment installation is expected in the fall of 2025 with patient use starting in early 2026.


ChristianaCare’s Radiation Oncology Department is recognized by the American Society of Radiation Oncology Accreditation Program for Excellence. Its radiation oncologists are leaders in adapting the very latest imaging and treatment advances into clinical practice. The team also helps write the standards for best practices in care delivery and teaches other doctors and health care professionals in this specialty.


With this latest advancement, ChristianaCare’s Helen F. Graham Cancer Center and Research Institute continues to solidify its position at the forefront of cancer care in Delaware and beyond, underscoring its commitment to improving patient outcomes and quality of life.


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3 min

ChristianaCare and Partners Launch Delaware’s First Nurse Anesthesiology Program

Wilmington University, in collaboration with ChristianaCare and the support of Anesthesia Services, P.A. (ASPA), announces the Delaware Nurse Anesthesiology Program at ChristianaCare and Wilmington University, Delaware’s first nurse anesthesiology program. This innovative, full-time, 36-month offering leads to a Doctor of Nursing Practice (DNP) degree, preparing graduates to sit for the National Certification Exam and become certified registered nurse anesthetists (CRNAs). A CRNA (or nurse anesthetist) is an advanced practice registered nurse who administers anesthesia and provides related care before, during, and after surgical, therapeutic, diagnostic, and obstetrical procedures. The program will offer students over 2,000 hours of hands-on clinical experience in high-acuity environments across various surgical specialties, supported by partnerships with ChristianaCare, ASPA—the largest anesthesia group in Delaware—as well as other health care organizations. Students will refine their clinical skills and decision-making in state-of-the-art simulation labs while engaging in diverse clinical settings. Led by experienced practitioners and educators, the curriculum integrates anesthesiology-specific coursework with advanced nursing practice, ensuring graduates are well-prepared to meet the evolving demands of clinical practice and systemic health care challenges. “We are proud to partner with ChristianaCare and ASPA to launch this transformative program,” says Wilmington University President Dr. LaVerne Harmon. “At Wilmington University, our caring, student-centered approach prioritizes academic excellence and personal well-being. While this initiative addresses Delaware’s critical need for anesthesiology professionals, we will focus equally on fostering an environment where students can excel and grow into compassionate, skilled leaders in the evolving health care field.” “ChristianaCare is excited to partner with Wilmington University and our colleagues at ASPA in this much needed program to help address Delaware’s growing need for highly qualified CRNAs,” says Janice E. Nevin, M.D., MPH, president and CEO of ChristianaCare. “By providing advanced training and education in anesthesiology services, we are helping to develop the next generation of health care experts who will serve our community with high-quality, safe care.” The U.S. Bureau of Labor Statistics projects a 38% growth in nurse anesthetist employment from 2022 to 2032, driven by increased demand for health care services like elective surgeries. Delaware’s health care system faces similar challenges due to a shortage of anesthesiologists and CRNAs, with many nearing retirements. With 15 programs in neighboring Pennsylvania unable to accommodate all qualified applicants, the Delaware Nurse Anesthesiology Program at ChristianaCare and Wilmington University aims to bridge this gap, providing essential local training to meet the growing demand in the workforce. “With an emphasis on evidence-based practice and patient-centered care, our graduates will be exceptionally equipped to provide high-quality anesthesiology services in diverse health care environments,” says Wilmington University Vice President of Academic Affairs Dr. Denise Wells. “This collaboration aims to cultivate a local pipeline of skilled registered nurses who will advance their careers as CRNAs, contributing to Delaware’s workforce and the surrounding region.” “Anesthesia Services, P.A. has been leading and innovating anesthesia care delivery in Delaware for the past 37 years,” says ASPA Board Chair Li Maceda, M.D., MBA. “This joint partnership with ChristianaCare and Wilmington University allows us to combine our expertise and resources to train the next generation of anesthesia providers for the communities that we serve and exemplifies our commitment to invest in the future advancement of perioperative care.” Dr. Jacqueline Mainwaring was recently named inaugural director of the Delaware Nurse Anesthesiology Program at ChristianaCare and Wilmington University. “I am excited to be part of this groundbreaking initiative that will provide critical care nurses in our state with the opportunity to advance their careers and become leaders in anesthesiology care,” says Dr. Mainwaring, also an associate professor. “We are committed to creating a high-quality program that prepares our graduates to excel in today’s complex health care landscape. This program will not only address the shortage of anesthesiology professionals in Delaware and the region but will foster a learning environment that emphasizes student well-being, clinical excellence, and interprofessional collaboration.” Leaders of the Delaware Nurse Anesthesiology Program at ChristianaCare and Wilmington University, currently in Capability Review, are pursuing initial accreditation from the Council on Accreditation of Nurse Anesthesia Educational Programs (COA). Please note, no students can be enrolled until initial accreditation has been awarded. Below is contact information for the COA: Council on Accreditation of Nurse Anesthesia Educational Programs (COA) 10275 W. Higgins, Suite 906 Rosemont, IL 60018 Phone: 224-275-9130 Email: accreditation@coacrna.org www.coacrna.org

4 min

New Trends and Treatments in Menopause Care

If you’re in your 40s and you menstruate, you may already be experiencing the effects of menopause: the point in life when your menstrual cycle stops permanently, which arrives for most people around the age of 50. This hormonal shift comes with numerous symptoms, some of which are manageable with at-home care and others—like intense mood swings, hot flashes or trouble sleeping—may need medical attention. Menopause has officially happened when a year has passed since your last period. The roughly two to eight years before that, when periods become irregular and fertility decreases, is known as perimenopause. Some people experience perimenopause in their 30s and some as late as their early 50s, but most reach perimenopause in their late 40s. Menopause is a naturally occurring life change, not a disease, and not everyone requires treatment for it. Many people seek medical help to deal with their symptoms. There are many new trends in menopause care, from hormones to drugs to supplements and beyond, and navigating them may feel overwhelming. What’s safest for managing side effects? Should I buy over-the-counter treatments or seek more involved care from a health care provider—or both? Read on for answers to these and other important questions on how best to treat menopause symptoms. Is hormone therapy right for me? Menopause happens to everyone who menstruates, and it’s important to bring up any symptoms of menopause as they occur at your annual primary care checkup. A gynecologist with special training or interest in the transition from ages 40 to 55 is an ideal specialist to seek additional care and treatment from, especially if you’d like to explore medical treatments like hormone therapy. Hormone therapy in the form of prescribed estrogen and progestin (both reproductive hormones that exist in the body naturally) has been used since the 1980s to treat the symptoms of menopause. A decline in estrogen is the culprit for many menopause symptoms, so adding estrogen back into the body through hormone therapy helps to diminish symptoms. Not all people who go through menopause need hormone therapy, but it has numerous positive side effects, including the lessening of some symptoms and lowering the risk of osteoporosis, a loss of bone density that can be exacerbated by natural estrogen decreasing over time as we age. These therapies can be administered in a cream, a patch, or even through low-dose birth control pills. However, hormone therapies can carry an increased risk of some cancers, including breast cancer. Non-hormonal, complementary medicine and lifestyle options Non-hormonal options to treat menopause symptoms are growing in popularity and represent an alternative to hormone therapies. Some of these include: Be sure to consult your provider before adding any new drugs or supplements to your daily routine. There are also many popular and effective options for treating menopause symptoms that come from Eastern and herbal medicine traditions. These include acupuncture, which has been shown to help with hot flashes and night sweats, as well as herbal supplements that often accompany treatment from a trained acupuncturist. A main downside to acupuncture can be cost, as the treatment is rarely covered by insurance. Eating mindfully and exercising regularly both also have proven benefits to treat menopause symptoms and to keep our bodies healthy more broadly as we age. This includes getting enough vitamin D and calcium through diet in order to keep bones strong as hormone levels change and to limit caffeine and alcohol consumption. Challenges in menopause care Despite the progress made in menopause treatment over the past years, there are still a few main challenges that you may face in menopause care. These include: Stigmas surrounding speaking openly about symptoms, especially sexual side effects like vaginal dryness and changes in libido that can affect intimacy. It’s important for you to feel empowered to discuss all symptoms with your provider. The increased availability of at-home tests, purchased online, for menopause and perimenopause. While these tests may be helpful in showing a snapshot of your hormone levels on a given day, more information is needed to diagnose menopause and perimenopause correctly, and at-home results can often be misinterpreted. It’s best to conduct these sorts of tests under the care of your provider, who can place them in the appropriate context. It can be hard to find the time needed to diagnose and treat menopause symptoms in a clinical setting, especially because it often takes time and communication outside of an office setting to ensure diagnosis and treat symptoms properly. Seeking out a provider who specializes in menopause care helps a great deal to expedite this process and get you the care you need. Not everyone experiences menopause the same way: for some people, symptoms are mild enough that at-home remedies will meet their needs. But for those with more intense symptoms—or anyone hoping for clinical support during this challenging time—working closely with a gynecologist will bring you relief and greater insight.

2 min

ChristianaCare Honored for Emergency Nursing Excellence

ChristianaCare has earned the 2024 National Certification Champion Award for health systems from the Board of Certification for Emergency Nursing (BCEN), a leading authority in nursing specialty certification across the emergency care spectrum. ChristianaCare is the only national winner in its category. “ChristianaCare is honored to be named the BCEN National Certification Champion,” said Danielle Weber, DNP, MSM, RN-BC, NEA-BC, chief nurse executive at ChristianaCare. “This prestigious recognition speaks to the passion and dedication of our incredible nursing teams, guided by our values of love and excellence, who make the difference for patients during some of their worst moments, going above and beyond to deliver quality care.” “It’s a privilege to be a part of a team that is committed to nursing excellence, practicing at the top of their license through specialty certification,” Weber continued. “This award represents the culmination of years of focused attention by nursing leadership to promote and facilitate ED nurse certification coupled with a highly motivated and passionate nursing staff who are dedicated to their patients as well as their professional development. We are so proud of our certified nurses and their commitment to lifelong learning.” According to BCEN, nursing specialty certification independently validates a registered nurse’s advanced knowledge, clinical judgment and professionalism across an entire nursing specialty. Specialty board certification of nurses helps assure patients and their families that they are receiving the highest level of nursing care. A growing body of research links nursing specialty certification to improved patient care, safety and outcomes. “We congratulate ChristianaCare on its commitment to nursing excellence,” said BCEN CEO Janie Schumaker, MBA, BSN, RN, CEN, ICE-CCP, CENP, CPHQ, FABC. “The 2024 BCEN National Certification Champions show us how nursing specialty certification empowers nurses, elevates patient care and helps ensure communities of every size have access to advanced emergency and trauma care.” BCEN is an independent not-for-profit organization that offers nursing specialty certification programs for nurses across the emergency care spectrum. Over 50,000 registered nurses specializing in emergency, pediatric emergency, flight, critical care ground transport, trauma and burn nursing hold one or more BCEN certification.

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