Author Interview with Prof. Anders Brahme
Author of the books: Fundamental Molecular Understanding of Quantum Biology Optimized Curative Radiation Oncology
-1. Please introduce yourself. What would you like your reader to know about you?
I am since some 40 years professor in Medical Radiation Physics at Karolinska Institute in Stockholm. I have spent a large part of my life trying to understand how the process of Radiation Therapy works and can be improved. This book summarizes my conclusions with focus on the last few years when our deeper understanding of the molecular function of radiation therapy have been substantially increased, resulting in a potential major improvement in clinical treatment outcome.
-2. What is your inspiration/motivation?
When I started, cancer was a life threatening disease with more than 50% fatal outcome, today more than 80% of the patients can be rather safely cured with minimal side effects by optimal treatment techniques. Tomorrow the common fear of getting cancer will almost be gone! The most problematic treatments are pediatric and many clinical improvements are suggested!
-3. How long did it take to complete your book from the idea to publication?
It took me about 2 years to finalize the book manly based on a hand full of key publications published the last five years. The new approaches in these papers opened the door to a better understanding of how to best perform radiation therapy and optimally use the wide rage of existing radiation modalities with minimal harm to the patients.
-4. What's the main message and idea of your book "Fundamental Molecular Understanding of Quantum Biology Optimized Curative Radiation Oncology"?
The key therapeutic process of radiation therapy is achieved by the Dual Double Strand Breaks produced by low energy electrons that are produced in all therapeutic beams. The secret is how to deliver them with high therapeutic effect and minimal harm to the patient. We also really need to reconsider the way we perform Time Dose Fractionated Radiation Therapy to improve the probability to achieve complication free tumor cure by the best tolerated ≈2 Gy/Fraction to non-extra sensitive organs at risk and use ≈3-4 Gy to the tumor volume using biologically optimized IMRT (not 2 Gy commonly used today). We also need to better consider the microscopic heterogeneity of modern carbon ion therapy which can be substantially improved by a 10GyE photon or electron roundup the last week of the treatment to really maximize complication free tumor cure or use lithium ions with lower damage to normal tissues. Interestingly, both these methods will allow a decrease in the total dose delivered by about 10 Gy and increase the complication free cure and treatment outcome by 20-30% compared to traditional methods.
-5. What was the most unexpected conclusion you came up with while preparing "Fundamental Molecular Understanding of Quantum Biology Optimized Curative Radiation Oncology"?
I probably invented a new way to design microscopically uniform ion beams (I never saw it described elsewhere) by using a 7nm uniform hexagonal ion grid which minimizes the risk of missing clonogenic tumor cells (≈ 10nm) at 40% lower therapeutic dose! I also suggested the use of Einstein’s 4D Space-Time concept to better minimize Normal Tissue damage during light ion therapy accounting for microscopic heterogeneity and low tumor cell density in set up margins the last week of the treatment!
-6. How would you describe your publishing experience with Eliva Press in a few words?
It worked very well possibly with an exception for the few mathematical equations I needed.