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Mon, Jun 1 12:14pm · Cancer can't wait: Why some patients may benefit from expedited breast cancer treatments

Breast surgeon Dr. Tina Hieken

When 62-year-old Diana Canty of Converse, Texas was diagnosed with invasive ductal carcinoma in February, 2020 she made plans to travel to Mayo Clinic in Minnesota because of the organization’s reputation for excellence in cancer treatment.

Diana’s first experience with Mayo Clinic was a video appointment in April with breast surgeon, Tina Hieken , M.D.

Then she made the journey to Rochester, Minnesota because cancer can’t wait. “I met with, Nicole Sandhu, M.D. of the Breast Diagnostic Clinic,” said Diana. “She explained the treatment options available to me and also explained that surgeries were temporarily being delayed due to COVID-19.”

While in Rochester, Diana also met with Dr. Hieken who offered information on an expedited treatment option for breast cancer.

According to Dr. Hieken the expedited breast cancer treatment protocol is available to women with certain types of early stage breast cancer and allows patients to complete their entire treatment, including surgery and radiation therapy, in less than 10 days.

“Women with small breast cancer tumors and no cancer in their lymph nodes may be able have a lumpectomy in an outpatient procedure,” explains. Dr. Hieken. “These patients can leave the operating room the same day as their surgery with a catheter in place, which is used to administer brachytherapy, a form of radiation therapy, post-surgery.” 

Watch: Dr. Tina Hieken discuss expedited breast cancer treatment

Journalists: Sound bites with Dr. Tina Hieken are in the downloads.

“After surgery, patients receive brachytherapy treatment over five weekdays, twice a day, approximately six hours apart, for a total of 10 treatments,” explains Dr. Sean Park, M.D., a Mayo Clinic radiation oncologist.

Given her concerns about being away from home and especially during a pandemic, Diana thought the treatment option was a perfect fit for her. She was also impressed by the steps Mayo Clinic put in place to help ensure the health and safety its patients during the pandemic.

Before leaving Rochester, Dr. Sandhu prescribed an Aromatase Inhibitor for Diana to help slow, or even stop, the growth of her cancer until she returned to Mayo Clinic in May for her expedited breast cancer treatment.  

When Diana returned to Rochester in May, she stayed at the Kahler Inn and Suites for two weeks while she prepared for and received the expedited treatment. Part of the preparation included a blood serum test and a nasal swab to test for antibodies to the COVID-19 virus or an active infection. 

Brachytherapy tool treatment

Next, Diana  prepared for and completed the expedited treatment which included surgery and brachytherapy treatments that were completed in less than two weeks.  

“The care I received was perfectly amazing,” says Diana. “Dr. Sandhu, Dr. Hieken, and Dr. Park made me feel confident and safe in their care. The staff was very reassuring and made me feel like I was in the safest and best place on earth for my care and treatment. I recommend Mayo Clinic to everyone!”

For more information on the treatment:


Check the CDC website for additional updates on COVID-19. For more information and all your COVID-19 coverage, go to the Mayo Clinic News Network and mayoclinic.org.

Wed, May 27 10:06am · Managing levels of specific protein, mineral early in COVID-19 may prevent severe illness

medical illustration of the coronovirus representing COVID19

PHOENIX ― Managing levels of calcium in the blood and the protein albumin early on in COVID-19 may prevent patients from progressing to severe illness and death, a study by Mayo Clinic researchers published in the journal Gastroenterology found. The findings are based on the remarkably similar clinical features and autopsy results of patients who died of COVID-19 and patients whose organ failure resulted from the release of unsaturated fatty acid caused by other illnesses, says lead researcher Vijay Singh, MBBS, a gastroenterologist at Mayo Clinic in Arizona.

The receptor for the COVID-19 virus has been reported on fat cells and  pancreatic cells that release enzymes breaking down fat, Dr. Singh says.

“When this happens, serum calcium and albumin are consumed by unsaturated fatty acids generated from the fat breakdown process and the remaining unsaturated fatty acids then injure vital organs, which can eventually lead to death,”  he says.

Supplementing serum calcium and albumin to maintain normal levels, starting early and continuing throughout a COVID-19 infection may help  bind and neutralize unsaturated fatty acids and prevent organ failure while giving the patient time to fight and clear the infection, Dr. Singh says.

 “This may help to prevent severe cases of COVID-19, and the need for patient treatment in intensive care units,” he says. “Supplementation to achieve and maintain normal serum calcium and albumin levels is  safe and can easily be tested in clinical trials.”

“Calcium carbonate, which can help maintain normal levels of serum calcium, is readily available over the counter, while albumin is commonly used intravenously in hospitals and costs about the same as common antibiotics,” Dr. Singh says.

Countries with a higher per-capita consumption of unsaturated fat also reported higher rates of mortality during the two weeks of the steepest increase in COVID-19 mortality from March 25 to April 8, food and agricultural organization data show, Dr. Singh notes.

“Among 11 other factors including wealth, access to health care resources and demographics such as age, unsaturated fat intake was the only factor associated with increased mortality on multivariate analysis. And, interestingly saturated fat intake was protective,” he says. 

Dr. Singh notes that, while giving calcium and albumin early in the course of COVID-19 may prevent unsaturated fatty acid-induced injury, several clinical trials have shown that supplementing them later was not effective.

###

About Mayo Clinic

Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news and An Inside Look at Mayo Clinic for more information about Mayo.

Media contact: Joe Dangor, Mayo Clinic Public Affairs, 507-284-5005, newsbureau@mayo.edu

Mon, Mar 9 12:00pm · Mayo Clinic-led study links obesity with pancreatitis

young overweight obese woman looking out at the ocean

PHOENIX — A
study by researchers at Mayo Clinic in Arizona
published in the The Journal
of Clinical Investigation
 has found that obesity is not only implicated
in chronic diseases such as diabetes,
but also in sudden-onset diseases such as pancreatitis.

“In our study, we were able to demonstrate that fat within the belly is rapidly
degraded during acute pancreatitis, but not during diverticulitis, despite
inflammation,” says Vijay Singh, M.B.B.S., a
Mayo Clinic gastroenterologist. 

Dr. Singh says while both diseases present with sudden
belly pain and account for about 300,000 cases annually in the U.S., the rapid
fat degradation that occurs in pancreatitis is triggered by a pancreatic enzyme
called PNLIP. This enzyme can form fatty acids that cause vital body systems
like circulation, kidney and lung functions to fail. Dr. Singh says this
multisystem failure is much more common in acute pancreatitis than in
diverticulitis.

Dr. Singh says obesity, which increases belly fat, also can
worsen acute pancreatitis. He says this highlights the role of obesity not just
in the development chronic diseases such as diabetes, but also in the
development of sudden-onset diseases such as pancreatitis. 

Dr. Singh says the study also found that unsaturated
fats, such as oleic acid contained in olive oil and recommended by the Food and
Drug Administration as being safer for human consumption, actually increase the
risk of organ failure. At the same time, PNLIP, the enzyme in the pancreas that
breaks down stored fat in fat cells was not abundant in cells specialized for fat storage.

“Our findings open the door to new therapeutic
targets to treat pancreatitis and thereby prevent organ failure,” says Dr.
Singh. “By inhibiting PNLIP, we may be able to prevent severe
pancreatitis, avoid prolonged hospitalizations and save lives.”

Mayo Clinic researchers involved in this study include:

  • Dr. Singh
  • Douglas Faigel, M.D.
  • Norio Fukami, M.D.
  • Rahul Pannala, M.D.
  • Doral Lam-Himlin, M.D.
  • Ann McCullough, M.D.

Dr. Singh reports no conflicts of interest.

###

About Mayo Clinic 
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news and An Inside Look at Mayo Clinic for more information about Mayo.

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Mon, Mar 2 4:30pm · Immune cells may improve accuracy of predicting survival in colorectal cancer

3D illustration of cancer cells

ROCHESTER, Minn.
— The density of immune
cells, called tumor infiltrating lymphocytes, when combined with analysis
of tumor budding may serve as a method to more accurately predict survival in
patients with stage III colon cancer. The findings, by a team of researchers
led by Mayo Clinic gastroenterologist and oncologist, Frank Sinicrope, M.D.,
were published today in Annals of Oncology.

Using colon cancer
tissues from a completed clinical trial, Dr. Sinicrope and his colleagues were
able to demonstrate that the extent or density of tumor infiltrating
lymphocytes (TILs), reflecting the patient’s anti-tumor immune response, is a
robust predictor of survival in patients with stage III colon
cancer.  TILs
are a type of immune cell that has moved from the blood into a tumor that can recognize and kill
cancer cells.

“Our ability to predict
patient outcome using TILs is strengthened when we combine it with tumor
budding,” says Dr. Sinicrope. Tumor budding is the presence of single cells or
small clusters of tumor cells at the invasive margin, or front edge of a cancer,
which can be scored by pathologists and may predict the potential for the
cancer to spread or metastasize.  .

“Determining the density
of tumor infiltrating lymphocytes and analysis of tumor budding can be performed
on resected tumor specimens,” says Dr. Sinicrope. “We found that the
combination of these tumor features were second only to number of
tumor-containing lymph nodes for predicting patient survival. Furthermore,
these features provided important data on patient survival in patients categorized
into low-risk and high-riskT and N stage groups which guide the recommendation
to receive 3 or 6 months of chemotherapy after surgery.” 

Dr. Sinicrope and his
colleagues are working to automate the scoring of TILs and tumor budding in tumors
from patients with stage III colon cancer. “We hope to provide important
prognostic information on individual patient tumors using routine tissue
sections without the need for the special stains typically used to identify specific
immune cell types,” he says.

###  

About Mayo Clinic 
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news and An Inside Look at Mayo Clinicfor more information about Mayo.

Media contact:

Mon, Mar 2 2:30pm · Mayo researchers recommend all women with breast cancer diagnosis under age 66 be offered genetic testing

a middle-aged woman, sitting outdoors with her chin resting on her hands and eyes downcast, looking sad or depressed

ROCHESTER, Minn. — A study by researchers at Mayo Clinic published this week in the Journal of Clinical Oncology suggests that all women with a breast cancer diagnosis under the age of 66 be offered germline genetic testing to determine if they have a gene mutation known to increase the risk of developing other cancers and cancers among blood relatives. Current guidelines from the National Comprehensive Cancer Network (NCCN) recommend germline testing for all women diagnosed with breast cancer under the age of 46 regardless of their family history and breast cancer subtype.

“There is considerable
confusion regarding the best method for selecting who may benefit from
hereditary cancer genetic testing from among all women diagnosed with breast
cancer,” says Fergus
Couch, Ph.D.
, a
breast cancer researcher at Mayo Clinic. “The NCCN has very specific guidelines
for who may benefit from genetic testing based on the age of diagnosis and
family history of certain cancers while the American Society of Breast Surgeons (ASBrS ) recommends testing all women with
breast cancer.”

For their study, Dr. Couch
and his colleagues evaluated all known breast cancer predisposition genes in a
Mayo Clinic breast cancer registry and showed that NCCN guidelines overlooked
approximately 30% of patients with genetic mutations known to increase the risk
of developing breast cancer.

Based on this information
Dr. Couch and his colleagues recommend increasing the age for genetic testing
to all women diagnosed with breast cancer under the age of 66 irrespective of
family history of cancer . “This change would help identify 98% of women with
BRCA1 and BRCA2 mutations, and more than 90% of women with mutations in other
predisposition genes, while avoiding testing of 20% of all breast cancers,”
says Dr. Couch. He says this approach may also result in a reduced burden on the
genetic services needed for women receiving testing.

“We were surprised to find
that the NCCN guidelines missed approximately 30% of mutation carriers in
breast cancer predisposition genes,” says Siddhartha Yadav, M.B.B.S., a medical
oncologist and first author of the study. “A few recent studies have
demonstrated that NCCN guidelines could miss a substantial number of mutation
carriers. However, these studies included several genes that are not typically
associated with breast cancer risk. Our study was appropriately restricted to
nine breast cancer predisposition genes with clear management guidelines.”

Dr. Couch says it was
encouraging to note that by simply changing the age cutoff for germline genetic
testing in women with breast cancer, rather than other more complicated
approaches, it should be possible to identify the majority of mutation carriers.
In women diagnosed with breast cancer over the age of 65, the study supports
the use of NCCN guidelines to decide who should undergo germline genetic
testing. The overall result is that many more women and their family members
can benefit from knowing that they are at increased risk of cancer.  

###  

About Mayo Clinic 
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news and An Inside Look at Mayo Clinic for more information about Mayo.

Media contact:

Mon, Jan 27 5:20pm · Dr. Perez shares perspective on new 'Stand Up To Cancer' Health Equity Initiative

Dr. Edith Perez, a Mayo Clinic oncologist and chair of the Stand Up To Cancer committee for health equity in cancer clinical trials today announced a new Stand Up To Cancer Health Equity Initiative aimed at reducing disparities among racial groups in cancer clinical trials.

“Despite an overall decline in U.S. cancer deaths since 1991, not all patients have benefited equally from advances in prevention, early detection, precision medicine and targeted cancer treatments,” says Dr. Perez.

Dr. Perez discusses Stand Up to Cancer Health Equity Initiative.

Only 4% of clinical trial participants are black; 4% Hispanic; and 15% Asian, according to the Food and Drug Administration. That’s despite minority groups overall in the U.S. having the highest death rate and shortest survival rate for most cancers.

“By having research teams dedicated to cancers that correlate to, or greatly affect different racial and ethnic populations, we’ll be able to ensure that strides are being made in cancers that typically affect these populations,” says Dr. Perez.

“Support for these teams further demonstrates our commitment to bringing breakthrough therapies to historically underrepresented racial and ethnic groups, and improving overall health equity in cancer research,” adds Dr. Perez. “We are proud and excited to play such a large role in serving this unmet need and look forward to setting the tone for scientific research to come.”

Dr. Edith Perez and her colleagues with Katie Couric at the
Stand Up To Cancer Health Equity Initiative announcement.

Dec 13, 2019 · Mayo Clinic researchers present findings at the 2019 San Antonio Breast Cancer Symposium

a smiling young Asian woman with shaven head representing cancer patient after chemo therapy

SAN ANTONIO — Mayo Clinic researchers will present findings at the San Antonio Breast Cancer Symposium Dec. 10–14 in San Antonio.

New Mayo
Clinic studies to be presented include:

“Women at Elevated Risk of Developing
Breast Cancer May Benefit From Taking Anti-inflammatory Drugs”

Embargoed until Friday, Dec. 13,
at 6 p.m. EST

Research
from Mayo Clinic investigators suggest that some women with an elevated risk of
developing breast cancer may benefit from taking anti-inflammatory medications.

“Several studies have evaluated whether the use of anti-inflammatory medications such as aspirin, ibuprofen and naproxen affect a woman’s risk of developing breast cancer,” says Amy Degnim, M.D., a breast surgical oncologist at Mayo Clinic in Minnesota, “but little is known about how use of these drugs might affect their risk after a benign breast biopsy.” Dr. Degnim says about one million women receive a diagnosis of benign breast disease annually in the U.S. and having this history increases their risk of developing breast cancer.

Researchers
surveyed women who had undergone a benign breast biopsy at Mayo Clinic between 1992
and 2001, and asked them to report which types of these medications they had
used and for how long. Researchers also obtained information on which women had
developed breast cancer at any point in the years after their initial benign
biopsy.

“We found
that women who reported using ibuprofen or naproxen had an approximately 40%
reduction in breast cancer risk, while women who reported using aspirin had no
reduction in breast cancer risk,” says
Dr. Degnim. “Women
who used the drugs more frequently on a regular basis also had greater
protection from breast cancer.”

Dr.
Degnim says the findings suggest that women who have had a benign breast biopsy
may benefit from medications that reduce inflammation, except for aspirin, in
terms of reducing later breast cancer risk. She cautions that this study was
not a clinical trial and she does not recommend that all women should take
these medications to reduce their breast cancer risk. “Our
results support the need for a clinical trial to further investigate the risks
and benefits of taking these medications to lower breast cancer risk.”

“Young Women With Breast Cancer May Help Preserve Fertility by Avoiding Intensive Chemotherapy”

Embargoed until Thursday, Dec. 12,
at 8 a.m. EST

Young women with HER 2-positive breast cancer may help preserve their
fertility by choosing one type of chemotherapy over another
according to the findings of a study led by Kathryn
Ruddy, M.D.
, an oncologist at Mayo Clinic. 

“Ovarian
dysfunction is an important issue after cancer treatment because it can be
associated with infertility and menopausal symptoms, such as hot flashes and
impaired sexual function,” says Dr. Ruddy.

Dr. Ruddy and her team surveyed study
participants taking part in a randomized clinical trial testing the
efficacy of T-DM1 versus a combination of paclitaxel and trastuzumab.
Participants were asked questions about menstrual periods. “We
found
that young women with HER 2-positive breast cancer may be more
likely to resume menstruation after receipt of two relatively new treatments,
T-DM1 or a combination of paclitaxel and trastuzumab,
than we have seen previously in young women who received older, more intensive
chemotherapy regimens.”

Dr. Ruddy says the findings should be good news for women who want to maintain
fertility after treatment for breast cancer and that menopausal symptoms such as hot flashes may be less burdensome for
patients treated with the
newer regimens. Dr. Ruddy and her colleagues will perform
additional analyses on the effect of tamoxifen on these results before
publishing a paper on this study. 

“Researchers
Develop Tool to Identify Patients at Higher Risk of Heart Damage From Breast Cancer
Therapy”

Embargoed until Friday, Dec. 13, at 6 p.m. EST

Researchers at Mayo Clinic in Florida have developed a tool to help identify
patients who
may be at higher risk of developing heart damage from anti HER 2 breast cancer
therapy at an early stage.

“Cardiac
toxicity is a known complication of anti-HER 2 therapy,”
says Pooja Advani, M.B.B.S., M.D., a Mayo Clinic oncologist. Dr. Advani says clinical studies have confirmed that the use
of anti-HER 2 therapy in breast cancer patients can have a profound effect on patient
survival.

“The
most common manifestation of cardiac toxicity in breast cancer
patients receiving anti-HER
2 therapy is
a reduction in the ejection fraction without any symptoms,”
says Dr.
Advani. Ejection fraction is a
measurement of the percentage of blood leaving the heart each time it
contracts.

Dr. Advani says risk factors, such as older age; a lower ejection fraction prior to the start of treatment; and the use of anthracycline chemotherapy, such as doxorubicin or Adriamycin, have been consistently associated with a higher risk of cardiac toxicity from anti-HER 2 therapy.

Dr. Advani and her colleagues followed 604 breast cancer patients who were treated
with anti-HER 2 agents at Mayo Clinic. They
collected patient data, including, age, race, gender, body mass index, smoking history,
medical comorbidities, use of heart medications, baseline heart function,
thickness of the heart muscle and prior use of anthracycline chemotherapy.

Researchers identified patients who developed cardiac toxicity —
asymptomatic, symptomatic,
or both. They performed a statistical
analysis to identify risk factors that were associated with a high risk of
developing cardiac dysfunction. 

“We
found that patients with certain risk factors including
being over the age of 55, having a lower baseline heart function (ejection
fraction less than 60 percent), having received anthracycline
chemotherapy or patients having enlargement
and thickening of the heart walls
were most significantly associated with an increased risk of developing cardiac
toxicity,” says Dr. Advani. “This is consistent with previously reported
studies.”

Dr. Advani says patients receiving radiation therapy as a part
of their breast cancer treatment were not found to be at a significantly higher
risk of developing cardiac toxicity from anti-HER 2 therapy based on their
findings.

Dr. Advani and her colleagues created a risk prediction model by
assigning a score to each
factor mentioned above and found that the cumulative risk score was a highly
significant predictor of cardiac toxicity in patients.

“Using
a risk
prediction model at therapy initiation may help us identify patients who may benefit from an
early referral to a cardiologist
for close cardiac monitoring and treatment with medications to protect their
heart function,” says Dr. Advani.

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news and An Inside Look at Mayo Clinic for more information about Mayo.

Media contact:

Nov 19, 2019 · Mayo Clinic, Hitachi to build first, next generation, carbon ion therapy treatment facility in North America

illustration of a carbon ion beam

ROCHESTER, Minn. and TOKYO, Japan — Mayo Clinic and Hitachi, Ltd. have reached an agreement in principle to build a carbon ion treatment facility as part of Mayo Clinic’s recently announced integrated oncology facility which will be constructed at Mayo Clinic’s campus in Jacksonville, Florida.

While carbon ion therapy was discovered in
the United States in the 1970s, there currently are no carbon ion therapy
treatment centers in North America. The technology is only available at a
handful of centers in Asia and Europe.

“As a leading NCI-Designated Comprehensive Cancer Center,
with locations in Florida, Minnesota and Arizona, Mayo Clinic is uniquely
qualified to bring carbon ion therapy to the United States,” says Gianrico
Farrugia, M.D.
,
president and CEO of Mayo Clinic. “Carbon
ion therapy has tremendous potential as a tool for treating patients with
challenging cancers that do not respond well to currently available therapies.”

“Making new and innovative treatments
available to patients with serious or complex health care needs is part of our
DNA at Mayo Clinic,”
says Kent Thielen,
M.D.
, CEO of Mayo Clinic in
Florida
. “We are proud to build on our
long-standing relationship with Hitachi to make carbon ion therapy available to
patients who will benefit from this technology.”

Steven Buskirk, M.D., chair of the Department of Radiation Oncology at Mayo Clinic in Florida says, “the availability of carbon ion technology will allow Mayo Clinic researchers to evaluate the efficacy of carbon ion therapy for the treatment of various cancer types including exploration into new and expanded therapies, including multi-modality treatment options.”

Keiji Kojima, Ph.D., executive vice president and executive officer at Hitachi, Ltd. says, “I am extremely honored to introduce North America’s first carbon ion facility at Mayo Clinic in Florida. Hitachi has several carbon facilities in Japan already treating patients and plans for installation of two more facilities in Asia. We are confident through our carbon experience, digital technology and the existing partnership with Mayo Clinic that we will continue to contribute to cancer treatment and increase our customer’s social value in the United States and across the globe. We look forward to enhancing our continued partnership with Mayo Clinic.”

“Carbon ion therapy belongs to a family of particle therapies which include protons, helium and other ions. Carbon ion therapy has the capability of killing cancer cells which are resistant to traditional radiation therapy. This capability combined with the ability to precisely deposit this treatment into the resistant tumor while minimizing the dose to adjacent normal tissue make it ideal to treat cancerous tumors in sensitive parts of the body,” says Nadia Laack, M.D., chair of the Department of Radiology Oncology at Mayo Clinic in Rochester Minnesota. Dr. Laack says “Mayo Clinic radiation oncologists and physicists have been studying carbon ion treatment in Asia and Europe for nearly a decade and have already developed a high level of expertise in treatment planning and delivery. ”

Additional resources

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news and An Inside Look at Mayo Clinic for more information about Mayo.

About Hitachi, Ltd.
Hitachi Ltd. (TSE: 6501), headquartered in Tokyo, Japan, is focusing on Social Innovation Business, combining its operational technology, information technology and products. The company’s consolidated revenues for fiscal 2018 (ended March 31, 2019) totaled 9,480.6  billion yen ($85.4 billion), and the company has approximately 296,000 employees worldwide. Hitachi delivers digital solutions utilizing Lumada in five sectors including Mobility, Smart Life, Industry, Energy and IT, to increase our customers’ social, environmental and economic value. For more information on Hitachi, please visit the company’s website at https://www.hitachi.com.

For more information on Hitachi’s Particle Therapy System
http://www.hitachi.com/businesses/healthcare/products-support/pbt/

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