At 63 years old, Lester Balaszek, a retired Chicago police officer, was following the recommended guidelines. He had a PSA screening that scored a little high. A subsequent biopsy drawing 12 samples came back conclusive for prostate cancer.

Surgery at an out-of-state facility left disappointing results: The tumor had attached to Balaszek’s rectum and couldn’t be removed.

Now, Balaszek’s finding renewed hope. He’s the first patient to receive adaptive radiation therapy at City of Hope Chicago through a new therapy machine called Ethos.

The new Varian Ethos linear accelerator has the ability to adjust treatment in real time and adapt to any changes in the body.

For patients, that means less radiation to healthy organs, reduced side effects and more accurate treatment. Patients describe the machine as big and open, noting it is quiet and fast.

Clinicians say it has comfort features – including a wide bore, quiet operation and patient-friendly environment.

“I went into my first treatment positive. I believe in City of Hope and I believe in Dr. King,” Balaszek said in a news release, “My treatment lasted less than a half hour. They put on Classic Rock music for me. I said some prayers and then I just started singing to the songs. I feel good, no side effects.”

Ethos is a CT-based adaptive radiation therapy system that can reimage patients on the same day and update the treatment plan right then and there. And that’s extremely valuable, said City of Hope radiation oncologist Dr. Kevin King, because tumors can move and a patient’s anatomy can change from day to day.

For instance, the prostate can change position based on bladder filling or rectal gas. The pancreas can move with breathing and digestion.

Ethos can treat any solid tumor, but will be especially beneficial for stereotactic body radiation therapy for the prostate and pancreas, and for head and neck cancers, where the tumor size can change dramatically throughout treatment.

More than half of all cancer patients receive radiation therapy as part of their cancer treatment, but treatment is typically administered based on scans taken days or sometimes even weeks earlier.

City of Hope Chicago is also getting a new PET/CT-CT Simulator for planning purposes. This, along with Ethos, will allow doctors to fine-tune radiation every day instead of using a one-size-fits-all plan.

Ethos was first unveiled by Varian in September 2019 at the American Society for Radiation Oncology meeting. Since then, Varian has developed an updated system, the new Ethos 2.0 version cleared by the FDA in 2024.