Radiation Oncology

“Radiation therapy” often refers to the use of a linear accelerator — or high-energy x-ray machine — that directs radiation to a tumor to eliminate the cancerous cells. Many radiation oncology treatments rely on some form of this technology. Other cancer treatments use internally delivered radiation targeted precisely at or near the tumor.

Since cancer cells grow and divide more rapidly than normal cells, they are more sensitive to the effects of radiation. Radiation therapy usually is given five days a week for six to eight weeks. Small amounts of radiation are given daily to protect normal tissues in the treatment area and weekend breaks allow the normal cells time to recover.

Radiation Therapy Treatment Options:

Stereotactic body radiotherapy (SBRT) is a precise, high-dose form of radiation therapy that allows the oncology care team to treat cancer in just one to five treatments, rather than the multiple doses over many weeks required in conventional radiation. With SBRT's high level of accuracy and precision, doctors can target and eliminate tumors while avoiding normal tissue. 

Stereotactic Radiosurgery (SRS): Similar to SBRT, stereotactic radiosurgery also delivers high-dose, precise radiation therapy; however, SRS is used specifically for treating localized brain tumors. Like other forms of radiation therapy, SRS works by damaging cancerous cells. Those affected cells then lose their ability to reproduce and, in turn, tumors to shrink.

IMRT (Intensity Modulated Radiation Therapy): Using 3-D images of the malignant tumor and its irregular shape, this mode of high-precision radiotherapy can deliver extremely accurate radiation doses that conforms to the tumor, or specific areas within the tumor, in a much more precise manner that previously achieved.  By being able to control the intensity of the radiation beam in multiple small volumes, IMRT further allows for a precise delivery of radiation doses, by providing a higher dose of radiation to areas with a higher concentration of cancer cells. This also helps the doctors minimize damage to the adjacent areas with healthy tissues and organs decreasing the risks of side effects significantly.

IGRT (Image Guided Radiation Therapy): Images taken during radiation therapy allow therapists to guide the precision and accuracy of treatment delivery. IGRT is used to treat tumors in areas of the body that move, such as the prostate. Radiation therapy machines are equipped with imaging technology to allow your doctor to image the tumor before treatment. By comparing these images to the reference images taken during simulation, the patient’s position and/or the radiation beams may be adjusted to more precisely target the radiation dose to the tumor. Our IGRT procedures use colored ink tattoos on the skin to help align and target the radiation equipment.

3D Conformal Therapy: This cancer treatment shapes the radiation beams to match the shape of the tumor, using three-dimensional images. Conformal radiation therapy uses the targeting information to focus precisely on the tumor, while avoiding the healthy surrounding tissue. This targeting makes it possible to use higher levels of radiation in treatment. More radiation is more effective in shrinking and killing tumors.  3D conformal therapy is similar to intensity-modulated radiation therapy (IMRT). They both target cancer while sparing healthy tissue. The radiation oncologist will decide which therapy is best for you, based on your tumor’s shape and location.

Internal Radiation Therapy (Brachytherapy): Brachytherapy is used for the treatment of prostate cancer and involves placement of radioactive sources inside the patient to damage cancer cells’ DNA and destroy the cells ability to divide and grow. This allows your doctor to use a higher total dose of radiation to treat a smaller area in less time than conventional external beam radiation therapy. The radioactive seeds give off their radiation slowly over several months and, within two years, their radiation completely decays. The seeds can remain safely in place for the rest of a man’s life. Brachytherapy can also be combined with external radiation, or by itself, depending on the stage of cancer. 

Each patient's specific type of cancer, location of cancerous cells and other health conditions are carefully considered when mapping the patient's treatment plan. 

What to Expect – First Steps

Before your treatment begins, the first steps involve answering all of your questions about radiation therapy services and what you can anticipate during the course of treatment. Once you are ready to proceed, careful planning is done to create a treatment plan individualized to your health needs.

Consultation: Your fist step after a diagnosis is a consultation with our team. A nurse will review your medical history with you and help answer questions.  The radiation oncologist may perform a physical exam and will visit with you, explaining the benefits and risks of radiation therapy. If you choose to receive radiation therapy, you will be asked to sign an informed consent, indicating your choice to proceed with radiation therapy.  Our social worker and also billing representative are available for any questions and assistance in regard to your care.

CT Simulation: Before radiation therapy begins, new computed tomography (CT) images are taken to use in planning your treatment. This step “simulates” or mirrors the position you’ll be in for radiation therapy to best target the cancerous area. The simulation step typically takes about an hour. During that time immobilization devices may also be fitted and marks and/or tattoos may be placed, all designed to help the radiation team align you for your future treatments.  Your comfort is important to us, so your healthcare team will work with you to find a comfortable and reproducible position. IV Contrast may be injected for the CT scan if needed. Your specifically designed treatment plan will be performed after the simulation using sophisticated computer software. 

Treatment Planning: Together, the radiation oncologist, dosimetrist and physicist use imaging, specialized computer software and other sources to generate a treatment plan that delivers the appropriate dose to the tumor while minimizing dose to surrounding normal tissues. In certain cases, this process may employ such techniques as three-dimensional conformal therapy or intensity-modulated radiation therapy (IMRT).

What to Expect – Receiving Care

When you arrive for your treatment, please check in at the front desk.  You are welcome and encouraged to bring family members to your daily appointments. Also, complimentary valet services are available each weekday.

Each radiation oncology treatment takes approximately 15 minutes and is quick and painless.  Treatments are usually scheduled Monday thru Friday, 5 days a week for a duration determined by your Oncologist (2 to 9 weeks).  Images will be taken throughout your course of treatment as prescribed by your physician to verify treatment positioning. 

Your oncology doctor and nurse will see you once per week to perform an assessment, address any side effects and answer any questions or concerns that you may have. Once your course of treatment is completed, routine check-up visits will be scheduled to continue to assess your health. 

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