Chemotherapy

What is it and how does it work?
During chemotherapy, cancer-attacking chemical agents are delivered into your body, usually through a liquid injection or a pill. At Saint Agnes Hospital, our medical oncologists are highly trained and highly skilled in administering chemotherapy. You’ll benefit from some of the most advanced and most experienced treatment in Maryland.

When is chemotherapy used?
Chemotherapy is often combined with other treatment methods, like radiation or surgery. Different types of chemotherapy drugs are used depending on your specific type of cancer. Together, you and your doctor will determine which chemotherapy drug is right for you.

What happens during chemotherapy?
Chemotherapy can be administered orally as a pill, or intravenously through an IV attached to your vein. For oral chemotherapy, you can simply take your pill at home with a glass of water. Intravenous chemotherapy is done as an outpatient procedure at the hospital.

At Saint Agnes Hospital, intravenous chemotherapy is administered at the Infusion Center, part of our renowned Cancer Institute. Our caring team is here for you throughout your treatment, monitoring your progress and working to make you as comfortable as possible.

Side effects of chemotherapy
Chemotherapy drugs work by attacking rapidly growing cells in your body. This includes cancer cells, but also hair and blood cells. Hair loss and low blood count are typical side effects of chemotherapy. Other side effects may include nausea and fatigue.

The nurses and oncologists at Saint Agnes are skilled in all aspects of chemotherapy treatment. We’ll be there every step of the way to answer your questions, explain procedures and potential side effects, and set you on the road to recovery.

Radiation Therapy

(For a video on radiation therapy click here)

What happens before, during and after radiation treatment?
Radiation therapy or radiotherapy uses radiation to target cancer cells. It’s often used in conjunction with other treatment methods like chemotherapy and surgery.

Saint Agnes Hospital offers some of Maryland’s most advanced radiation therapy. We use cutting-edge technology, innovative treatments and compassionate care to set you on the road to a speedy recovery.

Before treatment

• Consultation
  After you’ve been diagnosed with cancer, your first step is to meet with a radiation oncologist to find out if radiation therapy is right for you. During your visit, your doctor will evaluate your individual needs. This includes a full review of your current medical concerns, past medical and surgical history, family history, medications, allergies and lifestyle. The doctor will also perform a physical exam to assess your general health. After completing a thorough examination and reviewing your medical tests, including CT, MRI and PET scans, your radiation oncologist will discuss the potential benefits and risks and make time to answer all of your questions.
• Simulation (Radiation Planning)
  Using a dedicate CT , your radiation team will identify the precise location of the tumor. This will help determine the best course of treatment. Using temporary paint or small tattoos, your radiation therapist will mark the area to be treated directly on your skin. This is done so that your team knows exactly where to administer the radiation. In some cases, your radiation therapist may use immobilization devices like molds, casts or headrests that help you remain in the same position each time you receive treatment.
• Treatment planning
  After simulation, your radiation oncologist and other members of the treatment team will review your imaging and develop an individualized treatment plan. Saint Agnes uses sophisticated computer software to design the best possible plan just for you. Your doctor will write a prescription for how much radiation you should receive and to which parts of your body.

During treatment
Weekly status checks - Throughout therapy, your radiation oncologist and nurse will regularly check up on your progress. They’ll look for side effects and, if necessary, recommend treatments or medications. They’ll also take the time to answer your questions and address any concerns you may have.
Your radiation team always makes you and your treatment a top priority. The team meets regularly to review your status and ensure that everything is going as planned. Depending on your response to the radiation therapy, your team may recommend changes to your treatment.
If you’re treated with external beam radiation therapy, the correct positions of the treatment beams will be regularly verified with images made using the treatment beam itself. These images (also called port films, beam films or portal verification) are a great quality assurance check, but they don’t evaluate the tumor itself. Learn more about external beam radiation therapy below.

After treatment
Follow-up - To make sure that your recovery goes smoothly, your team will schedule a series of follow-up visits. Additional diagnostic tests may also be needed. As time goes by, you’ll need to visit less frequently. Just remember, your radiation oncology team is always available to speak with you in person and answer all of your questions.

Types of radiation therapy
At Saint Agnes, you’ll benefit from advanced treatment options and technologies, including:

• External beam radiation therapy
  Intensity Modulated Radiation Therapy (IMRT) is a specialized form of 3-dimensional external beam radiation therapy. It allows radiation to be more precisely shaped to fit your tumor. The radiation beam can be broken up into many smaller “beamlets” and the intensity of each beamlet can be adjusted individually.
  
  IMRT helps limit the exact amount of radiation received by normal tissue near the tumor. In some situations it may also allow a higher dose of radiation to reach the tumor, increasing the rate of success.
  
  Saint Agnes Hospital radiation oncologists are implementing IMRT with real-time image guidance utilizing either the TomoTherapy Hi Art System®. 
• TomoTherapy
  This unique system was introduced at the Saint Agnes Cancer Institute in the summer of 2004 under the direction of Dr. Hudes and Dr. Dziuba. It was the first such installation in the Mid-Atlantic and Northeastern United States.
  
  TomoTherapy http://www.tomotherapy.com combines a radiation therapy source, or Linear Accelerator, and CT into a single unit. Radiation is delivered continuously in a spiral fashion, spreading the dose around the treated area. Daily real-time CT imaging allows for the most precise targeting available. 
  
  360º delivery. While conventional machine design allows radiation to be delivered only from a few directions, the Hi Art treatment system’s linear accelerator, or Linac, is mounted to a CT scanner-like ring gantry. This means that TomoTherapy treatments can be delivered continuously and from all angles around the patient. More beam directions give physicians more control and more assurance that a dose will be confined to the tumor. This reduces the risk of short and long-term side effects.
  
  CTrue image guidance for every patient, every dayTM. The unique ring gantry design means that radiation can be delivered in a 360º pattern. Even more importantly, it integrates true CT imaging that can be used on a daily basis to guide the accurate delivery of each treatment session. This unique system was introduced at the Saint Agnes Cancer Institute in the summer of 2004 under the direction of Dr. Hudes and Dr. Dziuba. It was the first such installation in the Mid-Atlantic and Northeastern United States.
• Stereotactic Radiotherapy (SRT)
  This treatment technique uses a very high dose of ionizing radiation to treat well-defined lesions in the brain and other organs, like small lung tumors. Because SRT provides such a precise beam of radiation, your radiation oncologist may be able to better destroy certain types of tumors and spare more normal tissue than with conventional external beam therapy.
  
  Stereotactic radiotherapy is sometimes referred to as Stereotactic Radiosurgery or by the name of the machine used for treatment, such as GammaKnife, Linac Scalpel and Cyberknife. This outpatient treatment is often an excellent alternative to complex surgical procedures requiring lengthy hospitalization.
  
  SRT for brain tumors is typically done using frameless TomoTherapy technique. SRT is often performed in a single treatment, although several sessions are sometimes necessary. 
  
  SRT has shown encouraging results for localized lung cancer and is currently being investigated for the management of small tumors of the spine, prostate and pancreas.
• Brachytherapy
  This type of therapy involves the placement of radioactive sources in or just next to a tumor. These radioactive sources may be left in place permanently or only temporarily depending on your type of cancer. Special catheters or applicators are used to position the sources accurately. 
  
  There are two main types of brachytherapy:
  1. Intracavitary treatment, in which the radioactive sources are put into natural body cavities near the tumor such as the uterus, vagina or windpipe.
  2. Interstitial treatment, in which the radioactive sources are put directly into the affected tissues such as the prostate.
  
  These procedures sometimes require anesthesia and a brief stay in the hospital. Patients who receive permanent implants may have a few restrictions at first, but can soon return to normal activities. Temporary implants may be left inside the body for several hours or days.
  
  Brachytherapy can be completed in just 10 to 20 minutes using devices called high-dose-rate remote (HDR) afterloading machines. Powerful radioactive sources travel to the tumor through small tubes called catheters for the exact amount of time prescribed by your radiation oncologist. Most patients go home shortly after the procedure. However, depending on the area treated, you may need to receive several treatments over a number of days or weeks. After the applicator is removed, no radioactive material remains in the patient’s body.
  
  HDR brachytherapy is currently being used in the treatment of breast cancer. For some women, accelerated partial breast irradiation (APBI) may reduce the time required to complete radiation treatment. Using a balloon catheter system, the treatment can now be completed in the course of just five days. 
  
  Depending on the type of brachytherapy you receive, you may need to take certain precautions after treatment, especially around young children and pregnant women. Your radiation oncologist or radiation oncology nurse will provide more information.

Surgical Oncology

Surgical Oncology refers to the treatment of cancer with surgical methods. Below are some common types of surgery that are used in the treatment of cancer. For more information on surgical oncology consult your physician.

Thoracic Surgical Oncology
Continuing a strong tradition of thoracic surgical expertise and excellence, the Saint Agnes Thoracic Surgical Oncology Program provides a comprehensive outpatient and inpatient service—both diagnostic and therapeutic—for patients with surgical disease of the lung, mediastinum, pericardium and esophagus.

Our division offers surgical management of benign and malignant diseases of the chest (thoracic). Our physicians are experts in surgery for the lung, esophagus, thymus, hyperhidrosis (excessive sweating), and other diseases of the chest. Thoracoscopic (video-assisted) thoracic surgery is performed routinely for lung and pleural biopsies and the treatment of hyperhidrosis.

Abdominal Surgical Oncology
Our surgeons at Saint Agnes Hospital are some of the most experienced and skilled surgeons in the area. We offer expertise in complex procedures to treat complex cancer cases. Our experts are skilled all all areas of abdominal surgery including HIPEC, pancreatic surgery, hepatobiliary surgery, colorectal surgery and others. Our surgeons are dedicated to removing colorectal tumors in the most effective way possible while remaining committed to providing our patients the best quality of life possible after surgery. Surgery as treatment for cancer can seem overwhelming but the staff at Saint Agnes Hospital are committed to making the process as minimally invasive yet effective as possible.

HIPEC
HIPEC stands for Hyperthermic Intraperitoneal Chemotherapy. This complex procedure is utilized when cancer has spread, typically from the appendix to the surfaces of organs in the abdomen. This procedure requires that the patient’s abdomen be opened and a heated, chemotherapy solution be poured directly onto the affected organs. Saint Agnes Hospital is one of the few Hospital’s in Maryland to perform this procedure.

 

Pancreatic Surgery
Pancreatic prodecures are performed by our pancreatic surgeons who trained in advanced pancreatic surgery at the best institutions in the United States (Johns Hopkins, Cleveland Clinic, UCLA). These operations included minimally invasive (laparoscopic) distal pancreatomy for benign or malignant masses or cysts in the tail of the pancreas, the Whipple procedure for masses or cysts in the head of the pancreas, and a variety of operations performed for pancreatitis. In the Whipple procedure – also called pancreaticoduodenectomy – parts of the pancreas, stomach, gall bladder, intestine and bile duct may be removed. All pancreatic surgery patients are treated in a multidisciplinary setting. To learn more about pancreatic diseases click here.

 

Hepatobiliary Surgery
Hepatobiliary surgery is surgery of the liver and bile ducts. It is highly specialized surgery and is performed by our hepatobiliary surgeons who work closely with our colorectal surgeons, oncologists, gastroenterologists, and interventional radiologists in a multidisciplinary forum. Liver and biliary operations include removal (resection) of part of the liver or biliary ducts as well as ablation of liver masses. To learn more about hepatobiliary diseases click here.

 

Colorectal Surgery
1. Resection - For this procedure, your surgeon removes a portion of your colon and reattaches the remaining, healthy tissue. This is possible only when the cancer is caught early enough.
2. Colostomy - This procedure is done when there’s not enough healthy tissue left in the colon, or when the healthy tissue can’t be saved. For this, your surgeon connects the remaining portion of your colon to the wall of your abdomen, allowing waste to exit through a permanent tube.
To learn more about colorectal deiseases click here.

More Information

For more information on treatment options or any information regarding Caner Institute at Saint Agnes Hospital please contact us at 410-368-2910.

Resources
For more information please visit the following:

• The American Cancer Society
• The National Cancer Institute

To find a Physician please click here or call 1-866-690-9355.
 

VIDEO