TAKING AIM AT CANCER
Radiation therapy uses high-energy ionizing radiation as part of cancer treatment to control or kill malignant cancer cells by damaging their DNA. Radiation therapy is commonly applied to the cancerous tumor because of its ability to control cell growth. This radiation can also damage normal tissues (such as skin and organs), therefore treatment must be carefully planned to minimize side effects.
The radiation used for cancer treatment may come from a machine outside the body, or it may come from radioactive material placed in the body near tumor cells or injected into the bloodstream. A patient may receive radiation therapy before, during, or after surgery, depending on the type of cancer being treated. Some patients receive radiation therapy alone, and some receive radiation therapy in combination with chemotherapy. Learn more from this video on radiation therapy.
TYPES OF RADIATION THERAPY
At the Cancer Institute at Saint Agnes, you’ll benefit from the following advanced treatment options and technologies, all safely performed by our expert multidisciplinary team of oncologists, surgeons, and radiologists:
External Beam Radiation Therapy
Intensity Modulated Radiation Therapy (IMRT) is a specialized form of three-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®.
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 (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. 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 360 degrees 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.
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.
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) after-loading 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.
For more information on treatment options or any information regarding Cancer Institute at Saint Agnes Hospital, please contact us at
For more information please visit the following:
• The American Cancer Society
• The National Cancer Institute
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or call 1-866-690-9355.
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.
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 dedicated 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.
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.
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.
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.
We’re the only cancer center in Baltimore to have received three-year accreditation from the Quality Oncology Practice Initiative (QOPI) and Outstanding Achievement from the American College of Surgeons Commission on Cancer.