Radiation therapy, or radiotherapy, uses high-energy rays to damage or kill cancer cells by preventing them from growing and dividing. Similar to surgery, radiation therapy is used to eliminate or eradicate visible tumors. Radiation therapy may be externally or internally delivered. External radiation delivers high-energy rays directly to the tumor site from a machine outside the body. Internal radiation, or brachytherapy, involves implantation of a small amount of radioactive material in or near the cancer. Radiation may be used to cure cancer, control cancer, or to ease some of the symptoms associated with cancer. Sometimes radiation is used at the same time with other types of cancer treatment, such as chemotherapy, and sometimes it is used alone.
Radiation oncologists are the physicians who oversee your radiation therapy treatments. Radiation oncologists work with the other team members of the radiation therapy team to develop your specific treatment plan to ensure that each treatment is given safely and accurately. Your radiation oncologist also monitors your progress during treatment and will adjust the treatments as necessary to make sure the radiation is on target and minimizes side effects. Your radiation oncologist will also work closely with other physicians, such as medical oncologists and surgeons, to maximize the effectiveness of the treatments.
We have recently made several significant upgrades in our radiation clinic with new radiation planning software, hardware and new treatment techniques to improve the care of our patients. Examples of these new additions to our clinic include Real Time Position Management to avoid the heart and lung in left sided breast cancer; Stereotactic Body Radiotherapy to treat early stage lung cancer without surgery; and software which allows multiple types of images (MRI, CT, PET) to be fused allowing the radiation oncologist to better identify the tumor and the normal tissue.
Types of Radiation Therapy
Depending on the location of the tumor, different types of radiation treatments may be recommended:
Brachytherapy: This radiation treatment uses radioactive sources that are placed in or just next to a tumor, usually just for a few minutes at a time. This technique is used in our clinic for partial breast irradiation and certain gynecological cancers.
Intensity Modulated Radiation Therapy (IMRT): This radiation delivery technique uses advanced computer-controlled linear accelerators that help shape the dose of radiation to the tumor and spare the healthy surrounding tissue and organs. This technique is often used for tumors deep in the body or tumors that are near sensitive structures.
Stereotactic Body Radiotherapy (SBRT): This non-surgical high dose radiation treatment is completed in 1-5 sessions to completely treat tumors without the need for surgery. Certain lung, liver, bone tumors can be treated in this way.
SpaceOAR Hydrogel: This radiation therapy is an option for men who undergo radiation treatment for prostate cancer. It acts as a spacer providing space between the rectum and the prostate, reducing radiation exposure to the rectum – minimizing the side effects of prostate cancer radiation therapy. It is injected into place prior to the start of radiation treatment. Patients may be awake or asleep under general anesthesia for the procedure. SpaceOAR Hydrogel remains stable during radiation therapy and then is gradually absorbed by the body after radiation therapy has been completed.
About your Treatment
Consultation: your first visit
Before you begin radiation treatments, you will meet with members of your medical team to plan your treatments. During your consultation, your medical records, imaging, and laboratory tests will be reviewed by the radiation oncologist and an exam to assess your current condition. Finally, in consultation with other physicians, a decision will be made about whether radiation therapy is the best form of treatment for you.
Simulation and treatment planning
Next, you undergo a specialized CT scan which will allow the radiation oncologist and technical staff to design a custom radiation plan. This process usually takes about 7 to 10 business days unless it is an emergency.
Although the treatment itself may take only a few minutes, please plan on spending at least an hour for your first appointment and approximately 20 to 30 minutes for the rest of your treatments.
To help protect normal tissues, radiation treatments are often given in a series of small doses called “fractions.” This fractionation allows normal tissue to recover between treatments. Depending on your condition, the total treatment course may be as short as one day or as long as eight to nine weeks. Typical treatments are administered once a day, five days a week. If appropriate, some treatments are given twice a day; some are given in larger doses only twice a week.
You will be seen at least once a week by the radiation oncologist to monitor your care and answer any questions that you may have. If you want to see the physician at any other time, just ask.
After you complete your radiation therapy, you will be scheduled to return to the department at regular intervals for follow-up visits with your physician. Follow-up visits are necessary to evaluate your overall status and ensure that you achieve the highest quality of life. Frequently some laboratory tests or radiographic studies will be done. Follow-up visit intervals are scheduled based on each patient’s individual response to their treatment.