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  • Clinical Services

    Each day the Radiation Oncology staff and treatment team meet to discuss an array of cancer diagnoses for adult and pediatric cancer patients. Doctors, physicists, dosimetrists, nurses, therapists and many others with advanced training in using X-ray beam treatment, which destroys cancer cells, are on this team to provide and develop the best possible care for each person.

    Radiation, or radiotherapy, is a type of treatment used in cancer management. Radiation uses high dose energy, most often from X-ray beams, to kill cancer cells and help prevent them from spreading to other areas of your body. It may be used along, or in combination with chemotherapy and/or surgery to treat cancer. Sometimes, when a cure is not possible, radiation also may be used to help alleviate symptoms, such as pain and discomfort. Radiation is used mainly for cancer management, but sometimes, this treatment is recommended for non-malignant cases such as trigeminal neuralgia, severe thyroid eye disease or prevention of keloid scar growth.

    While both healthy and cancerous cells are destroyed by radiation therapy, the goal of each patient’s treatment is to destroy the genetic material that controls how cells grow and divide to the area of concern. Research is on-going in radiation therapy delivery with the goal of destroying as few normal, healthy cells as possible. UMMC’s Radiation Oncology Department has the most up to date delivery systems to provided treatment tailored to each patient, therefore providing patients the best treatment delivery with the least amount of damage possible.

    How is radiation therapy used in people with cancer?

    • Primary treatment for cancer (alone with no other treatment regimen)
    • Before surgery, to shrink a cancerous tumor (neo-adjuvant therapy)
    • After surgery, to stop the growth of any remaining cancer cells (adjuvant therapy)
    • In combination with other treatments, such as chemotherapy, to destroy cancer cells or shrink tumors to relieve pain.
    • In advanced cancer stages, to alleviate pain and discomfort caused by the cancer.

    What should I expect if I need radiation therapy treatments?

    • A consultation will be scheduled with you or for you after receiving the information from your primary physician. Our department will receive as much information about your case before your appointment as possible, but may contact you for other information needed.
    • Then you meet with your radiation oncologist and some of our team members. Your radiation oncologist will discuss your case with you, and your family if desired, and the best possible treatment delivery recommended.
    • If you agree to radiation therapy at this visit, you will be given another appointment to get started with your planning process for treatment.
    • If a previous CT or MRI can be used for treatment planning your team member(s) will share with you your next step. If a CT or MRI will be needed to show the distinct area of concern, your next appointment will be for radiation simulation, called planning scans.
    • We use a CT scanner to do radiation simulation. One of our radiation therapists will mark the area of your body that will receive the radiation. During simulation, the therapy team works with you to find the most comfortable position. It is imperative that you lie still during your treatments, so finding a comfortable position is very important. They may offer body cushions to help you find and hold a comfortable position.
    • Once the simulation process is complete, the radiation therapy team will decide what dose you will receive based on your type and stage of cancer. A radiation therapist will call you with your next appointment to begin daily radiation therapy treatments.
    • Before treatments begin, a radiation oncology team will plan the treatment. They will use the images taken of you and the area to be treated so they can design a specific treatment for you. With that image, physicists/dosimetrists and a radiation oncologist can determine how to target beams to the cancerous area and avoid as much healthy tissue as possible. This usually takes seven to 10 days for planning and review.
    • Radiation treatments usually last a few minutes each week day for five to seven weeks. Sometimes, doctors may be able to recommend an accelerated treatment schedule. Whenever possible, they will tailor treatment to a patient’s desires, needs and ability to get here.

    What type of delivery will I receive?

    Radiation therapy can be delivered from outside your body, known as external beam radiation, or inside your body, known as brachytherapy. Doctors have to consider the type of cancer, the location of the cancer and a person’s general health before recommending which radiation therapy will best help them.
    • External beam radiation

      This radiation is delivered from outside the body. Doctors have many choices of tools and delivery methods for external beam radiation.

      • Three-dimensional conformal radiation therapy (3D-CRT): This type of radiation uses shaped beams aimed at a tumor from different directions. This type of treatment lets the radiation team deliver a higher dose of radiation to the tumor and a smaller dose to surrounding tissue. Patients are fitted with a mold or cast to keep the area being treated still so the radiation can be aimed more accurately.
      • Intensity modulated radiation therapy (IMRT): This is similar to 3D-CRT, but it also lets a radiation team change the strength of the beams in some areas to decrease damage to healthy body tissue. It shapes X-rays to conform to the shape of a tumor.
      • Linear accelerator capable of IMRT with a robotic couch: For this combination of techniques, patients would lay on a couch which their radiation oncology team could move in six directions to better target their tumor.
      • Volumetric-modulated arc therapy (VMAT): This advanced form of IMRT can cut the time needed to deliver a radiation dosage from 20 minutes to 5 to 7 minutes. Like IMRT, it lets the radiation oncology team conform the beams to the shape of a tumor and decrease strength where needed to cause less harm to healthy tissue.
      • Image-guided radiation therapy (IGRT) with cone beam CT: This machine has a CT scanner and external beam radiation. With it, the radiation oncology team can see an image of a tumor right before treatment so they can very accurately target the tumor and spare normal tissue. It allows the team to account for changes in the position of a tumor on a daily basis.
      • Stereotactic body radiation therapy (SBRT): This treatment uses high doses of radiation given in five treatments or less. Doctors often use it when they cannot remove a tumor surgically or when cancer recurs.
    • Brachytherapy

      This just means the radiation dose is given from inside the body with implanted radioactive sources, which can be intracavitary, interstitial or attached to a patient’s body surface. These procedures usually can be done on an outpatient basis but sometimes require hospitalization. Any radiation treatment is based on the type of cancer, a person’s general health and their ability to tolerate treatments.

    • Processes

      A radiation oncology team also may consider other methods of making cancerous cells more sensitive to radiation treatments or when possible to target the cancer. Those include:

      • Radio sensitization: Doctors may recommend a drug which increases the effect of radiation on cancerous cells. This is most often recommended for stomach cancers.
      • Radiolabeled antibodies: A radioactive substance is attached to antibodies made in a lab. The antibodies target tumor cells, taking the radioactive substance to them. This may be recommended for liver cancers.
      • Image-guided radiation therapy: With the patient lying in a treatment position, doctors use imagining equipment to locate anatomical landmarks and guide the radiation dose to that target area.
      • Four-dimensional computed tomography scans (4DCT): This helps doctors account for the movement caused when a person breathes. Once they account for this, they can aim radiation at the tumor. This is especially important when someone is getting radiation near their lungs.