Experiencing & Understanding Radiation Oncology
About Radiation Oncology
FCS has numerous clinical locations, strategically located throughout our network, where patients can receive radiation therapy. Radiation therapy is an important weapon in our battle against cancer. Depending on the type and extent of cancer, radiation therapy can be used alone or in combination with other treatments, such as surgery or chemotherapy.
Radiation therapy effectively treats cancer by using high-energy beams of radiation to pinpoint and destroy cancerous cells. Although radiation therapy is similar to an x-ray, the dose of radiation in cancer treatment is much stronger and is given over a longer period of time.
Various forms of radiation therapy are available; the two basic types are external beam radiation and internal radiation, or brachytherapy.
If your physician determines that radiation therapy should be a part of your treatment plan, and it is not offered within the area where you receive other services, you will be referred to one of our strategic partners for treatment. Your physician will discuss whether radiation therapy is right for you.
Radiation Therapy Side Effects
The side effects of radiation therapy vary and are dependent upon the treatment dose and the part of your body that is being treated. Possible side effects of radiation therapy include fatigue, skin irritation, hair loss and loss of appetite.
Common Questions about Radiation Oncology
What is radiation therapy?
Radiation therapy uses high-energy radiation to shrink or eradicate tumor cells. Radiation therapy kills cancer cells by damaging their DNA, cancer cells whose DNA is damaged beyond repair stop dividing or die. There are a variety of options of radiation used for cancer treatments, the radiation may come from a machine outside of the body (linear accelerator - LINAC), or it may come from radioactive material paced in the body (brachytherapy). Patients may receive radiation therapy before, during or after surgery and or chemotherapy, depending the on the type and site of cancer being treated. Patients typically receive external-beam radiation therapy in daily treatment sessions over the course of several weeks. The number of treatment sessions depends on many factors, including the total radiation dose that will be delivered. Additional items the physician will consider are type and size of the cancer, location in the body, proximity of the tumor to normal tissues that are sensitive to radiation, patient’s general health and medical history and if the patient will have any other cancer treatment(ex. Chemotherapy).
Who will be involved in my treatment?
Delivery of radiation therapy requires a treatment team including a board certified radiation oncology physician, board certified therapeutic medical physicist, dosimetrists, radiation therapists and nursing. The radiation oncologist is a physician who evaluates the patient and determines the appropriate therapy or combination of therapies based on the area receiving treatment. The medical physicist and dosimetrist along with the radiation oncologist perform detailed treatment calculations to be delivered by licensed radiation therapists.
The therapists are specifically trained to acquire images and deliver the daily therapeutic treatments.
The nursing staff works with the team to assess the patient, provide education and helps manage any reactions or side effects that may occur during treatment. Our staff will monitor your personalized treatment throughout the entire process.
What is a linear accelerator?
A linear accelerator (LINAC) is a computerized machine used for external beam radiation treatments. The linear accelerator is used to treat all areas of the body by delivering high-energy x-rays to the area of the patient’s tumor by design they destroy cancer cells while sparing surrounding normal tissue. The linear accelerator uses electricity to produce high energy x-rays. The x-rays are planned to exit the machine in the shape of each patient’s tumor and are directed to the patient’s tumor. The beam exits the machine through the gantry which can rotate around the patient.
How do radiation therapy treatments work?
Radiation therapy involves the use of high energy x-ray beams in the treatment of malignant tumors. We use the most advanced 3-dimensional planning which allows precision and versatility for all therapeutic application. Radiation shrinks tumors by destroying cancer cells. Virtually all cancers respond to this treatment. Pain and other cancer related symptoms can also be reduced.
How long will your treatments last?
Most courses of radiation therapy require 25 to 35 treatments over a five to seven week period. The length and intensity of therapy can vary, depending on the type of cancer and the patient’s response to treatment. In addition to the radiation treatment sessions, our patients average one visit with a radiation oncologist each week while they are receiving treatments.
What will I feel during and after the procedure?
Throughout the imaging and radiation therapy session you may see and hear the equipment rotate around you however the sessions are painless.
The linear accelerators from Varian Medical Systems combine radiotherapy treatment technology with sophisticated imaging capabilities for precise forms of image guided radiotherapy. This technology allows the physician and therapist to visualize and verify that treatment is applied to exact area on daily basis.
What types of radiotherapy treatment are available?
This is a digital imaging device mounted on the linear accelerator via robotically controlled arms that operate along three axes of motion enabling them to be positioned optimally for the best possible view of the tumor. If produces high-resolution images of the tumor in order to show changes in tumor shape, size or position throughout the duration of the treatment.
IGRT (Image guided Radiotherapy)
IGRT is the use of daily imaging during a course of radiation therapy to guide in the precise and accurate delivery of radiation therapy. Machines equipped with IGRT technology allow the physician to image the tumor before or during the time radiation is being delivered while the patient is on the treatment table in treatment position. Specialized software is then used to compare the images to the reference images taken at the time of simulation. These daily images allow any necessary adjustments to be made to the patient’s position prior to the delivery of radiation therapy.
A benefit of IGRT is increased dosage levels of radiation to the tumor while sparing the surrounding healthy tissues.
Additionally, it reduces the possible side effects of radiotherapy.
SRS (Stereotactic radiosurgery)
SRS is a non-surgical radiation therapy used to treat small tumors. Each patient’s plan is created using precisely-targeted radiation fields which are used to destroy cancerous cells while preserving and minimizing radiation to healthy surrounding tissue. Due to its accuracy and small fields, SRS is ideal for tumors in the brain or spinal cord. When SRS is used to treat tumors in the body, it is called Stereotactic Body Radiotherapy (SBRT). SRS and SBRT are typically performed on an outpatient basis. Unlike conventional external beam radiation therapy, SRS and SBRT are normally provided in 1 to 5 treatments.
IMRT (Intensity Modulated Radiation Therapy)
IMRT is a high-precision mode of radiotherapy that delivers precise doses of radiation to a tumor. IMRT allows for the radiation dose to conform more precisely to the three-dimensional shape of the tumor with the use of collimation and multi-leaf collimators (MLC). MLC’s are a device that consists of a number of ‘fingers’ or ‘leaves’ which project in to the primary beam to create the required shape.
IMRT also allows higher radiation doses to be distributed to the tumor while sparing the surrounding organs and tissues.
Combinations of multiple intensity-modulated fields coming from multiple beam directions produce a custom radiation dose that maximizes tumor dose while minimizing the dose to adjacent normal tissues. Lower doses to healthy normal tissues may result in fewer complications or side effects. Types of tumors that may be treated with IMRT include head & neck cancer, brain, prostate, spinal cord or tumors very close to radiosensitive normal tissues.
Brachytherapy is the temporary or permanent placement of a radioactive source either on or within body tissues or cavities. Brachytherapy allows the delivery of a high dose of radiation to a small area while sparing the amount of surrounding normal tissue that is irradiated, additionally it allows a physician to use a higher total dose of radiation to treat a smaller area in a shorter amount of time. The implant may be temporary or permanent. During temporary brachytherapy, a radioactive material is placed inside a catheter for a specific amount of time and then withdrawn. Temporary brachytherapy can be administered at a low-dose rate (LDR) or high-dose rate (HDR). Permanent brachytherapy is an interstitial implant. It is a radioactive source that is contained within a needle, seed, wire or catheter which is placed directly in the tumor or tumor bed. Permanent implants, also known as seed implantation are LDR brachytherapy treatments that utilize radioactive materials, seeds or pellets, that are implanted permanently within the tumor to provide highly localized radiation. After several months, the radioactivity level of the implants eventually diminishes to nothing. The inactive seeds remain in the body but have no lasting effect on the patient.
A form of partial breast radiation using HDR brachytherapy. Only for select cases. Utilizes a device that can be custom-fitted to the lumpectomy cavity at the time of surgery, regardless of shape or size. Restricts the radiation to tumor bed, sparing radiation to healthy surrounding tissue. Reduces the potential for side effects. Advantage is that it can be completed in 5 days. FDA approved in 2006.
IMRT (Intensity Modulated Radiation Therapy)
IGRT (Image Guided Radiation Therapy)
Stereotactic Radiosurgery (SRS)
Stereotactic Radiation Therapy (SBRT)
Prone Breast Radiation Therapy
3-D Conformal Radiation Therapy
High Dose Rate (HDR) Brachytherapy
Low Dose Rate (LDR) Brachytherapy - Seed Implants
Accelerated Partial Breast Irradiation (APBI)
3D/IMRT Treatment Planning
3D Conformal Radiation Therapy
Advanced Treatment Planning - Eclipse
Positron Emission tomography (PET)
EMR (Electronic Medical Record)