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Radiation Therapy

Radiation treatment uses focused X-rays, which is a form of energy, to destroy can¬cerous cells while minimizing exposure to healthy tissue. Radiation damages the DNA in cancer cells, which interrupts their ability to reproduce, causing them to die and the tumor to shrink.

Types of Treatment
There are two basic types of radiation treatment: radiotherapy and radiosurgery. Both techniques are nonin¬vasive, so there are no incisions. In both treatments, a beam of radiation is focused directly to the tumor while minimizing exposure to surrounding healthy tissue. The main differ¬ence between the two techniques is the number of treatment sessions and the strength of each dose of radiation given.

Your cancer treatment will be delivered on a machine called a linear accelerator, or linac for short. This machine offers patients diagnosed with cancer image-guided radiation therapy for non-invasive treatment. This type of therapy is used to treat most organs of the body by delivering focused high-energy x-rays to the region of the patient's tumor. These x-ray treatments are designed in such a way that they destroy the cancer cells while sparing the surrounding normal tissue.


Varian TrueBeamTM
In the summer of 2013, The Chester County Hospital acquired the TrueBeam™ linear accelerator from Varian Medical Systems. TrueBeam™ is an innovative, non-invasive breakthrough technology for cancer patients. It provides oncologists with a wide range of options for treating tumors including those that are more complex in nature. With the expanded power and flexibility provided by the Varian TrueBeam™, clinicians are able to develop treatments that are best suited for patients' individual circumstances.



Benefits of the new TrueBeam System:

  • Increased speed provides patients shorter treatment times leading to less interruption of their daily lives. Most treatment take only minutes a day. Treatments that once took 10 to 30 minutes can now be completed in less than two minutes. Faster treatment times also allow for reduced chance of tumor motion during treatment, which makes delivery more accurate and helps to protect nearby healthy tissue and critical organs.
  • Precision. The TrueBeam system generates three-dimensional images used to fine-tune tumor targeting and ensure that the most precise patient position is achieved prior to and during the treatment process.
  • Comfort. To put the patient's mind at ease, an advanced communications system allows the therapist running the system to be in constant contact. If the patient chooses, music may also be played through the system during treatment.
  • Versatility. TrueBeam can be used for many forms of advanced treatment techniques including image-guided radiotherapy (IGRT), intensity-modulated radiotherapy (IMRT) and RapidArc® radiotherapy technology. Because of this, patients can receive the treatment that is best suited for their specific clinical circumstances.

How does it work?
TrueBeam combines imaging, beam delivery and sophisticated motion management to accurately and precisely target tumors with speed.

  • TrueBeam rotates around the patient to deliver a prescribed radiation dose from nearly any angle.
  • An accessory called a multileaf collimator (or MLC) is used to shape the beam into different shapes and sizes to match the 3-D shape of the tumor. These shapes can move and change during treatment to target the tumor and minimize the dose to the surrounding healthy tissue.
  • A cone-beam CT, a form of CT, is used to administer 25% less radiation.
  • Real-time imaging tools allow clinicians to "see" the tumor they are about to treat.
  • The system has the ability to synchronize beam delivery with respiration. This helps maintain accuracy during cases where tumor motion is an issue, for example during lung cancer treatments.
  • TrueBeam radiotherapy is not appropriate for all cancers. Please speak with your physician to see if radiotherapy is right for you.

Your Clinical Team
If radiotherapy or radiosurgery is right for you, your treatment will be planned and delivered by a team of specialists that may include a radiation oncologist, medical physicist, dosimetrist, radiation therapist, and radiation nurse. For radiosurgery treat¬ments, a radiation oncologist, neurosurgeon, thoracic pulmonologist or other specialty surgeons may be involved. Your team may be sup¬ported by other healthcare professionals, such as a physician assistant, nurse practitioner, radiologist, dietitian, physical therapist, social worker, and other individuals who specialize in the area of the body being treated (e.g., aurologist for prostate cancer).

The Treatment Process
There are several steps to any radiotherapy or radiosurgery treatment. They consist of tumor visualization, treatment planning, treatment delivery and follow-up. Again, your clinical team will determine which treatment technique is right for you, and will be able to answer any questions you may have before, during or after treatment.

Tumor Visualization
In order to design your treatment plan, initial images will be taken to reveal the exact location of the tumor, including its size and position relative to the surround¬ing tissues and organs. This is typically done with a CT scan. Depending on the general location of the tumor and other factors, ad¬ditional types of scans may be taken, such as an MRI, a PET scan or an ultrasound scan. Depending on your treatment needs, a custom body-mold (or mask if your head is being treated) will be made, and tiny skin marks may be used to help ensure you're in exactly the same position for each treatment session.

Planning
With the completed scans, your clinical team will use sophisticated treatment planning software to develop a three dimensional "picture" of the area where you will receive treatment. They'll determine the amount of radiation to be delivered, the appropri¬ate angles from which to deliver it, and the number of sessions needed to deliver the prescribed treatment. They'll also take into account many other factors -- including the type of cancer being treated, its location and size, your medical history, and your lab test results -- to create a plan uniquely designed for you.

Treatment
Before each treatment session, your radia¬tion therapist (RT) will help position you on the linac's treatment table, or "couch." Once you are positioned, the therapist may use the machine's imaging system to take a new image of the tumor in that day's treatment position to verify the correct target. During the imaging, you will notice motion from the robotic imager arms on each side of the linac as these arms extend and the linac begins to rotate around you. Adjustments to your position may then be made so that it precisely matches the position that was planned for you.

The therapist will leave the room before your treatment begins. Your therapist will likely be in constant contact with you, using cameras and microphones set up in the treatment room. During the treatment, you will not see the radiation beam. You may hear the quiet buzz or shuffling of the beam-shaping device located inside the head, or gantry, of the machine. This beam-shaping device is called a multi-leaf collima¬tor (MLC) and it adjusts to create a uniquely shaped opening for the radiation beam to pass through. As the gantry rotates around you to deliver radiation beams from various angles, the MLC continuously adjusts the beam to conform to the shape of the tumor, which helps to deliver accurate treatment. The linac will rotate around you as radiation is administered directly to the tumor.

Follow-up Care
After you complete your treatment, your radiation oncologist and healthcare team will monitor your progress with a series of follow-up visits. These visits can include a physical examination, blood screening, additional imaging, and other tests that may be needed. Your follow-up appoint¬ments are also a good opportunity for you and your caregivers to ask any questions about your progress, or inquire about the status of your overall health.

Last Updated: 7/25/2013