Radiation Treatment Process
When you first come to CarePoint Health Radiation Oncology Associates, you will meet with the radiation oncologist. This physician is the specialist best qualified to work with you to assess whether radiation therapy could be a beneficial treatment option. At your appointment, your doctor will review your medical records pertinent to the cancer, including past medical history, current medications, allergies, social history, and family history. Your physician will also perform a physical exam that will help us assess the extent of your problem and judge your general physical condition to estimate any influence it may have over your response to radiation therapy. Bringing a spouse, or another family member or friend, is strongly encouraged as they may help with questions or take notes.
If radiation therapy is recommended, your physician will review the details of the treatment, including the duration of treatment and potential side effects. If you require any additional testing before a recommendation can be made we will arrange for it to be done.
At times, we need additional information to decide the relative merits of radiation therapy or in preparation for treatment itself. We may arrange for tests such as CT, MR, and PET scans to determine if a tumor has spread to a regional lymph node basin or to a distant part of the body. Blood tests may help determine how well you are likely to tolerate treatment. Tests may be required simply to see precisely where your various internal organs are placed in 3-dimensional space.
For treatment of some parts of the body, specific pre-treatment testing is required. For example, if your are a premenopausal woman and need to receive radiation therapy that might affect your reproductive system, we will ask you to have a blood test to ensure that you are not pregnant when radiation therapy begins. Similarly, if you your cancer is located in an area close to your mouth and the radiation therapy field includes your teeth, we will ask you to have dental screening and to undergo any necessary restoration prior to therapy.
To be most effective, radiation therapy must be aimed precisely (within millimeters, despite breathing and movement) at the same target every time treatment is given. The process of measuring your anatomy and marking your skin in ways that help us guide the beams of radiation safely and exactly to their intended locations is commonly called "simulation."
During the simulation session, your radiation therapist will create immobilization devices to help ensure that the radiation treatment is delivered consistently from day to day. Using these devices, you will undergo a special CT scan to map the area to be treated so that your oncology team can plan your treatment.
After the scan, your therapist will put permanent freckle-like tattoo marks on your skin. These markings will also help ensure that your radiation therapy is consistent over the course of treatment. After the simulation session, your physician and dosimetrist will work to create your radiation plan.
As treatment plans have become more sophisticated, the ability of all radiation oncology facilities to cure tumors without harming patients has improved. Much of this success is directly attributable to the use of sophisticated computer systems operated by highly trained, full-time dedicated medical physicists. The radiation oncologist and the medical physicist seek to include all of the tumor and as little normal tissue as possible within the "envelope of irradiation."
All treatment plans must be reviewed and approved by the radiation oncologist, in writing, before they can be used in a patient's care.
The calculations used in treatment planning are only as reliable as the attention to detail paid by the people performing them. As part of our dedication to quality, all our calculations are independently double-checked by two medical physicists before a patient receives even one fraction of treatment.
Once your radiation plan has been created, you will return for a verification simulation, a sort of “dry run” for your treatment. Your radiation therapist will take images on the machine that your physician will review to ensure that the area to be treated coincides with the radiation plan.
After a successful verification simulation, you may begin treatment as soon as the next day. Radiation treatment is typically every day, Monday through Friday. You can expect to spend roughly 20-30 minutes in the department, and the actual treatment takes less than 10 minutes. The duration of the radiation treatment varies depending on the site and nature of the treatment, and can range from a couple of weeks to a couple of months.
Our Elekta Synergy is an extremely powerful, top-of-the-line, computer controlled, ultra-precise linear accelerator. It can produce a spectrum of different energy x-rays and electrons (each type and energy penetrates tissues differently, allowing us to match each patient's needs with the right combination). The high-energy beams of this machine are ideal for deeply situated tumors (for example, prostate cancers, rectal cancers, pancreatic cancers and uterine cancers). The lower energy is ideal for patients who do not need radiation that is so penetrating (for example, tonsil cancers, larynx cancers and brain tumors). The Elekta Synergy gives us a broad range of treatment options that are selected to match each patient's needs.
Weekly Status Checks
As you have every right to expect, our attention to detail continues throughout treatment. Our Radiation Oncologist meets with each patient every week to assess their progress and discuss their concerns. Your physician will also examine you to determine if you are experiencing any side effects. We can also adjust the original treatment plan to address your changing condition if necessary. If you need any additional services and medications, your doctor will prescribe them at this time.
Just as you would not expect to benefit from a medicine the instant you swallow a pill, the full effects of radiation therapy typically occur after treatment is complete. Consequently, we consider aftercare a critical component of our services. During each of these visits, your attending physician will review any changes in your condition and will examine you to assess the status of your disease and the health of your normal tissues. If additional action is required, we will arrange it or prescribe needed medications. As time goes on, the frequency of your visits may decrease if you are feeling well, but you will still know that we are here if you need us.