Radiation therapy is widely used in the treatment of breast and prostate cancers; gynecological cancer; cancers of the brain, head, and neck; colorectal malignancies; and lung cancer.
Today’s cutting-edge technology enables physicians to more accurately target malignancies and to spare more of the surrounding healthy tissue, making treatment easier and recovery faster. Shields Radiation Oncology centers are equipped with the best and most advanced radiation delivery systems available, capable of targeting malignancies even through the patient’s motion of breathing.
Specific treatment therapies include the following:
Sometimes referred to as internal therapy, brachytherapy means “short-distance therapy.” Brachytherapy delivers a high dose of radiation to a small area and is useful in situations that require a high dose of radiation or a dose that would be more than normal tissues could tolerate if given by external beam.
Shields uses the Axxent System, a new, advanced technology that allows Shields staff to precisely apply radiation to the affected tissue. The treatment unit consists of a controller, flexible X-ray source, breast catheter or GYN applicators, and miscellaneous accessories. During treatment, the X-ray source is inserted into the central lumen of a balloon for breast radiotherapy or a GYN applicator for gynecological radiotherapy. As radiation is applied during treatment, the X-ray source is withdrawn back through the applicator at a pre-programmed rate.
This system also allows our staff to be present in the room during treatment, which is advantageous to the treatment and comforting to our patients.
3D Conformal Therapy
Before a patient’s therapy can begin, Shields’ radiation physicists and dosimetrists work with physicians to develop a treatment plan. This plan is a complex set of instructions which is given to the linear accelerator (radiation-producing machine). It is designed to direct radiation to the cancerous cells while simultaneously protecting healthy tissues and organs.
Shields develops treatment plans using a three-dimensional conformal technique. Using a CT scan, which allows 3-D visualization of the tumor and surrounding normal tissues, as well as a very sophisticated computer system, the physicians and physicists customize the shape of the radiation beams to the tumor’s specific size and shape. This plan is then carried out with great precision each day of the patient’s treatment.
Intensity Modulated Radiation Therapy (IMRT)
In Intensity Modulated Radiation Therapy (IMRT), the radiation beam is carefully sculpted around the patient’s anatomy. Compared to conventional radiation therapy, IMRT provides more precise targeting of the tumor and greater sparing of surrounding normal organs. As a result, it allows safe increase in the radiation dose and, at the same time, reduces side effects.
Physicians and physicists work together to create an IMRT plan. They create an extensive list of treatment objectives and then work with a very advanced computer system to design hundreds of tiny radiation beams. Together, these beams produce a high-precision radiation dose pattern in the patient. The treatment itself is carried out with the use of a “multi-leaf collimator,” which has many small motorized rods of tungsten that do not allow radiation to penetrate through. These tungsten rods are programmed to move in and out of the radiation beam to deliver strategically shaped beams of radiation that conform to the tumor.
Our recently commissioned Volumetric Modulate Arc Therapy, or VMAT, can deliver a radiation treatment in a much shorter time than conventional treatment. This new technology is very helpful to patients who have a difficult time remaining still during radiation treatments. VMAT improves accuracy and safety. Extensive quality assurance testing is performed by our physicists on each patient’s treatment plan prior to any IMRT or VMAT treatments.
Image Guided Radiation Therapy (IGRT)
IGRT is a technique used to track the internal movements of a patient’s anatomy by taking digital images of the patient and using them to make fine adjustments to the patient’s positioning in real time. Each day when a patient comes in for radiation treatment, the part of the body being treated is carefully lined up to the radiation beam. This is usually accomplished with lasers and markings on the outside of the body.
In some instances, there can be an appreciable amount of organ movement inside the patient’s body, which can be corrected with IGRT. In some cases, tiny radio-opaque markers are placed in the patient’s body, and their locations are used to align the patient for treatment. By following the daily movement of these markers and adjusting the radiation beam accordingly, we enhance treatment accuracy and precision.
PET-CT and MR-CT Fusion
Patients at Shields Radiation Oncology routinely undergo a Computed Tomography (CT) scan as part of the treatment planning process. CT images allow the physician to see most tumors and healthy tissues and are used for treatment design. However, some cancers grow in a way that makes them almost impossible to see on a CT scan, and this is where other imaging modalities come into play.
Positron Emission Tomography (PET) is a nuclear medicine technique that utilizes radioactive glucose injected into the body to image tumors and metastases. Because many cancerous growths take up more of the glucose than their surrounding tissues, they appear as highlighted areas on the scan. Magnetic Resonance Imaging (MRI) uses electromagnetic fields to produce very detailed images of a patient’s anatomy.
Shields fuses the PET or MRI to the CT scan, which allows our team to take advantage of all imaging techniques. This planning procedure can be invaluable in allowing the radiation oncologist to know precisely where to direct the radiation.
Prostate brachytherapy is a procedure that involves placing many small radioactive sources, or seeds, into the prostate itself. The radiation dose delivered by these seeds is highly concentrated in the prostate, and is minimal elsewhere. The prostate implant is carried out as an outpatient procedure at one of our affiliated hospitals.
Superficial radiation therapy is a form of skin cancer treatment used for over 100 years. Shields has invested in a modern version of this proven technology. Superficial therapy has a very sharp focus, allowing for a small treatment area, which may result in a better cosmetic outcome than surgery, particularly in areas of the face.