Radiation Oncology
Our Radiation Oncology department is accredited by the American College of Radiation Therapy. This accreditation is recognition of the high level and quality care we offer our patients. As active members of the Radiation Therapy Oncology Group (RTOG) and Children’s Oncology Group (COG) we have further distinguished ourselves in the State of New Jersey. To learn more about our Radiation Therapists, click here. The application of radiation therapy varies greatly depending upon the stage of cancer and which particular area of the body is receiving treatment. The information regarding a particular cancer is organized by each general disease site. Choose one of the following for more information: Click here for answers to common questions about Radiation Therapy in Cancer Treatment. For patients with prostate cancer we have an active high dose rate program. Using state of the art technology we are able to deliver radiation to the prostate with more accuracy than other methods. We are one of the few centers in the area offering this procedure. Three of the therapies we offer for the treatment of cancer include:
Three-Dimensional Conformal Therapy External beam radiation uses high energy photons to destroy cancer cells within the body. The photons are in many ways similar to those used in diagnostic x-ray (chest x-ray) or rays from the sun except they are much higher in energy. The beams are generated by a device called a linear accelerator and deposit radiation dose as they pass through a particular portion of the body. The radiation damages the DNA of cells which ultimately leads to their destruction. Normal (non cancerous) cells are much better able to repair this type of damage and therefore survive. Like the light from a flash light, radiation dose is delivered only when the machine is on and the patient is not radioactive once the machine is turned off. One of the most important advances in the delivery of external beam radiation therapy has been the development of three-dimensional conformal therapy. Traditional conventional radiation therapy is targeted only by the location of bones seen on plain x-rays which cannot show the actual tumor. These bony landmarks do not show the unique anatomy of any particular patient. The fields therefore tend to be large, square shaped and generic. This results in more unnecessary radiation to the surrounding tissues. Conversely, conformal therapy allows for the customization of treatment for each particular individual. Every person has a unique tumor size, shape, as well as location of nearby normal organs. Conformal radiation is the process of accurately determining this unique anatomy and tailoring the radiation treatment such that it "conforms" to every patient. Where conventional therapy would treat all patients with the same big square beams, conformal radiation treats a round tumor by round beams and an elongated shaped tumor with elongated shaped beams. This technology is now applied to nearly all tumor sites. (Breast/ Gastrointestinal/ Prostate/ CNS/ Lung/ Gyn) Conformal treatment is a complex process which involves three basic components. The first is patient immobilization. Special body casts are created to improve the reproducibility of the patient’s position on the machine. The second step is computed tomography (CT) assisted organ identification. The precise location and shape of the tumor as well as the surrounding tissues is determined. The final step involves the use of powerful computer tools to generate the specific beams which will differentially deliver the radiation to the tumor while sparing the surrounding normal tissues. Specialized blocks are created to shape the beams which have been generated. This improvement in technology means that the radiation beams can be made the smallest size possible to safely treat the cancer while avoiding normal tissues. The less normal tissue irradiated results in less unwanted side effects. Simulation: This is the first step of conformal radiation. The total time needed for this first day is about 90 minutes. A custom body mold is made that is customized for each particular area of treatment. By lying in the mold, you will be in the same position on the treatment table every day - up to 67% more accurately than without the cast. Next is the CT scan in our department. Claustrophobia, a fear of close places, is rarely a problem. Contrast dye is often used during the CT scan to improve the image of the tumor on the film. Please tell your doctor or nurse if you are allergic to contrast dye or iodine. Small tattoos the size of a pencil point are then placed to be used every day for accurate positioning of the treatment beams. They are permanent but small and in locations that will likely not be publicly visible. 3-D Treatment planning: This process takes place behind the scenes over a 1 week period -you do not need to be present. The CT scan taken at simulation is examined by the physician who contours the important body organs which are then inputted into the computer. The physician then directs specially trained physicists and therapists in designing the conformal shape of the radiation beams. This is the custom tailoring - the radiation beams are designed to mimic the shape of the target with the narrowest margin of normal tissue possible. Set-up: We check the accuracy of your specific treatment on the actual therapy machine before starting radiation. Radiation Treatments: The time course of conformal radiation depends on the disease site being treated but in general ranges from 5 to 7 weeks, Monday through Friday, except for major holidays. The actual time in the treatment room is 10-15 minutes. Please allow 45-60 minutes total each day for parking, dressing and small delays. Treatment times are flexible from 7:30 - 5:30 - most requests for a specific time of day can be met. [ top ] Intensity Modulated Radiation Therapy (IMRT) The rapid evolution of computer programs has made possible further advancements in the delivery of conformal 3D radiation treatments called intensity modulated conformal therapy. Radiation beams are manipulated through advanced computer-controlled technology to change the intensity of the beam profile around both tumor and normal tissues. This new approach exploits the additional control that intensity modulation provides in achieving more conformality of the target. The availability of this new approach at Monmouth and Community Medical Centers creates the ability to deliver multiple, more complex conformal treatment fields in a shorter amount of time. Treatments that may have taken 15 minutes to deliver are now completed in 2-3 minutes. Patients can expect lower side effects and more convenient treatment. Because of greater healthy tissue sparing, IMRT can be combined with chemotherapy to improve cure rates. [ top ] High Dose Rate Temporary Implants for Prostate Cancer High Dose Rate implants for prostate cancer are now offered as an exciting non-surgical alternative for locally advanced disease. This novel approach involves implanting temporary catheters into the prostate, in a minimally invasive one-hour operative procedure. Concentrated high pulsed doses of radiation are then delivered with the aid of computer planning into the prostate, delivered through these catheters. Treatments are individualized to conform to the prostate shape, in order to spare normal surrounding tissue. Unlike conventional permanent seed implants the dose to the prostate can be individualized through varying the amount of time the radiation source spends in each position in each needle. Additionally this allows the physician to minimize dose to the urethra and rectum which may reduce potential side effects. Treatments are delivered over a 36 hour period with only a one-night hospital stay. The implant is temporary, and is removed prior to the patient leaving the hospital. This treatment is then supplemented by a short course of conformal external radiation therapy. Side effects are minimal allowing the patient to be treated in an outpatient fashion. Recovery time is quick, with most patients returning to their normal lifestyle routine during therapy. Results with this approach are promising, and appear comparable if not superior to standard external radiation alone for locally advanced disease. HDR has the advantage of shortening the overall course of therapy, while delivering higher doses of radiation to the cancer with greater precision. Our therapists are all American Registry of Radiologic Technologists (ARRT) licensed and have extensive training in the treatment of patients with cancer. They combine their clinical expertise with unparalleled compassion for our patients. As a rotation site for the St. Barnabas School of Radiation Therapy we also provide training for future therapists. [ top ] |
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Our Radiation Oncology department provides both inpatient and outpatient services including consultation, treatment planning, external beam radiation, IMRT, and follow up care for patients with cancer. To learn about state-of-the-art technology used in our Center, 
