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Advances in radiation therapy

Innovative techniques harness advances in computer imaging, satellite technology, and particle physics.

Radiation oncology is one of the most sophisticated and quickly evolving areas of medicine. From computer-assisted techniques to the application of particle physics, innovations in radiation therapy have the ability to precisely target the site of the cancer while sparing surrounding healthy tissue.

Your radiation team

Your radiation team includes a number of highly trained doctors, specialists, and caregivers who work with you throughout your treatment:

The radiation oncologist is a doctor who specializes in treating cancer with radiation therapy, and who will determine and oversee your treatment

The radiation physicist helps the radiation oncologist design and implement treatment and ensures proper functioning of equipment

The dosimetrist helps the radiation oncologist formulate treatment and determine techniques such as angle of radiation entry and daily radiation dose

The radiation therapist operates the equipment and positions you for treatment

The radiation therapy nurse has extensive experience working with people who are undergoing radiation treatment

State-of-the-art medicine

Intensity modulated radiation therapy (IMRT) is an important breakthrough in external radiation and effective in the treatment of difficult-to-reach cancers, and those located close to delicate organs. Using a computer program, the oncologist can plan a precise dose of radiation in three dimensions, based on the size, shape, and location of the tumor. IMRT delivers radiation in thousands of thin beams that enter the body from hundreds of angles, intersecting the cancer with great precision.

Another high-technology approach is 3D conformal radiation. Using three-dimensional computer mapping, the oncologist produces an accurate image of the tumor and surrounding organs, so that multiple radiation beams can be shaped exactly to the contour of the tumor.

Advanced imaging technology has opened the door to a variety of other highly targeted methods for treating cancer. For example, TheraSphere® is an advanced technique that specifically targets tumors in the liver by using microscopic glass beads to deliver radiation.

Using an angiogram, or X-ray of the blood vessels surrounding the liver, doctors select the artery through which they can deliver the beads. Then, using a technique called X-ray fluoroscopy, which allows them to see a live image of the body, doctors guide a catheter containing the beads to the proper place in the liver.

The beads, which contain the radioactive substance Yttrium-90, are the right size to lodge in the blood vessels associated with the cancerous tissue but not in the blood vessels of the healthy parts of the liver.

Proton therapy

One of the most significant advances in radiation therapy is proton therapy. Protons — or positively charged elementary particles found in the nuclei of all atoms — are extracted from hydrogen atoms and directed at the tumor using magnetic fields.

Unlike X-rays, protons emit a very high dose of radiation but scatter very little. These properties enable oncologists to deliver an extremely aggressive yet precise radiation dose to the tumor.

Proton therapy has proven remarkably effective in the treatment of many cancers, including lung, brain, and prostate cancers. However the size and cost of the equipment, which can weigh 900 tons and require an investment of $175 million or more, has so far limited the treatments to a few facilities in the United States. Proton beam treatment will likely become more common as additional facilities are built in coming years.

Tumor tracking

The effectiveness of radiation treatments depends in many cases on the ability to pinpoint the exact location of the tumor. But a challenge that doctors face is that many organs, glands, and other human tissue constantly shift slightly in the body. That means that during treatment, doctors often end up radiating large margins, or borders, of healthy tissue to make sure they target the entire cancerous area.

One innovative solution to this problem is a small wireless device akin to a global positioning system (GPS) that doctors can implant in the tumor to track its precise position in real time. Called the Calypso® 4D Localization System™, the technology is now being used in the treatment of prostate cancer.

High-dose rate brachytherapy (HDR)

In this innovative approach to brachytherapy, computers are used to deliver a few concentrated doses of radiation over a few short outpatient treatments. Each HDR session lasts only ten to twenty minutes over one to five days of treatment. That’s far less time than external radiation therapy, which takes six to eight weeks. Plus, HDR poses very little risk of radiation injury to the rest of your body.

MammoSite® radiation therapy (MRT) is used after a lumpectomy, or the surgical removal of a breast tumor to prevent a recurrence. The oncologist inserts a small, balloon-shaped catheter into the cavity where the tissue was removed. Then the oncologist loads the catheter with a radioactive pellet. You can receive treatment as an outpatient, usually over one to five days. MRT is far less invasive than external radiation, and can help doctors preserve as much of the healthy breast tissue as possible.