Cancer Care Services
Radiation Oncology
Radiation therapy is an integral part of cancer care. It may be a primary therapy by itself or radiation therapy can be combined with chemotherapy, hormone therapy, surgery or a combination of the three. The team at Beverly Hills Cancer Center includes the area’s leaders in radiation oncology and offers the latest in leading-edge technology. Few facilities are as well-equipped as our Los Angeles County Cancer Center. We invest in the most up-to-date technology available to provide the highest quality care to all of our patients.
Our on-site diagnostic imaging center with PET/CT scanning, CT, MRI and bone scans allows the physicians to use these technologies for computer modeling and automation to increase treatment specificity and accuracy. With more sophisticated treatment planning, radiation treatments can often be delivered with a maximum dose to the tumor, while minimizing potential side effects.
Three-Dimensional Conformal Radiation Therapy (3D CRT)
Tumors come in many different shapes and sizes. This type of radiation therapy uses computers and special imaging techniques to treat tumors of various sizes and shapes often in difficult locations. Computer-assisted tomography (CT or CAT scans), magnetic resonance imaging (MR or MRI scans) and/or positron emission tomography (PET scans) are used to create detailed, three-dimensional images of the tumor and surrounding organs. These help radiation oncologists precisely tailor the radiation beams to the size and shape of your tumor. Because the radiation beams are precisely directed, healthy nearby tissue receives less radiation.
Intensity-Modulated Radiation Therapy (IMRT)
This radiation therapy is a specialized form of 3D CRT that allows radiation to be more exactly shaped to fit a tumor. IMRT is considered the most advanced 3-D conformal radiation therapy and helps destroy cancer cells without damaging healthy tissue. It allows radiation oncologists to use different beam intensities to deliver radiation to the tumor sites via the most favorable paths. This allows higher doses of radiation to be delivered directly to the tumor while minimizing radiation to surrounding vital organs and tissues. In some situations, this may increase the chance of a cure.
Using IMRT allows your radiation oncologist to possibly treat some tumors that were previously untreatable with radiation therapy.
Some example include:
- IMRTcan be a non-invasive alternative to surgery in some cases.
- With early detection, IMRT can eradicate tumors before the cancer spreads.
- IMRT can be done on an outpatient basis.
- IMRT specifcally targets the tumor and not the entire body.
| IMRT for treatment of cancers of the throat and neck: This is an example of a 49 year old male with cancer of the right tonsil. He was treated with IMRT radiation and chemotherapy. IMRT treatments were used to treat the primary tumor in the right tonsil (red) as well as the lymph node regions in the right and left neck (turquoise and green) while minimizing radiation exposure to the parotid glands, larynx, spinal cord and other normal tissue structures. The patient is now two years out from completion of radiation treatments and is currently in remission. He is also back to work full time as a SWAT officer. |
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IMRT for treatment of prostate cancer: This is an example of a 72 year old male who was diagnosed with prostate cancer. He decided to undergo radiation therapy treatments to his prostate gland instead of surgery to remove his prostate. The prostate is shown in red sanwiched between the bladder (green) and rectum (brown). He was therefore treated with IMRT radiation therapy to the prostate gland which allows the prostate to receive sufficient dose of radiation for cure while significantly limiting the dose of radiation to the rectum and bladder. The patient tolerated the radiation treatments very well and is currently three years out from completion of radiation treatments with an undetectable PSA.
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IMRT for treatment of brain tumors: This is a 70 year old male who had a tumor of the left brain (red)near the left and right orbits(blue and green), left and right optic nerves(turquoise and pink) and optic chiasm. This tumor was in a location not accessible by surgery. Due to the critical location of the tumor, IMRT radiation therapy was used to treat this tumor while reducing potential radiation exposure to the eyes, optic nerves and optic chiasm as well as the surrounding brain. The patient tolerated the radiation treatments very well and is currently undergoing serial MRI scans of the brain without any evidence of tumor growth.
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Stereotacic Body Radiosurgery or Radiotherapy (SBRT)-
Stereotactic Body Radiosurgery or Radiotherapy (SBRT) is the use of high doses of radiation delivered to tumors in the liver, lung and spine in a single dose or in a limited number of treatments (2-5 doses). Patients are secured with an immobilization device during the treatment to minimize movement during the treatment. Other specific technologies such as respiratory gating and 4D CT may be used during these treatments since the tumor can move during the treatment.
- SBRT is commonly used for the following conditions: Small sized lung cancers
- Cancers located in the lung from tumors that started elsewhere (lung metastases)
- Liver cancers that started outside the liver (liver metastases)
- Tumors in the spine
- Very small tumors in the chest, abdomen, or pelvis that cannot be removed surgically or treated with conventional radiation therapy.
|
SBRT for treatment of liver tumors: This is a patient who had a diagnosis of lung cancer who was found to have involvement of the liver(green). The tumor target volume (red), was treated with SBRT in 5 sessions while safely limiting radiation dose to the normal tissues right next to the tumor such as small bowel (yellow) and both kidneys (blue and magenta). The patient tolerated the radiation very well without any complications or side effects. Repeat MRI of the liver and PET/CT scan three months later showed near complete resolution of the tumor. The patient's tumor markers also returned back to normal levels.
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SBRT for treatment of lung tumors: This is an 83 year old male who was found to have a small tumor in the left lung (red) right next to the heart (pink). The patient elected not to undergo surgery and he was treated with five sessions of SBRT. Respiratory gating and Image Guidance (IGRT) was used to minimize radiation dose to the heart as well as the surronding normal lung tissue. The patient tolerated the treatments extremely well without any side effects or complications. He is now over three years out from his SBRT treatments and is currently doing well without any evidence of tumor recurrence.
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SBRT treatment of a spinal tumor: Patient with melanoma that spread to the spine. The patient underwent surgery to remove the tumor. He was then treated with stereotactic radiation therapy to sterilize the tumor bed and help prevent recurrence of the tumor. Stereotactic radiation therapy was utilized to maximize the radiation dose to the treatment area (red) while protecting the normal tissues nearby such as spinal cord (yellow), esophagus (green), the liver, spleen, kidneys and right and left lungs..
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Stereotactic Radiosurgery (SRS) or Stereotactic Radiotherapy (SRT) of the Brain -
Stereotactic Radiosurgery (SRS) or Stereotactic Radiotherapy (SRT) is the use of high doses of radiation delivered to an extremely small volume within the brain. The treatment typically lasts longer than a normal treatment; however, it is delivered between one to five fractions or sessions and is best for very small tumors. Doctors use very specialized imaging equipment to pinpoint exactly where the cancer cells are. Doctors monitor the area of the cancer and other organs on a screen while treatment is taking place. A customized holder may be used to keep the area to be treated perfectly still during treatment. Combining the specialized imaging and the custom holder allows doctors to give a high dose of radiation to the tumor in a short amount of time.
Conditions Treated With SRT
- Cancers that spread to the brain (brain metastases) from tumors originating in other parts of the body.
- Cancers that start in the brain (gliomas and other brain tumors).
- Benign tumors that arise from the lining of the brain(meningiomas or acoustic neuromas).
- Cancers in the brain that already received radiation previously and surgery is not an option.
SRT may be useful for other cancers not readily addressed with surgery or conventional radiation therapy. Patients with tumors that are small and few in number are the best candidates for SRT. Your radiation oncologist can tell you whether SRT is an options for your specific condition as new research continues to broaden the use of this technology.
|
Stereotactic radiation treatment for brain metastases: 47 year old female with a history of lung cancer who was found to have 6 brain metastases (various colors) from her tumor in the lung. She was treated with stereotactic radiation therepy to each of the 6 brain tumors individually. By using stereotactic radiation therapy directed at each separate tumor nodule, we were able to avoid giving radiation therapy to the whole brain.
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Stereotactic radiation treatment for brain metastases: 83 year old female with a meningioma of the right cerebellum. The tumor is outlined in red and is in close proximity to the brain stem (blue). She did not want to have surgery and was therefore treated with stereotactic radiation therapy in 5 sessions. She tolerated the radiation treatments very well without any complications. MRI of the brain 6 months after treatment did not show any tumor growth.
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Image-Guided Radiation Therapy (IGRT)
Since tumors can move between treatments, radiation oncologists at Beverly Hills Cancer Center take advantage of image guidance (IGRT) to help better deliver the radiation to the cancer. IGRT involves radiation treatments guided by CT or X-ray imaging (Cone beam CT or KV matching). During IGRT treatments, doctors compare images daily, just prior to the treatment to see if the treatment needs to be adjusted. This increases the accuracy of very complex treatments. IGRT and CBCT are used in conjunction with IMRT and 3-D conformal treatments. In some cases, doctors will implant a tiny marker in or near the tumor to pinpoint it for IGRT.
Respiratory Gating and 4D CT
This allows the radiation oncologist, the radiation therapist and the radiation physicist to observe tumor motion during the regular breathing cycle. By integrating respiratory gating software into a treatment plan, we can more closely define a physical window or zone around the tumor and deliver radiation only when the tumor passes through that window or zone. By accounting for respiratory motion, the dose of radiation can be maximized to the tumor and minimized to surrounding normal tissues.
High Dose Rate (HDR) Brachytherapy –
Brachytherapy has been an effective treatment modality for the treatment of cancer used for many years. High Dose Rate (HDR) brachytherapy has specific treatment applications for breast cancers and uterine cancers (endometrial and cervical).
HDR Brachytherapy for Breast Cancer (SAVI, Contura, MammoSite)
Recent studies have shown that partial breast brachytherapy may be an acceptable treatment for early stage breast cancer as opposed to whole breast radiation therapy. After a
lumpectomy is performed by the surgeon and the primary tumor is removed, a balloon catheter device such as SAVI, Contura or MammoSite is placed in the lumpectomy cavity (pictured). The radiation is delivered through the use of the device twice daily for 5 days for a total of 10 separate radiation sessions on an outpatient basis. Since the balloon is inside the breast in the location where the tumor was previously located, this delivers radiation to the tumor bed where the tumor is most likely to recur, while minimizing radiation to the rest of the breast tissue. Studies have shown that the SAVI, Contura and MammoSite partial breast HDR brachytherapy radiation is well-tolerated, with minimal short-term side effects. However, only select patients with small, early stage tumors qualify and many patients with breast cancer do not qualify for partial breast treatments and require whole breast radiation therapy which is given daily for approximately 5-6 weeks.
HDR Brachytherapy for Uterine Cancers (Endometrial or Cervical)
Brachytherapy is an integral part of the treatment course for many patients with endometrial and cervical cancers. Special devices are placed near the cervix and radiation is given through the use of these devices. These treatments are usually given on an outpatient basis. The number of sessions varies from 3-5 depending on patient specific circumstances. Patients are often first treated with pelvic radiation therapy after which time they are treated with HDR brachytherapy. Many patients often receive concurrent chemotherapy during the radiation treatment course.
General Questions and Answers:
How do I know if I need radiation treatments?
Patients being considered for radiation therapy treatments will first require a consultation with a radiation oncologist. A radiation oncology physician has special training in using radiation to treat cancer. During your consultation your radiation oncologist will discuss your medical history and perform a physical examination. All of your reports (surgical, pathology) and your imaging studies (MRI, CT scans, PET/CT, mammograms and x-rays) will be reviewed. Your radiation oncologist will then determine if you qualify for radiation treatments and then prescribes the type and amount of treatment that best suits your particular needs. You will then be scheduled for a radiation planning session (simulation).
What is a radiation planning session (simulation) like?
A radiation planning session is when special measurements and scans are taken to help prepare a custom radiation treatment plan specific for your body. During this session you are place on a CT scanner table and measurements are taken and special custom molded devices are made to help maintain your body in the same position every day. Colored, permanent ink is often used to mark your skin to assist in aligning the radiation machine with your body and the treatment target area. CT images are taken through the body part that will be receiving radiation treatments. The treatment preparation session might take from thirty minutes to an hour. Over the next 1-2 days our team of physicians and physicists create a custom plan for you. When your unique plan is complete, we will contact you and arrange a series of appointments for your radiation treatments to start.
How are the treatments given?
In the treatment room, the radiation therapist sets you up on the treatment table and uses the marks on your skin (tattoos) to locate the treatment area. The same special devices used during the planning session are used to help with positioning of your body. The radiation therapist will leave the treatment room and remotely controls a digital imaging system rotating it around you to take digital images of the targeted area. These images are then used to final fine tune adjustments prior to starting the radiation treatments. The machine is controlled from outside the room. However, you can be seen on a television screen and the therapist can talk with you through an intercom. During the treatments you will not see or hear the radiation and you usually do not feel anything. Receiving external radiation treatment is painless, just like having an X-ray taken. However, if you become uncomfortable the machine can be stopped at any time.
How Long Is a Course of Treatment?
Radiation therapy usually is given daily, Monday through Friday, five days a week. The number of treatments will be determined by your radiation oncologist and may range from 3-45 depending on your unique circumstances. The total dose of radiation and the number of treatments a patient needs depend on the size and location of the cancer, the type of tumor, the patient's general health and other factors. For each radiation therapy session, the patient is in the treatment room for about 15 to 30 minutes.
What Are the Effects of Radiation Treatments?
Effects of radiation therapy are limited to the area being treated. For example, radiation treatments to the body such as the lung, breast or abdomen will not cause hair loss. However, radiation treatment of the head will likely cause some hair loss, which may take several months to re-grow. External radiation therapy does not cause a patient's body to become radioactive and patients do not need to avoid being with other people for fear of exposing them to radiation. Hugging, kissing, or having sexual relations will not pose a risk of radiation exposure.
Most side effects that occur during radiation therapy, although sometimes unpleasant, are not serious and can be controlled with medication or diet. They usually go away within a few weeks after treatment ends. Many people continue to work or maintain their normal regular lifestyle and daily activities. With newer technology and radiation treatment techniques such as IMRT, IGRT and stereotactic radiation therapy, some patients have minimal or no side effects at all. Prior to the start of radiation treatments, your radiation oncologist will review with you in detail the treatment course and potential side effects as they pertain to you and your body.
From the Doctors Desk...
At Beverly Hills Cancer Center, we offer a vast array of treatment options that are non-invasive and do not require surgery. This study published at Science Direct discusses the many unwanted an unknown side effects that can occur with surgery for prostate cancer. Many people are often not aware that there are better, non-invasive, alternatives to treating prostate cancer, including targeted radiation therapy. These non-surgical options, such as radiation therapy, may not only have less side effects but can also be more effective at fighting the cancer.
Patient Preoperative Expectations of Urinary, Bowel, Hormonal and Sexual Functioning Do Not Match Actual Outcomes 1 Year After Radical Prostatectomy
Go back to the Cancer Care Services main page
Cancer Care Services
Radiation Oncology
Radiation therapy is an integral part of cancer care. It may be a primary therapy by itself or radiation therapy can be combined with chemotherapy, hormone therapy, surgery or a combination of the three. The team at Beverly Hills Cancer Center includes the area’s leaders in radiation oncology and offers the latest in leading-edge technology. Few facilities are as well-equipped as our Los Angeles County Cancer Center. We invest in the most up-to-date technology available to provide the highest quality care to all of our patients.
Our on-site diagnostic imaging center with PET/CT scanning, CT, MRI and bone scans allows the physicians to use these technologies for computer modeling and automation to increase treatment specificity and accuracy. With more sophisticated treatment planning, radiation treatments can often be delivered with a maximum dose to the tumor, while minimizing potential side effects.
Three-Dimensional Conformal Radiation Therapy (3D CRT)
Tumors come in many different shapes and sizes. This type of radiation therapy uses computers and special imaging techniques to treat tumors of various sizes and shapes often in difficult locations. Computer-assisted tomography (CT or CAT scans), magnetic resonance imaging (MR or MRI scans) and/or positron emission tomography (PET scans) are used to create detailed, three-dimensional images of the tumor and surrounding organs. These help radiation oncologists precisely tailor the radiation beams to the size and shape of your tumor. Because the radiation beams are precisely directed, healthy nearby tissue receives less radiation.
Intensity-Modulated Radiation Therapy (IMRT)
This radiation therapy is a specialized form of 3D CRT that allows radiation to be more exactly shaped to fit a tumor. IMRT is considered the most advanced 3-D conformal radiation therapy and helps destroy cancer cells without damaging healthy tissue. It allows radiation oncologists to use different beam intensities to deliver radiation to the tumor sites via the most favorable paths. This allows higher doses of radiation to be delivered directly to the tumor while minimizing radiation to surrounding vital organs and tissues. In some situations, this may increase the chance of a cure.
Using IMRT allows your radiation oncologist to possibly treat some tumors that were previously untreatable with radiation therapy.
Some example include:
- IMRTcan be a non-invasive alternative to surgery in some cases.
- With early detection, IMRT can eradicate tumors before the cancer spreads.
- IMRT can be done on an outpatient basis.
- IMRT specifcally targets the tumor and not the entire body.
| IMRT for treatment of cancers of the throat and neck: This is an example of a 49 year old male with cancer of the right tonsil. He was treated with IMRT radiation and chemotherapy. IMRT treatments were used to treat the primary tumor in the right tonsil (red) as well as the lymph node regions in the right and left neck (turquoise and green) while minimizing radiation exposure to the parotid glands, larynx, spinal cord and other normal tissue structures. The patient is now two years out from completion of radiation treatments and is currently in remission. He is also back to work full time as a SWAT officer. |
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| |
|
|
IMRT for treatment of prostate cancer: This is an example of a 72 year old male who was diagnosed with prostate cancer. He decided to undergo radiation therapy treatments to his prostate gland instead of surgery to remove his prostate. The prostate is shown in red sanwiched between the bladder (green) and rectum (brown). He was therefore treated with IMRT radiation therapy to the prostate gland which allows the prostate to receive sufficient dose of radiation for cure while significantly limiting the dose of radiation to the rectum and bladder. The patient tolerated the radiation treatments very well and is currently three years out from completion of radiation treatments with an undetectable PSA.
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|
| |
|
|
IMRT for treatment of brain tumors: This is a 70 year old male who had a tumor of the left brain (red)near the left and right orbits(blue and green), left and right optic nerves(turquoise and pink) and optic chiasm. This tumor was in a location not accessible by surgery. Due to the critical location of the tumor, IMRT radiation therapy was used to treat this tumor while reducing potential radiation exposure to the eyes, optic nerves and optic chiasm as well as the surrounding brain. The patient tolerated the radiation treatments very well and is currently undergoing serial MRI scans of the brain without any evidence of tumor growth.
|
|
| |
|
Stereotacic Body Radiosurgery or Radiotherapy (SBRT)-
Stereotactic Body Radiosurgery or Radiotherapy (SBRT) is the use of high doses of radiation delivered to tumors in the liver, lung and spine in a single dose or in a limited number of treatments (2-5 doses). Patients are secured with an immobilization device during the treatment to minimize movement during the treatment. Other specific technologies such as respiratory gating and 4D CT may be used during these treatments since the tumor can move during the treatment.
- SBRT is commonly used for the following conditions: Small sized lung cancers
- Cancers located in the lung from tumors that started elsewhere (lung metastases)
- Liver cancers that started outside the liver (liver metastases)
- Tumors in the spine
- Very small tumors in the chest, abdomen, or pelvis that cannot be removed surgically or treated with conventional radiation therapy.
|
SBRT for treatment of liver tumors: This is a patient who had a diagnosis of lung cancer who was found to have involvement of the liver(green). The tumor target volume (red), was treated with SBRT in 5 sessions while safely limiting radiation dose to the normal tissues right next to the tumor such as small bowel (yellow) and both kidneys (blue and magenta). The patient tolerated the radiation very well without any complications or side effects. Repeat MRI of the liver and PET/CT scan three months later showed near complete resolution of the tumor. The patient's tumor markers also returned back to normal levels.
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| |
|
|
SBRT for treatment of lung tumors: This is an 83 year old male who was found to have a small tumor in the left lung (red) right next to the heart (pink). The patient elected not to undergo surgery and he was treated with five sessions of SBRT. Respiratory gating and Image Guidance (IGRT) was used to minimize radiation dose to the heart as well as the surronding normal lung tissue. The patient tolerated the treatments extremely well without any side effects or complications. He is now over three years out from his SBRT treatments and is currently doing well without any evidence of tumor recurrence.
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|
SBRT treatment of a spinal tumor: Patient with melanoma that spread to the spine. The patient underwent surgery to remove the tumor. He was then treated with stereotactic radiation therapy to sterilize the tumor bed and help prevent recurrence of the tumor. Stereotactic radiation therapy was utilized to maximize the radiation dose to the treatment area (red) while protecting the normal tissues nearby such as spinal cord (yellow), esophagus (green), the liver, spleen, kidneys and right and left lungs..
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| |
|
Stereotactic Radiosurgery (SRS) or Stereotactic Radiotherapy (SRT) of the Brain -
Stereotactic Radiosurgery (SRS) or Stereotactic Radiotherapy (SRT) is the use of high doses of radiation delivered to an extremely small volume within the brain. The treatment typically lasts longer than a normal treatment; however, it is delivered between one to five fractions or sessions and is best for very small tumors. Doctors use very specialized imaging equipment to pinpoint exactly where the cancer cells are. Doctors monitor the area of the cancer and other organs on a screen while treatment is taking place. A customized holder may be used to keep the area to be treated perfectly still during treatment. Combining the specialized imaging and the custom holder allows doctors to give a high dose of radiation to the tumor in a short amount of time.
Conditions Treated With SRT
- Cancers that spread to the brain (brain metastases) from tumors originating in other parts of the body.
- Cancers that start in the brain (gliomas and other brain tumors).
- Benign tumors that arise from the lining of the brain(meningiomas or acoustic neuromas).
- Cancers in the brain that already received radiation previously and surgery is not an option.
SRT may be useful for other cancers not readily addressed with surgery or conventional radiation therapy. Patients with tumors that are small and few in number are the best candidates for SRT. Your radiation oncologist can tell you whether SRT is an options for your specific condition as new research continues to broaden the use of this technology.
|
Stereotactic radiation treatment for brain metastases: 47 year old female with a history of lung cancer who was found to have 6 brain metastases (various colors) from her tumor in the lung. She was treated with stereotactic radiation therepy to each of the 6 brain tumors individually. By using stereotactic radiation therapy directed at each separate tumor nodule, we were able to avoid giving radiation therapy to the whole brain.
|
|
| |
|
|
Stereotactic radiation treatment for brain metastases: 83 year old female with a meningioma of the right cerebellum. The tumor is outlined in red and is in close proximity to the brain stem (blue). She did not want to have surgery and was therefore treated with stereotactic radiation therapy in 5 sessions. She tolerated the radiation treatments very well without any complications. MRI of the brain 6 months after treatment did not show any tumor growth.
|
|
| |
|
Image-Guided Radiation Therapy (IGRT)
Since tumors can move between treatments, radiation oncologists at Beverly Hills Cancer Center take advantage of image guidance (IGRT) to help better deliver the radiation to the cancer. IGRT involves radiation treatments guided by CT or X-ray imaging (Cone beam CT or KV matching). During IGRT treatments, doctors compare images daily, just prior to the treatment to see if the treatment needs to be adjusted. This increases the accuracy of very complex treatments. IGRT and CBCT are used in conjunction with IMRT and 3-D conformal treatments. In some cases, doctors will implant a tiny marker in or near the tumor to pinpoint it for IGRT.
Respiratory Gating and 4D CT
This allows the radiation oncologist, the radiation therapist and the radiation physicist to observe tumor motion during the regular breathing cycle. By integrating respiratory gating software into a treatment plan, we can more closely define a physical window or zone around the tumor and deliver radiation only when the tumor passes through that window or zone. By accounting for respiratory motion, the dose of radiation can be maximized to the tumor and minimized to surrounding normal tissues.
High Dose Rate (HDR) Brachytherapy –
Brachytherapy has been an effective treatment modality for the treatment of cancer used for many years. High Dose Rate (HDR) brachytherapy has specific treatment applications for breast cancers and uterine cancers (endometrial and cervical).
HDR Brachytherapy for Breast Cancer (SAVI, Contura, MammoSite)
Recent studies have shown that partial breast brachytherapy may be an acceptable treatment for early stage breast cancer as opposed to whole breast radiation therapy. After a lumpectomy is performed by the surgeon and the primary tumor is removed, a balloon catheter device such as SAVI, Contura or MammoSite is placed in the lumpectomy cavity (pictured). The radiation is delivered through the use of the device twice daily for 5 days for a total of 10 separate radiation sessions on an outpatient basis. Since the balloon is inside the breast in the location where the tumor was previously located, this delivers radiation to the tumor bed where the tumor is most likely to recur, while minimizing radiation to the rest of the breast tissue. Studies have shown that the SAVI, Contura and MammoSite partial breast HDR brachytherapy radiation is well-tolerated, with minimal short-term side effects. However, only select patients with small, early stage tumors qualify and many patients with breast cancer do not qualify for partial breast treatments and require whole breast radiation therapy which is given daily for approximately 5-6 weeks.
HDR Brachytherapy for Uterine Cancers (Endometrial or Cervical)
Brachytherapy is an integral part of the treatment course for many patients with endometrial and cervical cancers. Special devices are placed near the cervix and radiation is given through the use of these devices. These treatments are usually given on an outpatient basis. The number of sessions varies from 3-5 depending on patient specific circumstances. Patients are often first treated with pelvic radiation therapy after which time they are treated with HDR brachytherapy. Many patients often receive concurrent chemotherapy during the radiation treatment course.
General Questions and Answers:
How do I know if I need radiation treatments?
Patients being considered for radiation therapy treatments will first require a consultation with a radiation oncologist. A radiation oncology physician has special training in using radiation to treat cancer. During your consultation your radiation oncologist will discuss your medical history and perform a physical examination. All of your reports (surgical, pathology) and your imaging studies (MRI, CT scans, PET/CT, mammograms and x-rays) will be reviewed. Your radiation oncologist will then determine if you qualify for radiation treatments and then prescribes the type and amount of treatment that best suits your particular needs. You will then be scheduled for a radiation planning session (simulation).
What is a radiation planning session (simulation) like?
A radiation planning session is when special measurements and scans are taken to help prepare a custom radiation treatment plan specific for your body. During this session you are place on a CT scanner table and measurements are taken and special custom molded devices are made to help maintain your body in the same position every day. Colored, permanent ink is often used to mark your skin to assist in aligning the radiation machine with your body and the treatment target area. CT images are taken through the body part that will be receiving radiation treatments. The treatment preparation session might take from thirty minutes to an hour. Over the next 1-2 days our team of physicians and physicists create a custom plan for you. When your unique plan is complete, we will contact you and arrange a series of appointments for your radiation treatments to start.
How are the treatments given?
In the treatment room, the radiation therapist sets you up on the treatment table and uses the marks on your skin (tattoos) to locate the treatment area. The same special devices used during the planning session are used to help with positioning of your body. The radiation therapist will leave the treatment room and remotely controls a digital imaging system rotating it around you to take digital images of the targeted area. These images are then used to final fine tune adjustments prior to starting the radiation treatments. The machine is controlled from outside the room. However, you can be seen on a television screen and the therapist can talk with you through an intercom. During the treatments you will not see or hear the radiation and you usually do not feel anything. Receiving external radiation treatment is painless, just like having an X-ray taken. However, if you become uncomfortable the machine can be stopped at any time.
How Long Is a Course of Treatment?
Radiation therapy usually is given daily, Monday through Friday, five days a week. The number of treatments will be determined by your radiation oncologist and may range from 3-45 depending on your unique circumstances. The total dose of radiation and the number of treatments a patient needs depend on the size and location of the cancer, the type of tumor, the patient's general health and other factors. For each radiation therapy session, the patient is in the treatment room for about 15 to 30 minutes.
What Are the Effects of Radiation Treatments?
Effects of radiation therapy are limited to the area being treated. For example, radiation treatments to the body such as the lung, breast or abdomen will not cause hair loss. However, radiation treatment of the head will likely cause some hair loss, which may take several months to re-grow. External radiation therapy does not cause a patient's body to become radioactive and patients do not need to avoid being with other people for fear of exposing them to radiation. Hugging, kissing, or having sexual relations will not pose a risk of radiation exposure.
Most side effects that occur during radiation therapy, although sometimes unpleasant, are not serious and can be controlled with medication or diet. They usually go away within a few weeks after treatment ends. Many people continue to work or maintain their normal regular lifestyle and daily activities. With newer technology and radiation treatment techniques such as IMRT, IGRT and stereotactic radiation therapy, some patients have minimal or no side effects at all. Prior to the start of radiation treatments, your radiation oncologist will review with you in detail the treatment course and potential side effects as they pertain to you and your body.
From the Doctors Desk...
At Beverly Hills Cancer Center, we offer a vast array of treatment options that are non-invasive and do not require surgery. This study published at Science Direct discusses the many unwanted an unknown side effects that can occur with surgery for prostate cancer. Many people are often not aware that there are better, non-invasive, alternatives to treating prostate cancer, including targeted radiation therapy. These non-surgical options, such as radiation therapy, may not only have less side effects but can also be more effective at fighting the cancer.
Patient Preoperative Expectations of Urinary, Bowel, Hormonal and Sexual Functioning Do Not Match Actual Outcomes 1 Year After Radical Prostatectomy
Go back to the Cancer Care Services main page