Focus — Radiation Oncology

Treating Delicate Gynecologic Cancer

“O

ne of the great strengths of our program is the multidisciplinary approach that each patient’s care receives,” says Dr. Brookland. Fighting gynecologic cancer requires a team of experts. That’s why, several times a month, GBMC gynecologic, medical and radiation oncologists convene with the pathologists to review their cases and strategically plan optimal treatments to ensure each patient has the best chance for recovery.

Dr. Albert Blumberg shows a patient images from her scan in the CT simulator.

Radiation therapy is often a critical part of a patient’s treatment plan; however, treating gynecologic cancers in this manner is a delicate process due to the potential for damage to surrounding structures. Brachytherapy, the placement of radioactive material into the center of the cancer-bearing area, makes radiation treatment safer, more convenient and highly effective. Unlike treatment for patients with prostate cancer, these radiation sources are only temporarily in place.

Brachytherapy previously required a hospital stay of several days in order for physicians to insert an applicator into the vagina which would slowly administer low doses of radiation. Gynecologic cancer patients are now able to receive brachytherapy in as few as 10 minutes. Although the radiation is in higher doses, the side effects are minimal. Patients may experience mild urinary, rectal and vaginal irritation.

New Surface Brachytherapy Option Available for Skin Cancer Patients

F

or some skin cancer patients at GBMC, a new method for receiving radiation therapy treatments is available. The Radiation Oncology Department is now home to a piece of equipment capable of delivering brachytherapy directly to non-melanoma skin cancer (NMSC) tumors. This treatment may be considered as an alternative to surgery or standard external beam radiation in certain instances, or as a complement to a necessary surgical procedure. “Delivering brachytherapy via the microSelectron® Digital afterloader high dose rate (HDR) unit allows us to apply surface radiation with precision so that we can spare healthy tissue surrounding the tumor. This often means the patient can expect a shorter recovery time and excellent cosmetic results,” notes Dr. Blumberg.

Radiation Oncology at GBMC: A student in the Radiation Oncology Department demonstrates how the microSelectron Digital afterloader HDR unit is used.

To learn more about Radiation Oncology at GBMC, visit www.gbmc.org/radiationoncology. Or, GO MOBILE and get more information by snapping this tag with your smartphone.

Focus is produced by GBMC’s Marketing Department for the medical community of GBMC.

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Offering Comprehensive and Precise Treatments for Cancer Patients to Minimize Side Effects

DEPARTMENT OF

Radiation Oncology Providing cancer patients a comprehensive team approach to radiation treatment

G

BMC’s Department of Radiation Oncology, part of the Sandra & Malcolm Berman Cancer Institute at GBMC, offers cancer patients the most advanced, precise treatment techniques available, delivering effective results with minimal side effects. Three board-certified radiation oncologists provide years of experience treating patients with a variety of cancers. Every new patient is assigned a team of experts including radiation oncologists, radiation therapists, oncology-certified nurses, dosimetrists and physicists who work together to develop an effective treatment plan, ensuring each patient has the best chance for a successful recovery. Since timing is everything in cancer treatment, appointments are made quickly, usually within 48 hours.

Above: The CT simulator is an important tool for treatment planning because it provides the most exact image of the tumor site, a comprehensive field of view and it replicates the actual delivery of radiation.

Using Precise Technology to Limit Side Effects for Breast Cancer Patients

R

adiation therapy is a crucial component of treatment plans for many types of cancer. Breast cancer is no exception.

Using a state-of-the-art CT simulator, physicians are able to generate an exact image of a tumor and replicate the actual delivery of radiation. This precise image, along with other data compiled by the simulator, leads to a sophisticated, threedimensional conformal radiation treatment plan for each breast cancer patient in which each radiation beam is shaped to fit the profile of the target.

Below: After completing radiation therapy, patients look forward to ringing this bell, which hangs near the treatment rooms, as a celebration of life.

“Because we’re able to so accurately plan and deliver doses of radiation, we’re able to reduce damage to surrounding tissue and vital organs, such as the heart,” says Albert Blumberg, MD, Vice Chairman, Radiation Oncology. “Patients receiving treatment now have a lower risk for heart attack down the road because they will have received less radiation to normal tissues.”

Albert Blumberg, MD

“Additionally, radiation therapy for breast cancer patients used to have a higher chance of significant cosmetic effects,” says Dr. Blumberg. “Today’s treatments use a more homogenous dose distribution, so it has less effect on the skin. The most common side effects are minor redness, itching and irritation. Now the trauma of a breast cancer diagnosis doesn’t have to go hand-in-hand with the trauma of disease treatment.”

New Technology Reduces Head and Neck Cancer Treatment Time and Side Effects by Half

I

n the past, head and neck cancer patients undergoing radiation therapy had to endure a long list of unpleasant side effects including chronic dry Geoffrey Neuner, MD mouth, difficulty swallowing months to years after treatment, loss of taste and tooth decay, to name a few. With so many critical structures located in a confined space, it was nearly impossible to deliver radiation to tissues affected by cancer without damaging a healthy area. However, due to the advances in technology in recent years, patients are now significantly less likely to experience such long-term side effects from their radiation treatments. With a hybrid therapy of surgery to physically move the salivary glands, along with volumetric-modulated arc therapy enhanced with Image-Guided Radiation Therapy (IGRT), radiation oncologists

To learn more, visit www.gbmc.org/radiationoncology

Also, in the not so distant past, head and neck cancer patients needed to endure long, grueling treatments requiring them to stay perfectly still for up to 45 minutes.

The introduction of RapidArc® treatment planning to GBMC’s Radiation Oncology Department in 2009 has allowed for treatment times to be reduced to as few as five minutes. RapidArc uses volumetric-modulated arc therapy to deliver precise radiation directly to the tumor while sparing important surrounding structures critical to a patient’s long-term quality of life.

“On-board imaging capabilities and RapidArc planning help us to plan and deliver radiation as precisely as possible, minimizing the damage to surrounding tissue,” notes Dr. Neuner. “With this technology, we have achieved our long sought after goal of treating tumors with tight safety margins (within two to three millimeters) while sparing salivary glands and the muscles responsible for swallowing. This undoubtedly reduces

GBMC’s RapidArc linear accelerator targets a tumor site with pinpoint accuracy.

long-term side effects in patients, and improves their quality of life beyond cancer treatment.”

Radiation has Advantages over Surgery for Prostate Cancer Treatment

I

mproved technology has also made a difference in the treatment of men with prostate cancer.

A diagnosis of prostate cancer used to mean a host of lifealtering side Robert Brookland, MD effects, but the side effects of radiation treatment for the disease have become greatly reduced over the past 10 years.

When a man is diagnosed with prostate cancer at GBMC, he is categorized into one of five risk categories: Very High, High, Medium, Low or Very Low. This risk is determined from the patient’s prostate-specific antigen (PSA) level, cancer stage and the microscopic appearance of the cancer.

From the control room, a radiation therapist monitors her patient, who is undergoing treatment in the RapidArc linear accelerator.

like Geoffrey Neuner, MD, can now offer head and neck patients a better quality of life after treatment.

“The course of treatment for each patient depends on the risk that we assign to him,” says Robert Brookland, MD,

Chairman, Radiation Oncology. “Some men who are considered very low risk might not require immediate treatment and instead may only be under active surveillance to monitor the cells, while other patients may need surgery or treatments with radiation.”

An alternative or complement to daily radiation therapy is brachytherapy, which has become very popular in recent years for prostate cancer patients.

Brachytherapy uses radioactive seeds that are implanted into the prostate and gradually release a very high dose of radiation to “Brachytherapy, or implantation the cancer over Contrary to of radioactive seeds, may be popular belief, the next several an alternative or complement radiation months. For treatment to daily radiation therapy for implantation, typically has prostate cancer patients.” patients are fewer side effects —Robert Brookland, MD anesthetized for the patient and, following as compared to surgery. Because of the an ultrasound study of the prostate, precision of the conformal Intensitya computer program assists in Modulated Radiation Therapy (IMRT) determining the precise number and beams and the ability to make daily location for seed placement. The seeds adjustments to the target, radiation are then inserted by needles into has less effect on surrounding tissues the gland using a minimally invasive than when using older technologies. technique and will remain there for the This causes fewer incidences of rest of the patient’s lifetime, although impotence and incontinence than they stop giving off radiation after about surgical interventions. Treatment is a year. typically delivered in a 15-minute or less outpatient procedure, allowing patients to keep up with their normal routines, such as working full time.

To learn more, visit www.gbmc.org/radiationoncology

DEPARTMENT OF

Radiation Oncology Providing cancer patients a comprehensive team approach to radiation treatment

G

BMC’s Department of Radiation Oncology, part of the Sandra & Malcolm Berman Cancer Institute at GBMC, offers cancer patients the most advanced, precise treatment techniques available, delivering effective results with minimal side effects. Three board-certified radiation oncologists provide years of experience treating patients with a variety of cancers. Every new patient is assigned a team of experts including radiation oncologists, radiation therapists, oncology-certified nurses, dosimetrists and physicists who work together to develop an effective treatment plan, ensuring each patient has the best chance for a successful recovery. Since timing is everything in cancer treatment, appointments are made quickly, usually within 48 hours.

Above: The CT simulator is an important tool for treatment planning because it provides the most exact image of the tumor site, a comprehensive field of view and it replicates the actual delivery of radiation.

Using Precise Technology to Limit Side Effects for Breast Cancer Patients

R

adiation therapy is a crucial component of treatment plans for many types of cancer. Breast cancer is no exception.

Using a state-of-the-art CT simulator, physicians are able to generate an exact image of a tumor and replicate the actual delivery of radiation. This precise image, along with other data compiled by the simulator, leads to a sophisticated, threedimensional conformal radiation treatment plan for each breast cancer patient in which each radiation beam is shaped to fit the profile of the target.

Below: After completing radiation therapy, patients look forward to ringing this bell, which hangs near the treatment rooms, as a celebration of life.

“Because we’re able to so accurately plan and deliver doses of radiation, we’re able to reduce damage to surrounding tissue and vital organs, such as the heart,” says Albert Blumberg, MD, Vice Chairman, Radiation Oncology. “Patients receiving treatment now have a lower risk for heart attack down the road because they will have received less radiation to normal tissues.”

Albert Blumberg, MD

“Additionally, radiation therapy for breast cancer patients used to have a higher chance of significant cosmetic effects,” says Dr. Blumberg. “Today’s treatments use a more homogenous dose distribution, so it has less effect on the skin. The most common side effects are minor redness, itching and irritation. Now the trauma of a breast cancer diagnosis doesn’t have to go hand-in-hand with the trauma of disease treatment.”

New Technology Reduces Head and Neck Cancer Treatment Time and Side Effects by Half

I

n the past, head and neck cancer patients undergoing radiation therapy had to endure a long list of unpleasant side effects including chronic dry Geoffrey Neuner, MD mouth, difficulty swallowing months to years after treatment, loss of taste and tooth decay, to name a few. With so many critical structures located in a confined space, it was nearly impossible to deliver radiation to tissues affected by cancer without damaging a healthy area. However, due to the advances in technology in recent years, patients are now significantly less likely to experience such long-term side effects from their radiation treatments. With a hybrid therapy of surgery to physically move the salivary glands, along with volumetric-modulated arc therapy enhanced with Image-Guided Radiation Therapy (IGRT), radiation oncologists

To learn more, visit www.gbmc.org/radiationoncology

Also, in the not so distant past, head and neck cancer patients needed to endure long, grueling treatments requiring them to stay perfectly still for up to 45 minutes.

The introduction of RapidArc® treatment planning to GBMC’s Radiation Oncology Department in 2009 has allowed for treatment times to be reduced to as few as five minutes. RapidArc uses volumetric-modulated arc therapy to deliver precise radiation directly to the tumor while sparing important surrounding structures critical to a patient’s long-term quality of life.

“On-board imaging capabilities and RapidArc planning help us to plan and deliver radiation as precisely as possible, minimizing the damage to surrounding tissue,” notes Dr. Neuner. “With this technology, we have achieved our long sought after goal of treating tumors with tight safety margins (within two to three millimeters) while sparing salivary glands and the muscles responsible for swallowing. This undoubtedly reduces

GBMC’s RapidArc linear accelerator targets a tumor site with pinpoint accuracy.

long-term side effects in patients, and improves their quality of life beyond cancer treatment.”

Radiation has Advantages over Surgery for Prostate Cancer Treatment

I

mproved technology has also made a difference in the treatment of men with prostate cancer.

A diagnosis of prostate cancer used to mean a host of lifealtering side Robert Brookland, MD effects, but the side effects of radiation treatment for the disease have become greatly reduced over the past 10 years.

When a man is diagnosed with prostate cancer at GBMC, he is categorized into one of five risk categories: Very High, High, Medium, Low or Very Low. This risk is determined from the patient’s prostate-specific antigen (PSA) level, cancer stage and the microscopic appearance of the cancer.

From the control room, a radiation therapist monitors her patient, who is undergoing treatment in the RapidArc linear accelerator.

like Geoffrey Neuner, MD, can now offer head and neck patients a better quality of life after treatment.

“The course of treatment for each patient depends on the risk that we assign to him,” says Robert Brookland, MD,

Chairman, Radiation Oncology. “Some men who are considered very low risk might not require immediate treatment and instead may only be under active surveillance to monitor the cells, while other patients may need surgery or treatments with radiation.”

An alternative or complement to daily radiation therapy is brachytherapy, which has become very popular in recent years for prostate cancer patients.

Brachytherapy uses radioactive seeds that are implanted into the prostate and gradually release a very high dose of radiation to “Brachytherapy, or implantation the cancer over Contrary to of radioactive seeds, may be popular belief, the next several an alternative or complement radiation months. For treatment to daily radiation therapy for implantation, typically has prostate cancer patients.” patients are fewer side effects —Robert Brookland, MD anesthetized for the patient and, following as compared to surgery. Because of the an ultrasound study of the prostate, precision of the conformal Intensitya computer program assists in Modulated Radiation Therapy (IMRT) determining the precise number and beams and the ability to make daily location for seed placement. The seeds adjustments to the target, radiation are then inserted by needles into has less effect on surrounding tissues the gland using a minimally invasive than when using older technologies. technique and will remain there for the This causes fewer incidences of rest of the patient’s lifetime, although impotence and incontinence than they stop giving off radiation after about surgical interventions. Treatment is a year. typically delivered in a 15-minute or less outpatient procedure, allowing patients to keep up with their normal routines, such as working full time.

To learn more, visit www.gbmc.org/radiationoncology

Treating Delicate Gynecologic Cancer

“O

ne of the great strengths of our program is the multidisciplinary approach that each patient’s care receives,” says Dr. Brookland. Fighting gynecologic cancer requires a team of experts. That’s why, several times a month, GBMC gynecologic, medical and radiation oncologists convene with the pathologists to review their cases and strategically plan optimal treatments to ensure each patient has the best chance for recovery.

Dr. Albert Blumberg shows a patient images from her scan in the CT simulator.

Radiation therapy is often a critical part of a patient’s treatment plan; however, treating gynecologic cancers in this manner is a delicate process due to the potential for damage to surrounding structures. Brachytherapy, the placement of radioactive material into the center of the cancer-bearing area, makes radiation treatment safer, more convenient and highly effective. Unlike treatment for patients with prostate cancer, these radiation sources are only temporarily in place.

Brachytherapy previously required a hospital stay of several days in order for physicians to insert an applicator into the vagina which would slowly administer low doses of radiation. Gynecologic cancer patients are now able to receive brachytherapy in as few as 10 minutes. Although the radiation is in higher doses, the side effects are minimal. Patients may experience mild urinary, rectal and vaginal irritation.

New Surface Brachytherapy Option Available for Skin Cancer Patients

F

or some skin cancer patients at GBMC, a new method for receiving radiation therapy treatments is available. The Radiation Oncology Department is now home to a piece of equipment capable of delivering brachytherapy directly to non-melanoma skin cancer (NMSC) tumors. This treatment may be considered as an alternative to surgery or standard external beam radiation in certain instances, or as a complement to a necessary surgical procedure. “Delivering brachytherapy via the microSelectron® Digital afterloader high dose rate (HDR) unit allows us to apply surface radiation with precision so that we can spare healthy tissue surrounding the tumor. This often means the patient can expect a shorter recovery time and excellent cosmetic results,” notes Dr. Blumberg.

Radiation Oncology at GBMC: A student in the Radiation Oncology Department demonstrates how the microSelectron Digital afterloader HDR unit is used.

To learn more about Radiation Oncology at GBMC, visit www.gbmc.org/radiationoncology. Or, GO MOBILE and get more information by snapping this tag with your smartphone.

Focus is produced by GBMC’s Marketing Department for the medical community of GBMC.

FSC LOGO

Offering Comprehensive and Precise Treatments for Cancer Patients to Minimize Side Effects