Radiation Oncology

Radiation oncology (radiotherapy/radiation therapy) is a medical specialty that is an essential part of a multidisciplinary approach to cancer treatment. Radiation therapy uses x-rays or other high-energy types of radiation to kill cancer cells and shrink tumors. Radiation therapy can be a stand-alone treatment or may be paired with chemotherapy and/or surgery.

A radiation oncologist (doctor) has special training and experience designing radiation treatment plans to provide patients with the best radiation treatment possible. A certified oncology registered nurse assists the radiation oncologist to provide supportive care and coordinate treatment plans with other cancer specialists on the patient’s care team.

The radiation oncology team includes highly trained, licensed, certified, and experienced staff to provide accurate and safe radiation treatment for cancer patients. The team includes the Radiation Oncologist (doctor), Registered Nurse, Medical Physicist, Certified Medical Dosimetrist, and Radiation Therapists.

Before a patient’s first treatment, the Radiation Oncologist meets with the patient to determine what kind of radiation will be most effective. After that, a Radiation Therapist will complete a CT Simulation procedure on the patient to help the other radiation team members create a precise plan for the treatment.

Additional care team members include a Licensed Certified Social Worker, Registered Dietician, Nurse Navigator and others as needed.

How Does Radiation Therapy Work?
Radiation therapy, or radiotherapy, is the use of various forms of radiation to safely and effectively treat cancer and other diseases. Radiation therapy works by damaging the genetic material within cancer cells. Once this happens, the cancer cells are not able to grow and spread. When these damaged cancer cells die, the body naturally removes them. Normal cells are also affected by radiation, but they are able to repair themselves in a way that cancer cells cannot as effectively.

Your radiation oncologist will develop a plan to deliver the radiation to the affected area or tumor, shielding as much surrounding normal tissue as possible.

Your radiation oncologist may recommend using radiation therapy in a number of different ways. 
When the goal is to cure the cancer, radiation therapy may be used to: 

• Eliminate tumors
• Reduce the risk that cancer will return after you undergo surgery or chemotherapy by killing cancer cells that might remain
• Shrink the tumor before surgery

Radiation Treatment:

• A high-precision TrueBeam® radiotherapy system (treatment machine) is used to deliver external beam radiation therapy.  This treatment utilizes special features to protect healthy, non-cancerous tissue while maximizing the radiation dose delivered.
• Dedicated CT Simulator – A dedicated CT scanner allows the physician to the exact place on your body through which the treatments will be aimed.

External Beam Radiation Therapy
During external beam radiation therapy, a beam (or multiple beams) of radiation is directed from the outside of the body to the site of the cancer and the immediate surrounding area to destroy the tumor and any nearby cancer cells. If the cancer has been removed or reduced by surgery or chemotherapy before radiation therapy, the target will be the tissues surrounding the location of the tumor at diagnosis.

To minimize side effects, the treatments are typically given five days a week, Monday through Friday, for a pre-determined number of days or weeks. This allows doctors to give small daily doses of radiation that build up to enough radiation to kill the cancer while giving healthy cells time to recover. In certain cases, we can also use slightly higher doses of radiation to safely complete the treatment in a shorter period of time. This is called hypofractionation.

• Three-Dimensional Conformal Radiation Therapy (3-D CRT) 
  • Tumors are not all the same; they come in different shapes and sizes. Also, every patient’s body is unique. Three-dimensional conformal radiation therapy is a planning technique using computers and special imaging such as CT, MR or PET scans to show the size, shape and location of the tumor as well as surrounding organs. Your radiation oncologist can then precisely tailor the radiation beams to the size and shape of your tumor with special shielding. Because the radiation beams are carefully targeted, nearby normal tissue receives less radiation and is then able to heal better.
• Intensity Modulated Radiation Therapy (IMRT)
  • ​Intensity modulated radiation therapy is a more complex treatment planning technique that allows radiation to be specifically shaped to cover the tumor and potentially spare more normal tissue than 3-D CRT. With IMRT, the radiation beam is broken up into many “beamlets,” and the intensity of each beamlet can be adjusted individually.
• Image Guided Radiation Therapy (IGRT) 
  • IGRT involves radiation treatment guided by imaging taken in the treatment room just before or during each radiation treatment. Because tumors can move between or during treatments, due to differences in organ filling or natural movements while breathing, allows for better targeting of tumors. 
• Stereotactic Body Radiation Therapy (SBRT)
  • SBRT radiotherapy is a specialized technique that allows your radiation oncologist to use extremely focused beams of radiation to destroy certain types of tumors using higher doses than with daily lower dose radiation treatments. Since the beam is so precise, your radiation oncologist may be able to spare more healthy tissue. In selected cases, stereotactic treatments can be used to re-treat tumors that have previously received radiation.
  • Often used to treat tumors in the lungs, spine, prostate, pancreas, adrenal glands or liver, SBRT may allow radiation to be given in a way that is safer and more effective than other radiation techniques. Because specialized treatments with stereotactic radiation are often given at much higher doses than daily radiation treatment, additional precision and quality assurance are necessary. This involves using very secure immobilization of the head or body as well as using techniques that allow the radiation beam to account for organ motion during treatment. 
• Brachytherapy
  • This involves placing radioactive sources (such as radioactive seeds or a highly radioactive source) in or near the tumor. 
  • We do not offer this type of radiation treatment, but if it is determined that brachytherapy is best, we will collaborate with another radiation department such as Deaconess Gateway in Evansville, Indiana, to coordinate your care.