Radiation Oncology

At Cancer Treatment Centers of America (CTCA), we fight cancer—every day—with conventional medicine such as radiation. Furthermore, we do so with innovation, experience, constant communication and endless compassion.

Innovative Cancer Treatment

CTCA at Southwestern Regional Medical Center is one of only a handful of hospitals in the entire United States with two TomoTherapy^® units. Furthermore, it is the only hospital in Tulsa, Oklahoma that offers TomoTherapy^®.*

Our radiation oncologists believe that TomoTherapy^® Highly Integrated Adaptive Radiotherapy (HI-ART) is defining the future of radiation. It allows them to focus the radiation directly on the tumor, while keeping it away from healthy, surrounding organs.

TomoTherapy^® may be used to treat patients with tumors located in difficult-to-treat areas, such as the lungs, head and neck. Because of its pinpoint accuracy, this radiation therapy is also proving helpful for safe retreatment of tumors with minimal side effects.

TomoTherapy^® is an advanced form of Intensity Modulated Radiation Therapy (IMRT). According to Dr. Douglas Kelly, CTCA is years ahead of many hospitals when it comes to using IMRT, the predominant form of radiation treatment provided at Southwestern Regional Medical Center. We started IMRT treatment in 1998.

Chief Medical Physicist Dr. Amarjit Sen notes, “What distinguishes TomoTherapy^® from standard IMRT is that it uses IGRT—Image Guided Radiation Therapy.”

Dr. Sen explains that this means each TomoTherapy^® HI-ART System^® has imaging capabilities built into it. Every time a patient obtains TomoTherapy^® treatment, he or she first receives a MVCT (Megavoltage CT) scan from the same machine. Minutes after the MVCT scan is taken, radiation therapists match the MVCT images with the existing, treatment planning CT images on the console computer to determine the parameters necessary for accurately positioning the patient. This allows the system to accurately align the programmed radiation treatment to the precise position of the patient. The MVCT images allow for optimal alignment, so that each time patients receive the radiation exactly where they are supposed to.

Another cancer treatment Dr. Kelly says the hospital is known for is High-Dose Rate (HDR) brachytherapy, in particular, for the treatment of prostate, breast and lung cancers.

“With brachytherapy, we put radioactive pellets right in the tumor itself, so that we’re radiating the tumor from the inside out,” Dr. Kelly explains.

Dr. Kelly says HDR brachytherapy treatments only take a few minutes, because the radioactive seed implanted in the tumor is very intense. On the contrary, with low-dose rate brachytherapy, doctors have to put the seeds in the tumor for days.

“HDR brachytherapy is under a lot more computer control,” adds Dr. Kelly. “We put a catheter through the tumor, and then the computer can control where inside the catheter the little pellet will come to rest, and how long it will rest for. And if you have a series of catheters in the tumor, there’s even more computerization. Each catheter receives a different amount of time that the pellet stays in it. The pellet will rest in different spots in the catheter. So the computer can essentially create a nice, even dose for the tumor.”

Watch this Video of Dr. Kelly as he discusses some of the advanced treatments offered at CTCA. You may need to download flash player to view this video.

Dr. Kelly is also excited about another radiation therapy which is used to treat breast cancer, Accelerated Partial Breast Irradiation (APBI). APBI is a new way to administer radiation therapy to the breast after a lumpectomy.

With APBI, the radiation treatment is focused specifically on the part of the breast where the tumor was removed. This allows the radiation to be contained to the tumor cavity as much as possible, emitting less radiation to the nearby lungs, heart, ribs, muscles and skin.

Furthermore, this breast cancer treatment can be given in a more condensed schedule than some other radiation therapies for breast cancer. APBI allows breast cancer to be treated with radiation therapy in five days instead of six to seven weeks.

APBI treatments can be administered via brachytherapy or through external radiation beam techniques. The external beam radiation modality used at Southwestern Regional Medical Center is TomoTherapy^®.

In 2004, we also began to make TheraSphere^® available as a treatment for inoperable liver cancer. Drs. Brunk and Sen spearheaded this innovative offering at CTCA. To date, Southwestern Regional Medical Center is the only hospital in Oklahoma providing TheraSphere^® as an alternative to chemotherapy, external beam radiation and other common treatment modalities for liver cancer.**

This unique treatment, which consists of millions of microscopic glass beads containing radioactive Yttrium-90, may be used to treat cancers that metastasize to the liver (e.g., colorectal cancers that spread to the liver). The actual treatment procedure requires a radiation oncologist to inject a saline solution containing the tiny radioactive particles into the main artery of the liver through a catheter, which is inserted into the liver by an interventional radiologist using an angiographic procedure.

Before TheraSphere^® can be recommended, patients must undergo a series of tests to see if they are candidates for this therapy.

Experienced Cancer Treatment Providers

The formation of Southwestern’s Radiation Oncology Department began in 1992 with the addition of radiation oncologist Dr. James Flynn, who serves as Southwestern Regional Medical Center’s Chief of Staff and National Clinical Director of Oncology Services for CTCA. Dr. Kelly joined the team in 1996.

At CTCA, we are experienced in treating recurrent cancer. Dr. Kelly says for those patients being retreated, “We’ll do a PET scan to find out exactly where the cancer is, use TomoTherapy^® to hit it exactly and then we’ll give the patient radioprotective drugs in order to protect the healthy tissues from further damage from the radiation.”

Dr. Kelly says he is particularly proud of the number of patients with prostate cancer he has been able to treat with HDR brachytherapy. He says that over the past 10 years, the Radiation Oncology team has treated approximately 900 prostate cancer patients with HDR brachytherapy.

Southwestern Regional Medical Center offers three radiation treatments to fight prostate cancer: HDR brachytherapy, Intensity Modulated Radiation Therapy (IMRT) and a combination of both HDR and IMRT.

Dr. Kelly notes, "It's the combination treatment that we’ve done the most of because we find that with the combination you can end up with a higher total dose to the tumor, with quite reasonable side effects. It’s our most aggressive treatment for prostate cancer.”

Communication

A highly skilled team of cancer doctors, physicists, dosimetrists, nurses and radiation therapists coordinate your cancer treatment with precision and thoroughness. Keep in mind, your care team at CTCA also includes other doctors and specialists in complementary and alternative medicine (e.g., naturopathic practitioners, nutritionists) to make your treatment comprehensive.

Dr. Flynn emphasizes the importance of your care team’s communication, “We meet at least three times a week to discuss, in concert, each patient that is seen. That gives us an opportunity—everyone at those conferences—to say, ‘By the way, did you think of this? Did you see that article? Might we bring this to bear on this patient’s treatment?’ That, I feel, is the very best way to treat a patient.”

At CTCA, physicists (such as Dr. Sen, pictured above) are
integral to planning and delivering your radiation
treatment.

Dr. Sen emphasizes that close collaboration among staff is a key to the high standard of care provided at CTCA.

"It's very much a team effort,” says Sen. "The physician looks at the clinical side—diagnosing the disease and determining what he or she wants to treat the cancer with. Physicists and dosimetrists are then involved in the planning and execution of the radiation therapy delivery."

The medical physicists are very important members of your care team at CTCA. They study the location of your cancer and plan every precise angle and spot where the radiation needs to strike the tumor, or as the physicists call them, the “target.”

Another determination the physicists make, for a HDR brachytherapy treatment, for example, is how long the radiation pellets should stay in the tumor.

The medical physicists perform an important job of accurately calibrating the high-tech machines and maintaining them through a comprehensive, quality assurance program.

There are three medical physicists on staff at Southwestern Regional Medical Center:

• Amarjit Sen, PhD (Dr. Sen is also the Radiation Safety Officer for the hospital; he is certified by the American Board of Radiology.)
• Matthew K. West, PhD (He is certified by the American Board of Radiology.)
• Allen Movahed, PhD (He is certified by the American Board of Radiology.)
  

Compassionate Cancer Care

Our radiation therapists provide reassurance and
comforting guidance.

Patients at Southwestern Regional Medical Center have nothing but the highest regard for our radiation therapists, who are with them during their cancer treatment. They offer reassurance and comforting guidance, as they understand how intimidating it can be to undergo treatment.

Moreover, our physicians or physician assistants and nurses take time to meet with you each week during your cancer treatment. They make sure to answer every question you might have and help you feel at ease with the process.

Radiation Therapy at Southwestern Regional Medical Center

CTCA at Southwestern Regional Medical Center offers several types of radiation therapy, including

• External Beam Radiation Therapy
• Intensity Modulated Radiation Therapy (IMRT) (includes TomoTherapy^® HI-ART)
• High-Dose Rate (HDR) Brachytherapy
• TheraSphere^®
• MammoSite^® Radiation Therapy System (RTS)
• 3D Conformal Radiation Therapy

* TomoTherapy Incorporated. "TomoTherapy^® Treatment Centers." http://www.tomotherapy.com/index.php/centers/na (accessed 30 April 2007).

** MDS Nordion. “TheraSphere^® Treatment Centers."