Radiation Oncology
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At CTCA at Southwestern Regional Medical Center (Southwestern) we fight cancer with advanced treatments, including innovative forms of radiation therapy.
The formation of Southwestern’s Radiation Oncology Department began in 1992 with the addition of radiation oncologist Dr. James Flynn, who serves as Southwestern’s Chief of Staff and National Clinical Director of Oncology Services for CTCA.
The Department includes radiation oncologists, physicists, dosimetrists, nurses and radiation therapists. If radiation therapy is part of your treatment plan, they will work closely with the other members of your care team, including medical and surgical oncologists.
Your care team also includes clinicians from other disciplines, such as naturopathic medicine, nutrition and mind-body medicine, to help reduce treatment-related side effects and improve your quality of life. Your entire care team is here to answer your questions and support you throughout the treatment process.
Radiation Therapies at Southwestern
Southwestern offers several types of radiation therapy, including, but not limited to, the following:
- Accelerated Partial Breast Irradiation (APBI)
- Calypso® 4D Localization System™
- CyberKnife® VSI™ Robotic Radiosurgery System
- Deep Tissue Hyperthermia
- External Beam Radiation Therapy (EBRT)
- High-Dose Rate (HDR) Brachytherapy
- Local Hyperthermia
- Intensity Modulated Radiation Therapy (IMRT)
- Intraoperative Radiation Therapy (IORT)
- MammoSite® Radiation Therapy System (RTS)
- RapidArc®
- TheraSphere®
- 3D Conformal Radiation Therapy
- TomoTherapy® HI- ART
Innovative Radiation Therapies
Accelerated Partial Breast Irradiation
Another radiation therapy used to treat breast cancer at Southwestern, Accelerated Partial Breast Irradiation (APBI). APBI is a 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 is TomoTherapy®.
Calypso® 4D Localization System™
The Calypso® 4D Localization System™, also known as GPS for the Body®, provides real-time, continuous target localization and tracking by means of implanting electromagnetic beacon transponders. The transponders may help to increase the accuracy of radiation and reduce exposure to adjacent normal tissues.
The Calypso system is currently being offered at Southwestern to treat prostate cancer, with the potential to greatly minimize side effects like incontinence and erectile dysfunction. In addition, interventional pulmonologist Dr. Daniel Nader is currently conducting a research study of the Calypso system for the treatment of lung cancer.
CyberKnife® VSI™ Robotic Radiosurgery System
In July 2012, Southwestern introduced the CyberKnife® VSI™ Robotic Radiosurgery System, the lastest version of the CyberKnife technology, and a non-invasive alternative to cancer surgery.
The CyberKnife VSI System enables our radiation oncologists to deliver high doses of radiation with pinpoint accuracy to a broad range of tumors throughout the body, including the brain, spine, lungs, prostate, liver, pancreas and kidneys.
Deep Tissue Hyperthermia
In January 2011, Southwestern became the third hospital in the country to offer the BSD- 2000 Deep Regional Hyperthermia technology.
The machine, which is part of a national investigational research study, delivers deep tissue hyperthermia, an innovative therapy that uses heat to treat cancerous tumors deep within the body.
Our doctors are using deep tissue hyperthermia in conjunction with radiation therapy for certain locally advanced, persistent or recurrent deep tumors of the pelvic area, including the cervix, prostate, rectum and bladder.
The hospital is currently screening patients for their eligibility to participate in this clinical study, which is being led by principal investigator and radiation oncologist Dr. Michael Payne.
HDR Brachytherapy
Video: HDR Brachytherapy
HDR BrachytherapyAnother cancer treatment the hospital is known for is High-Dose Rate (HDR) brachytherapy, in particular, for the treatment of prostate, breast and lung cancers.
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.
Intraoperative Radiation Therapy (IORT)
In 2011, Southwestern became the second hospital in the nation to offer the Novac™ 7 Intraoperative Radiation Therapy (IORT). This machine delivers a concentrated beam of radiation directly to a tumor bed immediately after the tumor is surgically removed. This helps to increase the dose of radiation that can be given, shield the surrounding healthy tissue, and lessen the number of radiation treatments needed.
IORT may be used alone, or in combination with other therapies, to treat patients with a variety of cancer types, including but not limited to: breast, cervical, colorectal, head and neck, ovarian, pancreatic, and soft tissue sarcoma.
TheraSphere®
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. TheraSphere® may be 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 occur and/or 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, which is FDA approved as a Humanitarian Device, can be recommended, patients must undergo a series of tests to see if they are candidates for this therapy.
TomoTherapy® HI-ART
Southwestern is one of only a handful of hospitals in the United States with two TomoTherapy® units. TomoTherapy is an advanced form of Intensity Modulated Radiation Therapy (IMRT). Southwestern started offering IMRT treatment in 1998.
TomoTherapy® Highly Integrated Adaptive Radiotherapy (HI-ART) allows our radiation therapists to focus radiation directly on the tumor, while keeping it away from healthy, surrounding organs.
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 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.
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 helpful for the retreatment of tumors, with minimal side effects.
Communication Among Your Care Team Members
At CTCA, physicists (such as Dr. Sen, pictured above) are
integral to planning and delivering your radiation
treatment.
Your care team will work together to coordinate your radiation treatments alongside your other cancer treatments.
Dr. Flynn emphasizes the importance of communication among your care team members, “We meet every day 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.”
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."
