Radiation Oncology

By Dr. Chitti Moorthy

In recent years, Radiation Oncology has made great strides in cancer treatment. Alone or in combination with other treatments, radiation therapy is dramatically raising cancer cure rates. Leading medical centers provide state-of-the-art radiation therapy in a comfortable and caring environment.

CLINICAL TREATMENT

The word "oncology" refers to the study and treatment of tumors. Radiation oncology utilizes X-rays and other forms of radiant or particulate energy for the treatment of cancer. The amount of radiation is precisely measured and targeted to the tumor, and the duration of application is closely controlled.
Radiation therapy is one of the three major forms of treatment for cancer, the other two being surgery and chemotherapy or drug therapy, Radiation may be used alone or in combination with one or both of the other modalities, and is dramatically improving cancer cure rates. Approximately 60 percent of cancer patients receive some form of radiation therapy during the course of their cancer treatment.
Physicians and physicists like those at Westchester Medical Center are leading the way in the development of 3D conformal treatment planning. Using a sophisticated computer program including data from the patient's CT or MRI scan, they develop an individual treatment plan to conform the distribution of radiation exactly to the dimensions of the patient's tumor. In so doing, they can deliver the precisely calculated dosages that will most effectively fight the cancer.

There are two forms of radiation therapy:

In external beam therapy, X-rays or electron beams are directed at the tumor from outside the body using a machine called a linear accelerator.
In brachytherapy, radioactive pellets are introduced directly into the body, next to or inside the tumor, and are used for higher-intensity applications to small areas.
Depending on the needs of the patient, this may be done in one of two ways. The material is sent by remote control through a catheter or thin tube and then withdrawn, or it is implanted during a minor surgical procedure.

TECHNOLOGIES ARE TAILORED TO TREAT ALL TYPES OF CANCER
Be confident that teams of radiation oncologists, technologists, physicists and nurses have trained at major cancer centers throughout the country and work together to develop and deliver a treatment plan that is customized to your unique needs.
TREATMENT PLANNING
CT Scan Simulator
A stimulator with CT scanner precisely outlines the target for radiation in preparation for treatment. This imaging equipment is designed to permit accurate visualization of the target area (tumor and its surrounding normal physical structures) in three dimensions. This enables planning for radiation treatments with the highest precision while sparing healthy tissues from unnecessary exposure.

3-Dimensional Treatment Planning
3-Dimensional Conformal Treatment Planning utilizes sophisticated computer programs, which integrate data from the CT scans and MRI scans to develop a plan that directs radiation delivery with precision.

PROTECTIVE STRATEGIES
Special Positioning and Immobilization Devices guarantee radiation delivery to the "same exact spot" for each treatment.
Custom-designed Blocks or Shields positioned in the path of the radiation beam spare healthy tissues from radiation exposure.
Multi-Leaf Collimator (MLC-device) utilizes a computer-controlled, automatic blocking system.

TREATMENT ACCURACY
Treatment Verification Network (TVN) permits a continuous, real-time and fail-safe monitoring to ensure accurate treatment delivery.
Specialized dose monitoring devices ensure safe and accurate delivery of the prescribed radiation dosages at all times.

TREATMENT DELIVERY
Two high energy linear accelerators to deliver external radiation using:
Photon beams (high energy x-rays) to treat tumors located deep within the body, such as cancers of the breast, prostate, lung, bowel, cervix and others.
• Electron beams to treat tumors on the surface of the body such as cancers of the skin, breast, head and neck and superficial lymphomas.
3-Dimensional Conformal Radiation Therapy (3-D CRT)
3-D CRT is achieved by a unique computer-driven device called a multileaf collimator (MLC). This device directs radiation beams precisely, conforming to the shape of the tumor, allowing the maximum amount of radiation required to control the tumor without exposing normal tissue to high doses of radiation.

Brachytherapy - High-Dose Rate (HDR)
A robot-like unit provides rapid delivery of high doses internally, directly to the tumor. Performed on an outpatient basis, HDR is commonly used for gynecological, lung, esophageal, digestive system, head and neck, skin and soft tissue cancers.

Brachytherapy - Low-Dose Rate
Internal radiation delivered by radiation "seed" implants, used at Westchester Medical Center for over 20 years, in the treatment of gynecological, prostate, lung, brain, pancreas, head and neck and other cancers.

Hyperthermia (only facility in the region)
Treatment with heat (increasing the temperature within the tumor) combined with radiation to enhance control of tumors resistant to radiation or those that have recurred after conventional treatments.

Stereotactic Radiosurgery
Also known as "knifeless" surgery, this technology is used to treat brain tumors using laser-thin beams of high-dose radiation focused precisely on the tumor masses in the brain, avoiding normal brain tissue.

Systemic Radiation Therapy

Total Body Irradiation (TBI) and Total Lymph Node Irradiation (TLI) or Total Skin Electron Beam (TSEB) are techniques used to deliver radiation to the whole body for specialized treatment of lymphomas and leukemias (TBI or TLI) or to the whole skin for lymphomas of the skin (TSEB).

Radioisotope Therapy
Delivered by injection of radiation isotopes to target cancer cells through out the body systems (eg: spread of cancer to bone, to the lining of the lungs and abdomen etc.)

Novalls Body Radiosurgery & Intensity Modulated Radiation Therapy (IMRT)
This new technology applies the stereotactic approach to cancers in all parts of the body.

PATIENT / FAMILY SUPPORT GROUPS
People Helping People is a support group co-facilitated by certified oncology nurses and social workers with special expertise in assisting individuals dealing with the crisis of cancer. Patients, families and friends of the patients, from Westchester Medical Center and other institutions, meet weekly to share their experiences, issues and concerns associated with life with cancer and benefit from mutual support. Guest speakers are invited to speak about a wide range of topics of interest to the group.

RESEARCH
New treatment modalities and programs resulting from the research are made available to patients through the protocols designed by our physicians and sponsored by national cancer research groups, such as the National Cancer Institute, Radiation Therapy Oncology Group, Children's Cancer Study Group and other cooperative groups.