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Spring 2006 Radiating ExcellenceAAMC’s Radiation Oncology services are under one roof, highly personalized, and state-of-the-art.
Radiation oncologists Mary Young, M.D., (L) and Ashish
Chawla, M.D., (R) pose with Dr. Linda Ferris, executive
director of the DeCesaris Cancer Institute, with the High
Dose Rate (HDR) radiation equipment. HDR is one of several
treatment options available in AAMC's Radiation
Oncology Department, where state of the art equipment
gives patients the best outcomes possible.Not so long ago, when a cancer was labeled inoperable, it was often the same as calling it untreatable. Today, thanks to a series of dramatic advances in radiation therapy technology, fewer and fewer cancers are beyond the reach of the radiation beams that attack and destroy cancer cells. Used alone or in combination with either surgery or chemotherapy, these advances offer patients an array of new and encouraging treatment options. In the past, when cancer cells were embedded deep within other normal tissues, or located in a part of the body that made them a moving target (lung or prostate cancer), radiation to wide areas had to be performed, necessitating treatment to large areas of normal tissue. This increases the toxicity of the treatment and can limit the total dose given to the patient. Many recent advances in radiation therapy involve technology that solves those problems. In conjunction with imaging systems that can determine the location, size, and shape of a tumor with great accuracy, radiation now can be delivered with greater precision to the tumor and thereby minimize damage to the surrounding tissue. Meeting of the minds at case conferences Radiation therapy is often employed in tandem with surgery or chemotherapy. Radiation Oncologist Mary Young, M.D., described the interaction she and other radiation oncologists have with doctors from the other cancer disciplines and how their collaboration produces a team approach. “Whenever a case has special characteristics,” she said, “it is presented to a group of doctors who gather for case conferences held either weekly or bi-weekly. Because our approach to each case is so personalized and involves a number of specialists, a large percentage of cases come before other specialists at case conferences.” Case conferences include medical oncologists, surgeons, pathologists, radiation oncologists, radiologists, and other healthcare specialists, all of whom contribute to a consensus recommendation. Nurse navigators help patients manage the process The technology involved in the treatment, the terminology, and the disease itself all combine to make cancer a profoundly stressful experience. The physicians at the DeCesaris Cancer Institute have designed a care environment that takes into account the emotional as well as the physical stresses of the disease. At Anne Arundel Medical Center’s DeCesaris Cancer Institute, education and personal communication with the patient are top priorities. Dr. Young said, “We have a long and very detailed discussion with our patients about what the radiation therapy options are and the advantages and disadvantages of each. What comes out of those meetings is a treatment plan. The more informed and involved our patients are with those plans, the better.” Nurse navigators act as guides, facilitators, and communicators. As they help patients and family sort through the complexities of treatment, they are also the information links between the primary care doctor and specialists. Linda Ferris, PH.D., executive director of the Cancer Institute at AAMC, said the conveniences and personalized care patients find at AAMC can make a difficult time a little less so. “Radiation therapy may well involve multiple visits,” she said. “Patients who come here for their therapy discover that our technology not only is leading edge, but that it’s all in one building with a valet parking stand right in front of it. We can’t turn back the clock on the fact of their cancer, but we can do a great deal to treat it with world class care while we make their lives a little easier.” For more information about AAMC’s Cancer Institute, call askAAMC at 443-481-4000, toll-free at 1-800-MD NURSE, or simply visit www. askAAMC.org Radiation Therapy 101Below are thumbnail descriptions of radiation therapies and how they apply to various forms of cancer. This should be considered only a very basic overview. Find more detailed information and descriptions by visiting askAAMC.org, choosing the “Cancer” tab on the main page and then clicking on the Radiation Oncology link. HIGH DOSE RATE BRACHYTHERAPY—Used in the treatment of lung, gynecological and breast cancers, High Dose Rate Brachytherapy involves the computer-guided placement of radioactive seeds that can deliver high doses of radiation to a limited area. The seeds are placed inside a hollow tube adjacent to the tumor and are left in place for only a short time. High Dose Rate Brachytherapy has the advantage of reducing the time of treatment from weeks to days. LOW DOSE RATE BRACHYTHERAPY—The same basic principle as above but with a less concentrated dose. The radioactive “seeds” are placed directly into the tumor site and left in place for an extended period or permanently. Used in the treatment of prostate cancer. STEREOTACTIC RADIOSURGERY—SRS is used for treating cancers of the brain and spine; 3-D images of a tumor illustrate its exact size, shape and location, which are then translated into instructions that guide the precise delivery of radiation beams to the tumor. INTENSITY MODULATED RADIATION THERAPY—Typically used to treat cancers of the head and neck, and prostate. This technology can modulate or change the intensity of the radiation being delivered during treatments. This allows the doctor to conform or “shape” the beam to spare critical surrounding structures such as the rectum or spinal cord. IMAGE-GUIDED RADIATION THERAPY—IGRT is a radiographic technology that visualizes the tumor immediately prior to daily treatment to ensure the accuracy of treatment. This allows for more restricted treatment fields to reduce side effects without compromising treating the target tissue. RESPIRATORY GATING—Refers to software used to map the movement of a tumor through a “window” as a patient breathes. The beams of radiation are aimed and timed to cover the tumor when it moves into the treatment window sparing surrounding healthy tissue. Used in the treatment of lung cancer. |
