Treatment

Brachytherapy is a type of radiation therapy used to treat:

• Prostate cancer
• Cervical cancer
• Endometrial cancers

Unlike external beam therapy, in which high-energy x-ray beams generated by a machine are directed at the tumor from outside the body, brachytherapy involves placing a radioactive material directly inside the body. The seeds are carefully placed inside of the cancerous tissue and positioned in a manner that will attack the cancer most efficiently.

Brachytherapy allows a physician to use a higher total dose of radiation to treat a smaller area and in a shorter time than is possible with external radiation treatment.

In temporary brachytherapy, the radioactive material is placed inside or near a tumor for a specific amount of time and then withdrawn. Temporary brachytherapy can be administered at a low-dose rate or high-dose rate.

Permanent brachytherapy, also called seed implantation, involves placing radioactive seeds or pellets (about the size of a grain of rice) in or near the tumor and leaving them there permanently. After several weeks or months, the radioactivity level of the implants eventually diminishes to nothing. The seeds then remain in the body, with no lasting effect on the patient.

A linear accelerator (LINAC) is the device most commonly used for external beam radiation treatments for patients with cancer. It delivers a uniform dose of high-energy x-ray to the region of the patient's tumor. These x-rays can destroy the cancer cells while sparing the surrounding normal tissue.

The Varian Trilogy is the most advanced, sophisticated radiation machine of its type in use today. It is so precise that it can deliver a beam within one-millimeter accuracy. It is the world's first image-guided radiation therapy system to deliver all forms of external-beam radiation therapy. There are only 54 of these machines in the world, and the Cancer Partnership has one of them.

The Trilogy provides physicians with advanced imaging capabilities. Because the machine is so precise, it allows physicians to deliver very high doses of radiation with precise accuracy, and spare patients' healthy tissue. It is also 60 percent faster than conventional machines, which reduces the effect of tumor motion, shortens treatment times and improves patient comfort. The system can deliver radiation treatment so many different ways that the choice of treatment technique can be customized for each patient.

Positron emission tomography, also called PET, and computed tomography (CT) are diagnostic imaging methods used to find and assess tumors inside the body, and evaluate how a patient is responding to treatment. The GE Discovery PET/CT scanner blends both into one—a single, full-body scan generates two sets of images, which are fused to show a patient's anatomy and any hot spots of suspected cancer. It also can be used with radiation therapy equipment for treatments.

The GE Discovery PET/CT scanner is a new breakthrough in technology and helps physicians see and treat cancer faster than ever before with increased accuracy. It also provides patients with a more accurate diagnose, reduces exam times—results can be obtained within an hour—and can potential reduce invasive procedures such as biopsies and unnecessary surgeries for detection.

TomoTherapy is a new way to deliver radiation treatment for cancer. It delivers a very sophisticated form of intensity-modulated radiotherapy (IMRT), and combines treatment planning, CT image-guided patient positioning, and treatment delivery into one integrated system.

The radiation treatment is delivered similar to the way a CT obtains an image, by continually rotating around a patient. However, it's not only capturing an image, but delivering a highly focused, intense beam of radiation to the cancer target area from multiple angles. TomoTherapy assists physicians in developing highly precise treatment plans with minimized side effects for patients.

The Cancer Partnership's new TomoTherapy machine is one of only 120 in the world.

This new technology is adaptive, and allows physicians to adjust and customize the size, shape, and intensity of the radiation beam to target the radiation to the size, shape, and location of the patient's tumor. This benefits the patient by minimizing radiation exposure to healthy tissue. New images are also created every time the patient is treated to help guide treatment based on patient anatomy for that day, rather than for last week or last month.

Patients who need surgery for treatment of lung cancer and other pulmonary diseases now have a minimally invasive alternative to traditional open thoracic surgery called Video Assisted Thoracoscopic Surgery (VATS) at Providence Regional.

VATS is performed by thoracic surgeons for biopsies and other small procedures, as well as for removing cancer in the lung (lobectomies). Using a tiny camera and surgical instruments inserted through a few small incisions, VATS gives the surgeon a clear view inside the patient's chest.

Because only small incisions are needed, VATS patients typically recover more quickly and with significantly less discomfort and scarring compared to traditional open thoracic surgery. And, since the recovery is less painful and shorter after VATS than traditional surgery, most patients who need chemotherapy can start it sooner.