In radiation therapy, high-energy x-rays are used to treat cancer, either by destroying the cancer cells or by making them unable to grow and divide.
In external radiation therapy, a machine called a linear accelerator is used to produce a beam of rays that is directed to the tumor or the part of your body that is being treated.
A team of skilled doctors, nurses, physicists, dosimetrists, and therapists plans and provides treatment designed especially for you.
A dietitian and a social worker are also available.
This team of health professionals is here to help you as you receive radiation therapy.
At your first visit with our Radiation Oncology Specialists
When you come for your first appointment, you will meet your nurse and doctor. They will review your records and x-rays, examine you, and explain why radiation treatments are recommended. Expect to spend about two hours during your first visit.
Be sure to bring or have your referring doctor send us the following information:
- Having these reports sent to us before your appointment will help the doctor in planning your care. It is also important to bring your insurance information. Financial counselors and billing staff will be available to answer any questions you might have about insurance coverage.
- Your radiation therapy will continue Monday through Friday for the number of treatments your doctor has prescribed. You will have the same appointment time each day and every effort will be made to start your treatment at the scheduled time. However, there are occasional delays due to emergency patients, technical problems, and other difficulties, and the schedule may need to be altered.
- You will see your doctor and nurse at least once a week while you are undergoing treatment. If you are having any problems, let us know when you come in for your treatment or call the department and your nurse will meet with you.
- Patients often ask if radiation therapy treatments can make them radioactive. We want to assure you that radiation therapy treatments do not pose this risk and that you should continue your normal activities with your family and friends.
- Simulation may take up to an hour. Afterward, you will make an appointment for your daily treatment time. While at home, do not use soap or lotion on the marks, unless you have the permanent dots. You may rinse your skin with water, if necessary, and pat it dry without removing the temporary marks. Your nurse will review skin care instructions.
Before you begin treatment, you will need to sign a consent form. This form lists possible side effects from radiation treatments and gives us your permission to treat you.
If you and your doctor decide to start radiation therapy, the next steps are simulation and treatment planning.
The EDGE™ Radiosurgery
CCS Healthcare is pleased to announce the first and only Edge radiosurgery system in WNY, available at our new Orchard Park location.
Many clinics worldwide have already adopted Edge technology to help advance the way cancer is treated.
Using technology designed for radiosurgical ablation, the Edge™ radiosurgery system represents an evolution in the way advanced radiosurgery is delivered.
The Edge™ radiosurgery system provides a turn-key solution for delivering full-body radiosurgery treatments with accuracy.
- Edge offers advanced tools designed to deliver highly conformal dose distributions to tumors of the lung, brain, spine, and other areas of the body where radiation is indicated.
One of the key aspects of radiosurgery is precision and accuracy. Edge radiosurgery tracks the patient’s tumor in real time for intracranial and extracranial treatments, precisely calculates patient movement in all six degrees of freedom, and monitors respiratory motion.
- It includes capabilities such as, high dose radiation delivery of up to 2400 monitor units per minute, a new bed that adjusts on six axes, and continuous correction of beam targeting every ten milliseconds. The 6 degree freedom couch allows for accurate patient positioning.
A growing body of clinical evidence is demonstrating the benefits of delivering high doses in a small number of fractions. Starting from classical neurosurgical targets, Stereotactic Radiosurgery (SRS) is progressing to treat targets previously not considered candidates for high-dose, hyprofractionated delivery.
The ability to accurately deliver targeted treatments and manage tumor motion is driving growth in radiosurgery.
A 108% increase in SRS utilization for brain cancer treatments is predicted over the next 10 years. SRS treatment volume is expected to grow 93% and Stereotactic Body Radiation Therapy (SBRT) volume is expected to grow 144% within the next 10 years. These numbers are suggestive of the high level of confidence that clinicians have in targeting tumors with precision.
Having the power to not only treat quickly, but to deliver high, accurate dose rates are hallmarks of the Edge system.
The TrueBeam STx
The TrueBeam™ STx system from Varian Medical Systems is a powerful noninvasive radiosurgery system that opens up treatment options for some of the most complex cancers in areas such as the lung, liver, kidney, pancreas, brain and spine. TrueBeam STx technology was developed from its inception to deliver cancer treatments with pinpoint accuracy and precision.
It works by choreographing highly sophisticated systems—imaging, beam delivery and motion control.
These allow your clinician to “see” the tumor they are about to treat and apply very accurate and precise beams of radiation to it while compensating for your movement.
TrueBeam STx is fast and powerful, with most treatments lasting only a few minutes.
TrueBeam STx enables many different types of radiosurgery, so doctors can choose the best form of treatment for your particular cancer.
- The system performs both stereotactic body radiotherapy (also known as SBRT) for treatments throughout the body and stereotactic radiosurgery (SRS) for treatments in the brain or central nervous system.
TrueBeam STx was also designed with your comfort in mind.
You can be in constant contact with the therapist running the system, thanks to an enhanced communications system that enables constant interaction between you and the therapist.
It’s almost as if they are there in the treatment room with you. Music can be played during the treatment, which can help create a more soothing treatment environment.
- TrueBeam STx gives medical professionals the tools to treat more challenging cancers such as cancers of the brain, spine, lung, liver, pancreas and prostate.
- With advanced imaging, the TrueBeam STx system allows clinicians to deliver treatment accurately by enabling them to “see” the tumor they treat and target tumors with submillimeter accuracy.
- Enhanced motion-management tools synchronize beam delivery with the tumor motion that occurs as you breathe in and out.
- TrueBeam STx was developed with an emphasis on your comfort.
Intensity Modulated Radiation Therapy (IMRT)
As with 3D conformal therapy, CT images of the patient’s anatomy are used to define the tumor volume and treatment area in three-dimensions.
And again, the physicians work with our certified medical dosimetrist to create an individualized treatment plan.
The difference between the techniques (IMRT and 3D Conformal) is that IMRT treatments use a device called a multi-leaf collimator (MLC) to mold the shape of the external beams to the shape of the tumor.
- Our MLC consists of 120 independently moving leaves the traverse the external beam treatment fields while the radiation is turned on.
Theses leaves accurately modulate, or change, the shape of the radiation dose being delivered to the treatment area.
As such, a higher dose can be precisely given to the tumor with drastically minimizing the dose to healthy tissue.
IMRT treatments are ideal for stationary tumors located near critical structures like eyes, heart, and spinal cord.
Typical IMRT treatment plans consist of multiple fields, each having a varying degree of rotation around the patient. For this type of therapy, the patient will undergo treatment 5 days a week for up to 9 weeks.
Image Guided Radiation Therapy (IGRT)
Image-Guided Radiation Therapy is a term used to define treatments that take advantage of daily patient imaging for enhanced tumor localization.
X-ray images of the treatment area are taken in the treatment room directly prior to plan delivery.
These newly acquired images are then analyzed against the pre-treatment CT images, by our physicians and certified radiologic technologists, to verify positioning of the tumor.
If any discrepancies in patient position are seen, corrections are made immediately to adjust for the differences prior to treatment.
As such, IGRT procedures greatly increase the accuracy of the radiation delivered by both 3D conformal or IMRT treatments.
Each of our offices have the capability of using MV portal images, kV orthogonal image pairs, or Cone-Beam CT (CBCT) images for enhanced tumor localization and patient positioning.
RapidArc: Volumetric Modulated Arc Therapy
RapidArc is a recent development in radiation therapy that sculpts a 3D dose distribution around the tumor in a shorter amount of time than conventional Intensity Modulated Radiation Therapy treatments.
In IMRT, thousands of tiny beams from several beam angles are used to target a tumor.
But with RapidArc, thousands of tiny beams from only one or two 360-degree rotations are used to target a tumor.
This process delivers treatments two to eight times faster than IMRT while increasing the dose to tumors and also improving normal tissue dose sparing. RapidArc is today’s state-of-the-art treatment technique.
All of these benefits are accomplished through CCS Oncology’s advanced treatment planning algorithms that vary the rotational speed of the machine, the shape of the treatment aperture (using MLC), and the rate at which the dose is delivered.
RapidArc treatments are also combined with daily image-guidance technology to improve tumor localization and patient positioning.
High-Dose-Rate Brachytherapy (HDR)
High Dose Rate (HDR) Brachytherapy is a technique using a radioactive source of Iridium-192 to deliver dose to a tumor site.
This source is laser welded to the end of a wire or cable. During HDR treatments, the radioactive source is guided through catheters that have previously been placed in the patient. The source dwells in a preplanned position for a preset time.
Typical HDR treatment use a number of different positions with varying times to create the required dose distribution of the plan.
- By varying the position and time, the dose can be neatly sculpted to provide a dose geometry conforming to the shape of the target.
The patient typically receives the total dose in a series of 2-10 treatment sessions, also known as fractions.HDR brachytherapy has proven to be a highly successful treatment for cancers of the cervix, endometrium, breast, skin, bronchus, esophagus, head and neck, as well as soft tissue sarcomas and several other types of cancer.
At CCS Oncology we offer a number of different HDR treatment possibilities including but not limited to the following:MammoSite® Brachytherapy
After a patient undergoes lumpectomy, radiation is often delivered to the surrounding site.
MammoSite treatments are the perfect tool for this process. At the time of surgery a catheter with an inflatable balloon is inserted into the lumpectomy cavity.
The balloon is then filled with a saline solution and the balloon conforms to the shape of the missing tissue. A CT scan is then taken of the area, and a plan is generated to administer radiation dose to the area.
- Patients are given 2 treatments a day for 5 days.Tandem & Ovoid Brachytherapy
- Treatment consists of 3 specifically designed applicators, a central tandem and two lateral ovoids.
The tandem is a small metal tube that is placed inside the patient’s uterus and the ovoids are a similar metal tube with cylindrical spacers for treating the cervix.
During treatment the radioactive source will pass through both the tandem and the ovoids at different times to ensure the entire region is properly treated.Vaginal Cylinder Brachytherapy
Vaginal cylinder treatments are most commonly used for patients who have previously had a hysterectomy.
- The applicator has a central tube, constructed of a composite material, in which the radioactive source is guided.
The cylinder is inserted into the vagina during treatment and the radioactive source delivers conformal dose based on source position and time.
Low-Dose-Rate Brachytherapy (LDR)
Low Dose Rate (LDR) Brachytherapy is widely used as a treatment modality for patients with prostate cancer. In this technique, radioactive “seeds” about the size of a grain of rice are positioned in the prostate using needles that are guided into position by CT images and a template or grid through which the needles are inserted to control their spacing.
Between 50 and 100 individual seeds may be placed in a single session using 20 to 50 needles.
Radiation is then delivered, by the seeds, to the prostate slowly over the following months as the sources decay.
At CCS Oncology our qualified staff works with a treatment planning system which uses CT images to help design the intended placement of each seed.
These personalized plans are generated for each patient prior to the procedure.
At our offices, LDR prostate seed brachytherapy procedures are a minimally invasive surgery taking between 60 and 90 minutes.
- Patients are released back into the care of their families the same day.
Respiratory gating is a treatment tool that accounts for a patient’s respiratory motion during external beam radiation treatment. At CCS Oncology we use Varian’s RPM system for gated treatments.
The process involves placing a small device, with two reflective markers, on the patient’s chest. An infrared signal is sent to the marker, which redirect the light to a video camera that tracks the device’s position. This allows for real-time monitoring of the patient’s breathing.
With the aid of specialized software, our team of medical professionals can tailor the radiation beam to turn on/off with the breathing pattern. As such, radiation is only delivered to the tumor and greatly improves the sparing of healthy tissue.
Respiratory gated treatments are occasionally used for lung, liver, stomach, and pancreatic cancers.
Stereotactic Radiosurgery (SRS)
Stereotactic treatments are advanced radiation procedures that use high energy X-rays in the fight against cancer.
In both SRS and SRT treatments, large doses of radiation are delivered to small tumors within the brain.
But where Stereotactic RadioSurgery and RadioTherapy differ, is in the typical course of treatment.
- SRS delivers a large radiation dose in only one treatment.
SRT delivers higher total doses over a few fractionated treatments.
In both cases, stereotactic treatments require a high level of precision that utilize immobilization devices and image-guidance for localization.
Because of the larger doses, SRS and SRS require sub-millimeter accuracy of tumor and patient position.
As such, these procedures are highly complex and require a fully dedicated team of physicians, physicists, dosimetrists, and therapists during the course of treatment.
Stereotactic Body Radiotherapy (SBRT)
Stereotactic Body RadioTherapy is a similar treatment to SRS and SRT, but the distinction with SBRT is that radiation is being delivered to a tumor outside of the cranium.
As with the other stereotactic treatments, larger doses of radiation are delivered when compared with typical IMRT treatments.
SBRT procedures can span a 1-2 week time period with roughly 2-5 treatments being delivered to the patient.
Candidates for SBRT are elderly patients who are high risk for surgery, patients with medically inoperable tumors, or patients who refuse surgical treatment.
SBRT procedures also use immobilization devices and image-guidance for localization. At CCS Oncology, full body Vac-Lok™ cushions are used for this purpose.
The device is a non-invasive, vacuum activated fixation system to limit tumor motion during simulation and treatment.
Three-Dimensional Conformal Radiation Therapy is a treatment technique that utilizes CT images to create an individualized treatment for each patient.
The CT images allow our physicians to define the tumor volume and treatment area in three-dimensions.
The physicians then work directly with our certified medical dosimetrist to create the treatment plan.
External beam radiation fields are implemented using the CT data to conform to the shape of the tumor in three dimensions (length, width, and height).
This process of planning provides high radiation dose to cancerous areas within the body while minimizing the amount of radiation administered to healthy tissue.
Typical 3D conformal treatment plans consist of multiple external beam fields, each having a varying degree of rotation around the patient.
For this type of cancer therapy, the patient will undergo treatment 5 days a week for about 6 weeks.
Electron Beam Therapy
Electron Beam Therapy is a treatment technique generally used for superficial skin lesions and cancer node sites. Electrons have specific properties that allow them to deposit the majority of their dose at shallow depths, thus reducing the radiation dose to deeper tissue.
Electrons are administered using the external beam method, where the beam/beams are directed at the site of the lesion.
What is external beam radiation therapy?
- It is a common cancer treatment that uses high doses of radiation to destroy cancer cells and shrink tumors. A large machine aims radiation at the cancer. The machine moves around you without touching you. It doesn’t make you radioactive.
How does treatment work?
- At low doses, radiation is used as an x-ray to take pictures inside your body. In cancer treatment, higher doses of radiation are used to destroy cancer cells.
How long does treatment take?
- The length of your treatment depends on your type and stage of cancer. Most treatments take 2 to 10 weeks. Most treatments will take about 20 minutes.
Why do I need another CT when I had one?
- This CT scan is for planning purposes only. The CT scan that we use serves as a copy of your body when we enter it into our computer planning software. Our physics department will then incorporate the necessary angles needed to treat the area of interest and the software will simulate how the radiation will work.
What is an IMRT radiation treatment?
- IMRT means Intensity Modulated Radiation Therapy. IMRT is a new type of conformal radiation therapy that uses radiation beams of varying intensities to deliver different doses of radiation to small areas of tissue at the same time. This technology allows for the delivery of higher doses of radiation within the tumor and lower doses to nearby healthy tissue.
What about side effects?
- You can discuss the possibility of side effects with your physician. If any side effects are experienced during your treatments, it is important that you tell your doctor.
Will my insurance cover radiation treatment?
- We accept all insurance, including Medicare and Medicaid. Our independent billing experts will work for you and with your insurance company. They will take care of all billing and insurance related needs.