Radiotherapy (RT) also known as radiation therapy, is a cancer treatment modality whereby high energy radiations are used to kill cancer cells. The effect of radiation is more pronounced in cells that are rapidly multiplying. Because cancer cells are multiplying faster than normal cells, they are more likely to be killed than normal cells. Normal cells will sometimes be damaged by radiation but are usually able to recover.
Aim of radiotherapy
Radiation therapy can be used for different purposes depending on the cancer type and other characteristics as follows;
- It can be used alone, as the only treatment modality to cure cancer.
- In combination with surgery with the purpose of shrinking the tumor before surgery or killing remaining cancer cells after surgery
- In combination with chemotherapy where chemotherapy makes cancer cells more sensitive to radiations
Radiotherapy treatment team
Accurate delivery of Radiotherapy is a team effort requiring the interaction of multiple professionals including Radiation Oncologists, Radiation Therapists, Radiation medical physicists, and radiation oncology nurses. The Ocean road cancer institute has a very competent team of professionals to offer standard radiotherapy services. In our institute these professionals are well organized in their areas of specialization as described as follows;
- RadiationOncologists – Are medical Doctors specialized in radiotherapy treatment. Radiation oncologists not only decide on the patient to go for radiotherapy but also prescribe radiation dose as well as participates in treatment planning. In addition, this doctor reviews the patients during and after treatment.
- Radiation Therapists – Are allied health professional who works in the field of radiation oncology. A radiation therapist is responsible for deciding suitable immobilizing devices to use, positioning and sets up of a patient for radiation treatments as well as delivery of the prescribed dose of radiation. Additionally, Radiation therapist monitors patients on a daily basis during radiation treatment schedule which allow identifying any side effects hence notifying radiation oncologist.
- Radiation Medical Physicist – is an allied health professionalwho creates, implement and monitor the procedures which allow the best treatment using radiation, taking into account the protection and safety of patients and others involved in the treatment process. He / She is responsible for treatment planning and radiotherapy quality assurance.
- A radiation oncology nurs is a registered nurse who works independently and interdependently with the radiotherapy treatment team in providing quality patient care. The radiation oncology nurse provides clinical care, consultation, and education to patients undertaking radiotherapy.
Types of Radiotherapy
There are two types of radiotherapy treatments which include external beam radiotherapy and internal radiotherapy (brachytherapy).
- External Beam Radiation Therapy
External radiation therapy uses high energy radiations produced by Co60 machines or linear accelerators to deliver radiation dose from outside to the patient’s body. In this situation, the beam of radiation generated outside the patient’s body is directed to the cancerous tumor found inside the patient’s body. The treatment machine can change positions so that beams may enter the body from different angles. By changing the angle of the beams, it is possible to irradiate the tumor from all directions whilst sparing as many healthy tissues as possible. The Ocean road cancer institute offers external beam radiation treatment using modern Colbat 60 (Co60) machines and linear accelerators.
- Preparation for External Beam Radiotherapy
Before radiotherapy treatment is given to the patient, the patient’s treatment plan is precisely prepared so as to ensure patient safety and accurate treatment. Treatment preparation involves imaging, contouring, and planning.Imaging is very important because obtained patients’ images consist of detailed information about tumors and adjoining critical organs. We have several imaging modalities that are used in a diverse manner. These imaging modalities include CT scan, Ultrasound, and conventional x-ray imaging modalities. CT Images play a great role to allow Contouring to be performed purposely to localize the tumor and normal critical organs and thereafter treatment planning follow to generate beam arrangement against tumor thus to allow delivering of dose to be concentrated only to the tumor while minimizing dose to surrounding normal tissues. Moreover, during treatment planning, computerized systems using specialized software known as the Treatment planning system (TPS) to place radiation beams to target the tumor while avoiding critical organs. On the other hand, ultrasound and conventional x-ray imaging modalities before treatment are used to evaluate metastasis via trans-abdominal ultrasound and chest as well as musculoskeletal x-rays.
- Treatment Planning
Radiotherapy treatment is carefully planned to ensure most of the radiation goes to cancer cells and thereby reduce the damage to surrounding healthy tissue. At the same time, Radiotherapy produces good effects if it is delivered in an appropriate clinical context. Radiation therapy planning involves simulation where the patient is positioned comfortably on the treatment couch so that the same position can be reproduced throughout your treatment. Then CT images are taken appropriately depending on cancer site and stage. These images are transported electronically from the CT scan room to the planning room. Next, our competent radiation treatment team uses our latest treatment planning system (TPS) to contour disease and normal adjacent organs. Eventually, beam placement and planning optimization are performed to obtain the final treatment plan. The final approved plan allows the scheduling of the patient for treatment.
- Treatment Delivery
During radiation treatment, you can be escorted by your Family or close friends to our department. We have a good waiting area where you can be comfortable. In the treatment room, our radiation treatment team will check and recheck all of the dose delivery requirements to make sure the intended plan is produced. These requirements include your position on the treatment couch, set-up references, immobilizing devices, and your identification to match your treatment plan. Your treatment can take one to eight weeks depending on your cancer type, stage, and general condition. Ocean road cancer institute has four machines for external beam radiation treatment. These include two Colbalt-60 machines and two modern linear accelerators.
- Preparation for External Beam Radiotherapy
Brachytherapy is the radiation treatment modality in which the radioactive source is placed inside the body either direct or close to the tumor/cancer cells. These radioactive sources can be in a form of pellets, capsules, or seeds.Ocean road cancer institute has a well equipped Brachytherapy unit with a computerized treatment planning system, two High dose rate Brachytherapy machines (HDR) and two C-arm x-ray imaging machines. In this situation, we perform computerized treatment planning by using images from C-arm x-ray imaging modality. Currently, we are offering intracavitary Brachytherapy of cervical cancer using High dose rate Brachytherapy machines.
Our cervical cancer patient receives intracavitary Brachytherapy once a week for three weeks to boost external beam radiotherapy.