Radiation Oncology

Radiation Therapy

Radiation Therapy is the localized treatment of cancer through controlled use of radiation. Advanced technology at Conemaugh Memorial Medical Center allows specific targeting of cancerous cells with limited damage to healthy cells surrounding the tumor. Measurements are made in millimeters for improved accuracy to specific areas of the body to be treated. This is a specialized treatment for malignant and benign tissues in the body. By tearing down the cancer cells it gives the body opportunity for the good cells to grow back and fight against the bad. A high voltage of radiation can break down the tumor, creating smaller fragments to be destroyed. 

Treatment

Consult Appointment
The first step in knowing if a patient is a candidate for radiation therapy is talking with the Radiation Oncologist. Speaking with the doctor, asking questions, and finding out more about the specific cancer are all included in this visit.

CT Scan and Mold Creation
After the consult, if the patient is to receive radiation therapy they will be scheduled for a CT scan, also known as a simulation. The scan times can vary and there may be special instructions for the patient to follow prior to this day for the scan to be optimal for a treatment plan. During this simulation the therapists will make molds for the patients, mark the patient, take pictures of the patient, and ensure the patient has no further questions or concerns and are comfortable with all aspects of this journey. Once the patient is done, the scan is sent to the treatment planning system to create a plan dedicated to each individual patient. Physics, the doctor, and the therapists are all involved in making sure the plan is accurate and precise for the treatment of the patient. The therapists will complete the process by having the patient come in for a “dry run” which involves taking the patient into the treatment room and taking some x-rays or cone beam CT’s (mini CT scan) to ensure the proper alignment of the patient has been obtained.

Radiation Therapy
Following mold creation will begin the treatments of radiation prescribed by the Radiation Oncologist. Patients can expect to be in the department for treatment no more than 15-20 minutes on average, but many factors will alter this time. The number of total treatment days an individual will expect to have can vary depending on the type of cancer, stage, grade, and cell type. The most important piece of knowledge to remember is every patient is different and may react differently to radiation. Side effects are possible with this form of treatment but severities may fluctuate depending on different dynamics. The physician will explain all steps involved with Radiation Oncology in the initial consult prior to signing a consent form.

Chemotherapy

Some patients will need radiation in conjunction with chemotherapy.  This would be based on the cancer diagnosis and physician consultation.

Advanced Technology

Conemaugh Memorial Medical Center offers advanced technology for the treatment of cancer patients.

CT Discovery RT
This CT unit is specifically designed for the Radiation Oncology Patients. Every patient will get a “Treatment Planning CT” prior to their initial treatment. This allows the physician the ability to outline specific organs at risk and also the exact treatment volume of interest.

Laser positioning for improved accuracy
Conemaugh Memorial uses what is known as a Lap Laser System. This allows the transfer of tumor localization from the CT unit to the treatment planning system through the use of a precision aligned laser localization.

Head / Neck Positioning
This is accomplished through a rigid but comfortable restraining system that allows the therapists to set up the treatment area in the exact position each treatment day. A semitransparent mask is formed to exactly align patient anatomy. This immobilization device will attach the patient to the table for daily treatments.

“Vac” Bag
Vac bags are for comfort and accuracy. During the initial CT scan these positioning devices are molded around the body by the therapists. These bags are then used each treatment day for better set ups and ease of the patient for their daily treatments.

Eclipse Treatment Planning
The treatment planning system is dedicated to the cancer treatment plan. It communicates with the CT equipment and the linear accelerator. This is where a medical dosimetrist designs the actual plan for treatment. The data used in this system exactly matches the machine used for treatment. The resulting plan is similar to a roadmap of how the radiation is distributed to the tumor and surrounding anatomy. Eclipse is a specialized tool used to make the treatment plan specific for each patient we scan.

Linear Accelerator
The linear accelerator delivers powerful cancer treatments with pinpoint accuracy and precision. The equipment integrates imaging and motion management technologies that allow the physician to administer the treatment and compensate for tumor movement. The treatment can be adjusted based on the patient’s breathing patterns to ensure healthy tissue is not damaged and the tumor is targeted. The technology also allows for faster delivery of radiation, reducing dose and exposure dramatically. A quicker treatment time means increased comfort for patients and less time needed for appointments.

Benefits for Patients

• Linear accelerator enables physicians to treat cancer without surgery, using powerful, state-of-the-art radiation therapy, delivered precisely and accurately, and individualized for each patient.
• Treats more cancers more ways
• The linear accelerator at Conemaugh Cancer Center was developed to deliver powerful cancer treatments with pinpoint accuracy and precision. Because of its highly automated precision, the equipment opens the door to new possibilities for the treatment of challenging cases such as cancers in the lung, breast, abdomen, and head and neck as well as other cancers that are treatable with radiotherapy.
• Varian’s TrueBeam system can deliver many forms of radiotherapy, including:
  • image-guided radiotherapy (IGRT)
  • intensity-modulated radiotherapy (IMRT)
  • volumetric-modulated arc therapy (VMAT)
  • stereotactic radiosurgery (SRS)
  • stereotactic body radiotherapy (SBRT)
• Precision and speed enhance treatment effectiveness
• Deliver fast, accurate image-guided treatments within just a few minutes per day
• Allows clinicians to deliver treatment more accurately by enabling them to “see” the tumor immediately prior to each treatment, then target those tumors with pinpoint precision while protecting nearby healthy tissue and critical organs.
• Tumors sometimes grow in parts of the body that move when a patient breathes. The linear accelerator system includes a “respiratory gating” option that follows a patient’s breathing and turns the beam on only at the optimal points in the breath cycle. Ensuring enhanced accuracy whenever there is tumor motion is very important, for example during lung and certain breast cancer treatments. Conemaugh's linear accelerator uses 4D imaging, so that our clinical team can see the full range of the patient's tumor’s motion while he / she breathes in real time. Treatment can be designed to compensate for breathing motion more accurately.

Patient Comfort

• Non-invasive treatments. No surgery and no cutting, and overnight hospital stays are not required.
• Fast treatment time can minimize interruption of daily life.
• Closed-circuit television systems with two-way audio mean patients can be in constant and continuous contact with the therapist during treatment; the therapist can see and hear the patient throughout the whole process.
• Ability to listen to music during treatment

Ali Tunio, PhD, MD
Radiation Oncology

Radiation Oncology Department at Conemaugh Cancer Center
1020 Franklin Street, Lower Level
Johnstown, PA 15905
Phone: (814) 534-1245
Fax: (814) 534-1240

Hours: Monday – Friday, 7 am – 3 pm
Inpatient consultations as needed.