Breast Cancer: 3 (Radiation Medicine Rounds)

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Still, some doctors have been reluctant to use a hypofractionated radiation schedule. In the study reviewed here, researchers from the University of Texas MD Anderson Cancer Center randomly assigned women diagnosed with early-stage breast cancer to one of two radiation schedules after lumpectomy:.

When might radiation therapy be used?

The researchers collected information on how the women viewed the cosmetic and functional outcomes of the radiation treatment, as well as other quality of life factors before the study started, and then at 6 months, 1 year, 2 years, and 3 years after radiation treatment ended. The two radiation schedules had the same outcomes before the study started and at 6 months, 1 year, and 3 years after the treatment ended.

Two years after treatment, women in the hypofractionated radiation group reported slightly better functional outcomes than women in the conventional schedule radiation group. This difference was small, but it was statistically significant. This means that the difference in functionality was probably because of the different radiation schedules and not just due to chance. D, radiation oncology resident at MD Anderson.

The results of this study echo earlier results showing that hypofractionated radiation is as good as a conventional radiation schedule. Smith currently leads an ASTRO guideline panel on whole-breast irradiation, and he hopes these and other data will support development of evidence-based treatment guidelines for early breast cancer. Be sure to talk about your scheduling needs and ask your doctor whether you meet the criteria for hypofractionated whole-breast radiation.

The current guideline says that most women diagnosed with breast cancer who will have radiation therapy after lumpectomy should be treated with accelerated, also called hypofractionated, whole-breast radiation therapy as the standard of care. The preferred hypofractionated dose schedule is 40 Gray in 15 doses or Proton beam therapy is a form of external beam radiation treatment that uses protons rather than X-rays to treat certain types of cancer and other diseases. The physical characteristics of the proton therapy beam allow doctors to more effectively reduce the radiation dose to nearby healthy tissue.

Proton therapy is available at only a few specialized centers in the country.

Radiation therapy for breast cancer - Mayo Clinic

Like proton therapy, neutron beam therapy is a specialized form of external beam radiation therapy. It is often used to treat certain tumors that are radioresistant, meaning that they are very difficult to kill using conventional X-ray radiation therapy. Neutrons have a greater biologic impact on cells than other types of radiation. Used carefully, this added impact can be an advantage in certain situations.

Neutron therapy is available at only a few specialized centers. Stereotactic radiotherapy is a technique that allows your radiation oncologist to precisely focus beams of radiation to destroy certain types of tumors. Since the beam is so precise, your radiation oncologist may be able to spare more healthy tissue. This additional precision is achieved by using a very secure immobilization, such as a head frame used in the treatment of brain tumors. Stereotactic radiotherapy is frequently given in a single dose sometimes called radiosurgery although certain situations may require more than one dose.

In addition to treating some cancers, radiosurgery can also be used to treat malformations in the brain's blood vessels and certain noncancerous benign neurologic conditions. Sometimes a high dose of stereotactic radiotherapy can be focused upon a tumor outside the brain and given in a few treatments typically three to eight. This form of treatment is called stereotactic body radiation therapy.

Radiation oncologists use image-guided radiation therapy, or IGRT, to help better deliver the radiation to the cancer since tumors can move between treatments due to differences in organ filling or movements while breathing. IGRT involves conformal radiation treatment guided by imaging, such as CT, ultrasound or X-rays, taken in the treatment room just before the patient is given the radiation treatment.

All patients first undergo a CT scan as part of the planning process. The imaging information from the CT scan is then transmitted to a computer in the treatment room to allow doctors to compare the earlier image with the images taken just before treatment. During IGRT, doctors compare these images to see if the treatment needs to be adjusted. This allows doctors to better target the cancer while avoiding nearby healthy tissue.

In some cases, doctors will implant a tiny marker in or near the tumor to pinpoint it for IGRT.


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Also known as internal radiation, brachytherapy involves placing radioactive material into a tumor or its surrounding tissue. Because the radiation sources are placed so close to the tumor, your radiation oncologist can deliver a large dose of radiation directly to the cancer cells. The radioactive sources used in brachytherapy, such as thin wires, ribbons, capsules or seeds, come in small sealed containers.

These sources may be implanted permanently or temporarily. A permanent implant remains in the body after the sources are no longer radioactive. Other radioactive sources are placed temporarily inside the body and are removed after the right amount of radiation has been delivered.

Certain cancers may be treated by swallowing radioactive pills or receiving radioactive fluids in the vein intravenous.


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This type of treatment is called systemic radiation therapy because the medicine goes to the entire body. For example, radioactive iodine I capsules are given to treat some types of thyroid cancer. Another example is the use of intravenous radioactive material to treat pain due to cancer that has spread to the bone. Radiolabeled antibodies are monoclonal antibodies with radioactive particles attached.

These antibodies are designed to attach themselves directly to the cancer cell and damage it with small amounts of radiation. Cancer doctors now know much more about how cancer cells function. New cancer therapies use this information to target cancer cell functions and stop them. Called targeted therapies, they can be more specific in stopping cancer cells from growing and may make other treatments work better. For example, some medicines work to prevent cancers from growing by preventing the growth of new blood vessels that would nourish the cancer.

Other targeted therapies work more directly on cancer cells by blocking the action of molecules on the surface of cancer cells called growth factors. Any drug that can make tumor cells more sensitive to radiation is called a radiosensitizer. Combining radiation with radiosensitizers may allow doctors to kill more tumor cells. Some types of chemotherapy and some novel targeted therapies can act as radiosensitizers. Some medicines called radioprotectors can help protect healthy tissue from the effects of radiation. Radiation therapy given during surgery is called intraoperative radiation therapy.

Radiation therapy - what to expect

Intraoperative radiation therapy is helpful when vital normal organs are too close to the tumor. During an operation, a surgeon temporarily moves the normal organs out of the way so radiation can be applied directly to the tumor. This allows your radiation oncologist to avoid exposing those organs to radiation. Intraoperative radiation can be given as external beam therapy or as brachytherapy.

Medicines prescribed by a medical oncologist that can kill cancer cells directly are called chemotherapy. Some are given in pill form, and some are given by injection. Chemotherapy can also be considered a type of systemic therapy, because medicines go through the bloodstream to the entire body.

Radiation therapy

Some treatments are designed to help your own body's immune system fight the cancer, similar to how your body fights off infections. A team of highly trained medical professionals will be involved in your care during radiation therapy. This team is led by a radiation oncologist, a doctor who specializes in using radiation to treat cancer. Radiation oncologists are the doctors who will oversee your radiation therapy treatments. These physicians work with the other members of the radiation therapy team to develop and prescribe your treatment plan and make sure that each treatment is given accurately.


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  8. Your radiation oncologist will also track your progress and adjust the treatment as necessary to make sure you receive the best care. Radiation oncologists help identify and treat any side effects that may occur due to radiation therapy. They work closely with other cancer doctors, including medical oncologists and surgeons, and all members of the radiation oncology team.

    Radiation oncologists have completed at least four years of college, four years of medical school, one year of general medical training and four years of residency specialty training in radiation oncology. They have extensive training in cancer medicine and the safe use of radiation to treat disease. If they pass a special examination, they are certified by the American Board of Radiology. You should ask if your doctor is board certified.

    For Patients

    Medical physicists work directly with the radiation oncologist during treatment planning and delivery. They oversee the work of the dosimetrist and help ensure that complex treatments are properly tailored for each patient. Medical physicists develop and direct quality control programs for equipment and procedures. They also make sure the equipment works properly by taking precise measurements of the radiation beam and performing other safety tests on a regular basis. Dosimetrists work with the radiation oncologist and medical physicist to carefully calculate the dose of radiation to make sure the tumor gets enough radiation.

    Using computers, they develop a treatment plan that can best destroy the tumor while sparing the healthy tissue. Radiation therapists work with radiation oncologists to give the daily radiation treatment under the doctor's prescription and supervision.