Cancer treatment options vary according to type of cancer, how advanced it is and the patient’s general health. The three main types of treatment offered at Tanner Health System are surgery, chemotherapy and radiation therapy, prescribed alone or in some combination.
In early stages of cancer, more aggressive treatment—including a combination of these three treatment modalities—may be used in order to treat the cancer. For patients with advanced stages of cancer, palliative treatment may be prescribed to relieve symptoms such as pain, bleeding and shortness of breath.
Most cancer patients will receive some type of surgery. A biopsy may be used to determine whether or not a lump or mass is cancerous. During a biopsy, some of or the entire tumor may be removed and sent to a pathologist for diagnosis. If surgery is recommended as a treatment option, a surgeon may remove all of the tumor and surrounding tissue.
Chemotherapy consists of medication administered orally or intravenously (through the veins). Known as a systemic therapy because the cancer-killing drug circulates through the body, chemotherapy may be a single drug or a combination of drugs.
Radiation therapy is the use of focused, high-energy radiation beams (X-rays) to kill cancer cells. Radiation destroys the DNA in cancer cells and prevents the cancer from growing. As the cancer cells die, the tumor shrinks. Some normal tissue will also be damaged, but will eventually regenerate. Since radiation therapy is a localized treatment, it destroys only the cancer in the treatment area.
Tanner offers the following types of radiation therapy:
External Beam Radiation Therapy (EBRT)
EBRT is a high-energy radiation that is directed to a localized area. The beam is created in a machine called a linear accelerator and directed through the skin to the cancer. During treatment, the patient lies on a table (similar to receiving an X-ray). EBRT destroys cancer cells and any normal cells in the treatment field. Radiation is typically administered in small doses for six to eight weeks. No pain is involved in receiving EBRT. Daily treatments take about 10 minutes.
Three-Dimensional Conformal Radiation Therapy (3D-CRT)
A type of EBRT, 3D-CRT uses state-of-the-art computers in conjunction with CT scans to create a digitally reconstructed 3-D image of the tumor and surrounding normal tissue. Radiation oncologists can thus shape and direct the treatment field more precisely to better target the cancer and spare the normal tissue, thereby reducing radiation side effects.
Intensity Modulated Radiation Therapy (IMRT)
Another type of EBRT, IMRT is a more sophisticated form of 3D-CRT. Not only is the beam shaped more accurately to form the shape of the tumor, but the intensity of radiation coming from the machine is also varied during a single treatment. This spares normal tissue and allows higher radiation doses to the cancer, thus increasing chance of cure. Since not all cancers may be treated with IMRT or 3D-CRT, the appropriate treatment is at the physician’s discretion.
Stereotactic Radiosurgery and Radio Therapy (SRS, SRT)
Stereotractic refers to knowing exactly where a tumor is located in three-dimensional space, and stereotactic radiosurgery (SRS) employs both internal (imaging) and external (fixation) localization and treatment techniques. A key to treatment precision is the use of sophisticated imaging techniques to ensure accurate target positioning both prior to the treatment for patient setup and during the treatment procedure. The Novalis Tx&™ radiosurgery platform has the most advanced imaged platform of any radiosurgery system available, with three sophisticated imaging chains: ExacTrac X-Ray 6D for pretreatment positioning and snap verification during treatment; the Varian On-Board Imager (OBI) for cone beam CT; and fluoroscopy.
Image-Guided Radiation Therapy (IGRT)
Dynamic targeting IGRT provides high-resolution, 3-D images to pinpoint tumor sites, adjust patient positioning when necessary and complete a treatment—all within the standard treatment time. Innovative radiographic, fluoroscopic and cone-beam CT modes are integrated with automated repositioning and motion management visualization software. These capabilities take IMRT and stereotactic IMRT technologies one step further by raising the quality of patient care and improving efficiency.
Varian RapidArc™ Radiotherapy
Varian RapidArc is a noninvasive external beam radiotherapy treatment representing an advanced new form of image-guided IMRT that combines the use of both IMRT and IGRT to deliver a treatment in less than two minutes (compared with 10 minutes or longer for conventional IMRT). This technology enables clinicians to program a linear accelerator to deliver precise forms of IMRT up to eight times faster than other IMRT systems. Varian RapidArc radiotherapy is the first to deliver a precisely-sculpted 3-D dose distribution with a single 360-degree rotation of the linear accelerator gantry, and Tanner is the first non-academic community hospital in Georgia and Alabama to utilize this technology.
This is a form of partial breast irradiation. It works by delivering radiation from inside the lumpectomy cavity (the space that is left after the tumor is removed) directly to the tissue surrounding the cavity where cancer is most likely to recur. Radiation therapy with MammoSite can be completed in five days, allowing you to get back to your life. A soft balloon attached to a thin catheter (tube) is placed inside the lumpectomy cavity. In order to deliver radiation, a tiny radioactive source, called a seed, is placed within the balloon by a computer-controlled machine. Because the seed is inside the balloon, radiation is directed only to the area of your breast where cancer is most likely to recur or return. When used as primary therapy—the only form of radiation following a lumpectomy—you would receive treatment twice a day for 5 days. If your doctor feels that whole breast external beam radiation is more appropriate for you, MammoSite may be used as boost therapy. In this case, you would receive MammoSite treatment for one to two days.
Superficial Radiation Therapy (SRT)
The traditional methods for treating skin cancer involve surgery and/or non-invasive Superficial Radiation Therapy (SRT). SRT has been a proven skin cancer treatment method for treating basal and squamous cell carcinomas since the 1950s, providing a high cure rate and low recurrence. Low energy radiation (aka X-ray therapy) is used to treat only the affected layers of the skin, eliminating the need for anesthetics or skin grafting. Tanner has a very successful cure rate and excellent cosmetic results with this type of skin cancer treatment.
Prostate Seed Implant
This type of radiation treatment is internal treatment for prostate cancer and is usually used with external beam radiation at the end of the treatment course. During prostate seed implant treatment, radioactive seeds of Palladium (Pd 103) are inserted directly into the prostate under general anesthesia. The patient usually stays in an observation bed for several hours after the procedure and is sent home the same day. Both a radiation oncologist and urologist are involved in this treatment.
High Dose Rate Brachytherapy (HDR)
This form of radiation therapy uses a radioactive source that is placed inside the cancer or part of the body to be treated. A high dose of radiation is given to a limited area, sparing the surrounding normal tissue. HDR brachytherapy lasts only a few minutes in the outpatient setting and causes little discomfort. It can be used in the treatment of gynecological cancers, and esophageal cancers. Other local regional tumors can be considered for HDR brachytherapy on an individual basis. HDR brachytherapy is used alone or combined with other treatment modalities, such as external beam radiation. You and your physician will decide your optimal course of treatment.
Learn more about cancer care at Tanner’s Roy Richards, Sr. Cancer Center.