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Radiation Oncology

Radiation therapy is sometimes called radiotherapy. Radiation is used to treat cancer and other diseases. Learn about Vanderbilt's world-class radiation oncology here.

Doctors use radiation to:

  • Cure cancer
  • Control cancer growth
  • Relieve pain and other symptoms

A radiation oncologist, a doctor specializing in radiation therapy for cancer, leads your team of those caring for you with radiation treatment.

Types of radiation therapy include:

3D conformal radiotherapy: This technology uses 3-D images to allow the radiation oncologist to treat the tumor with precision and spare healthy tissues.

Intensity Modulated Radiation Therapy (IMRT): A precise way of delivering high dose radiation to the tumor while sparing nearby organs. This is done with advanced software that uses many radiation beams at different weights and shapes.

Stereotactic Radiosurgery (SRS): This technology gives of a high dose of radiation in a single treatment, typically to the brain, but also the spinal cord in certain cases. The radiation is delivered with millimeter precision and spares the rest of the brain from high dose radiation. Occasionally, if the lesion is large, 3 or 5 treatments are used to decrease side effects; this is called stereotactic radiotherapy (SRT).

Stereotactic Body Radiotherapy (SBRT): Also called stereotactic ablative radiotherapy (SABR), this is very similar to SRS except that it is used to treat other sites in the body including the lungs and liver. Treatment is usually done in 3 to 8 treatments, depending on tumor size. For SRS and SBRT, we use the Novalis Tx, which is a dedicated radiosurgery machine similar to the GammaKnife or CyberKnife.

High-Dose Rate (HDR) Brachytherapy: Often an outpatient procedure where radiation is inserted briefly into the tumor in several sessions. At Vanderbilt, HDR is often used in gynecologic cancers and occasionally lung cancer.

Low-Dose Rate (LDR) Brachytherapy: This technique inserts radiation into the tumor but the radiation is released over several days. LDR is often used in prostate cancer, gynecologic cancers and ocular melanoma.

Intra-operative Radiation Therapy (IORT): This technique is most often used at Vanderbilt for very early breast cancers. Radiation is given at the time of lumpectomy in one treatment as compared to 4-6 weeks of radiation. For IORT, we use the Xoft system, which delivers a concentrated beam of radiation in the operating room at the time of surgery to the lumpectomy site without exposing other normal organs to radiation.

Radiation Oncology Treatment Doctors

What to Expect During Radiation Therapy Treatment

Your radiation oncologist will talk with you about the benefits and risks of radiation therapy. He or she will review your medical tests and imaging scans and do a medical exam to help determine what kind of radiation therapy will be most effective for you.

Make a list of questions to ask about your treatment. If you want to ask a question later, you can contact your provider through My Health at Vanderbilt.

Simulation and Treatment Planning

To be effective, radiation therapy must be aimed precisely at the same target every time. Simulation is the process whereby your care team pinpoints where your treatment will be given.

Youll schedule an appointment for simulation in a special suite, where youll receive a CT scan. Your care team will help you get into the position youll be in during treatment, and temporary marks may be placed on your skin.

Advanced treatment and planning software is used to help design your treatment plan. Your radiation oncologist will study all your test results and images to create a personalized radiation treatment plan.

Treatment

External Beam Radiation Therapy Treatments

This type of procedure is painless and usually takes less than 30 minutes. A machine sends a beam of radiation into your body, targeting only the cancer. Most patients dont need to miss work after this kind of radiation.

Some treatment courses can be as little as 1 treatment; others may last several weeks. Each treatment is called a "fraction." Sometimes the course of treatment requires two fractions per day with several hours between each fraction. The treatment course depends on:

  • The tumor's location
  • Disease stage
  • Cancer type
  • If radiation is being given with other types of treatment
  • Previous surgery or radiation
  • Your general medical condition

Brachytherapy

Brachytherapy, also called internal radiation, is when radioactive sources are placed in or just next to a tumor. The radioactive sources may be left in place permanently or only temporarily, depending upon your cancer. To position the sources accurately, special catheters or applicators are used. Brachytherapy often requires anesthesia and brief hospitalization.

Patients with permanent implants may have a few restrictions at first and then can quickly return to their normal activities. With temporary implants, while the sources are in place, you will stay in a private room. Doctors, nurses and other medical staff will continue to take care of you, but they will need to take special precautions to limit their exposure to radiation.

Devices called high dose rate (HDR) machines allow radiation oncologists to complete brachytherapy in 10-20 minutes. Powerful radioactive sources travel through small tubes called catheters to the tumor for the amount of time prescribed by your radiation oncologist.

Depending on the area treated, you may receive several treatments over a number of days or weeks. No radiation restrictions are required.

During radiation therapy, your radiation oncologist and nurse will see you regularly to follow your progress, evaluate whether you are having any side effects, recommend treatments for those side effects and answer your questions.

After treatment is completed, follow-up appointments will be scheduled so that your radiation oncologist can make sure your recovery is proceeding. Your radiation oncologist may also order diagnostic tests.