【医学英文课件】 Understanding Radiation TherapyIntroduction to Radiation Oncologyn nRadiation therapy, or Radiation therapy, or radiotherapy, is the use of radiotherapy, is the use of various forms of radiation to various forms of radiation to safely and effectively treat safely and effectively treat cancer and other diseases.cancer and other diseases.n nRadiation therapy has been an Radiation therapy has been an effective tool for treating cancer effective tool for treating cancer for more than 100 years.for more than 100 years.n nAbout two-thirds of all cancer About two-thirds of all cancer patients will receive radiation patients will receive radiation therapy as part of their therapy as part of their treatment.treatment.n nRadiation oncologists are Radiation oncologists are doctors trained to use radiation doctors trained to use radiation to treat cancer.to treat cancer.Patient being treated with modern Patient being treated with modern radiation therapy equipment.radiation therapy equipment.Brief History of Radiation Therapyn nThe first patient was treated with The first patient was treated with radiation therapy in 1896, just two radiation therapy in 1896, just two months after the discovery of the months after the discovery of the X-ray.X-ray.n nRapid technology advances began in Rapid technology advances began in the early 1950s, with the invention the early 1950s, with the invention of the linear accelerator.of the linear accelerator.n nPlanning and treatment delivery Planning and treatment delivery advances have enabled radiation advances have enabled radiation therapy to be more effective and therapy to be more effective and precise, while decreasing the severity precise, while decreasing the severity of side effects. of side effects. AS Show a AS Show a picture of a modernpicture of a modernLinear acceleratorLinear acceleratorThe linear accelerator is still used The linear accelerator is still used today to deliver external beam today to deliver external beam radiation therapy.radiation therapy.How Does Radiation Therapy Work?n nRadiation therapy works by damaging Radiation therapy works by damaging the DNA within cancer cells, destroying the DNA within cancer cells, destroying their ability to reproduce and causing their ability to reproduce and causing the cells to die.the cells to die.n nWhen the damaged cancer cells are When the damaged cancer cells are destroyed by radiation, the body destroyed by radiation, the body naturally eliminates them.naturally eliminates them.n nNormal cells can be affected by Normal cells can be affected by radiation, but they can repair radiation, but they can repair themselves in a way cancer cells themselves in a way cancer cells cannot. cannot. When is radiation used?n nThe best treatment plan for The best treatment plan for each patient is frequently each patient is frequently determined by a team of determined by a team of doctors, including a radiation doctors, including a radiation oncologist, a medical oncologist, a medical oncologist and a surgeon. oncologist and a surgeon. n nSometimes radiation therapy Sometimes radiation therapy is the only treatment a patient is the only treatment a patient needs.needs.n nOther times, it is combined Other times, it is combined with other treatments, such as with other treatments, such as surgery and chemotherapy.surgery and chemotherapy.Tumor boards meet to discuss Tumor boards meet to discuss comprehensive patient treatment plans comprehensive patient treatment plans Is Radiation Therapy Safe?n nNew advances in technology and New advances in technology and treatment delivery continue to treatment delivery continue to make radiation safe and make radiation safe and effective. effective. n nA team of medical professionals A team of medical professionals develop and review the develop and review the treatment plan for each patient treatment plan for each patient to minimize side effects and to minimize side effects and assure that the area where the assure that the area where the cancer is located is receiving the cancer is located is receiving the dose of radiation needed. dose of radiation needed. n nThe treatment plan and The treatment plan and equipment are constantly equipment are constantly reviewed to ensure the proper reviewed to ensure the proper treatment is being given.treatment is being given.Why Use Radiation Therapy?n nTo cure cancer:To cure cancer: Destroy tumors that have not spread to other body parts.Destroy tumors that have not spread to other body parts. Reduce the risk that cancer will return after surgery or Reduce the risk that cancer will return after surgery or chemotherapy. chemotherapy. Shrink the cancer before surgery.Shrink the cancer before surgery.n nFor palliation (to reduce symptoms):For palliation (to reduce symptoms): Shrink tumors affecting quality of life, like a lung tumor Shrink tumors affecting quality of life, like a lung tumor that is causing shortness of breath.that is causing shortness of breath. Alleviate pain or neurologic symptoms by reducing the Alleviate pain or neurologic symptoms by reducing the size of a tumor.size of a tumor.Meet the Radiation Oncology TeamA team of highly trained medical professionals work A team of highly trained medical professionals work together to make sure you receive the best together to make sure you receive the best possible care while you are undergoing radiation possible care while you are undergoing radiation therapy.therapy.n nRadiation OncologistRadiation Oncologist Oversees the radiation therapy treatments, including working Oversees the radiation therapy treatments, including working with other members of the radiation therapy team to develop with other members of the radiation therapy team to develop the treatment plan and ensure that each treatment is given the treatment plan and ensure that each treatment is given safely and accurately.safely and accurately.n nMedical Radiation PhysicistMedical Radiation Physicist Ensures that complex treatment plans are properly tailored for Ensures that complex treatment plans are properly tailored for each patient and directs quality control programs for equipment each patient and directs quality control programs for equipment and procedures.and procedures.Meet the Radiation Oncology Team, cont.n nDosimetristDosimetrist Works with the radiation oncologist and medical physicist to Works with the radiation oncologist and medical physicist to calculate the proper dose of radiation given to the tumor.calculate the proper dose of radiation given to the tumor.n nRadiation TherapistRadiation Therapist Administers the daily radiation under the radiation oncologists Administers the daily radiation under the radiation oncologists prescription and supervision.prescription and supervision.n nRadiation Oncology NurseRadiation Oncology Nurse Cares for the patient and family by providing education, Cares for the patient and family by providing education, emotional support and tips for managing side effects.emotional support and tips for managing side effects.n nAdditional Members of the TeamAdditional Members of the Team Social workers, nutritionists, dentists, physical therapists and Social workers, nutritionists, dentists, physical therapists and patient navigators may also assist in a patients care during patient navigators may also assist in a patients care during their treatment.their treatment.What to Expectn nReferralReferraln nConsultationConsultationn nSimulationSimulationn nTreatment PlanningTreatment Planningn nTreatment ProcessTreatment ProcessReferraln nA cancer is diagnosed.A cancer is diagnosed.n nThe diagnosing or The diagnosing or referring physician referring physician reviews potential reviews potential treatment options with treatment options with patient.patient.n nTreatment options may Treatment options may include radiation include radiation therapy, surgery, therapy, surgery, chemotherapy or a chemotherapy or a combination.combination.It is important for a patients to ask their It is important for a patients to ask their referring physician about all possible treatment referring physician about all possible treatment options available to themoptions available to themConsultationn nRadiation oncologist Radiation oncologist discusses the radiation discusses the radiation therapy treatment therapy treatment options with patient.options with patient.n nA treatment plan is A treatment plan is developed.developed.n nCare is coordinated with Care is coordinated with other members of other members of patients oncology team.patients oncology team.The radiation oncologist will discuss with the The radiation oncologist will discuss with the patient which type of radiation therapy patient which type of radiation therapy treatment is best for their type of cancertreatment is best for their type of cancerSimulationn nPatient is set up in treatment position Patient is set up in treatment position on a dedicated CT scanner.on a dedicated CT scanner. Immobilization devices may be Immobilization devices may be created to assure patient comfort created to assure patient comfort and daily reproducibility.and daily reproducibility. Reference marks or “tattoos” may Reference marks or “tattoos” may be placed on patient.be placed on patient.n nCT simulation images are often fused CT simulation images are often fused with other scans such at MRI or PET with other scans such at MRI or PET scans to create a treatment plan.scans to create a treatment plan.A CT scan of the area of the body to be treated with A CT scan of the area of the body to be treated with radiation. The CT images are reconstructed and used to radiation. The CT images are reconstructed and used to design the best and most precise treatment plan.design the best and most precise treatment plan.Treatment Planningn nThe radiation oncologist works The radiation oncologist works with the medical physicist and with the medical physicist and dosimetrist to create an dosimetrist to create an individualized treatment plan for individualized treatment plan for the patient.the patient.n nThe treatment is mapped out in The treatment is mapped out in detail including the type of detail including the type of machine to be used, the amount machine to be used, the amount of radiation that is needed and of radiation that is needed and the number of treatments that the number of treatments that will be given. will be given. Radiation oncologist and dosimetrist creating a Radiation oncologist and dosimetrist creating a treatment plantreatment planTreatment Processn nEach day the patient will check Each day the patient will check in at the cancer center for in at the cancer center for treatment.treatment.n nThey will then be verified as the They will then be verified as the correct patient and be set up for correct patient and be set up for their treatment.their treatment.n nThe radiation oncologist will The radiation oncologist will monitor the treatments and the monitor the treatments and the patient will meeting with them patient will meeting with them weekly to discuss their weekly to discuss their treatment.treatment.During their check in at the cancer center, a During their check in at the cancer center, a patients identity will be verified.patients identity will be verified.How is Radiation Therapy Delivered?n nRadiation therapy can Radiation therapy can be delivered either be delivered either externally or internally. externally or internally. External beam External beam radiation radiation therapy typically delivers therapy typically delivers radiation using a linear radiation using a linear accelerator.accelerator. Internal radiation Internal radiation therapy, called therapy, called brachytherapybrachytherapy, involves , involves placing radioactive placing radioactive sources into or near the sources into or near the tumor.tumor.The type of treatment used will depend on The type of treatment used will depend on the location, size and type of cancer.the location, size and type of cancer.Types of External Radiation Therapy Three-dimensional conformal Three-dimensional conformal radiation therapy (3D-CRT)radiation therapy (3D-CRT)n nA technique where beams of radiation A technique where beams of radiation used in treatment are shaped to used in treatment are shaped to match the tumor and are delivered match the tumor and are delivered accurately from several directions.accurately from several directions. Intensity modulated radiation Intensity modulated radiation therapy (IMRT)therapy (IMRT)n nA form of 3-D CRT in which the A form of 3-D CRT in which the physician designates specific doses of physician designates specific doses of radiation that the tumor and normal radiation that the tumor and normal surrounding tissues receive.surrounding tissues receive.The type of equipment used will depend on the The type of equipment used will depend on the location, size and type of cancer.location, size and type of cancer.A multileaf collimator is used to A multileaf collimator is used to shape the radiation beam to shape the radiation beam to match the tumor, sparing match the tumor, sparing surrounding healthy tissuesurrounding healthy tissueTypes of External Beam Radiation Therapy Proton Beam TherapyProton Beam Therapyn nA type of radiation therapy that uses high-A type of radiation therapy that uses high-energy beams (protons) rather than X-rays energy beams (protons) rather than X-rays to treat certain types of cancer. to treat certain types of cancer. n nMost commonly used in the treatment of Most commonly used in the treatment of pediatric, CNS and intraocular cancers.pediatric, CNS and intraocular cancers. Stereotactic Body Radiotherapy or Stereotactic Body Radiotherapy or Stereotactic RadiosurgeryStereotactic Radiosurgeryn nA specialized form of radiation therapy that A specialized form of radiation therapy that focuses high-power energy on a small area focuses high-power energy on a small area of the body. Despite its name, radiosurgery of the body. Despite its name, radiosurgery is a treatment, not a surgical procedure.is a treatment, not a surgical procedure.n nRadiosurgery generally implies a single high Radiosurgery generally implies a single high dose or just a few high dose treatments.dose or just a few high dose treatments. AS maybe a AS maybe a picture of a protonpicture of a protongantry?gantry?Internal Radiation Therapyn nRadioactive material is placed into Radioactive material is placed into tumor or surrounding tissue.tumor or surrounding tissue. Also called brachytherapy.Also called brachytherapy. Radiation sources are placed close Radiation sources are placed close to the tumor so large doses can to the tumor so large doses can damage the cancer cells. damage the cancer cells. Allows minimal radiation exposure Allows minimal radiation exposure to normal tissue.to normal tissue. Radioactive sources used are thin Radioactive sources used are thin wires, ribbons, capsules or seeds.wires, ribbons, capsules or seeds. These can be either permanently These can be either permanently or temporarily placed in the bodyor temporarily placed in the bodyRadioactive seeds for a Radioactive seeds for a permanent prostate implant, permanent prostate implant, an example of low-dose-rate an example of low-dose-rate brachytherapy.brachytherapy.Permanent vs. Temporary Implantsn nPermanent implants release small amounts of Permanent implants release small amounts of radiation over a period of several radiation over a period of several monthsmonthsn nExamples include low-dose-rate prostate implants Examples include low-dose-rate prostate implants (“seeds(“seeds”),”),n nPatients receiving permanent implants may be minimally Patients receiving permanent implants may be minimally radioactive and should radioactive and should temporarily temporarily avoid avoid close close contact with contact with children or pregnant children or pregnant women. women. n nTemporary implants are left in the body for Temporary implants are left in the body for several hours to several days several hours to several days n nPatient may require hospitalization during the implant Patient may require hospitalization during the implant depending on the treatment site ,depending on the treatment site ,n nExamples include low-dose-rate gynecologic implants and Examples include low-dose-rate gynecologic implants and high-dose-rate prostate or breast implants,high-dose-rate prostate or breast implants,Side Effects of Radiation Therapyn nMost side effects begin during Most side effects begin during the second or third week of the second or third week of treatment. Doctors and nurses treatment. Doctors and nurses may prescribe medications to may prescribe medications to help with these side effects.help with these side effects.n nSide effects, like skin redness, Side effects, like skin redness, are generally limited to the are generally limited to the area receiving radiation.area receiving radiation.n nFatigue is a common side Fatigue is a common side effect for all cancer patients.effect for all cancer patients.n nSide effects may last for Side effects may last for several weeks after the final several weeks after the final day of treatment.day of treatment.Side effects vary based on a patients Side effects vary based on a patients medical profile or diagnosismedical profile or diagnosisWho is the Cancer Care Team?All those involved with a patient during and after All those involved with a patient during and after their care is part of the Cancer Care Team. This their care is part of the Cancer Care Team. This includes:includes: The Treatment Team includingThe Treatment Team includingn nPhysiciansPhysiciansn nNursesNursesn nRadiation therapistsRadiation therapistsn nPhysicistsPhysicistsn nDosimetristsDosimetristsn nSocial workersSocial workersn nReceptionistsReceptionists Family and FriendsFamily and FriendsThe Cancer Care Team, cont.It is important for the Cancer Care Team to have It is important for the Cancer Care Team to have an open dialogue throughout the treatment an open dialogue throughout the treatment process.process. Always ask questions if you have them - there Always ask questions if you have them - there are no dumb questions.are no dumb questions. Always share your concerns whether you are Always share your concerns whether you are the patient or the caregiver, discuss your the patient or the caregiver, discuss your concerns with the medical team during the concerns with the medical team during the treatment consultations.treatment consultations. Do your research there are many good Do your research there are many good resources out there to help patients before, resources out there to help patients before, during and after their treatment.during and after their treatment.For More InformationVisit Visit www.rtanswers.orgwww.rtanswers.orgn nTo view information on To view information on how radiation therapy how radiation therapy works to treat various works to treat various cancerscancersn nTo find a radiation To find a radiation oncologist in your areaoncologist in your arean nFor support resourcesFor support resources