Radiation is a scary word used to describe high energy light waves. These are either generated by a machine (X-Rays) or come from a radioactive piece of metal (Gamma-Rays). Regardless they pass through your body painlessly. Radiation works by damaging both the cancer and healthy tissues in its path. Since cancer develops due to an inability of the cancer cell to correctly repair itself, cancer cells are more likely to die after radiation than normal cells which retain their ability for cell repair. Just as surgeons perform surgery and medical oncologists deliver chemotherapy, radiation oncologists deliver radiation therapy.
- You do not see, hear, taste, smell, or feel the radiation beam enter of exit your body.
- There is less energy in the daily radiation treatments than in a hot cup of coffee!
- While used since 1897 for breast cancer, radiation techniques have evolved considerably over the last century
(and even last 5-10 years!)
- Kettering's physicians deliver state of the art treatments utilizing the latest technological advances.
3D Conformal Radiation Therapy (3D-CRT) - Given over the course of 16 to 36 treatments depending upon a woman's individual cancer, these painless treatments are delivered 5 days a week, Monday through Friday. Each session lasts less than 30 minutes, and the radiation beam itself is only on for about three minutes or less.
- 3D-CRT uses X-rays from a machine called a linear accelerator or linac.
- 3D-CRT can treat the breast with or without including nearby lymph nodes that may also need treatment.
Intensity Modulated Radiation Therapy - (IMRT) is a form of a 3D-CRT that further modifies the radiation by varying the intensity, size, and shape of each radiation beam.
Accelerated Hypofractionation - is a shortened more intensive course of 3D-CRT given over 16-21 days.
4D Treatment Delivery is utilized at Kettering to minimize radiation to the heart in women with left sided breast cancers. It involves breathing maneuvers to move the heart out of the radiation beam during treatments.
At Kettering, we deliver this treatment using a high dose-rate afterloader (HDR). This is a machine that houses a piece of radioactive metal to deliver gamma rays from the inside of the breast outwards. This is also called Accelerated Partial Breast Irradiation. To have breast brachytherapy a surgeon places an inflatable balloon in the cavity where the cancer was removed. The balloon has a catheter (hollow tube) that extends outside the body. This tube connects to the HDR to let the radioactive metal enter and exit the tumor cavity twice a day for 5 days.
- Breast brachytherapy is only recommended for early stage cancers < 3 cm in size
- Each treatment lasts about 10 minutes, although additional set-up is required
- Treatments are at least 6 hours apart, delivered twice a day for five days
- Brand names of balloons are: Mammosite, Contura, and Savii
Radiation After A Mastectomy
Many patients opt for a mastectomy in an attempt to avoid the need for additional treatments or worries about cancer recurrence. Some more advanced cancers, however, may still benefit from additional chemotherapy and radiation therapy to the chest wall to prevent the cancer from coming back in the skin of the chest, lymph nodes, or elsewhere in the body.
- Radiation is indicated in more advanced cancers treated with mastectomy.
- Radiation does not prevent/preclude having a breast reconstruction.
When in doubt, ask to see a radiation oncologist so they can help you weigh the risks and benefits of additional radiation treatments.
Side effects from radiation therapy are gradual in onset and are very well tolerated. The majority are temporary and resolve a few days after daily treatments end. Most do not occur until two to three weeks into treatment. However, ask your doctor what you can expect from your specific treatment.
High Dose Rate (HDR) Brachytherapy
KHN offers a painless option to eliminate skin lesions with minimal side effects - High Dose Rate (HDR) brachytherapy with a tool called the Valencia Applicator.
For small superficial skin carcinomas, HDR offers an effective alternative to other treatment options. Patient set-up is fast and accurate, and the treatment and recovery times are very short. The HDR unit robotically feeds a radioactive source to quarter-sized Valencia applicator. This delivers a more uniform dose than previous metal applicators and provides outstanding clinical and cosmetic results.
These non-invasive treatments are delivered painlessly and last approximately 10 minutes per site, with treatments given every other week day for 2-4 weeks until the cancer is eliminated.
An experienced KHN radiation oncologist and a dermatologist work collaboratively to decide whether the Valencia HDR treatment or surgery would be the best fit for the patient. For more information on the treatment of skin cancer with the Valencia Applicator, ask your physician or call (937) 395-8115.
Chemotherapy is the name for a group of medicines or drugs used to treat cancer and some other conditions. Because chemotherapy works throughout the entire body, it can kill cancer cells that may have already spread or metastasized to parts of the body that are far away from the primary or original tumor. The goal may be to cure the cancer, to keep the cancer from spreading, to slow the cancer's growth, or to relieve symptoms such as pain or nausea caused by the cancer.
Chemotherapy is most frequently administered intravenously (IV) through a needle or special catheter into a vein. However, chemotherapy can also sometimes be administered by pills or capsules, into a body cavity such as the bladder, or by other special methods. A single drug or a combination of drugs may be used in a variety of dosages and schedules, depending on the type of cancer you have, where it is in your body, how big it is, and your overall health.
Chemotherapy may be the only treatment you will need, but it may be also be used with other types of cancer treatments such as surgery, radiation therapy, hormone therapy, and biotherapy and targeted therapy. At this time, more than 100 chemotherapy drugs exist and new drugs are under development.
Your IV chemotherapy may be administered in a variety of locations, depending on the drugs you need to receive, your insurance coverage, your preference, and your physician's recommendation. You may receive treatment in your physician's office, in a clinic, as an outpatient at your hospital, or as an inpatient at your hospital. A few chemotherapy drugs may be administered in your home.
Chemotherapy drugs are made to kill fast-growing cells. Some types of normal cells are fast-growing and may be affected by chemotherapy. Damage to normal cells causes side effects. The types of normal cells most often affected by chemotherapy include blood-forming cells in the bone marrow, hair follicles, the lining of your mouth and digestive tract, and reproductive system. This is the reason that some people who are receiving chemotherapy experience fatigue, infection, anemia, hair loss, and nausea and vomiting.
It is important to remember that every person does not experience these side effects and that most side effects are temporary. Your physician may give you medicines or suggest other ways that you can prevent some side effects. Be sure to talk to your physician and nurse about which side effects are most likely to occur with your chemotherapy and when you should seek medical care for them.
Biotherapy and Targeted Therapy
Biotherapy and targeted therapy are newer treatments for cancer and other conditions. They work very differently from chemotherapy. Chemotherapy directly attacks and kills cancer cells, but biotherapy and targeted therapy are more specific.
Biotherapy works with your immune system to fight cancer or to control side effects. Many biotherapy drugs are administered intravenously (IV), but some can be administered by intramuscular (IM) or subcutaneous (SQ) "shots" or injections. Biotherapy may be the only cancer treatment you will need, but it is often used with other types of cancer treatments such as surgery, chemotherapy, and radiation therapy.
Biotherapy may be administered in a variety of locations, depending on the drugs you need to receive, your insurance coverage, your preference, and your physician's recommendation. You may receive treatment in your physician's office, in a clinic, as an outpatient at your hospital, or as an inpatient at your hospital. Treatment schedules vary from once or twice per day to once per month.
Side effects of biotherapy may include skin rash, flu-like symptoms such as fever, chills, and body aches, and a lower blood pressure. It is important to remember that every person does not experience these side effects and that most side effects are temporary. Your physician may give you medications or suggest other ways to prevent some side effects. Be sure to talk to your physician and nurse about which side effects are most likely to occur with your biotherapy and when you should seek medical care for them.
Targeted therapy moderates or controls signals that tell the cancer cell when to grow and divide into new cells. Many targeted therapy drugs are administered orally as pills or capsules over a period of time. Targeted therapy may be the only cancer treatment you will need, but it is often used with other types of cancer treatments such as surgery, chemotherapy, and radiation therapy.
Targeted therapy can cause a variety of side effects, not limited to skin rash, diarrhea, altered liver function, fatigue, and fluid retention. It is important to remember that every person does not experience these side effects and that most side effects are temporary. Your physician may give you medications or suggest other ways to prevent some side effects. Be sure to talk to your physician and nurse about which side effects are most likely to occur with your biotherapy and when you should seek medical care for them.
Gamma Knife Perfexion
The Gamma Knife Perfexion is actually not a knife, but a treatment that directs 192 beams of radiation to treat brain tumors. Your doctor designs a treatment customized for your brain tumor. Then, the Gamma Knife accurately treats the abnormality in your brain with less damage to the healthy tissue. Gamma Knife is considered the "Gold Standard" for radiosurgery.
The treatment is non-invasive (no incisions) and can be used as an alternative to, or along with conventional surgery. Brain tumors and other problems that were once thought to be inoperable can now be safely and effectively treated. Patients who are poor candidates for conventional surgery due to age, certain health conditions, or an inability to have general anesthesia, may also benefit from Gamma Knife radiosurgery.
Learn more about Gamma Knife Perfexion
The Innovation Center at Kettering Health Network provides a variety of opportunities for our cancer patients to participate in clinical trials:
KHN partners with US Oncology to conduct studies of promising chemotherapy drugs at various stages in the development and testing process prior to FDA approval. Some of these clinical trials are Phase I studies featuring drugs that are being used in humans for the first time. Through his work with US Oncology, Dr. Robert Raju brings years of experience and expertise as a clinician and researcher to the forefront, allowing our patients to participate in groundbreaking research with potential new therapies that are not readily available elsewhere.
Gynecology Oncology Group (GOG)
Dr. Thomas Reid oversees GOG studies at KHN through an affiliation with the University of Cincinnati. GOG is a national non-profit organization that advances the aims of the National Institutes of Health (NIH) and the National Cancer Institute (NCI) by making clinical trials available to women with reproductive cancers.
Dayton Clinical Oncology Program (DCOP)
KHN is a member of this regional cancer research consortium which is comprised of physicians, hospitals and universities throughout the Miami Valley. DCOP is a non-profit cooperative effort that combines the talents and resources of the local medical community to make national therapeutic drug trials available in Dayton.
National Oncologic PET Registry (NOPR)
KHN's positron emission tomography (PET) department has participated in the NOPR since 2006. The NOPR is a CMS "coverage with evidence development" program. It is a research project designed to provide Medicare with data to justify expanding the current coverage for PET scans. If the conditions of the NOPR are met, participating patients can receive Medicare reimbursement for their scans even though a national coverage decision has not yet been made. This saves the patient a large out of pocket expense that could, in some cases, be prohibitive. By participating in this program, we ensure that our cancer patients have access to the PET scans they need without an additional financial burden.
Oncology Imaging Studies
KHN also supports oncology research studies that are initiated by investigators on our staff, particularly in the field of medical imaging. Positron Emission Tomography and Magnetic Resonance Imaging studies increase our knowledge of the anatomy and physiology of cancer at the cellular and molecular level. By evaluating and improving the technology used in the diagnosis and staging of cancer, our research could lead to new diagnostic methods, new therapies and improvements in the current standard of care.
Leukemia, Lymphoma, & Myeloma Family Support Group
For adult patients and survivors and their families and friends. An official Leukemia-Lymphoma Society Support Group. This group meets at Kettering Medical Center on the first Tuesday of each month except June and December. Check the Looking Ahead newsletter or call Cancer Services at (937) 395-8115 for more information.
Looking Ahead Support Group
This group helps individuals living with cancer, their families and friends. For those newly diagnosed with cancer as well as long-term survivors. Meets at Kettering Medical Center on the first Tuesday of each month except June and December. Check the Looking Ahead newsletter or call Cancer Services at (937) 395-8115 for more information.
I Can Cope
This is a series of educational classes for people with cancer, their families and friends. The program helps people meet the challenge of coping with cancer by distinguishing cancer myths from facts. This FREE program provides practical information about cancer, cancer treatments, and offers self-care strategies and resources for those facing cancer. This American Cancer Society Program is co-sponsored by Kettering Health Network.
Call the American Cancer Society at 1-888-ACS-OHIO (227-6446) for current dates, location and to register.
Cancer Resource Center
The Cancer Resource Center (CRC) is a collaborative effort between your American Cancer Society and Kettering Medical Center. The CRC is located at Kettering Memorial Hospital, ground floor, adjacent to the Radiation Therapy waiting area, and is open to the public from 9 AM to 4 PM, Monday through Friday, except holidays and during special events. Trained volunteers are available to assist you with information about cancer, cancer prevention and early detection, cancer treatments, coping and support groups and other resources. Information called also be mailed upon request. Call (937) 395-8081.
The Makarius Library is located at Kettering Memorial Hospital, 3 South. This is a free lending library with materials on cancer, treatment, coping and inspiration. Items may be signed out for up to four weeks. The library is open daily, except during patient care meetings.
Cancer Support Group
The Gebhart Center for Cancer Care at Fort Hamilton Hospital sponsors a monthly meeting for patients and families dealing with all types of cancer. The group meets on the third Monday of every month from 6:30 - 8:30pm and assists patients and their families with the changes that cancer may bring into their lives. For more information or register, please call (513) 867-2315.
Fort Hamilton Hospital offers a wide array of wigs and turbans at no charge to those who have suffered hair loss due to illness. The Wig Room is open on Wednesdays from 9am - 1pm in the volunteer services department. For other arrangements, please (513) 867-2288.
The Gebhart Center for Cancer Care offers easy access to a wealth of information in the department's resource center.