Aspirus Wausau Hospital

Radiation Therapy

Radiation therapy uses high-energy rays to kill or shrink cancer cells and decrease their ability to divide. If the disease is advanced, radiation may be used to reduce the size of the tumor and to provide relief from symptoms.

Radiation therapy technology continues to advance, and the Aspirus Regional Cancer Center offers the latest radiation therapy options, including TomoTherapy, a revolutionary radiation treatment that allows doctors to target cancer with greater precision and safety.

Types of radiation therapy

There are generally two types of radiation therapy:

• External radiation (external beam therapy) – This treatment precisely sends high levels of radiation directly to the cancer cells. The machine is controlled by the radiation therapist, and since radiation is used to kill cancer cells, special shields may be used to protect the tissue surrounding the treatment area.
  
  Radiation treatments are painless and usually last a few minutes. This type of radiation therapy may be given daily for several weeks. TomoTherapy, is a type of external radiation.
  
  For more information about some of the advanced types of radiation therapy offered at Aspirus Regional Cancer Center, please visit our listing of advanced technology and treatments.
• Internal radiation (implant therapy) – This is a procedure that uses small, radioactive seeds (each about the size of a grain of rice) that are implanted directly into a tumor. The implanted seeds can be left in permanently or only temporarily. The seeds emit small amounts of radiation for a period of weeks or months.
  
  In addition to seed therapy, another type of internal radiation offered at the Aspirus Regional Cancer Center is a 5-day breast cancer treatment called Electronic Brachytherapy. In this treatment, radiation is delivered internally, directly to the cancerous site.

Treatment steps

Radiation therapy treatment occurs over a course of “treatment steps.” Click on any of the steps below to read about them in detail.

STEP 1: Treatment consultation

The first step is a consultation visit with the radiation oncologist and nurse. They discuss the patient’s medical history, further evaluate the cancer, and discuss treatment options with the patient and family. Once the decision is made to proceed with treatment appointment times for simulation are made. The physician will inform the patient about possible treatment side effects, and a treatment consent form is signed.

STEP 2: Simulation and CT scans

CT simulation is the important second step where the patient’s internal anatomy is “mapped” so radiation can be directed to the cancer, while minimizing its effect on normal tissues. Under the direction of the radiation oncologist, the radiation therapist will have the patient lie on the CT simulator table in the customized treatment position while images are taken.

The radiation therapy staff often makes devices to help the patient maintain the proper treatment position, for example, a facemask is often made and used in the treatment of head or neck cancer. The devices are used each day during treatment to reproduce an exact body position for treatment. When simulation is complete, the radiation therapist will mark the treatment area on the skin with a marker, and with the patient’s permission, will give permanent tattoos.

STEP 3: Treatment planning

Step three is treatment planning, where the radiation oncologist and the medical dosimetrist work together to make a unique treatment plan for each patient, designing the radiation dose to go the target area while avoiding as much normal tissue as possible. Sometimes an MRI or PET scan is done to enhance the CT simulation that the patient has already had done.

STEP 4: Treatment appointments

Once planning is complete, a series of appointments are made for radiation treatment. Therapists will work hard to develop a schedule that fits with your life.

STEP 5: Radiation therapy treatments

Treatment usually begins one to three weeks after simulation, depending on the complexity of the treatment plan. Patients and family come to the Aspirus Regional Cancer Center and check in with the receptionist before each treatment. Therapists and nurses are available to answer any questions before or after each treatment.
The first treatment may take up to 20 minutes or more. The patient is positioned on the treatment table by the therapists using any positioning devices used during the simulation step.

Patients can bathe with a mild soap during radiation treatment, being careful not to scrub the treatment area since the skin can become irritated. Over time, positioning markings or tattoos on the skin can fade. Patient and family members should bring faded markings to the therapists’ attention. It is important that only the therapists reapply markings drawn on the skin – this contributes to treatment accuracy.

After the patient has been positioned correctly on the treatment machine, the therapist exits the room to start the treatment. This is for the therapist’s safety. The therapist monitors the patient from the console area outside the treatment room using a two-way intercom system and camera.

It is extremely important that the patient lie completely still during treatment. This contributes to treatment accuracy. Treatment is completely painless. The patient does not see or feel anything different when the radiation machine is on.

STEP 6: Verification images

Verification images or ultrasound images (also called port films) are taken in the treatment room the day prior to or on the first day of treatment. These images are used to verify that the area to be treated with radiation is aligned properly with the machine. Images will be repeated daily or weekly to verify the radiation is treating the area correctly as prescribed by the radiation oncologist. These images are for positioning only – they do not monitor the effect of the treatments on the cancer.

STEP 7: Weekly visits during treatment

Each patient will see their radiation oncologist and a nurse for a weekly visit during treatment. The patient’s weight and vital signs will be monitored, blood counts may be checked, and time is spent with patients for their educational needs.

STEP 8: Completion of radiation and follow-up care

At the completion of radiation therapy treatment, each patient will talk with the nurse and radiation oncologist. Instructions for continued care will be given and a follow-up appointment is made.   A usual follow-up visit is one to three months after the completion of radiation therapy. As always, the Aspirus Regional Cancer Center team members are available to answer any questions or concerns at any time before, during or after your treatment.