Radiation Oncology

Radiotherapy works by damaging the genetic material within the cancer cells. Once this happens the cancer cell are not able to grow and spread. When these damaged cancer cells die the body naturally removes them. 

EBRT [External Beam Radiotherapy/ Teletherapy]-
In this method, radiation is targeted towards the body from a distance. This radiation beam is generated from a machine called linear accelerator which produces high energy X-rays. 

BRACHYTHERAPY [Internal Radiation] - this involves placing radiation sources in or near the tumour in the body.
               
TREATMENT TECHNIQUES- 

3DCRT - Three Dimensional Conformal Radiotherapy 
The medical physicist using planning computers and specific software, controls the size and shape of beams using multileaf collimator [MLC- which provides the desired shape] as well as how it is directed at one’s body to effectively treat the tumor while sparing the surrounding normal tissues.

IMRT - Intensity Modulated Radiotherapy -IMRT is a specialized form of conformal radiotherapy that allows radiation to be specifically shaped to cover the tumour. Here the beam can be broken into segments and intensity of each segment can be adjusted individually. Higher tumor dose and maximum sparing of normal tissues is possible with this technique.

IGRT - Image Guided Radiotherapy- IGRT is used by the Radiation Oncologist to deliver the radiation more accurately to the tumour by confirming with an imaging such as CT or X-Ray in the treatment position. This is compared to the planning CT to check the accuracy of the set up and also the progress of the reduction of size of the tumor, if any adjustments need to be made before treating the patient. 

VMAT - Volumetric Modulated Arc Therapy- VMAT is a rotational arc therapy where the dose of radiation is more conformed than other techniques & hence treatment time is reduced and so the side effects are to a minimal.

SRS - Stereotactic Radio Surgery - SRS is used for small lesion in brain and spine.  Sometime it is used for benign(non-cancer) conditions. Doctors use specialized scans to pinpoint exactly where tumor target is located. Higher dose of radiation is given in single setting.  

SBRT- Stereotactic Body Radiotherapy - SBRT/SRT or SABR stereotactic ablative radiotherapy delivers high radical(curative) dose of radiation in 1-5 settings. It requires high precision radiation machine.

GATING /DIBH - This technique is used in special cases where deep inhaling and expansion of the lungs helps. It is mainly used in cases where area of radiation moves with respiration like breast, lung, mediastinum, liver and esophagus. Left breast cancer are benefitted where expansion of lungs causes the heart to move out of the treatment field. Late cardiac toxicity is reduced considerably.
 

Radiation Oncologist – These are doctor who specializes in using Radiation to treat cancer, they will oversee the radiation therapy and thereafter. These Doctors work with other team members of radiation team to develop treatment plan and ensure that each treatment is given safely and accurately. They receive extensive training in Cancer medicine and the use of radiation to treat the disease and in managing any side effects caused by radiation. They work closely with other doctors like medical oncologists and surgical oncologists, physiotherapiest, dietician to improve the outcome of treatment.

Medical Physicists - Medical Physicists involved in treatment planning and delivery. They ensure that the complex treatments are properly tailored for each patient. They develop and direct quality control programs for the equipment's and procedures to ensure the maximum safety. 

Radiation Therapists / Technologists - Technologists are experts specifically trained to use in operating the radiation machines. They carefully and skillfully set the patients daily for their treatments and monitor patient’s progress and reactions. 

Oncology Nurse - Oncology Nurses work with every member of the treatment team in caring for the patient before, during and after treatments.