Treatment Proper

Radiation therapy, or radiotherapy, is the use of various forms of radiation to safely and effectively treat cancer and other diseases. Radiation oncologists may use radiation to cure cancer, to control the growth of the cancer or to relieve symptoms, such as pain. Radiation therapy works by damaging cells. Normal cells are able to repair themselves, whereas cancer cells cannot. New techniques also allow doctors to better target the radiation to protect healthy cells.

Cancer doctors usually treat cancer with radiation therapy, surgery or medications, including chemotherapy, hormonal therapy and/or biologic therapy, either alone or in combination. If your cancer can be treated with radiation, you will be referred to a radiation oncologist — a doctor who specializes in treating patients with radiation therapy. Your radiation oncologist will work with your primary doctor and other cancer specialists, such as surgeons and medical oncologists, to oversee your care. He or she will discuss the details of your cancer with you, the role of radiation therapy in your overall treatment plan and what to expect from your treatment.

Sometimes radiation therapy is the only treatment a patient needs. At other times, it is only one part of a patient’s treatment. For example, prostate and larynx cancer are often treated with radiotherapy alone, while a woman with breast cancer may be treated with surgery, radiation therapy and chemotherapy.

Radiation may also be used to make your primary treatment more effective. For example, you can be treated with radiation therapy before surgery to help shrink the cancer and allow less extensive surgery than would otherwise be needed, or you may be treated with radiation after surgery to destroy small amounts of cancer that may have been left behind.

The radiation oncologist may choose to use radiation therapy in a number of different ways. Sometimes the goal is to cure the cancer. In this case, radiation therapy may be used to:

• 1. Destroy tumors that have not spread to other parts of your body.
• 2. Reduce the risk that cancer will return after you undergo surgery or chemotherapy by killing small amounts of cancer that might remain.
• 3. Sometimes, the overall goal is to slow down the cancer as much as possible. In other cases, the goal is to reduce the symptoms caused by growing tumors and to improve your quality of life. When radiation therapy is administered for this purpose, it is called palliative care or palliation. In this instance, radiation may be used to:
  • a. Shrink tumors that are interfering with your quality of life, such as a lung tumor that is causing shortness of breath.
  • b. Relieve pain by reducing the size of your tumor.

It is important for you to discuss the goal of your treatment with your radiation oncologist.

A very large machine called a linear accelerator is used to deliver radiation. It will rotate around you to deliver the radiation dose to your tumor from multiple angles. As the treatment begins, you will lie on a table. The radiation therapist will align your body to ensure proper administration of the therapy. Then, the table will raise you up under the linear accelerator. Your therapist will step outside the room to monitor your treatment via closed circuit television. You can communicate by using the intercom system. The linear accelerator will make a buzzing sound while the radiation is being delivered, but you will not feel or see it. It is very important that you do not move during your treatment.

Radiation therapy is usually given on a structured schedule over the course of several weeks - typically 6 - 8 weeks. Treatments generally are completed within 15 minutes, but could be longer, depending on complexity.

During the course of treatment, you will be seen once a week by the radiation oncologist to monitor how you are responding to the treatments and to assess your overall progress. This meeting day should not vary, unless a major holiday, emergency or other conflict interferes. At least weekly and sometimes daily, the therapist will take your "port films" or X-rays that verify your treatment setup and treatment prescription. This is one way to ensure the quality and accuracy of your radiation therapy. Port films do not give your physician information on the status of your cancer.

Some days, your appointment will be longer than usual. On-treatment visits (OTV) and end-of-treatment visits (ETV) with your radiation oncologist are examples of longer appointment days.

We treat many patients in our facility, and appointments are scheduled at 15-minute intervals.  As much as possible, we will try to schedule the treatments at times that are convenient for you. You have to let the front desk or your therapist know if there is a specific time that works best for you, or any ongoing time conflicts you may have. We will do our best to accommodate your request, but cannot guarantee that the specific time you want will be available. If you must see your radiation oncologist on a day other than your regularly scheduled day, please let your therapist or the front desk know. They will help you arrange a different time for the physician meeting. Please arrive on time so that other patients are not delayed or inconvenienced. If you will be late for your treatment, please give us a call immediately at (718) 835-9729.

We understand that emergencies and occasional conflicts may occur at your appointment time. It is essential that you do not skip any treatments or other clinic appointments. Therefore, if you must reschedule your appointment, please call us as soon as possible. (One day's notice is helpful.) Your therapist or our front desk will advise you of any schedule changes caused by major holidays.

Our goal is to make every patient as knowledgeable about the radiation therapy process as possible and comfortable enough to ask questions. If, at any time during your many visits with us, you are unsure as to what is happening around you, please do not hesitate to ask. At a time in your life when things are seemingly out of your control, knowing what to expect can be a powerful tool in becoming refocused and moving onward. .  Follow instructions carefully, and report any unusual symptoms to your radiation therapy team.