Cancer (Oncology)

Radiation Oncology

Radiation Therapy
More than half of all people with cancer have radiation treatment, either alone or in combination with surgery and chemotherapy.

Radiation therapy serves two purposes: to cure cancer by destroying tumors and to reduce or ease symptoms, such as shortness of breath and pain. The therapy works by damaging the DNA within cancer cells. These cells are then naturally eliminated from the body.

Patients who are not eligible for surgery because of other medical conditions may also benefit from radiation therapy.

Three-dimensional computer-generated images and other radiological tools are used to develop individualized treatment plans based on the size, shape, and location of the tumor. Advanced technology allows physicians to target higher doses of radiation directly at the tumor, sparing healthy tissue and minimizing side effects.

Radiation therapy is delivered in one of three ways:

1. External Beam Radiation Treatment
The linear accelerator (LINAC) is a computerized device that delivers external beam radiation. It is image-guided, which means it uses X-ray and CT scan technology to locate the cancer and pinpoint delivery of treatment. There are several types of therapies that the linear accelerator can provide:

Image-guided radiation therapy (IGRT)
Internal organs and tumors can move between and during treatments. IGRT allows the radiation therapy team to see and track the tumor at the time of treatment and to make fine adjustments to the patient’s position. This greatly increases the precision and accuracy of radiation therapy treatment.

Intensity-modulated radiation therapy (IMRT)
This method uses multiple beams with varying intensities to attack a tumor from different directions while limiting the radiation to surrounding healthy tissues. IMRT technology allows the radiation oncology team to tackle cancers that are close to, or wrapped around, critical organs. IMRT is effectively used to treat prostate, head and neck, brain, and some tumors of the intestinal tract. A built-in computed tomography (CT) scanner provides three-dimensional images of the targeted area. This helps ensure that the patient is positioned accurately during treatment.

Volumetric modulated arc therapy (VMAT)
Single or multiple radiation beams are delivered in uninterrupted arcs around the patient, dramatically reducing treatment times compared to similar modalities. It is often used to treat prostate, and head and neck cancers.

Respiratory patient monitoring (RPM) is an additional tool that enables the radiation to follow a lung lesion even during a patient’s natural breathing cycle. This provides an accurate dose of radiation to the tumor while sparing the surrounding lung tissue.

Stereotactic radiosurgery
This procedure is used to treat parts of the brain where standard surgery would be difficult or impossible. The radiation oncology team can deliver a single dose of radiation to a tumor or several tumors, while minimizing radiation to healthy tissue. Stereotactic radiosurgery offers a minimally invasive alternative to neurosurgery and conventional radiation treatment for some brain tumors.

Stereotactic body radiation therapy (SBRT)
Even the smallest lesions in the lung, liver or spine can be treated with stereotactic body radiation. The linear accelerator offers the advantage of a high definition "multileaf collimator." This device can precisely outline the targeted treatment area to receive radiation down to 2.5 mm. Physicians can deliver a high dose to a targeted area during a shorter treatment period.

Because the lung moves with every breath the risk of damaging healthy tissue had been a challenge. Now, SBRT allows a physician to track the motion of the lung and turn on the radiation only when the diseased tissue comes into focus. This may be a suitable option for patients with Stage 1 or 2 lung cancer. SBRT can destroy a tumor in just a few sessions, and many times can replace surgery entirely when cancer is detected early.

2. Internal  / Brachytherapy
This procedure involves placing radioactive sources into or near the tumor to deliver high doses of radiation to the target without harming surrounding normal tissue. The radioactive materials used are thin wires, ribbons, capsules or seeds. They are inserted temporarily or permanently in the body. Brachytherapy can be used to treat prostate, uterine, lung, breast and esophageal cancers.

Sometimes patients receive a hybrid of external beam radiation treatment and internal radiation therapy (brachytherapy).

3. Radiopharmaceuticals
Radiation therapy can also be delivered by an injection of radioactive particles into the blood vessel or attached to an antibody targeted at tumor cells. The radiopharmaceutical Xofigo, commonly referred to as Radium 223, is especially significant for patients whose cancer has spread to the bone.

Radium 223 can not only prolong a patient’s life, but vastly improve the quality of life by reducing debilitating pain for patients with advanced stage metastatic cancer. As an alternative to chemotherapy, patients receiving radiopharmaceuticals also experience fewer side effects such as infection, nausea and hair loss.


Soothing environment facilitates care
Providing practical and emotional support to patients is as important as having access to advanced technology. Smilow Cancer Hospital's Greenwich Hospital Campus stands by patients and their families every step of the way – from education about the treatment process and managing side effects, to finding transportation, social services, home care, support groups or other community resources.

The treatment suite was designed to help patients feel calm and comfortable. A Zen garden with raked gravel and meditation stones sets a serene tone. The soothing décor extends to the radiation treatment room, where cherrywood cabinets conceal much of the medical equipment. Patients lying on the treatment table view a colorful, lighted ceiling panel filled with trees and blossoms.

Contact information
For questions about radiation oncology or to make an appointment with Radiation Oncology Services please call 203-863-3701.

Professional and Personalized Care
The staff includes a board certified radiation oncologist, licensed radiation therapists, an oncology-certified nurse, board-certified medical physicists and others. These experts work together to provide the safest and highest caliber of cancer treatment. The team’s focus on service excellence is exemplified by consistently high patient satisfaction ratings among the top in the nation.

Affiliation with Yale School of Medicine
Smilow Cancer Hospital's Greenwich Hospital Campus's partnership with Yale School of Medicine gives patients access to a wide network of clinicians in addition to the cancer expertise offered locally. Learn more >>  

Other options for treating cancer may include:
Surgical Oncology >>
Medical Oncology >>

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