A common treatment for cancer, radiation oncology uses high-energy x-rays, gamma rays, electrons or radioactive materials to kill cancer cells, to stop or slow their growth and treat patients for pain or symptom relief (palliation). Cancer Care Northwest provides the following radiation therapy techniques:
More than half of people with cancer get radiation therapy. Radiation therapy may be the only kind of cancer treatment you need, and other times it is combined with other treatment methods. Radiation therapy is used today as a safe and effective treatment that is offered at three Cancer Care Northwest locations in Spokane. Radiation therapy is used to:
Our radiation oncologists are board-certified physicians who specialize in the use of radiation therapy to treat cancer. The radiation oncologists are among the most technologically savvy in the region, with expertise in external beam radiation therapy, stereotactic radiotherapy, gamma knife radiosurgery for brain tumors, and brachytherapy for prostate, intravascular, breast and gynecologic cancers. The radiation team includes radiation therapists, medical physicists, dosimetrists, nurses and imaging technologists.
What is external beam radiation?
External beam radiation sends high-energy X-ray beams from outside your body through your skin to the tumor, killing or slowing the growth of the cancerous cells.
How does it work?
Your radiation oncologist utilizes a machine called a linear accelerator (LINAC) to produce and precisely aim high-energy radiation beams at the tumor. Your radiation treatment team can adjust the size and shape of the beam, its intensity, and how it is directed at your body so that the radiation effectively destroys your cancer while avoiding damage to healthy tissue.
External beam radiation usually requires a series of treatments over a period of several weeks, depending on your cancer.
Cancer Care Northwest’s South Spokane (Sherman Ave.), Downtown Spokane, and North Spokane (Holland Ave.) treatment centers each have a linear accelerator, making radiation therapy easily accessible and convenient for patients throughout the area. The North Office is home to the new Varian Clinac ix Linear Accelerator, a state-of-the-art, digital linear accelerator that delivers some of the most advanced forms of radiation therapy in the region.
Before treatment begins, your radiation oncologist will take CT images (CAT Scan) pictures of your body in a process called “simulation.” These three-dimensional images help your doctor pinpoint your cancer and determine how to position your body so that the beams can be accurately aimed at your cancer.
Your doctor may make a special mold so you can replicate that exact position during your actual treatment. Sometimes your doctor will also make a device called a “block” or use automatic blocking built right into the machine to shield your healthy cells from the radiation.
External Beam Radiation at Cancer Care Northwest
The type of external beam radiation therapy you receive depends on the size and shape of your tumor and where it is located in your body. Our radiation oncologists’ expertise and sophisticated techniques safely and effectively destroy the cancer, while causing as little damage to the healthy cells as possible.
Three-Dimensional Conformal Radiation Therapy (3D-CRT)
In three-dimensional conformal radiation therapy, your radiation oncologist uses imaging technologies, such as PET/CT, CT or ultrasound, to create 3-D pictures of the tumor so that the radiation beams can be formed to fit the size and shape of your tumor. Usually the treatment is delivered through several different angles.
Intensity Modulated Radiation Therapy
Intensity Modulated Radiation Therapy (IMRT) is an advanced form of 3D-CRT treatment in which radiation beams of various intensities are formed to fit the exact shape of the tumor. This approach precisely targets the cancer, while reducing the amount of radiation that affects healthy tissue. IMRT makes it possible to safely use radiation to treat tumors that are next to vital organs and body structures.
Cancer Care Northwest’s radiation oncologists have offered IMRT longer and are more experienced than any other cancer care provider in the region.
Image Guided Radiation Therapy
In Image Guided Radiation Therapy (IGRT), radiation oncologists use x-rays or ultrasound just before or during treatment to measure any changes in size and location of the cancer. They use specialized computer software to compare these images and to accurately adjust your treatment as needed.
Hypofractionated Radiotherapy (Stereotactic Body Radiotherapy)
Cancer Care Northwest’s radiation oncologists use hypofractionated radiotherapy (three-five large doses to small, focused areas) to treat early lung cancers that are not surgical candidates.
This treatment involves approximately 10 radiation beams, each 1/10 of the full dose of radiation, that are precisely aimed at the cancer from different angles. The computerized radiation plan is developed by taking 4-dimensional images that track the tumor’s movement while the patient breathes. This assures that the tumor is always within the small radiation field while the patient breathes normally during treatment.
To better prepare yourself for external beam radiation, we invite you to discuss any concerns with your Cancer Care Northwest physician or radiation therapist.
What is brachytherapy?
Brachytherapy is an internal radiation therapy that involves placing radioactive materials inside or near the tumor.
How does it work?
During brachytherapy, your radiation oncologist inserts an implant with radioactive material directly inside or as close to the cancer as possible. Your doctor uses special catheters or applicators to position the implant. Brachytherapy frequently allows your doctor to deliver the radiation to a smaller area than external beam radiation allows.
The main types of brachytherapy are:
Intracavitary treatment: The radioactive source is put into a cavity or space where the tumor is located, such as the uterus or windpipe.
Interstitial treatment: The radioactive source is inserted directly into the tissues, such as the prostate.
Low-dose rate brachytherapy releases the radiation over days to months. High-dose rate brachytherapy releases the radiation over several minutes, usually divided into two to five treatments.
Brachytherapy at Cancer Care Northwest
Cancer Care Northwest radiation oncology team offers an extremely high level of expertise and experience in innovative brachytherapy treatments.
High-dose Rate Brachytherapy
Our radiation oncologists were the first in Spokane to provide high-dose rate (HDR) brachytherapy for treatment of prostate cancer, breast cancer and gynecologic cancers such as uterine cancer, cervical cancer and ovarian cancer.
This fairly new method of treatment involves inserting a temporary catheter (or catheters) next to or directly into the cancerous tissue. The catheter serves as the channel for the delivery of extremely powerful doses of radiation in quick, short bursts by a tiny “radioactive seed” that is welded on the end of a wire. This is robotically controlled by a precise computerized delivery system.
High-dose rate brachytherapy delivers complete doses of radiation more quickly than in traditional brachytherapy, which gradually releases the radiation over a period of several days or months.
Intraoperative Radiation Therapy (IORT)
Cancer Care Northwest is the only treatment center in the region to provide intraoperative radiation therapy (IORT). This approach treats tumors that may be difficult to remove entirely with surgery, or to kill remaining cancerous cells to avoid recurrence.
Working with your surgical oncologist, your radiation oncologist inserts a catheter into the tumor or into the tumor bed after surgical removal, and sends high doses of radiation to the cancerous region while you are in surgery.
Cancer Care Northwest is also the only cancer center in the region to provide temporary high-dose rate (HDR) prostate brachytherapy. This treatment involves placing temporary catheters into the prostate (called an implant). Small radioactive seed travels precisely through these catheters to the cancerous area in the prostate.
This procedure can be done alone (two implants separated by two to four weeks) or in combination with external radiation (approximately five weeks of external radiation plus one implant). With each implant, two treatments are given in the same day.
This treatment method has many advantages over the older technique of permanent prostate seed implant. The dose can be customized and delivered more quickly and accurately, reducing immediate side effects. No permanent radiation is left in the body. And since the radiation is delivered after the catheters are securely in place, the medical staff is not exposed to radiation.
Breast Brachytherapy (Mammosite RTS or Contura)
MammoSite is a type of breast brachytherapy in which your surgical oncologist inserts a balloon catheter into the cavity that was created when the tumor was removed from the breast (lumpectomy). MammoSite uses a single catheter to deliver radiation to the lumpectomy site.
Contura, similar to Mammosite, uses a balloon with multiple channels. After being inserted, the Contura balloon is inflated and filled with saline and then a vacuum is used to help the balloon fit closely within the often irregularly shaped lumpectomy cavity. A radiation seed is sent through five separate channels inside the balloon, allowing the radiation dose to be contoured to reach the targeted area. The dose is directed by where the seed sits in the balloon, allowing the physician to concentrate the radiation dose on the tumor area. With the advanced multi-channel design, more accurate treatment is achieved.
Breast Brachytherapy (Multi-Catheter Technique)
The multi-catheter technique can be applied to any patient with an identifiable lumpectomy cavity. Any lumpectomy cavity size, shape and location within the breast can be treated with the multi-catheter technique. In this technique, a tiny radiation seed is guided into several catheters strategically placed to treat the entire cavity that was created by the lumpectomy. Cancer Care Northwest is the only center in the region offering this type of treatment.
Brachytherapy is standard therapy for certain types of cervical cancer, vaginal cancer and uterine cancer. Working as team with the region’s only two gynecologic oncologists, our radiation oncologists serve as a regional referral center for standard treatment and challenging and difficult cases.
Other Brachytherapy Procedures
Cancer Care Northwest offers a wide range of treatment alternatives with brachytherapy including:
Endobronchial (treatment of the airways of the lungs) to open up blockages from tumors.
Esophageal (food pipe) to treat swallowing difficulty from tumor blockages.
Brachytherapy for sarcomas (soft tissue tumors) and other complex or rare cancers.
Multiple individualized, customized treatments can be developed for many types of cancers using brachytherapy.
To better prepare yourself for brachytherapy, we invite you to discuss any concerns with your Cancer Care Northwest physician or radiation therapist.
What are radioactive pharmaceuticals?
Radioactive pharmaceuticals are unsealed radiation sources usually given in a liquid or pill form to treat some types of cancer. Examples include Iodine 131 to treat thyroid cancer, Samarium 153 (Quadramet) to treat cancer that has spread to the bone (bone metastases), and Zevalin (ibritumomab tiuxetan) used to treat certain lymphomas.
How does it work?
The radioactive materials used in radiopharmaceuticals are specifically designed to travel through the body, seek out the cancerous cells, or collect at the cancerous site. The radiation is then released at the targeted area.
Radiopharmaceuticals can be injected into the body, given in the vein (IV) or taken orally.
To better prepare yourself for treatment with radiopharmaceuticals, we invite you to discuss any concerns with your Cancer Care Northwest physician or radiation therapist.
What is Gamma Knife?
Gamma Knife is not a knife, but a non-invasive brain surgery tool that uses precisely guided radiation beams to eradicate brain tumors (cancerous and noncancerous).
Gamma Knife is also used to treat arteriovenous malformations (AVMs), clusters of abnormal blood vessels that can bleed. It is also used to treat functional disorders, such as trigeminal neuralgia (one-sided facial pain), and movement disorders, such as essential tremor and Parkinsonian tremor.
How does it work?
Gamma Knife is a machine used to perform stereotactic radiosurgery, a non-invasive radiation treatment that uses hundreds of narrow radiation beams that are precisely aimed from different angles to target and destroy small to medium-sized, well-defined brain tumors or other precise targets.
Gamma Knife technology allows radiation oncologists to pinpoint the tumor, shape the radiation beams and immobilize the patient so that the radiation dose can be delivered with extreme accuracy (to less than 1mm). Computer-aided precision makes it possible to deliver high doses of radiation that kill the tumor in one treatment, while sparing damage to healthy brain tissue surrounding the tumor.
Gamma Knife at Cancer Care Northwest
Cancer Care Northwest’s radiation oncologists partner with Gamma Knife of Spokane to offer our patients focused radiosurgery treatment for brain tumors and other disorders. Gamma Knife of Spokane is home to the only dedicated stereotactic radiosurgery technology in Spokane.
To better prepare yourself for Gamma Knife treatment, we invite you to discuss any concerns with your Cancer Care Northwest physician or radiation therapist.