Cancers We Treat

LRG_VIEW_Prostate-Cancer_image-1024x291The Radiation Therapy Team at RadAmerica works diligently to provide optimal cancer care and treatment options for a variety of cancers including:

  • Brain Cancer. Brain and spinal cord tumors result from the abnormal growth of cells inside or near the brain. Radiation therapy treatments for brain cancer include the use of external beam x-rays, gamma rays, or the CyberKnife.
  • Breast Cancer. Treatment options for breast cancer include breast conservation therapy, mastectomy, external beam therapy, intraoperative radiation therapy and brachytherapy.
  • Bone Cancer. Bone cancer types and treatments can vary greatly, depending on the location of the tumor, whether or not the tumor is cancerous (malignant) or benign (noncancerous), and other components. Radiation therapy can be used to treat bone cancer.
  • Colorectal Cancer. Colorectal cancer is cancer of the rectum and/or colon. Radiotherapy treatment options for colorectal cancer include external beam therapy, in which high-energy x-rays beams are delivered to the tumor.
  • Head and Neck Cancer. Tumors of the head and neck are often categorized as salivary gland tumors, sarcomas, lymphomas or squamous cell carcinoma. Head and neck cancer treatment options include surgery, CyberKnife treatment, intensity-modulated radiation therapy and external beam therapy.
  • Lung Cancer. Lung cancer tumors result from the growth of tissue cells lining the air passages of lungs. Radiotherapy involving the use of high-energy x-rays, CyberKnife technology, external beam therapy, brachytherapy or intensity-modulated radiation therapy can be used to treat lung cancer.
  • Prostate Cancer. Prostate cancer treatments include surgery, brachytherapy, proton beam therapy, cryotherapy, CyberKnife prostate treatment, image-guided radiation therapy and external beam radiation.
  • Skin Cancer. Skin cancer results from the abnormal growth of skin cells. Radiation therapy treatment options for skin cancer include x-ray beams and skin brachytherapy.

Radiation treatments for each cancer type differ and are dependent on factors including the stage of cancer, area in which the cancer originated and the rate of tumor growth.

To learn more about available treatments specific to your cancer, visit Radiation Treatment Options. To learn more about cancers we treat or to schedule an appointment, contact us.

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Implant Treatment Tools

CT Simulator

The CT simulator is utilized to ensure accurate mapping of the treatment area. The CT simulator creates 3D images that are used to precisely outline the tumor volumes so that your therapy team can meticulously plan a course of treatment, tailored specifically to your anatomy. Because radiation affects normal cells as well tumor cells, treatment teams carefully map out the area minimize damage to normal tissue.


High Dose Remote Afterloader

External Radiation or Brachytherapy can be delivered near or directly into a tumor using a High Dose Rate Afterloader. The high dose rate remote afterloading unit provides radiation therapy to a localized area. Typically, an applicator or catheter is used to deliver the radioactive source directly to the tumor. This unit provides a method of treating cancer that has not been available in the past.

Traditionally, a radioactive implant would have been performed under general anesthesia and required several days of hospitalization. However, with the HDR, this procedure is performed at our centers on an outpatient basis. Thus, both the risk of general anesthesia and the cost of an extended hospital visit are avoided.


Implants (Brachytherapy)

Implants are the clinical use of encapsulated radioactive sources placed either temporarily or permanently into the tumor and surrounding structures which deliver radiation continuously over an extended period of time. Brachytherapy is used in the management of specific cancer sites where its physical advantage is a superior localization of the dose to the tumor volume.

Temporary implants include certain gynecological malignancies with treatments usually one to three days in duration in a hospital setting. Permanent implants include certain prostate cancers and are often done as an outpatient procedure. 

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Prostate Seed Therapy Eligibility

Who is eligible?

In cases where prostate seed therapy may be appropriate, the patient will typically have a consultation with the urologist and the radiation oncologist. Based upon the findings, a decision to pursue prostate seed therapy may be made.

Who is a candidate for this procedure?

  • Patients with localized prostate cancer, in these clinical stages:
    • Stage I — cannot be felt during a rectal exam and has no symptoms. Cancer is only in the prostate and usually found by PSA testing.
    • Stage II — Can be felt during a rectal examination
    • Stage III — tumor has spread outside the covering of the prostate to tissues immediately around the prostate.
  • Patients with PSA up to 40 (a blood test that determines the amount of prostate-specific antigen (PSA), which at high levels may indicate prostate cancer.) Some patients with elevated PSAs may require pelvic lymph node dissection to confirm if they are candidates for the procedure.
  • Patients with both aggressive and non-aggressive cancer, determined by Gleason scores. These scores are based on a 10-point grading system that indicates the aggressiveness of the prostate cancer, with 2/10 the least aggressive and 10/10 the most aggressive.

Who is not a candidate for this procedure?

  • Patients with metastatic prostate cancer that has moved to bone or lymph nodes cannot be considered for this procedure.
  • Patients, whose prostate cancer has moved into the seminal vesicle, found right next to the prostate, can't be considered for this procedure.
  • Patients with an especially large or small prostate.
  • Medical conditions that make anesthesia too dangerous.
  • Pubic bone "shielding" the prostate.
  • Patients who have difficulty with urinary stream and flow.
  • A large center lobe of the prostate.

 

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Prostate Seed

elderly_patientProstate seed implementation is a minimally invasive treatment option for men with prostate cancer. The procedure is a form of brachytherapy, in which the organ containing the tumor is implanted with radioactive material. Minuscule titanium metal capsules that produce high levels of radiation are permanently implanted. Prostate sees emit radiation to an area that is about the size of a marble.

Radiation oncologists perform the procedure using CT scans, software programs and transrectal ultrasounds. Specialists utilize these tools to decipher the number of seeds and seed distribution required.


Prostate Seed Treatment Options

Radical Prostatectomy (surgical removal of the prostate) 

  • Advantages — surgery is a one-time procedure that may cure early prostate cancer.
  • Disadvantages — This treatment includes a hospital stay. Most often older men do not tolerate this type of procedure well.
  • Side effects — include impotence and stress urinary incontinence in a considerable number of patients. 

External Beam Radiation Therapy

  • Advantages — external beam radiation therapy has a good cure rate for early prostate cancer and no hospitalization is needed.
  • Disadvantages — include two months of daily visits to the radiation oncology center. There is still a risk of impotence but not as high as Radical Prostatectomy.
  • Side effects — healthy surrounding tissue can suffer radiation damage. There are also number of complications including skin reactions, rectal irritation or bleeding, diarrhea, upset stomach, frequent and uncomfortable urination and fatigue. 

Radioactive Seed Implants 

  • Advantages — less risk of impotence, and less risk of urinary complications. Recovery time is shorter because patient does not require a surgical incision. Since this is an outpatient procedure, patients can return to normal activities in just a few days.
  • Disadvantages — there are few published results that demonstrate the effectiveness of the implant treatments after 10 years, although early results are promising.
  • Side effects — Within four to six weeks, side effects usually fade. The most common problems include urinary frequency, burning with urination, blockage of urinary flow and soreness in the area of the implant.

Recovery and Follow-up Care

Most patients can go home the same day of the implant insertion. The urologist and radiation oncologist work together on follow-up care, which typically includes an evaluation after one month, and a visit every three to six months for the first five years to check the seed placement and progress of the treatment. 

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CyberKnife Prostate Treatment

About Prostate Cancer

Prostate cancer affects the prostate gland, which is the part of a man's reproductive system that helps produce semen. It is located under the bladder, behind the rectum, and it surrounds the urethra. Prostate cancer develops when cells begin to grow abnormally in the prostate.

Prostate cancer is common in men older than 50. For some, prostate cancer does not produce symptoms. For other men, it can cause blood in the urine, difficulty urinating, and lower back and pelvis pain.


Treating Prostate Cancer with CyberKnife Radiation

Treatments for prostate cancer often include surgery and conventional radiation. Since the prostate is a moving target, this movement can make performing surgery or conventional radiation a challenge.

With CyberKnife radiation, computers and imaging tools are used to find the exact location of the tumor. The technology tracks the movement of the prostate and the tumor as a patient breathes and as other bodily processes occur. The tool operates with enough precision and accuracy to enable doctors to focus radiation onto the tumor itself and not on surrounding healthy tissue.


What Should I Expect from CyberKnife Prostate Cancer Treatment?

  • CyberKnife treatment begins with the implantation in the prostate of four tiny gold fiducials that act as markers or targets for the system’s missile-like rays.
  • Afterward, a team of experienced physicians uses MRIs, CT scans and three-dimensional technology to pinpoint the exact location and size of the patient’s cancer to create a treatment plan.
  • A week or two later, the patient returns for five days of therapy over one to two weeks, with each treatment lasting about an hour.
  • Patients are usually able to resume their normal activities almost immediately.
  • Follow-up consists of regularly scheduled PSA (prostate-specific antigen) tests and monitoring.

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Patient Stories

Read prostate cancer treatment stories from patients at MedStar Franklin Square Medical Center.

 


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CyberKnife Treatment Process

Cyber_group_final-(1)

1. Initial consultation: During your consultation, the procedure and its risks and benefits will be explained in detail.

2. Fiducial placement: Fiducials are small (1 mm in diameter, approximately 5 mm long), cylindrical markers implanted into soft tissues in or near the tumor (lesion) for the purpose of accurately guiding the CyberKnife radiation beams.

3. CT scan: Your MedStar medical team will use a CT scan to identify the exact size, shape, and location of the tumor and the healthy surrounding tissues to avoid.

4. Tumor mapping: Your MedStar CyberKnife team will review your CT scan in great detail and plan your treatment.

5. Treatment: CyberKnife treatment may be given one to five times, depending on individual needs.

6. Side effects: Possible side effects vary, and will be discussed during your consultation. Fatigue may occur a few days after treatment, and generally improves within two to three weeks; if needed, your doctor will prescribe medication to help.

7. Follow-up: Follow-up visits are scheduled after treatment is complete. Your team will perform follow-up imaging to monitor the tumor's treatment response. You'll meet with doctors to discuss these image results and answer any questions or concerns you may have.

Location Information

MedStar Franklin Square Medical Center
The Harry and Jeanette Weinberg Cancer Institute
CyberKnife Center
9103 Franklin Square Drive
Baltimore, Maryland 21237


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Skin Brachytherapy

David_PerryWhat is Skin Brachytherapy?

Electronic surface brachytherapy, or skin brachytherapy,  is a form of radiotherapy that is an option for treating non – melanoma skin cancers.  Electronic surface brachytherapy uses a portable machine that physicians apply through an applicator placed directly on the skin.  The procedure is a painless, non-invasive alternative for those not able or willing to undergo surgical excision.

HDR electronic brachytherapy for carefully selected skin cancers is an excellent treatment option and requires a multi-disciplinary approach between the dermatologists and radiation oncology team.


Quick Facts About Skin Cancer  

  • Skin cancer is the most common cancer worldwide
  • There are more cases of skin cancers than all other cancers combined
  • Skin cancer procedures are growing at an estimated 4-6% per year
  • Treatment options include Electrodessication & Curretage, wide excision, cryotherapy, photogynamic therapy, tropical creams and radiation therapy

Treating Skin Cancer with Brachytherapy

Physicians apply a portable machine through an applicator placed directly on the skin. Each treatment takes from 3-6 minutes. Typically, treatment requires a total of 8 fractions per lesion administered twice weekly, at 6 minutes per lesion. Since the procedure is non-surgical, it requires much less treatment time than traditional radiotherapy.


Benefits

  • The procedure is a painless, non-invasive treatment option
  • Excellent cosmetic results, particularly in difficult locations such as the eyes, nose, ears, scalp and joints
  • A shorter course of treatment that allows for immediate return to normal, daily activity

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Intraoperative Radiation Therapy

Intraoperative Radiation Therapy (IORT) in breast cancer patients is a new single treatment modality which replaces the boost of external beam radiation therapy (EBRT), or in some cases the entire course of therapy, at the time of the lumpectomy. Radiation can be delivered accurately and safely in the operating room following removal of the tumor, and before the surgeon closes the incision. An IORT treatment is completed in 20-30 minutes. A single-dose radiation treatment is now offered to low-risk breast cancer patients by the RadAmerica Team.

MedStar RadAmerica is the first in Maryland to acquire the INTRABEAM® Radiotherapy System, a novel radiation platform used to deliver IORT. Unlike whole breast radiation treatment, which is administered five times per week for as many as seven weeks, patients undergoing IORT receive a targeted, single-fraction treatment immediately following tumor removal – followed by a shorter whole breast radiation course, or no additional radiation.

Team members who deliver IORT include surgical oncologists, radiation oncologists, nursing staff and OR personnel, and medical physicists from RadAmerica.


Benefits of Intraoperative Radiation Therapy

Besides precision and patient comfort, IORT in breast cancer offers significant medical and quality of life benefits, including:

1. Maximum effect while minimizing recurrence. IORT delivers a concentrated dose of radiation to a tumor site immediately after a tumor is removed, helping to destroy the microscopic tumor cells that may be left behind.

2. Spares healthy tissues and organs. During breast cancer IORT, a precise radiation dose is applied at low energy thus sparing healthy tissues just a few centimeters away from the tumor bed – such as skin, lungs and the heart. This allows a higher, single radiation dose to be delivered to the tumor bed, while sparing normal surrounding breast tissues.

3. Shortened treatment times. IORT helps patients finish treatment and get back to their lives quicker by reducing the length of breast cancer radiation therapy, eliminating part or possibly need for all external beam radiation treatment.

4. A boost for whole breast cancer radiotherapy patients. Patients who must receive additional breast radiation therapy following surgery can receive a boost of radiation during IORT. After they have recovered from the surgical procedure, they can continue with their radiation treatments, with typically fewer complications.

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External Beam Radiation Therapy

doctor_patient_external_beamExternal beam radiation therapy uses a high-energy x-ray machine called a linear accelerator (linac) to direct radiation to the tumor. The procedure lasts several minutes, and is typically repeated several times a week over several months. Types of external beam radiation treatments include:

  • Three-dimensional conformal radiation therapy — a technique where the beams of radiation used in treatment are shaped to match the tumor.
  • Intensity-modulated radiation therapy (IMRT) — a treatment method in which the intensity of the radiation can be changed during treatment. In conventional therapy, intensity is set for the entire treatment session.

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Radiation Treatment Options

radiation_therapyWe offer a variety of types of radiation therapies throughout our nine locations. Each of our centers utilizes state of the art equipment to deliver radiation therapy treatment. Our staff have specialized skills, and continuously stay a abreast with the new technology that constantly is changing to improve patient care. 

We utilize sophisticated computer equipment and software to perform dosimetry calculations and treatment planning for maximum benefit and minimal doses to normal tissue. Treatment planning determines the number of fields (portals) required to treat the tumor site optimally and the direction the beams will take to enter your body. At various intervals during the course of therapy, port films will be taken to verify this placement.

All patient treatment will be precisely customized with the latest technology. Our facilities and services are designed with your care, comfort and convenience in mind.


Radiation Safety

We want to protect you from unnecessary radiation. Therefore, we enlist the use of essential safeguards to ensure that significant radiation is applied only to a specific area. For example, our machines are fully shielded and comply with rigorous state and federal safety regulations. Safeguards built into the machines limit the radiation to the field marked by the treatment team.

 

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