Sunday, March 3, 2024

What Is External Beam Radiation

Volumetric Modulated Arc Therapy

External Beam Radiation Therapy explained

Volumetric modulated arc therapy is an extension of IMRT where in addition to MLC motion, the linear accelerator will move around the patient during treatment. This means that rather than radiation entering the patient through only a small number of fixed angles, it can enter through many angles. This can be beneficial for some treatment sites where the target volume is surrounded by a number of organs which must be spared radiation dose.

How Does The Equipment Work

The linear accelerator uses microwave technology to accelerate electrons in a part of the accelerator called the wave guide. Then, it allows these electrons to collide with a heavy metal target to produce high-energy x-rays. These high energy x-rays conform to the shape of the patients tumor as they exit the machine. The customized beam is also directed to the patients tumor. The beam is usually shaped by a multileaf collimator that is incorporated into the head of the machine. The patient lies on a movable treatment couch. We use and lasers to make sure the patient is in the proper position. The treatment couch can move in many directions including up, down, right, left, in and out. The beam comes out of a part of the accelerator we refer to as the gantry. We can rotate the gantry around the patient. We are able to deliver radiation to the tumor from any angle by rotating the gantry and moving the treatment couch.

How Does Your Doctor Plan Your Radiation Treatment

Radiation is planned and given by a team of trained health care providers. The radiation oncologist is a doctor who treats cancer with radiation and oversees the care of each patient getting radiation. Working closely with the radiation oncologist, the radiation therapist gives the daily radiation treatment and positions patients for each treatment. Other professionals include the medical physicist and dosimetrist who plan and calculate the doses of radiation.

Before starting radiation therapy, your radiation oncologist will examine you, review your medical history and test results, and pinpoint the exact area to be treated. This planning session is called simulation. You might hear this referred to as the sim. Youll be asked to lie still on a table while the radiation therapist uses imaging scans to define your treatment field . These are the exact places on your body where the radiation beams will be aimed.

The simulation is very important and may take some time. It’s used to plan exactly where the treatment will be on or in your body. The radiation can then be delivered as directly as possible to the tumor while affecting normal, healthy tissues as little as possible.

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Scheduling Your Radiation Treatments

You will schedule your radiation treatments before you leave your simulation appointment. We offer radiation treatments Monday through Friday. Some people get their radiation therapy in just 1 day. Others get it treatments spread over a few weeks.

You must come to all your radiation treatment appointments. Your radiation therapy may not work as well if you skip or miss treatments. If you cannot come to one of your radiation treatments for any reason, call your radiation oncologists office. If you need to change your schedule for any reason, talk with your radiation therapists.

What Can I Do To Take Care Of Myself During Therapy

External beam radiation therapy for prostate cancer

Each patient’s body responds to radiation therapy in its own way. That’s why the doctor must plan, and sometimes adjust, your treatment just for you.

Nearly all cancer patients receiving radiation therapy need to take special care of themselves to protect their health and help the treatment succeed. Your doctor or nurse will give you advice on caring for yourself at home that is specific for your treatment. Some general guidelines to remember are given below:

Ask your doctor, nurse, or radiation therapist any questions you have. They are the best experts for advice about your treatment, side effects, at-home care, and any other medical concerns you may have.

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How Long Does External Beam Radiation Therapy Take

Treatment time usually lasts between 15 and 30 minutes, with most time spent positioning you correctly. The therapist will tell you when the radiation starts.

Most cancer treatments involving EBRT take place daily, from Monday to Friday. Treatment may last anywhere from two to eight weeks. Spreading out your treatment allows healthy cells recovery time, lessening side effects.

There are some exceptions. For example, stereotactic radiosurgery often involves receiving a single strong dose in one treatment session.

Are There Different Types Of External Beam Radiation Therapy Treatments

There are several different types of external beam radiation therapies, including:

  • Image-guided radiation therapy, which uses computer imaging to map the prostate location and then aim radiation beams to the precise spot
  • Intensity-modulated radiation therapy , which uses a computerized machine to sculpt the radiation beam to match the shape of the cancer
  • Proton beam radiation therapy, which uses proton beams instead of X-rays
  • Stereotactic body radiation therapy , which delivers large radiation doses in a concentrated way over several days

The type of external beam radiation therapy your doctor selects will depend on several factors including the level of cancer youre experiencing, your overall health, and your goals for the treatment.

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What Happens During Each Treatment Visit

External radiation is a lot like getting a regular x-ray. The treatment itself is painless and takes only a few minutes. But each session can last 15 to 30 minutes because of the time it takes to set up the equipment and put you in the right position.

External radiation therapy is usually given with a machine called a linear accelerator which delivers a beam of radiation. The machine has a wide arm that extends over the treatment table. The radiation comes out of this arm. The machine can move around the table to change the angle of the radiation, if needed, but it wont touch you. The radiation beams are invisible and you will not feel anything, but the machine will make noise.

Depending on the area being treated, you might need to undress, so wear clothes that are easy to take off and put on. Youll be asked to lie on the treatment table next to the radiation machine.

The radiation therapist might put special heavy shields between the machine and parts of your body that arent being treated to help protect normal tissues and organs.

Once youre in the right position, the radiation therapist will go into a nearby room to operate the machine and watch you on a TV screen. The room is shielded, or protected from the radiation so that the therapist isnt exposed to it. You can talk with the therapist over an intercom. Youll be asked to lie still during the treatment, but you wont have to hold your breath.

Stereotactic Body Radiation Therapy Or Stereotactic Ablative Radiotherapy

External Beam Radiation Therapy

This type of therapy is used to deliver high doses of radiation to a precise area in the prostate using specialized techniques not achievable by standard conventional radiation therapy. This allows the total dose of radiation to be given in a shorter amount of time, usually 4 -5 treatments over 1 2 weeks rather than the several weeks used for other types of external radiation therapy.

The radiation beam needs to be extremely accurate in order to limit the side effects on healthy tissue. During treatment, the body immobilization used is often more restrictive than with IMRT due to the high doses of radiation. Fiducials, or internal prostate markers, are often used in this type of treatment.

Cyberknife and Truebeam are two types of LINACs used for SBRT treatment of prostate cancer.

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How Often Will I Get External Beam Radiation Therapy

Most people get external beam radiation therapy once a day, 5 days a week, Monday through Friday. Treatment lasts for 2 to 10 weeks, depending on the type of cancer you have and the goal of your treatment. The time between your first and last radiation therapy sessions is called a course of treatment.Radiation is sometimes given in smaller doses twice a day . Your doctor may prescribe this type of treatment if he or she feels that it will work better. Although side effects may be more severe, there may be fewer late side effects. Doctors are doing research to see which types of cancer are best treated this way.

Types Of Beams Used In External Radiation Therapy

Photon beams are the same type of radiation that is used during an x-ray, like a chest x-ray, but at a much higher amount. The radiation is released from the machine as a wave of energy. Photon beams can travel deep into the body to the tumor but can also damage healthy tissue in front of and behind the tumor. Photons are given by a machine called a linear accelerator. The photon beams are invisible and cannot be felt when they are passing through the skin to the cancer.

Particle beam radiation therapy: Particle beams are separate units of energy like a proton or neutron. The radiation is released from the machine as a stream of high-energy particles. Particle beam radiation can also travel deep into the body like photon beams but their energy is released at a certain distance. This means that this type of radiation is often able to deliver more radiation to the tumor while reducing its effects on normal tissues in front of and behind the tumor. Particle beams are given by special types of machines called particle accelerators, like a cyclotron or synchrotron. The particle beams are invisible and cannot be felt when they are passing through the skin to the cancer.

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External Beam Radiation Therapy

External Beam Radiation Therapy refers to the delivery of tightly targeted radiation beams from outside the body. A course of EBRT involves several daily treatments over a few days to a few weeks. The radiation oncology team controls the radiation machine to generate and direct the radiation beams. EBRT usually delivers X-rays but can also use electrons or other rarer particles such as protons. These have different properties which can be useful for different cancers or settings. The experience for the patient is similar to having an X-ray or CT scan there is no sensation of being treated.

What Are The Side Effects Of Radiation Treatment

What Are The Side Effects Of External Beam Radiation Therapy

External radiation therapy does not cause your body to become radioactive. There is no need to avoid being with other people because of your treatment. Even hugging, kissing or having sexual relations poses no radiation exposure risk for others.

Side effects of radiation therapy most often are related to the area that is being treated. Your doctor and nurse will tell you about the possible side effects and how you should deal with them. You should contact your doctor or nurse if you have any unusual symptoms during your treatment, such as coughing, sweating, fever, or unusual pain. Many patients experience no side effects at all from radiation treatment.

If side effects do occur, it may be helpful to realize that they typically are not serious and can be controlled with medication or diet. They usually go away within a few weeks after treatment ends. However, some side effects can last longer.

Throughout your treatment, your radiation oncologist will regularly check on the effects of the treatment. You may not be aware of changes in the cancer, but if you had symptoms such as pain, bleeding or other discomfort before beginning treatment, you probably will notice decreases, especially after your treatment is completed. You may continue to notice more improvements with time.

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How Long Will My External Beam Radiation Therapy Take

When asking how long your EBRT will take, there are two questions to consider:

  • The length of each treatment and
  • The duration of your treatment cycle

Your medical team will first identify the total dose of radiation you should receive. Because you cannot receive this entire dose at once, this will then be divided into smaller, daily doses, or fractions.

Radiation is usually delivered once daily, Monday through Friday. The weekends away allow cells to recover and the body to rest. These treatments usually last five to eight weeks. However, depending on your cancer, you may receive two treatments a day, or your treatment schedule may last longer.

Each daily treatment will only take a few minutes. Including time to position your body and the EBRT machine, each appointment will take 15 to 30 minutes.

Types Of External Radiotherapy

Most types of radiotherapy treatments use photons , but tiny particles called electrons and protons can also be used.

Treatments using photons, protons and electrons will vary slightly but the experience of having radiotherapy will be similar.

Your doctor chooses the type of radiotherapy and the machine for your treatment according to the type of cancer you have and where it is in your body. There are different types of external radiotherapy treatment. They include:

  • conformal radiotherapy
  • stereotactic radiotherapy and radiosurgery
  • adaptive radiotherapy

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What To Wear For Your Treatments

Wear clothes that are comfortable and made of soft fabric, such as fleece or cotton. Choose clothes that are easy to take off, since you may need to expose the treatment area or change into a hospital gown. Do not wear clothes that are tight, such as close-fitting collars or waistbands, near your treatment area. Also, do not wear jewelry, adhesive bandages, or powder in the treatment area.

Side Effects Of Radiotherapy

What is external beam radiation therapy? (Colleen Lawton, MD)

External radiotherapy doesn’t make you radioactive. It is safe to be with other people after each treatment, including children.

Side effects vary depending on which part of the body is being treated, and if you are having radiotherapy with other treatments, such as chemotherapy. General short term side effects include tiredness, and sore skin and hair loss in the treatment area.

People react to radiotherapy in different ways:

  • some carry on working and just take time off for their treatment
  • others feel tired and want to stay at home
  • some people stay in hospital for all or part of the treatment

Your doctors, radiographers and nurses will advise you about how best to manage your course of treatment. If you have family members to look after, you may need extra help. You can ask for help from your employer, family or friends, or the staff in the radiotherapy department.

As your treatment goes on you’ll have more of an idea of how it makes you feel. You can then make any necessary changes to your daily life to help you cope with the rest of your treatment course.

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Why Would My Doctor Prescribe External Beam Radiation Therapy For My Prostate Cancer

External beam radiation therapy is a standard treatment for prostate cancer. Its a primary treatment for cancer that is caught early before it has spread to other parts of the body. External beam radiation therapy can be used with other types of cancer treatments, such as hormone therapy, when the disease is serious.

Your doctor could also order external beam radiation after youve had surgery. This is called adjuvant therapy, and its goal is to lower the risk that your cancer will return. Your doctor will monitor the levels of prostate-specific antigen with blood work and will also watch for signs of cancer in your pelvic area.

If your prostate cancer is advanced, external beam radiation therapy may also help with bone pain or other symptoms.

How Often You Will Have External Beam Radiation Therapy

Most people have external beam radiation therapy once a day, five days a week, Monday through Friday. Radiation is given in a series of treatments to allow healthy cells to recover and to make radiation more effective. How many weeks you have treatment depends on the type of cancer you have, the goal of your treatment, the radiation dose, and the radiation schedule.

The span of time from your first radiation treatment to the last is called a course of treatment.

Researchers are looking at different ways to adjust the radiation dose or schedule in order to reach the total dose of radiation more quickly or to limit damage to healthy cells. Different ways of delivering the total radiation dose include:

  • Accelerated fractionation, which is treatment given in larger daily or weekly doses to reduce the number of weeks of treatment.
  • Hyperfractionation, which is a smaller dose than the usual daily dose of radiation given more than once a day.
  • Hypofractionation, which is larger doses given once a day or less often to reduce the number of treatments.

Researchers hope these different schedules for delivering radiation may be more effective and cause fewer side effects than the usual way of doing it or be as effective but more convenient.

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What Should I Wear When I Get External Beam Radiation Therapy

Wear clothes that are comfortable and made of soft fabric, such as cotton. Choose clothes that are easy to take off, since you may need to change into a hospital gown or show the area that is being treated. Do not wear clothes that are tight, such as close-fitting collars or waistbands, near your treatment area. Also, do not wear jewelry, BAND-AIDS®, powder, lotion, or deodorant in or near your treatment area, and do not use deodorant soap before your treatment.

Side Effects Of Radiation Therapy

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Some people have side effects from radiation therapy. This section has information about the most common side effects.

You may have all, some, or none of these side effects. The ones you have and how strong they are depends on many things, such as:

  • The area of your body being treated.
  • The dose of radiation youre getting.
  • The number of radiation treatments youre getting.
  • Your overall health.

The side effects may be worse if youre also getting chemotherapy.

You and your radiation therapy care team will work together to prevent and manage side effects.

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