Radiation Therapy

Comprehensive Care

FirstHealth's cancer care team offers a number of radiation therapy treatments at the Cancer Center in Pinehurst. While you undergo radiation therapy, a team of highly trained medical professions work together to make sure you receive the best possible individualized care. Radiation oncologists are the doctors who oversee the care of each person undergoing radiation treatment. Other members of the treatment team include nurses, radiation therapists, medical physicists, dosimetrists, patient navigators, social workers and nutritionists.

External Beam Radiation Therapy

External Beam Radiation Therapy is one of the most commonly used forms of radiation therapy. During external beam radiation therapy, a beam (or multiple beams) of radiation is directed through the skin to the cancer and the immediate surrounding are to destroy the tumor and any nearby cancer cells. To minimize side effects, the treatments are typically given five days a week, Monday through Friday, for a number of weeks. This allows enough radiation to get into your body to kill the cancer while giving healthy cells time to recover.

The radiation beam is usually generated by a machine called a linear accelerator, or linac. The linear accelerator is able to produce high-energy X-rays or electrons for the treatment of your cancer. Using treatment planning computers and software, your treatment team controls the size and shape of the beam, as well as how it is directed at your body, to effectively treat your tumor while sparing the surrounding normal tissue. There are several special types of external radiation therapy used for specific types of cancer.

Three-Dimensional Conformal Radiation Therapy (3-D CRT)

Tumors are not all the same; they come in different shapes and sizes. Also, every patient's body is unique. Three-dimensional conformal radiation therapy, or 3-D CRT, uses computers and special imaging techniques such as CT, MRI or PET scans to show the size, shape and location of the tumor as well as surrounding organs. Your radiation oncologist can then precisely tailor the radiation beams to the size and shape of your tumor with special shielding. Because the radiation beams are carefully targeted, nearby normal tissue receives less radiation and is able to heal better.

Intensity-Modulation Radiation Therapy (IMRT)

Intensity Modulated Radiation Therapy (IMRT) is a specialized form of 3-D CRT that allows radiation to be specifically shaped to cover the tumor and spare more normal tissue. With IMRT, the radiation beam can be broken up into many "beamlets," and the intensity of each beamlet can be adjusted individually. Using IMRT, it may be possible to further limit the amount of radiation received by healthy tissue near the tumor. In some situations, this may also safely allow a higher dose of radiation to be delivered to the tumor.

Image-Guided Radiation Therapy (IGRT)

Radiation oncologists use image guided radiation therapy, or IGRT, to more accurately deliver radiation to the cancer. IGRT involves conformal radiation treatment guided by imaging, such as CT or X-rays, taken in the treatment room, just before the patient is given the radiation treatment on a daily basis. Because tumors can move between treatments, due to the differences in organ filling or movement while breathing, IGRT allows for better targeting of cancer cells. 

High-Dose Brachytherapy

High Dose Rate (HDR) Brachytherapy is a form of internal radiation therapy that precisely delivers radiation from the inside out, sparing surrounding healthy tissue and organs and potentially reducing the need for surgery. It can deliver a high dose of radiation over a short period of time. It can be used in conjunction with external beam radiation. It is used during treatment for gynecologic malignancies most often.

Stereotactic Radiation Therapy

Stereotactic radiotherapy is a specialized technique that allows your radiation oncologist to use extremely focused beams of radiation to destroy certain types of tumors using higher doses than with daily radiation treatments. Since the beam is so precise, your radiation oncologist may be able to spare more healthy tissue. In selected cases, stereotactic treatments can be used to retreat tumors that have received radiation before.

Stereotactic radiotherapy was first developed to treat brain tumors in a single dose, sometimes called stereotactic radiosurgery or SRS. In addition to treating cancers, radiosurgery can also be used to treat benign tumors and certain noncancerous neurologic conditions. In some cases, using more than a single dose may help decrease the risk of side effects with stereotactic brain radiation therapy.

Treatment outside the brain is called stereotactic body radiation therapy (SBRT). It is typically given in a few treatments with higher doses per fraction. Often used for lung cancers, other sites such as spine, pancreas, bone metastasis, metastatic lymph nodes or liver metastasis can benefit from SBRT. The therapy may allow radiation to be given in a way that is safer and more effective than other radiation techniques.

Because specialized treatments with stereotactic radiation are often much higher doses than daily radiation treatment, additional precision and quality assurance is necessary. This involves using secure immobilization of the head or body as well as using techniques that allow the radiation beam to account for organ motion during treatment. Stereotactic radiation offers new ways for your doctor to treat cancer.