Radiation Treatment
Radiation treatment is the medical use of ionising electro-radiation to target and control cancer. Our expert team is here to ensure you get the best outcome from your radiation treatment.
With the latest in radiation treatment technology, St George's Cancer Care Centre provide the highest level of patient outcomes and care.
What is radiation therapy?
Radiation treatment is the non-invasive medical use of high energy x rays to target, reduce and eradicate cancer cells. It can also be used to relieve pain or discomfort resulting from cancer symptoms. It can be used as a standalone treatment or in combination with other therapies, shrinking tumours before surgery or chemotherapy or destroying any cancer cells that might remain after other treatments.
One of the critical components of quality radiation therapy is the ability to maximise the dose to the tumour or target volume, while minimising dose to surrounding normal tissue, therefore decreasing the side effects experienced. Here at St George’s cancer care we are committed to offer a range of advanced treatment techniques using new state of the art technology to improve patient outcomes and experiences.
Our highly skilled team work together to create a treatment plan targeting the tumour by delivering a course of small doses of radiation, called a “fraction”. The treatment plan allows us to target the cancerous cells reducing the impact of radiation to healthy tissues. Normal cells recover from the treatment, whilst cancer cells do not. The number of fractions required depends on the nature of the tumour and cancer cells being treated.
How is the treatment delivered?
After you and your radiation oncologist have made the decision to proceed with radiation treatment, you will have a planning CT scan. This scan is required in order to accurately prescribe and design the personalised radiation treatment plan.
Radiation treatment is delivered using a range of technologies such as linear accelerators and the superficial x-ray therapy machine. Once the plan has been created and passed thorough quality assurance processes, you will attend your first treatment.
Each day follows a similar process. After confirming your identity, the radiation therapists will position you on the treatment couch. This may involve immobilisation equipment and measurements to aid in reproducibility of the position. An x ray scan will be taken and reviewed to confirm the location of the tumour and internal organs. This scan will be compared to the planning scan and minor adjustments will be performed if required. Once the radiation therapists are satisfied with the position the radiation treatment will be delivered.
Our friendly team is always available to answer any questions you might have before, during or after your treatment.
Radiation therapy side effects
It is important to know that any side effects experienced vary greatly depending on the treatment site and the dose of radiation you receive. Generally, you will generally only experience side effects in the area being treated.
Before beginning your treatment, your radiation oncologist will discuss with you the short and long-term side effects that may arise with your personalised treatment plan.
Most side effects go away within a few months of finishing treatment. Some side effects may continue after treatment ends because it takes time for the healthy cells to recover from radiation.
Please ask your treatment team if you have questions regarding side the effects expected or experienced from your specific treatment.
Some common side effects may include:
Fatigue
Fatigue or tiredness is a common side effect of radiation treatment and is experienced to some degree by most patients.
If you find yourself feeling more tired than usual, try to take things easier. Only do as much as you feel comfortable doing, and accept help from others with routine activities and tasks. Drink plenty of fluids and eat well. Having some form of physical activity will also help you improve your wellbeing during treatment.
Skin reaction
Radiation can cause a skin reaction in the area being treated only. The area may become dry, red or itchy, similar to a sunburn.
The degree of skin reaction depends on the amount of radiation the skin receives. Your radiation oncologist and radiation therapists will advise you on the expected changes to you skin and the management of this.
It is important that you advise your treatment team of any changes to your skin, such as cracks or blisters, rashes or pain. It is also important that you follow any skin care advice given by your treatment team and avoid any products directly on the skin unless provided or advised by the team.
Do not scrub, rub or scratch your skin, avoid tight fitting clothing, and extreme hot or cold temperatures (eg – ice packs, hot shower etc)
The skin usually returns to normal around four to six weeks after you finish your treatment.
Bowel changes
Radiation treatment to the pelvis can irritate parts of the bowel resulting in some side effects. It is important that you advise your treatment team of any changes to your bowel habits so they can help manage these changes.
More commonly this may include an increased frequency of bowel motions, softer or looser bowel motions and at times, diarrhoea.
Some may also experience discomfort when passing a motion, the urge to open your bowels without passing a motion, a mucous discharge or bleeding from the rectum.
Bladder changes
Radiation therapy to the pelvis can also cause some irritation to the bladder lining and the urethra.
This may result in needing to urinate more often, including overnight. Some may experience a sudden urge to empty your bladder, a burning sensation when urinating, a change in urine flow or the feeling of incomplete emptying of the bladder.
It is important that you advise your team of changes to aid in the management of these side effects.
Nausea
Nausea and sometimes vomiting can be common reactions from radiation therapy to areas such as the abdomen. If your Radiation Oncologist suspects this will be a likely side effect for you, they may prescribe an anti-nausea medication for you take prior to treatment each day.
Mouth changes and difficulty with swallowing
Radiation therapy to the head and neck region may cause changes within the mouth. These can include change to or loss of taste, dry mouth, ulcers or oral thrush.
When treating the throat or oesophagus, you may also experience a sore throat and difficulty or pain with swallowing.
Your treatment team will keep a close eye on any of these side effects and management will be advised as required. You may also see a Dietitian or Speech and language therapist as part of your treatment program to assist with the management of any anticipated side effects.
Our friendly team are experienced in helping you manage any side effects that you may have. Please talk to your treatment team for further information on any of these or any other anticipated or experienced treatment side effects and their management.
Treatment options
We are proud to offer the first and only MRI Linear Accelerator in New Zealand. This new technology delivers radiation with a fully operational MRI imaging machine. During the radiation administration, the MRI is constantly obtaining images, thus allowing for real-time control of the radiation beam during treatment. This type of machine is also capable of fine-tuning the radiation treatment plan in between each treatment, thus, providing the ability to adapt the radiation delivery as needed on a daily basis.
Superficial radiation treatment is a simple non-invasive procedure used to treat cancer on or close to the skin surface. This treatment technique provides an alternative to surgical excision for skin cancers such as cutaneous non-melanoma. It provides the best cosmetic and /or functional result as a primary treatment, particularly for areas where surgical intervention may be difficult due to the location of the tumour, such as lesions arising on the face.
Adaptive Radiation therapy is a technique where we adapt your treatment plan daily to match the changes to your target shape on any given day (eg – bladder target it defined by how full the bladder is each day). Adaptive radiation therapy may involve creating multiple plans before the course of treatment and choosing the best fitting plan according to the online imaging.
With the addition of our MR Linac to our radiation treatment suite we are currently the only centre in New Zealand to be able to offer real time online adaptive radiation therapy. This technique involves creating daily, a new radiation plan before the treatment is delivered to account for changes taking place within the patient's body, with the goal of administering an optimal radiation dose. As a course of radiation therapy often takes several days or weeks to complete, certain anatomical and physiological changes can occur during that time, whether due to treatment itself or other factors. Even some minor changes can benefit from an adjustment to the dosage of radiation, changes may include:
The size, shape or location of the tumour – this can occur as the tumour responds to the radiation treatment.
The size, shape or location of nearby organs – such as bladder filling, swallowing and physiological movements.
Changes to the patient contour, ie – weight loss or gain.
Also known as Stereotactic ablative radiation therapy (SABR), or stereotactic body radiation (SBRT) is a specialist technique which delivers extremely precise, very intense doses of radiation to cancer cells. It is an advanced technique that requires complex planning and highly accurate image guidance to treat small, well-defined tumours. This technique allows treatment plans to be delivered in less fractions therefore reducing the number of visits to the hospital required by the patient.
In addition, doctors use SABR to treat tumours that have spread, or metastasised, from another site. This includes oligometastatic disease, in which a patient has just a few metastatic spots. In these cases, SABR may halt further spread of metastatic disease.
Patients may choose SABR instead of surgery in some cases. This lets them avoid a hospital stay, a recovery period and other aspects of a surgical procedure. The treatment also may be an option for those who are not a surgical candidate.
Deep Inspiration Breath Hold (DIBH) is a treatment technique whereby the patient holds their breath, keeping internal anatomy in a constant position. This limits the radiation to normal tissue which in turn minimises side effects that may be experienced. This technique is often utilised when treating in the chest or abdomen. Using an Active Breathing Coordinator (ABC) system patients are supported to hold their breath during treatment preventing radiation treatment being delivered when the patient is not in a breath hold state.
Image guidance is available on all our linear accelerator machines and includes X-rays, CT imaging and now MR imaging built into radiation machines. We also have a fully functional CT imaging scanner within our treatment suite alongside the radiation machines. These imaging systems will locate or track your tumour or target area during the course of radiation. Thus, allowing us to give higher doses of radiation to the cancer or target volume, while avoiding harm to healthy tissue and keeping radiation side effects to a minimum.
Our linear accelerators are equipped with 4DCBCT – a form of four dimensional imaging – allowing as to measure and observe tumour motion in real time.
VMAT is a form of intensity modulated radiation therapy in which multiple radiation beams of different intensities are directed at the tumour through a constantly rotating treatment machine. As the machine rotates, radiation is delivered at every angle focusing the highest possible dose of radiation to the tumour while minimising radiation to surrounding healthy organs. Used alongside IGRT this technique allows for higher, more effective doses of radiation while limiting damage to healthy surrounding tissues and organs.
Why Choose St George's Cancer Care for your Radiation Therapy?
Our radiation oncologists are experts at using imaging technology to more precisely and safely target the tissue that contains cancer cells and avoid harming healthy tissue. Our state of the art technology allows us to map out the treatment area with great accuracy, so we can deliver a safe but effective dose of radiation to the target location.
Our radiation oncologists, radiation therapists and nurses are highly trained to treat specific types of cancers. Our large team of radiation therapists and medical physicists develop and fine-tunes each patients treatment plan and regularly conduct thorough machine quality assurance measures to make sure we deliver the most optimal treatment possible. This increases the chances of cure and control of your disease.
World leading treatment. Future forward care.
Here, and now.
At St George's Cancer Care Centre we pride ourselves on being the patients' choice for world class cancer treatment. With cutting edge technology and decades of experience in our field we go above and beyond to provide innovative clinical care with you at the centre of everything we do.