Issue 3 Stories
Physicians Perspective

A Perfect Pairing for Cancer Care

Advanced Technology, Compassionate Caregivers at Sentara Martha Jefferson

As the most recent addition to the Sentara Martha Jefferson Radiation Oncology team, I am routinely asked by my patients about how I landed in Charlottesville, and specifically at Sentara Martha Jefferson. While I could go into many details, the short answer is simple: I found a hospital that offers the equipment, technology and personnel of a major academic center and also offers a caring, personal approach. Here I will discuss some of the state-of-the-art technologies that enhance cancer care and help to improve outcomes for Sentara Martha Jefferson patients.

Planning: The First Step in Radiation Treatment

Radiation therapy, also known as radiotherapy, uses photons (X-rays and/or electrons) as part of cancer treatment to control or kill cancerous cells. Patients often ask me how a course of radiation therapy is planned, since it is highly customized to each individual’s circumstances. The first step is for each patient to undergo a planning appointment, during which a CT scan is taken of the area of the body to be treated. The scan is then imported into a computerized planning system known as MIM Software, a system that Sentara Martha Jefferson has invested in to enable physicians to view 3-D images of a patient’s body. The software is able to overlay multiple prior types of scans (e.g., CT, MRI, PET and PET-CT scans) to form a single “virtual” patient image. This allows the cancer care team, which includes the physician, physicist and dosimetrist, to view the patient’s tumor and organs in multidimensional ways, improving accuracy in targeting the radiation toward tumors and away from normal, healthy tissue. This improved accuracy reduces side effects during and after radiotherapy treatment.

An Array of Radiation Therapy Options

Once a patient’s treatment has been planned, many different techniques can be used to deliver the therapy, and Sentara Martha Jefferson has invested in some of the most advanced technology in order to provide these options to patients. Since radiation therapy is such an exact science, doctors select the appropriate treatment method based on what will work most effectively for each individual.

Undergoing external beam radiation, which can be used to treat any area of the body, is much like getting an X-ray, although for a slightly longer period of time. This type of treatment is usually delivered on a daily basis (excluding weekends) over multiple weeks using a linear accelerator, typically requiring only a brief visit to the hospital.

To minimize the amount of radiation delivered to normal tissues and organs, and to reduce side effects to patients during and after treatment, special methods for delivering external beam radiation have been developed. Intensity-modulated radiation therapy (IMRT), a complex form of treatment requiring specially equipped machines and computers, maps the patient’s tumor precisely in three dimensions. Using that map as a guide, the beam can be aimed from several directions and its strength can be adjusted to several different levels of intensity. This versatility allows for exact control over the radiation dose, helping to decrease the amount reaching sensitive normal tissues and deliver higher doses to the tumor. A variation of IMRT known as volumetric-modulated arc therapy (VMAT) uses a special linear accelerator, combined with RapidArc® technology, to deliver radiation quickly as the equipment rotates around the body. This allows each treatment to be administered over just a few minutes, decreasing the time the patient is required to lie still on the treatment table.

Another technique known as image-guided radiation therapy (IGRT) is available on both of the radiation treatment machines at Sentara Martha Jefferson. The machines have built-in imaging scanners, giving the cancer care team the ability to take pictures of the patient’s tumor and make minor aiming adjustments just before the radiation is administered. Again, this helps to ensure that we are delivering radiation as precisely as possible to the tumor.

Finally, stereotactic radiosurgery (SRS) and stereotactic ablative radiotherapy (SABR) use advanced image-guided techniques to deliver large, precise doses of radiation to small, well-defined tumors. (The term “surgery” when referring to SRS can be a bit confusing, however, since the treatment does not involve any actual cutting.) SRS, which can be delivered in a single treatment, is used to treat tumors in the brain. SABR, also known as stereotactic body radiation therapy (SBRT), is used to treat tumors in other parts of the body, including the spine, liver, pancreas, kidneys, lungs and prostate.

Thankful to Be Part of the Team

As I hope you can see, Sentara Martha Jefferson is fortunate to have the latest and greatest technology available. As a physician, I am certainly grateful for the resources I have available to me, but I’m also grateful for the team of bright, professional colleagues with whom I collaborate daily. Their kind, compassionate, caring ways, coupled with the hospital’s advanced radiation therapy options, make Sentara Martha Jefferson an outstanding choice for patients who may need radiation therapy.

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