Precision care: Advances in radiation therapy minimize side effects

Radiation therapy technician Andrew Brown talks with a patient prior to treatment for prostate cancer. (PHOTO BY RICHARD WHELSKY)

Radiation therapy technician Andrew Brown talks with a patient prior to treatment for prostate cancer. (PHOTO BY RICHARD WHELSKY)


The first visit with the radiation oncologist is usually where patients unload their fears.

In general, people may be more familiar with the negative image of radiation and somewhat unaware of its powers to help heal. So a good portion of that first visit is spent educating and assuaging fears, says Anna Shapiro, MD, associate professor of radiation oncology at Upstate.

Patients may or may not have had surgery or chemotherapy before they arrive for radiation oncology. But they have had time to think about their cancer diagnosis and what their body will now face.

Anna Shapiro, MD

Anna Shapiro, MD

Patients receive a general overview of what their treatments will be like at that first appointment, says radiation oncology resident Emily Daugherty, MD, “but it’s not a cookie-cutter treatment. It’s very personalized.”

Shapiro says patients who recall parents or friends who received radiation therapy years ago are often surprised to learn how much technology has advanced. Radiation is delivered much more precisely today, which means side effects are minimized.

After meeting with the patient, radiation oncologists, medical physicists and radiation therapists convene to determine where, precisely, to aim the radiation, and how best to avoid healthy tissues.

Pretty much everyone asks about side effects, how the treatment schedule will affect the rest of their life and whether they will be radioactive. (The answer is no, unless they are receiving some forms of brachytherapy in which radioactive pellets are implanted in the body.)

It doesn’t hurt. It’s like getting an X-ray, so the patient cannot tell whether it’s working.

“You just have to believe,” says Shapiro. “It’s not something you can see or feel or smell.”

The physicians, however, can watch the tumor shrink, treatment after treatment, through advanced medical imaging.

The first appointment for radiation oncology is like a rehearsal. Patients are fitted with immobilization structures that will help them assume the exact position for every treatment. They see what treatments will be like.

Patients who require radiation to the head or neck have a special thermoplastic mask made that fits over their face. These custom-made immobilization structures are stored near the TrueBeam radiotherapy system.

Staying still is crucial. Radiation therapist Amanda Spence  explains, “we’re treating to the 10th of a millimeter, so it’s very precise.”

14 unique ways Upstate helps patients through radiation therapy

Radiation therapy is an important part of treatment for many patients with a variety of cancers. The treatments often take place every weekday for several weeks. Each visit is designed to be as easy as possible on patients.

What helps?

  • No-charge valet parking means patients can get in and out of the Upstate Cancer Center quickly and without a lot of walking.
  • The routine of receiving treatment about the same time every day, usually with the same technicians, adds some predictability to the unknown.
  • Friendships often form between patients who receive treatment at the same time of day.
  • Some patients derive comfort by praying during treatment or holding rosary beads.
  • Just understanding the treatment plan offers relief to many patients. Technicians are good at explaining what to expect.
  • Having directions to follow adds focus for some patients. Those with prostate cancer may be asked to arrive with full bladders. Those with pancreatic cancer may be asked to fast, so their stomach is deflated during radiation.
  • Few patients turn down the offer of a warm blanket.
  • Patients choose what type of music they want to hear.
  • Patients pick the color of the lights in the room — blue, orange, green, pink or a rotation.
  • Lots of thought went into the selection of tranquil and interesting nature-themed artwork on the walls, designed to provide a calming distraction.
  • Anti-anxiety medications are available but rarely required.
  • During the treatment, radiation therapists can speak to the patient through an intercom. Sometimes a spouse or loved one will speak encouraging words, too.
  • Radiation therapist Brian Goodrich describes the general approach to patients: “We really just treat them like regular people.”
  • Therapy dogs including Sebastian and Lumpy spread cheer by making regular visits to the radiation therapy facilities.
Cancer Care magazine winter 2018 issue

Cancer Care magazine winter 2018 issue

This article appears in the winter 2018 issue of Cancer Care magazine.

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