IMRT - Intensity Modulated Radiotherapy

Intensity Modulated Radiation Therapy is an advanced type of radiation which allows the treatment to be more precise and the volume to conform more accurately to the shape of the tumor. In turn, this technology can deliver the necessary dose to the tumor cells, while sparing the normal tissue and reducing side effects. These radiation doses are distributed to the targeted area by a high-precision computer controlled x-ray linear accelerator. The intensity of the radiation beam is controlled in order to keep the radiation dose consistent with the shape of the tumor. This customized radiotherapy is intended to maximize tumor radiation while protecting the surrounding normal tissue. 

3-Dimensional Conformal Treatment

During 3-Dimensional Conformal Treatment each radiation beam is shaped to fit the tumor's profile from a beam's eye view using a multileaf collimator (MLC) and a variety of beams. The relative toxicity of radiation to the surrounding normal tissues becomes reduced once the treatment volume conforms to the tumor's shape, allowing a higher dose of radiation to be delivered to the tumor than conventional techniques allow. 

Body Radiosurgery

North Cypress is One of Few Facilities in the World Offering This Treatment.

Until 1991, patients with certain types of cancers faced no hope of recovery. Fortunately, the physicians of the Karolinska Institute in Sweden adopted a proven medical treatment called Stereotactic Radiosurgery. This innovative cancer treatment uses concentrated beams of radiation at many angles to attack primary and metastatic cancers such as liver, lung and prostate, among other tumors. Since its development, doctors have achieved 85 percent positive control rates.

A positive control rate is either cessation of growth, tumor shrinkage or disappearance of the cancer. Body Radiosurgery can be used when surgery, conventional radiation therapy or chemotherapy are not viable options, or have been used and failed. Even if you have been told by your physician there is no further treatment available for your cancer, you may still be a candidate for Body Radiosurgery.

How Does It Work?

Despite its name, Body Radiosurgery does not require surgery or any incisions. The procedure is virtually painless and the patient can return to work the next day. State-of-the-art computers and technology create a treatment plan that attacks the cancer and spares normal, healthy tissue. Temporary side effects of conventional radiation therapy are eliminated. During the actual treatment, customized radiation fields are directed on the cancer from various angles. Each radiation beam is contoured to take into account the size and location of the cancer as well as the patient's shape. The net effect is a "super" dose of radiation. 

Stereotactic Radiosurgery/Photon Knife

The Photon Knife, also known as Stereotactic Radiosurgery, is a minimally invasive type of brain surgery that uses high doses of radiation with pinpoint accuracy to treat and eradicate intracranial tumors and other abnormalities. North Cypress Medical Center is one of the few cancer centers in Texas to offer stereotactic radiosurgery using the Brain Lab System. Since this procedure is minimally invasive, it is not necessary to shave the head, incise and retract the scalp or open the skull.

How It Works

The neurosurgeon fits a stereotactic head frame on the patient under local anesthesia. The patient undergoes an MRI and CTI Scan where the data is transferred to a special treatment planning program. A 3-D image of the brain is created and the treatment team pinpoints the exact location and proper radiation dosage. The patient is immobilized on the couch of the Linear Accelerator where the treatment is delivered. During treatment, the Photon Knife sends a laser sharp high-intensity X-ray beam to one precise, small area of the brain. The advanced computer software of the Photon Knife allows it to deliver high doses of radiation therapy to an area as small as 2 millimeters in approximately 20 minutes.

Benefits include:

  • No shaving of head
  • Only minor discomfort
  • Outpatient procedure so no long, costly hospital stays
  • Quick recovery since minimally invasive procedure - most patients go home the same day and typically return to work the following morning  

High Dose Rate Brachytherapy Implants

HDR Remote Afterloading

This treatment involves placing very tiny plastic catheters into the prostate gland, and then giving a series of radiation treatments through these catheters. The catheters are then easily pulled out, and no radioactive material is left in the prostate gland. A computer-controlled machine pushes a single highly radioactive Iridium-192 seed into the catheters one by one. Because the computer can control how long this single seed remains in each of the catheters, we are able to control the radiation dose in different regions of the prostate. We can give the tumor a higher dose, and we can ensure that the urine passage (urethra) and rectum will receive a lower dose. This ability to modify the dose after the needles are placed is one of the main advantages of temporary Brachytherapy over Low Dose Rate (LDR) Remote Afterloading Brachytherapy. Brachytherapy is a highly effective alternative for prostate cancer (and other cancers) and is a medical term for a radioactive source applied in or near a tumor.

What Does HDR Treatment Involve?

Treatment by the North Cypress Cancer Team frequently consists of a three-pronged attack, known as " tri-modality therapy". This can include a combination of the three following separate therapies:

  1. High-dose-rate temporary Brachytherapy
  2. Moderate doses of intensity modulated radiation therapy (IMRT)
  3. Short term hormonal therapy (occasionally omitted)

It is possible for cancer cells to migrate outside of the HDR Brachytherapy program. Because of this, external beam radiation is often added. This treatment can also be used for many tumors which are considered too advanced for radical prostatectomy. As long as there is no obvious spread to distant areas of the body, like the bones, this treatment can be considered. For early stages, treatment is an alternative to the radical prostatectomy, but with fewer side effects.

Another reason to use external beam therapy is to minimize the chances of permanent complications, especially urinary side effects. By spreading the dose delivery out over internal and external treatments we can minimize the chances of causing a complication by either treatment.

Benefits of HDR Treatment:

  • No nausea, hair loss, or diarrhea
  • Decreased impotence, incontinence, and urinary side effects
  • Decreased damage to adjoining tissue and organs
  • Minimal recovery time
  • Able to go home safely and return to normal activities within days of procedure
  • No special dietary considerations or major pre-treatment preparations

Success of HDR

This treatment has been used extensively worldwide for more than a decade and exceeds the most stringent safety requirements. Studies at the Swedish Medical Center have shown that the temporary implantation radioactive seeds that are inserted, and then removed, in the HDR procedure - used in concert with external beam radiation - have one of the lowest prostate cancer recurrence rates compared to surgery or external radiation alone.

Low Dose Rate Brachytherapy Implants

Brachytherapy, in general, is a procedure that involves directing radiation directly in or near tumor cells. This allows doctors to deliver higher doses of radiation to more-specific areas of the body while sparing normal tissue and minimizing side effects. Low Dose Rate Brachytherapy uses seed implants which are placed directly into or near the tumor and is often given after a course of extended radiation. The seed implant may be placed temporarily or permanently. 

Chemotherapy

Chemotherapy is a drug treatment that uses powerful chemicals to kill fast-growing cells in your body. Since cancerous cells grow and multiply much quicker than normal cells, chemotherapy is commonly used for cancer treatment. There are a variety of chemotherapy drugs available, some which may be used alone or combined for treatment. Though chemotherapy is an effective way to treat may types of cancer, this treatment also carries a risk of various side effects which can range from mild to severe. Our very broad and skilled team of Medical Oncologists will carefully evaluate the disease and will plan the treatment that is best for the patient.  

Hormonal Therapy

Hormones are chemicals circulating in your bloodstream that are produced by glands in your body. Hormonal therapy is used to keep cancer cells from receiving estrogen and progesterone, which they need for growth. If tests show that your cancer cells contain estrogen, progesterone and/or testosterone receptors, hormone therapy is used to block the way these hormones help the cancer grow. Hormonal therapy may include the use of drugs to change hormones' action or surgery to remove the body parts in which produce hormones.  

Targeted Therapy

During cancer treatment, targeted therapy uses drugs or other substances to identify and attack cancer cells while doing little damage to the healthy cells. Within the cancer cells, these therapies attack the DNA of the cell which in turn will alter the way a cancer cell grows, divides, repairs itself, or interacts with other cells. 

Biological Therapy

Biological therapy is a type of treatment that uses your immune system to help fight cancer and control side effects. Biological therapy is designed to boost the immune system by assisting in the following:

  • Forces cancer cells to stand out by the immune system, making them more susceptible to destruction by the immune system
  • Boosting the effectiveness of immune system cells
  • Changing the way cancer cells multiply/grow to be more like healthy cells
  • Enhancing the body's ability to repair normal cells damaged by other forms of treatment
  • Preventing cancer cells from spreading (metastasizing) to other body parts  

Surgery

Cancer surgery, an operation to repair or remove part of your body to diagnose or treat cancer, remains the foundation of cancer treatment. Surgery in cancer patients is frequently used to remove growths or obtain small samples of tissue to examine. The primary purpose is to cure the patient by removing the cancer along with some surrounding tissue from their body to eliminate any microscopic disease that might be present. The removal of small samples or healthy tissue may be necessary to ensure all the cancer is removed or to exam to determine if the cancer has spread.