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What is Radiation Oncology?

Radiation therapy, or radiotherapy, involves the use of ionizing radiation to treat many forms of cancer.  It can be delivered both internally and externally.  The goal of all radiation therapy is to give the tumor a lethal dose of radiation while limiting the exposure to the surrounding healthy tissue. Before treating with radiation, sophisticated dose calculations are made in order to contour the shape and intensity of the beam, which will help facilitate a precise dose to the targeted area.  Radiation is a painless treatment and does not result in hair loss.

There are many forms of external radiation delivery systems.  Traditional equipment delivers 3-D conformal and Intensity Modulated Radiation Therapy (IMRT), which can create high dose volumes that are concave in shape and spare normal tissues that are close to and surrounded by the tumor.

During each field of treatment, the dose delivered is contoured by the multi-leaf collimator (a device that consists of a number of moving “fingers” or “leaves”), that position themselves dynamically in order to block portions of the primary beam and create a desired shape. IMRT is supported by Image-guidance, which involves mapping the internal organs, treatment area and nearby structures by using 2-D and 3-D imagery so that the clinician can make adjustments for more accurate targeting.  See Radiation Technologies.

Radiation Therapy - Treatment Planning for Radiotherapy

Initial Consultation

During the initial consultation, the patient will be interviewed and examined by a Radiation Oncologist. To help us understand the patient's medical status, we will need to obtain copies of medical records, health history, prescribed medications, and recent medical visits with other specialists, and if applicable, any biopsy reports. We will review the information with the patient and family members and answer any questions they may have.  Patients may continue their routine prescription medications unless advised otherwise by their physician.

Developing a Treatment Plan

Once it is determined that radiation therapy is the best way to treat the cancer, treatment planning begins. A treatment plan, which is a collection of measurements, imagery and dosing calculations, will be developed specifically for each patient so that the post-treatment results are optimal. This custom-made plan is influenced by overall health, type and stage of cancer. It also takes into consideration information from other specialists. Patients will undergo a special CT or PET scan called a "simulation". The imagery and information acquired during the simulation will allow the physician to target the tumor and avoid the other organs and healthy tissues nearby. The treatment will take place daily over several days or more.  In order to ensure that the patient is in the exact same position for every treatment, specialized equipment may be used to help hold the patient in place. Small ink marks may be drawn on the skin to assist the therapists with body alignment.

Starting Daily Treatments

When the planning is complete, the patient will be treated with one or more machines that will deliver the radiation to your prescribed location. These technologies generate high energy x-rays or electrons that destroy tumor cells.  Other systems are designed to deliver radiation through the use of isotopes and catheters. Radiation therapists, who are certified by the American Registry of Radiologic Technologists (ARRT), administer the daily treatment under the supervision of the Radiation Oncologist. They record and document treatment progress and run tests on the treatment machines daily to ensure that they are working properly. Most radiation treatments are given five times a week, Monday through Friday.

Post-Treatment Care and On-going Support

Most people undergoing radiation treatment are able to continue with their normal activities. Some may need to adjust their level of activity temporarily during treatment, if recommended. Patients are encouraged to check with their doctor before starting any exercise or fitness program during this time. Good nutrition during therapy is essential to promote healing and recovery, and the oncology nurse or nutritionist can help determine the best approach. The patient is weighed regularly during radiation therapy to monitor health and any weight loss. Patients should do their best to eat a normal, well-balanced diet with three or more regular meals. Smaller, more frequent meals and snacks may also be suggested. Patients should also consult with their doctor about the use of multivitamins and other dietary supplements. Nutrition information is also available through the oncology nurse.

In addition to the care and information that patients receive, we can also provide information for local support groups in the community. Many local and national organizations cater to all cancer types such as the American Cancer Society, or more specifically, Susan G. Komen for the Cure, who provides support and information for women with breast cancer and collects donations for research and treatment. See Cancer Resources.


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