Summary: Radiation therapy for cancer is a complex and personalized treatment that involves a team of medical professionals working behind the scenes. This invisible team consists of medical physicists, radiation therapists, imaging technologists, radiation protection professionals, and nurses. While patients may not be aware of the important role these professionals play, their expertise and dedication are vital in delivering high-quality care to cancer patients.

Takeaways:

👩‍⚕️ Radiation therapy is a crucial treatment option for many cancer patients, with up to 50 percent of cancers being potentially treated with external beam radiation therapy.

🔬 Linear accelerators (LINACs) are the primary tools used in radiation therapy. These machines deliver precise radiation doses to target tumors while minimizing damage to surrounding healthy tissues.

📅 Patients typically undergo daily radiation therapy sessions for one to eight weeks, with each treatment session lasting about 30 minutes.

🏥 Radiation therapists play a crucial role in the delivery of radiation treatments. They work closely with patients to ensure proper positioning and use various tools and techniques to ensure treatment precision.

🤝 Multidisciplinary rounds and quality assurance processes are conducted before treatment to ensure the highest standards of care.

🔬 A network of medical physicists, radiation safety professionals, imaging technologists, and nurses work behind the scenes to ensure the proper functioning of radiation therapy machines and provide patient care and support.

🌟 The future of radiation therapy lies in customization and precision. Treatment plans are tailored to each patient's specific cancer type, size, and location, with a focus on administering higher-dose fractions to the tumor with millimeter-level accuracy.

👏 It is important to recognize and appreciate the essential role played by the behind-the-scenes professionals in radiation therapy. Their expertise and dedication contribute to the effective and safe delivery of cancer treatment.

Radiation Therapy for Cancer: The Invisible Team Behind the Scenes

Introduction

Radiation therapy for cancer is becoming increasingly complex, sophisticated, and personalized. Behind the scenes, there is an invisible team of medical physicists, radiation therapists, imaging technologists, radiation protection professionals, and nurses. However, this backstage world is little understood by most patients.

The Prevalence of Cancer

About 40% of Canadians will ultimately receive a cancer diagnosis in their lifetime, and one in four will die from it. These numbers are only expected to grow with an aging population.

Evolution of Radiation Therapy

Radiation therapy has been around for decades, with Canada playing a key role in its development. Cobalt 60 treatment, developed in the 1950s and '60s under the leadership of Sylvia Fedoruk, was a significant milestone. However, early treatments irradiated tumors and surrounding tissues crudely. Advances in radiation therapy have focused on reducing normal tissue damage while effectively targeting the tumor.

External Beam Radiation Therapy

External beam radiation therapy can help in up to 50% of cancers. This treatment method is set to expand further with the projected growth and introduction of new nuclear medicine magic bullet therapies.

The Role of Therapy Devices

The key tools in radiation therapy are therapy devices, most commonly linear accelerators (LINACs). These machines resemble CT scanners but have treatment heads that move around the patient instead of a "doughnut" CT mechanism.

Radiation Oncologists: The First Point of Contact

Radiation oncologists are the first point of contact for patients. They assess the risks and benefits of radiation therapy, develop treatment protocols, and consider the risk to normal tissues in the therapy.

Multidisciplinary Review Process

Approximately 70% of cases are reviewed in dedicated quality assurance multidisciplinary rounds before treatment. This ensures the highest standard of care. However, there are only 584 currently credentialed radiation oncology physicians in Canada.

The Role of Radiation Therapists

Radiation therapists play a significant role in the treatment process. They establish body positioning using CT images and trial runs, immobilize patients using various techniques such as skin markers, tattoos, and molds, and ensure precision placement of radiation.

Continuous Image Guidance

Modern LINAC machines take CT-like images (kV cone beam CT) to ensure that the patient's anatomy and tumor align with the original CT scan. This continuous image guidance enhances treatment accuracy.

Radiation Therapists as part of CAMRT

Radiation therapists are part of the broader Canadian Association of Medical Radiation Technologists (CAMRT), which includes CT, nuclear medicine, and MRI imaging technologists. In 2021, radiation therapists accounted for one-fourth of Canada's registered technologists.

Treatment Process and Frequency

Patients typically receive daily treatments for one to eight weeks, excluding weekends. Each treatment takes about 30 minutes. Before each session, patients undergo a cone-beam CT scan to ensure proper positioning and maintain the accuracy of the treatment plan.

The Role of Radiation Oncology Medical Physicists

In the background, a network of 460 radiation oncology medical physicists, most with PhDs, ensures the proper functioning of radiation therapy machines. Their expertise is crucial in maintaining treatment quality and safety.

Additional Team Members

Other team members involved in radiation therapy include radiation safety professionals, general imaging technologists, and nurses. They play vital roles in protecting workers and the public from radiation exposure and managing radiation-related side effects and allergic reactions.

The Future of External Beam Radiotherapy

The future of external beam radiotherapy lies in customizing therapy for each patient based on the type, size, and location of the cancer. The trend is to deliver fewer higher-dose fractions to the tumor, requiring precise control of the radiation beam.

Precision Therapies - "Radiation Scalpels"

Some further advancements in radiation therapy, such as hypofractionation and stereotactic body radiation therapy (SBRT), provide highly precise treatments that can kill cancer with a very high radiation dose. Technologies like TomoTherapy, Edge, CyberKnife, and Gamma Knife offer this level of precision for various types of tumors.

Recognizing the Invisible Team

As radiation therapy becomes increasingly sophisticated and personalized, it is essential to recognize the vital roles played by the "behind the scenes" professionals in caring for cancer patients undergoing radiation therapy.