Topic: Choosing a location for radiation therapy

Beegirl ~

I had asked my surgeon for a couple of recommendations...I went to another Rad.Onc. ( rated 16 in the nation cancer center ) and they actually, suggested somewhere close as treatments/rads is a big commitment and can take a toll.  I asked if it was standard procedure across the board as far as treatments ( another words same treatment ) and the Dr. agreed 

So, I went w/ one of my surgeons recommendations and they said, they have the IMRT at this particular location and that would be best...Just something you may want to consider.

What is Intensity-Modulated Radiation Therapy and how is it used?

Intensity-modulated radiation therapy (IMRT) is an advanced mode of high-precision radiotherapy that utilizes computer-controlled x-ray accelerators to deliver precise radiation doses to a malignant tumor or specific areas within the tumor. The radiation dose is designed to conform to the three-dimensional (3-D) shape of the tumor by modulating-or controlling-the intensity of the radiation beam to focus a higher radiation dose to the tumor while minimizing radiation exposure to surrounding normal tissues. Treatment is carefully planned by using 3-D computed tomography (CT) images of the patient in conjunction with computerized dose calculations to determine the dose intensity pattern that will best conform to the tumor shape. Typically, combinations of several intensity-modulated fields coming from different beam directions produce a custom tailored radiation dose that maximizes tumor dose while also protecting adjacent normal tissues.

Because the ratio of normal tissue dose to tumor dose is reduced to a minimum with the IMRT approach, higher and more effective radiation doses can safely be delivered to tumors with fewer side effects compared with conventional radiotherapy techniques. IMRT also has the potential to reduce treatment toxicity, even when doses are not increased.

Currently, IMRT is being used to treat cancers of the prostate, head and neck, breast, thyroid and lung, as well as in gynecologic, liver and brain tumors and lymphomas and sarcomas. IMRT is also beneficial for treating pediatric malignancies.

Radiation therapy, including IMRT, stops cancer cells from dividing and growing, thus slowing tumor growth. In many cases, radiation therapy is capable of killing cancer cells, thus shrinking or eliminating tumors.

Hi all, I asked my rad onc about IMRT after hearing about it and I was pissed that it isn't what they are doing with my breast.
But, he explained to me that they make the machine perform (by some settings) so that it actually works like IMRT. He said that IMRT is very expensive (like $75,000 isn't?), it isn't reimbursed by insurance for the right breast treatment. Basically the performance is the same as an IMRT treatment. I don't know if that made any sense.
I found that I don't get info on anything unless I drill with questions. It is too bad, they could definately benefit from a little marketing, I guess it would cost them a few seconds of explanations. Sorry just a little irritaded with that mode, don't tell unless asked, rant...rant...

Hey Beegirl, back to your original question.  I'm in Arlington, too (I've followed you a bit over on the TC Only thread on the Chemo board, but never posted).  I was trying to choose between G'town and Arlington Hospital for rads (I did my chemo over at G'town because I got the oogies talking to both Butler and Feigert).  I called both rad depts on the same day and heard back from G'town right away.  I made an appointment there to consult.  I really liked the doc--good personality.  The accommodations are older, but the communication there is really good and the techs all knew my name immediately.  I didn't hear back from Arlington Hospital till a week after my original call.  Since I'd been in to see the doc at G'town in the meantime, and liked him, I decided to do rads at G'town.  Georgetown is not bright and shiny like Arlington, but I decided there was more to it than a shiny hospital.  I will say the drive to G'town is longer and you do have to pay for parking, whereas there are a few free parking spaces at Arlington for rad patients.  (But wait, don't I remember you saying you could walk to Arlington?)

Long story short, we do have options here.  If you haven't already made your decision, I'd take the time to check out your alternatives.

D1

I think an article like this might make you think about where you choose to go:

http://www.cancer.gov/clinicaltrials/results/postmastectomy-radiation0106

Quality has a lot to do with the outcome, according to it. So do your research and don't just pick the closest or easiest to get to. Pick the best for your cancer.

Nancy - thanks for the article. My onc specialized in bc at NCI before joining the private group next to VHC in December. I had a lumpectomy rather than a mastectomy, plus I'm certain the hospital radiation oncology uses the latest equipment, etc. They may even have IMRT. Yesterday my onc told me that if she didn't believe I would get appropriate treatment here she wouldn't hesitate to send me elsewhere.

Sharonw - I'd been wondering where you were! Sounds like you've been doing lots of research. I'm not sure I understand how it works when you're on your stomach--is the radiation done from below? Given your early stage diagnosis, you've been hitting all the treatments. That's great that you can do it in 3 weeks, too. Let us know how it goes at NYU.

I'm now set for my simulation at Arlington on May 13, about 3 weeks after my last TC chemo.