Radiation center’s accreditation
How important is a radiation center’s accreditation? And if they aren’t accredited what other ways can you find out their quality assurances and quality control?
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Hi @ccw1885 , There are three different accreditations for a radiation center (ACR-ROPA, ACRO, ASTRO-Apex) but only about half of the radiation centers in the country are certified by one of them. My local rural hospital provides radiation therapy without certification (even though their chemo delivery is certified) so this is what I checked out several years ago.
Are there licensed medical ROs on staff and present? What is their education and experience?
Is there a medical dosimetrist involved in radiation planning (even if remotely)?
Are the radiation techs certified or what kind of training do they have for delivering radiotherapy?
How old is the LINAC machine? After about 10 - 12 years it is out of date in terms of the treatment it can deliver even though it still works.
Are there documented policies and procedures that must be followed? (You don't have to read them but should verify there is something in place.)
If possible get an opinion of the center from an RO or other knowledgeable person in a certified center.
My local hospital was lacking in several areas. I found out the age of the LINAC (which was said to be up-to-date but was actually 15 yrs old) by googling and locating a local newspaper article heralding its arrival. Most of the techs had certifications in other imaging modalities and were trained by "someone." The oncologist at another small hospital about 45 minutes away said some of his patients went there for radiation and he hadn't seen anything terrible happen.
I ended out travelling 100 miles for treatment at a certified hospital. At the time I was teaching online so it was possible to stay at a hospital owned hostel (cheap) and do two commutes a week. Otherwise I would have gone with what was available locally. Travelling like I did can be very time consuming and expensive.
There are a couple of ladies who post here who are/were radiology techs and might have more insight than I do as a patient. I hope you can find a decent place to have your radiation treatment.
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Great post, @maggie15 — very helpful!
@ccw1885 welcome to the community! We are so sorry for the reasons that bring you here, but are so happy you decided to join and post. As you can already see, our community is made up of some wonderful members always willing to offer advice, information, encouragement, and support — we're all here for you!
We hope others will weigh in soon with their insight, but in the meantime, let us know if you need anything at all!
—The Mods
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Ccw1885, I was fortunate that my small community hospital was accredited by the American College of Radiology (ACR) with two board-certified radiology oncologists on staff. It was important to me that trained, experienced physicians were treating me instead of a doctor who just completed training or someone still in residency. It was also reassuring that the radiation therapy technicians and nurse worked only in radiation therapy and held certifications where available.
I hope you find a radiation therapy facility that meets your needs. Best wishes.
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Thank you for talking the time to reply and all the great info. The RO has a great Bio. I haven’t checked the radiation therapists or the dosmetrist. They already think I’m a nut job for asking for accreditation so I’m half afraid to even ask. I guess that should tell me something. However
, it seem everyone goes there and loves it. But my thing, niceness is great but skill is another thing. I’m just so paralyzed 😰
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@ccw1885, Don't be afraid to ask questions whatever the doctor might think so that you can make an informed decision. I'm grateful to have my small hospital close by for routine and emergency medical matters and know many people who work there because I was their (or their childrens') math teacher/swim coach. I questioned my PCP about what seemed like an abnormality of my breast and was reassured it was only a cyst since I had received a birads2 score two weeks prior. A year later an oral surgeon figured out I had breast cancer (jawbone osteomyelitis which only occurs in those with cancer or HIV.)
One of the radiologists apologized explaining that the tumor didn't show up on the older mammography machine but her colleague had missed other suspicious signs and scored it wrong. She said it was also unfortunate that my PCP hadn't ordered an ultrasound since that would have shown the tumor. Twice the ER has sent me by ambulance on the 100 mile trip for things they couldn't treat so they do know they have limitations. However I am now very proactive about deciding for myself whether they may be out of their depth.
Good luck with your decision.
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A couple other things to consider…
At major centers, radiation plans are often actually designed by a resident in conjunction with the dosimetrist. The radiation oncologist then approves their plan, and often a board of ROs reviews the plan again. So there are many layers to catch potential issues. This is especially important if the dosimetrist is lacking in experience. There is also a physicist making certain the plan meets the parameters of the machine delivering the dose. You might ask your RO what the review process is, but if you trust them you are probably fine.
However, the one question I would ask is how many techs are present during the sessions. I say this from personal experience. I was at a major center. On Fridays they were short staffed and the one tech on duty twice programmed my breath hold incorrectly, leading to a higher dose. If two techs are in the room they should be checking each other, which is much, much safer.0
