Washington Radiation Oncology Center: Technology and Training Enhance Results and Safety
In the fight against deadly cancers, new technologies in radiation therapy have dramatically improved both the effectiveness and safety of treatment. For example, intensity-modulated radiotherapy (IMRT) allows physicians to adjust the intensity and shape of radiation beams to deliver high doses of radiation directly to the tumor, while sparing healthy tissue surrounding the tumor. Another recent innovation, image-guided radiation therapy (IGRT), combines imaging and treatment capabilities in a single machine. With IGRT, physicians can pinpoint the exact location of tumors before each dose of radiation is delivered, minimizing radiation exposure to healthy tissue.
"When these technologies are utilized properly, they are extremely effective and safe," says Dr. Michael Bastasch, a radiation oncologist at the Washington Radiation Oncology Center. "We place a major emphasis on patient safety, repeatedly assessing calculations and measurements throughout the course of treatment."
The Washington Radiation Oncology Center has had IMRT equipment since 2002, while IGRT was introduced in the summer of 2008. "Since I arrived in September 2006, we have not noted any incidents of unexpected radiation side effects," says Bastasch, "but that doesn’t mean we stop checking."
The radiation oncology team at the center includes a medical physicist who is certified by the American Board of Radiology and a medical dosimetrist who is certified by the Medical Dosimetry Certification Board. The center’s radiation therapists are licensed by the State of California. All of these practitioners go through rigorous training and must take continuing education courses to keep up with the latest treatment technology.
Working with the center’s board-certified radiation oncologists, these skilled professionals help develop each patient’s treatment plan and assure that the highest level of quality care is maintained.
"In a typical case, a patient will come in and have a three-dimensional CT scan performed so the physician can determine what areas need to be treated," says Medical Physicist Pam Fuerst. "Then the dosimetrist and I will work with the physician to develop the treatment plan, including the dosage and frequency of treatments as well as the areas to be radiated and the sensitive areas of the body that must be limited in exposure to radiation. The plan is electronically transmitted to the treatment machine. Then we check the settings on the machine to make sure they are accurate, and the radiation therapist re-checks the settings again."
In addition to checking the machine settings prior to treatment, the radiation therapist takes digital images of the patient (while in the treatment position), comparing those to the treatment plan. "These verification images help us ensure that we are treating the appropriate areas of the body," Fuerst explains. "The physician must review and approve them before treatment begins. Our policy is to provide patient-specific quality assurance for every patient prior to the first treatment."
Quality assurance at the center goes beyond checking, re-checking and triple-checking the patient’s plan and images prior to treatment. It also involves checking the equipment each day to measure the level of radiation output to insure the correct dosages. The medical physicist also conducts monthly checks on the equipment with even more sensitive measuring devices to assure radiation dosage levels.
"Annually, we use the services of the Radiological Physics Center, an outside testing service financed by the federal government," Fuerst says. "They send us a device that we put in our radiation beam and then send back to them. We tell them what we think the dosage level is, and they verify and confirm the accuracy of our measurements. Additionally, every two years, we must do an even more extensive testing of the equipment to confirm that it is still operating according to the standards that were originally specified by the manufacturer."
Bastasch notes that the radiation equipment offers additional safeguards, including default settings that stop the treatment if a problem arises. "Also, if the system senses that the machine settings don’t match the patient’s treatment plan, it issues a warning to the therapist," he says.
"The key, though, is to make sure you enter the proper information into the system," he adds. "When we develop a patient’s treatment plan, we have to assess a variety of factors such as the size and location of the tumor, the type of tumor and its growth characteristics, and the surrounding critical structures that we must avoid radiating. Patient safety goes hand in hand with our patient-first ethic. Each and every patient we treat should receive a course of radiation therapy specifically designed for their diagnosis, delivered safely and accurately."
Learn More About the Washington Radiation Oncology Center
For more information about the Washington Radiation Oncology Center, located at 39101 Civic Center Drive in Fremont, please visit www.whhs.com/cancer or call (510) 796-7212.