IMRT next

coxjames52
coxjames52 Member Posts: 5
edited March 2014 in Colorectal Cancer #1
After 7 months of 'remission' my colon cancer reaffirmed itself with two tumors in my left lung. I have been back on chemotherapy for 5 months with only marginal reduction in the tumors. I have now decided to seek radiation therapy in hopes to eliminate these tumors and maybe reduce my chemotherapy to a degree.
Has anyone else done this kind of treatment?

Comments

  • geotina
    geotina Member Posts: 2,111 Member
    IMRT
    What exactly is IMRT? Lots of people have radiation but I have never heard it called IMRT. Tina
  • Buzzard
    Buzzard Member Posts: 3,043 Member
    geotina said:

    IMRT
    What exactly is IMRT? Lots of people have radiation but I have never heard it called IMRT. Tina

    Questions and Answers...............

    Intensity-Modulated Radiation Therapy (IMRT)

    * What is Intensity-Modulated Radiation Therapy and how is it used?
    * Who will be involved in this procedure?
    * What equipment is used?
    * Who operates the equipment?
    * Is there any special preparation needed for the procedure?
    * How is the procedure performed?
    * What will I feel during and after this procedure?

    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 linear accelerators to deliver precise radiation doses to a malignant tumor or specific areas within the tumor. IMRT allows for the radiation dose to conform more precisely to the three-dimensional (3-D) shape of the tumor by modulating—or controlling—the intensity of the radiation beam in multiple small volumes. IMRT also allows higher radiation doses to be focused to regions within the tumor while minimizing the dose to surrounding normal critical structures. 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 minimizing the dose to 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. IMRT does require longer daily treatment times and delivers a low dose to larger volumes of normal tissue than conventional radiotherapy.

    Currently, IMRT is being used most extensively to treat cancers of the prostate, head and neck, and central nervous system. IMRT has also been used in limited situations to treat breast, thyroid, lung, as well as in gastrointestinal, gynecologic malignancies and certain types of sarcomas. IMRT may also be beneficial for treating pediatric malignancies.

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

    top of page
    Who will be involved in this procedure?

    Most facilities rely on a specially trained team for IMRT delivery. This team includes the radiation oncologist, medical radiation physicist, dosimetrist, radiation therapist and radiation therapy nurse.

    The radiation oncologist, a specially trained physician who heads the treatment team, sets an individualized course of treatment with the help of the radiation physicist, who ensures the linear accelerator delivers the precise radiation dose and that computerized dose calculations are accurate. A dosimetrist, under the supervision of the medical radiation physicist, calculates the IMRT exposures and beam configurations necessary to deliver the dose prescribed by the radiation oncologist. A highly trained radiation therapist positions the patient on the treatment table and operates the machine. The radiation therapy nurse provides the patient with information about the treatment and possible adverse reactions as well as help in managing any reaction.

    top of page
    What equipment is used?

    A medical linear accelerator generates the photons, or x-rays, used in IMRT. The machine is the size of a small car—approximately 10 feet high and 15 feet long. The patient lies on the treatment table, while the linear accelerator delivers multiple beams of radiation to the tumor from various directions. The intensity of each beam's radiation dose is dynamically varied according to treatment plan.

    See the Linear Accelerator page for more information.

    top of page
    Who operates the equipment?

    The radiation therapist operates the equipment from a radiation-protected area nearby. The therapist is able to communicate with the patient throughout the procedure. The therapist observes the patient on closed circuit television.

    top of page
    Is there any special preparation needed for the procedure?

    Before planning treatment, a physical examination and medical history review will be conducted. Next, there is a treatment simulation session, which includes CT scanning, from which the radiation oncologist specifies the three-dimensional shape of the tumor and normal tissues. In some cases, a treatment preparation session may be necessary to mold a special device that will help the patient maintain an exact treatment position. The dosimetrist and medical radiation physicist use the CT information to design the IMRT beams used for treatment. Several additional scanning procedures, including positron emission tomography (PET) and magnetic resonance imaging (MRI), might also be required for IMRT planning. These diagnostic images can be merged with the planning CT and help the radiation oncologist determine the precise location of the tumor target. In some cases it is necessary to insert radio dense markers into the target for more accurate positioning. Typically, IMRT sessions begin about a week after simulation. Prior to treatment, the patient's skin may be marked or tattooed with colored ink to help align and target the equipment.

    top of page
    How is the procedure performed?

    IMRT often requires multiple or fractionated treatment sessions. Several factors come into play when determining the total number of IMRT sessions and radiation dose. The oncologist considers the type, location and size of the malignant tumor, doses to critical normal structures, as well as the patient's health. Typically, patients are scheduled for IMRT sessions five days a week for five to ten weeks.

    At the beginning of the treatment session, the therapist positions the patient on the treatment table, guided by the marks on the skin defining the treatment area. If molded devices were made, they will be used to help the patient maintain the proper position. The patient may be repositioned during the procedure. Imaging systems on the treatment machine may be used to check positioning and marker location. Treatment sessions usually take between 10 and 30 minutes.

    top of page
    What will I feel during and after this procedure?

    IMRT is painless. You will not feel or sense anything out of the ordinary during treatment. However, the machine can be stopped if you become uncomfortable. As treatment progresses, some patients may experience treatment-related side effects. The nature of the side effects depend on the normal tissue structures being irradiated. The radiation oncologist and the nurse will discuss and try to help you with any side effects.

    Side effects of radiation treatment include problems that occur as a result of the treatment itself as well as from radiation damage to healthy cells in the treatment area.

    The number and severity of side effects you experience will depend on the type of radiation and dosage you receive and the part of your body being treated. You should talk to your doctor and nurse about any side effects you experience so they can help you manage them.

    Radiation therapy can cause early and late side effects. Early side effects occur during or immediately after treatment and are typically gone within a few weeks. Common early side effects of radiation therapy include tiredness or fatigue and skin problems. Skin in the treatment area may become more sensitive, red, irritated, or swollen. Other skin changes include dryness, itching, peeling and blistering.

    Depending on the area being treated, other early side effects may include:

    * hair loss in the treatment area
    * mouth problems and difficulty swallowing
    * eating and digestion problems
    * diarrhea
    * nausea and vomiting
    * headaches
    * soreness and swelling in the treatment area
    * urinary and bladder changes

    Late side effects, which are rare, occur months or years following treatment and are often permanent. They include:

    * brain changes
    * spinal cord changes
    * lung changes
    * kidney changes
    * colon and rectal changes
    * infertility
    * joint changes
    * lymphedema
    * mouth changes
    * secondary cancer

    There is a slight risk of developing cancer from radiation therapy. Following radiation treatment for cancer, you should be checked on a regular basis by your radiation oncologist for recurring and new cancers.

    Using techniques such as IMRT, imaging specialists are maximizing the cancer-destroying capabilities of radiation treatment while minimizing its effect on healthy tissues and organs and the side effects of the treatment itself.

    That will be $39.95 payable in Skittles.........
  • coxjames52
    coxjames52 Member Posts: 5
    Buzzard said:

    Questions and Answers...............

    Intensity-Modulated Radiation Therapy (IMRT)

    * What is Intensity-Modulated Radiation Therapy and how is it used?
    * Who will be involved in this procedure?
    * What equipment is used?
    * Who operates the equipment?
    * Is there any special preparation needed for the procedure?
    * How is the procedure performed?
    * What will I feel during and after this procedure?

    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 linear accelerators to deliver precise radiation doses to a malignant tumor or specific areas within the tumor. IMRT allows for the radiation dose to conform more precisely to the three-dimensional (3-D) shape of the tumor by modulating—or controlling—the intensity of the radiation beam in multiple small volumes. IMRT also allows higher radiation doses to be focused to regions within the tumor while minimizing the dose to surrounding normal critical structures. 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 minimizing the dose to 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. IMRT does require longer daily treatment times and delivers a low dose to larger volumes of normal tissue than conventional radiotherapy.

    Currently, IMRT is being used most extensively to treat cancers of the prostate, head and neck, and central nervous system. IMRT has also been used in limited situations to treat breast, thyroid, lung, as well as in gastrointestinal, gynecologic malignancies and certain types of sarcomas. IMRT may also be beneficial for treating pediatric malignancies.

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

    top of page
    Who will be involved in this procedure?

    Most facilities rely on a specially trained team for IMRT delivery. This team includes the radiation oncologist, medical radiation physicist, dosimetrist, radiation therapist and radiation therapy nurse.

    The radiation oncologist, a specially trained physician who heads the treatment team, sets an individualized course of treatment with the help of the radiation physicist, who ensures the linear accelerator delivers the precise radiation dose and that computerized dose calculations are accurate. A dosimetrist, under the supervision of the medical radiation physicist, calculates the IMRT exposures and beam configurations necessary to deliver the dose prescribed by the radiation oncologist. A highly trained radiation therapist positions the patient on the treatment table and operates the machine. The radiation therapy nurse provides the patient with information about the treatment and possible adverse reactions as well as help in managing any reaction.

    top of page
    What equipment is used?

    A medical linear accelerator generates the photons, or x-rays, used in IMRT. The machine is the size of a small car—approximately 10 feet high and 15 feet long. The patient lies on the treatment table, while the linear accelerator delivers multiple beams of radiation to the tumor from various directions. The intensity of each beam's radiation dose is dynamically varied according to treatment plan.

    See the Linear Accelerator page for more information.

    top of page
    Who operates the equipment?

    The radiation therapist operates the equipment from a radiation-protected area nearby. The therapist is able to communicate with the patient throughout the procedure. The therapist observes the patient on closed circuit television.

    top of page
    Is there any special preparation needed for the procedure?

    Before planning treatment, a physical examination and medical history review will be conducted. Next, there is a treatment simulation session, which includes CT scanning, from which the radiation oncologist specifies the three-dimensional shape of the tumor and normal tissues. In some cases, a treatment preparation session may be necessary to mold a special device that will help the patient maintain an exact treatment position. The dosimetrist and medical radiation physicist use the CT information to design the IMRT beams used for treatment. Several additional scanning procedures, including positron emission tomography (PET) and magnetic resonance imaging (MRI), might also be required for IMRT planning. These diagnostic images can be merged with the planning CT and help the radiation oncologist determine the precise location of the tumor target. In some cases it is necessary to insert radio dense markers into the target for more accurate positioning. Typically, IMRT sessions begin about a week after simulation. Prior to treatment, the patient's skin may be marked or tattooed with colored ink to help align and target the equipment.

    top of page
    How is the procedure performed?

    IMRT often requires multiple or fractionated treatment sessions. Several factors come into play when determining the total number of IMRT sessions and radiation dose. The oncologist considers the type, location and size of the malignant tumor, doses to critical normal structures, as well as the patient's health. Typically, patients are scheduled for IMRT sessions five days a week for five to ten weeks.

    At the beginning of the treatment session, the therapist positions the patient on the treatment table, guided by the marks on the skin defining the treatment area. If molded devices were made, they will be used to help the patient maintain the proper position. The patient may be repositioned during the procedure. Imaging systems on the treatment machine may be used to check positioning and marker location. Treatment sessions usually take between 10 and 30 minutes.

    top of page
    What will I feel during and after this procedure?

    IMRT is painless. You will not feel or sense anything out of the ordinary during treatment. However, the machine can be stopped if you become uncomfortable. As treatment progresses, some patients may experience treatment-related side effects. The nature of the side effects depend on the normal tissue structures being irradiated. The radiation oncologist and the nurse will discuss and try to help you with any side effects.

    Side effects of radiation treatment include problems that occur as a result of the treatment itself as well as from radiation damage to healthy cells in the treatment area.

    The number and severity of side effects you experience will depend on the type of radiation and dosage you receive and the part of your body being treated. You should talk to your doctor and nurse about any side effects you experience so they can help you manage them.

    Radiation therapy can cause early and late side effects. Early side effects occur during or immediately after treatment and are typically gone within a few weeks. Common early side effects of radiation therapy include tiredness or fatigue and skin problems. Skin in the treatment area may become more sensitive, red, irritated, or swollen. Other skin changes include dryness, itching, peeling and blistering.

    Depending on the area being treated, other early side effects may include:

    * hair loss in the treatment area
    * mouth problems and difficulty swallowing
    * eating and digestion problems
    * diarrhea
    * nausea and vomiting
    * headaches
    * soreness and swelling in the treatment area
    * urinary and bladder changes

    Late side effects, which are rare, occur months or years following treatment and are often permanent. They include:

    * brain changes
    * spinal cord changes
    * lung changes
    * kidney changes
    * colon and rectal changes
    * infertility
    * joint changes
    * lymphedema
    * mouth changes
    * secondary cancer

    There is a slight risk of developing cancer from radiation therapy. Following radiation treatment for cancer, you should be checked on a regular basis by your radiation oncologist for recurring and new cancers.

    Using techniques such as IMRT, imaging specialists are maximizing the cancer-destroying capabilities of radiation treatment while minimizing its effect on healthy tissues and organs and the side effects of the treatment itself.

    That will be $39.95 payable in Skittles.........

    IMRT
    Thanks for the great information.
    I will be talking with the Dr.s today and hopefully schedule the treatment within the next couple of weeks.
  • coxjames52
    coxjames52 Member Posts: 5

    IMRT
    Thanks for the great information.
    I will be talking with the Dr.s today and hopefully schedule the treatment within the next couple of weeks.

    IMRT - Scheduled for set-up session
    I am scheduled to go in for a 'set-up' session on Monday afternoon.
    Dr. seems confident that this procedure will 'eliminate' those lung tumors.
  • Buzzard
    Buzzard Member Posts: 3,043 Member

    IMRT - Scheduled for set-up session
    I am scheduled to go in for a 'set-up' session on Monday afternoon.
    Dr. seems confident that this procedure will 'eliminate' those lung tumors.

    That sounds great...
    Keep us abreast of how it goes , as it goes........Love and Hope , Buzzard
  • lcarper2
    lcarper2 Member Posts: 635 Member
    Buzzard said:

    That sounds great...
    Keep us abreast of how it goes , as it goes........Love and Hope , Buzzard

    IMRT
    Holly Cow that was intense I am exhausted just reading all that , buzzard what do you do for a living it has to be in the writting field...