Advanced Radiation Therapies | Rio Bravo Cancer Cen

THERAPIES & TECHNOLOGIES

At the Rio Bravo Cancer Center, our priority is patient care. That’s why we continue to offer our patients the most advanced technologies available to treat their disease. Volumetric Modulated Arc Therapy (VMAT) technology represents another step in fulfilling our ongoing mission.

ADVANCED RADIATION THERAPIES FOR THE
TREATMENT OF CANCER IN BAKERSFIELD, CA

Rio Bravo Cancer Center provides some of the most cutting-edge therapy and treatment planning alternatives for patients who have been diagnosed with various types of cancers. Our advanced radiation therapies are used to treat kidney cancer, breast cancer, bone cancer, brain cancer, CNS cancer, head and neck cancer, prostate cancer, and skin cancer, just to name a few. However, this is not the radiation of years passed. Advancements in science, physics, medicine, and cancer treatment options have resulted in radiation therapy that enables the radiation oncologists at Rio Bravo Cancer Center to pinpoint the precise areas to be treated while leaving healthy tissue unharmed.

3D conformal radiation therapy is a cancer treatment that shapes the radiation beams to match the tumor's shape.

In the past, radiation beams only matched the height and width of the tumor — exposing healthy tissue to radiation. Advances in imaging technology have made it possible to locate and treat the tumor precisely. Conformal radiation therapy uses the targeting information to focus precisely on the tumor while avoiding the healthy surrounding tissue.

This exact targeting makes it possible to use higher radiation levels in treatment. Higher Radiation doses are more effective in shrinking and killing tumors.

Before treatment, you will have a radiation planning (or simulation) session, where a therapist will make a custom-fit mold.

The radiation oncologist will take a 3D image of your tumor, often using one or more of the following imaging methods:

CT (computed tomography) scan.
MRI (magnetic resonance imaging).
PET (positron emission tomography) scan.
PET-CT scan.

Then, a computer program analyzes the 3D image and designs radiation beams that conform to the tumor's shape.

A 3D conformal radiation treatment session takes about 30 minutes total.

The therapist sets up the treatment according to the 3D images of the tumor and the info from the simulation.

You lie in the mold on the x-ray table.
During treatment, beams from several directions precisely match the tumor's height, width, and depth.
The linear accelerator moves circularly around the tumor area.
The actual treatment lasts only a few minutes.

Your oncologist will decide your treatment schedule, including how many times per week you will need to repeat radiation treatment.

ELEKTA VERSA HD

Intensity Modulated Radiation Therapy (IMRT) is an advanced form of external beam radiation therapy delivered with astonishing accuracy to cancerous tissues in the body, using a computer-controlled and highly technical device known as a "linear accelerator." IMRT allows our radiation oncologists to "modulate" (or vary) the amount of radiation dose given to different parts of the cancerous area. The modulation is done with tremendous precision and three-dimensional detail, according to the cancerous tumor's shape, size, and location. This allows our patients to know they are receiving radiation only where needed, and surrounding healthy tissue will be unaffected by the treatment.

Image-Guided Radiation Therapy (IGRT): harnesses powerful computer technology to combine tumor imaging and cancer treatment on a single machine called a "linear accelerator." Because cancerous tumors can move during treatment, IGRT provides high-resolution, 3-D images, allowing the radiation oncologists at Rio Bravo Cancer Center to view and track tumors while a patient is on the table. Knowing exactly where the tumor is allows our cancer treatment specialists to fine-tune patient positioning, compensate for motion and breathing, irradiate only the tumor, and complete radiation treatment with greater accuracy than ever before.

At our state-of-the-art cancer treatment center, IMRT/IGRT radiation therapy is enhanced with Volumetric Modulated Arc Therapy (VMAT) radiotherapy technology by Elekta. VMAT sets a record for speed without compromising quality. In many cases, radiation treatments that once took 15 – 20 minutes can now be completed with a single machine revolution – often in less than two minutes.

Cone-beam computed tomography (CBCT) is an imaging technique that provides computed tomographic (CT) images from a rotational scan before radiation treatment. It allows for an accurate 3D representation of your body and tumor before delivering the daily radiation treatment. This will enable us to use tighter radiation beams to target the tumor, thus leading to fewer side effects from treatment. A CBCT takes less than a minute to acquire but increases the accuracy of the radiation beam tremendously.

Elekta is proud to be the leading innovator of radiation equipment and software used to improve, prolong, and save the lives of people with cancer and brain disorders. The Elekta Versa HD is Kern County's newest advanced radiation therapy system (linear accelerator). This cutting-edge radiation therapy system can be found at large academic centers like UCSF and Cedars Sinai. We are the only free-standing facility in California to have this technology. It has advanced radiation capabilities like no other machine in the region. It can treat traditional 3-D conformal radiotherapy to advanced stereotactic radiation therapy.

Equipped with sophisticated conformal beam-shaping technology and High Dose rate mode delivery, the Versa HD is designed to provide the precision and speed necessary to deliver advanced stereotactic radiotherapy (SRT) and stereotactic radiosurgery (SRS). These techniques demand maximum accuracy in tumor targeting and protection of critical structures. The Versa HD utilizes the Agility 160 leaf multi-leaf collimating system, allowing for the beam's precision shaping to the treatment area.

At the same time, Versa HD gives radiation oncologists the flexibility to employ conventional therapies to treat the broad spectrum of tumors throughout the body. Proven in its application, Versa HD unlocks the true potential of high dose rate delivery due to its market-leading leaf speeds and ultra-low leaf transmission. For patients with tumors that have considerable movement (lung/liver tumors), the Versa boasts the only online 4D cone beam system worldwide. This feature allows our physicians to track the activity of tumors with the breath cycle to more accurately target the tumors and decrease the potential side effects. Benefits include:

Reduced treatment times with rapid leaf speeds and high dose delivery
Submillimeter accuracy in treating tumors
Potential to deliver SBRT/SRS in a standard time slot
Lower non-therapeutic doses to protect organs-at-risk and potentially reduce the risk of secondary cancer
Exploit the full potential of high doses for advanced therapies by eliminating previous multi-leaf collimator speed limitations
Provide custom configurations for unique clinical needs
Utilize the latest imaging technology to allow soft tissue visualization during treatment
Expansion of established programs to reach more challenging targets, including lung, brain and spine, prostate, and liver SBRT providing more relief to more patients.

To learn more, please visit Elekta Versa HD.

Stereotactic Radio Surgery (SRS) and Stereotactic Body Radiation Therapy (SBRT) are employed to ensure that your radiation therapy can correct for motion and organ position during treatment. At the Rio Bravo Cancer Center, we utilize SRS and SBRT to deliver an accurate dose, allowing our radiation specialists to control the amount of radiation that gets to organs, all in real-time. Both methods are equivalent to surgery. SRS is utilized for the brain, whereas SBRT is used in the body.

Stereotactic Radio Surgery and Stereotactic Body Radiation Therapy is a cutting-edge radiation technique that allows tumors to be treated with high doses of accurate pinpoint radiation beams while causing minimal effects on the surrounding normal organs. SBRT is like SRS for brain lesions; however, it treats tumors outside of the brain. This is commonly used in surgically inoperable tumors of the brain and body. Rio Bravo Cancer Center utilizes SRS and SBRT to deliver an accurate dose and allows our radiation specialists to control the amount of radiation that gets to organs, all in real-time. Depending on the clinical situation, SRS/SBRT can be equivalent to or even better than surgery. SRS/SBRT usually is completed in 1-5 daily treatments.

SpaceOAR

All prostate cancer treatments, except active surveillance, can cause side effects for the patient. Radiation therapy is a commonly recommended form of treatment due to its effectiveness and increased accuracy in targeting only the cancer cells within the prostate. Patients undergoing radiation therapy can, however, experience side effects during and after treatment, including:

Erectile dysfunction
Urinary incontinence, urgency, and frequency
Fecal incontinence
Rectal bleeding and painful bowel movements
Diarrhea

The severity of these side effects varies from patient to patient and is influenced by the dosage and frequency of the radiation therapy. We are dedicated to helping patients maintain the highest quality of life during and after treatment. For patients receiving radiation therapy, we offer SpaceOAR, a revolutionary system that helps to protect the rectum of patients undergoing radiation therapy with clinically proven results.

WHAT IS SPACEOAR?

SpaceOAR Hydrogel is designed to reduce rectal injury in men receiving radiation therapy for prostate cancer. Side effects of radiation therapy are typically caused by radiation damage to the neighboring organs, such as the rectum. SpaceOAR acts as a spacer for an organ at risk (OAR) – pushing the rectum away from the prostate so that it won't receive the high dose radiation directed at the prostate gland.

HOW DOES SPACEOAR WORK?

The SpaceOAR hydrogel spacer is put in place during a minimally-invasive procedure. Once this spacer is in place, patients cannot usually feel it. This system is similar to other products that may be used to protect patients in cardiology, ophthalmology, and brain surgery. The spacer will remain in place for three months to protect the rectum during radiation treatment. After this time has passed, the spacer is absorbed by the body and excreted in the patient's urine.

BENEFITS OF SPACEOAR SYSTEM

Some of the notable benefits of the SpaceOAR System for prostate cancer patients include:

Less risk of damage to the rectum– SpaceOAR moves the rectum further away from the target of radiation treatment, thus reducing the amount of damage to rectal tissue.
Fewer rectal side effects and complications – With SpaceOAR in place during radiation treatment, patients are less likely to experience rectal side effects, including mucus discharge, rectal bleeding, rectal urgency, diarrhea, and rectal pain.
Minimally-invasive – The placements of SpaceOAR hydrogel is minimally-invasive and cause minimal discomfort.
Quick, easy recovery– Following the placement procedure, most patients can immediately return to normal activities with little to no restrictions.
No need for removal – The body will begin to absorb SpaceOAR after three months, and it will be wholly absorbed in approximately six months, so there is no need to have it removed. Once the hydrogel is absorbed, nothing foreign will remain in the body.
Painless and non-disruptive– Patients don't typically feel SpaceOAR while it is in place. It doesn't disrupt the patient's life or cause noticeable side effects.
Low risk of side effects and complications – Although side effects and complications are possible after any surgical procedure, problems following the placement of SpaceOAR are relatively low.

Studies have shown that SpaceOAR's biocompatible material can be used safely in the body. The FDA has also cleared this technology, and it has been used successfully by more than 10,000 prostate cancer patients.

Published Article: Clinical Investigation of Prostate Radiation Therapy

SPACEOAR CLINICAL STUDIES

Published results of a randomized clinical trial on the SpaceOAR system demonstrate that the spacer was safe, that patients tolerated it well, and that the spacer significantly reduced rectum radiation injury. This reduced rectal radiation decreased reports of pain during radiation treatment, and one year after radiation treatment decreased the rectum complications by 71%.

In the year following radiation treatment, clinical trial patients that did not get SpaceOAR System were 3.5 times more likely to have rectal complications than those who did.

Additional Resources:

ELECTRON BEAM RADIATION THERAPY

At Rio Bravo Oncology, Electron Beam Radiation Therapy (EBRT) is frequently used to treat various types of skin cancer. EBRT uses technology that employs tiny, electrically charged particles to target cancer cells on the body's surface. The ultimate level of precision this type of radiation therapy affords allows for higher doses of radiation with less risk to surrounding tissue. This helps our radiation oncologists to achieve their single objective, which is to increase the likelihood of controlling or eliminating the cancer.

Electron therapy is external beam radiotherapy where electrons are directed to a tumor site. Electron beam therapy is used to treat superficial tumors such as cancers of the skin (e.g., squamous cell carcinoma, basal cell carcinoma, melanoma, mycosis fungoides) & nodal irradiation. It may also be used to boost the radiation dose to the surgical bed after mastectomy or lumpectomy.

Superficial radiation therapy using electron beams is a proven procedure for treating skin cancers. This type of treatment is an excellent alternative to surgery, especially for skin lesions located in sensitive head and neck regions such as the fold in the nose, eyelids, lips, corners of the mouth, and the ear lining. Performing surgery on these areas can be difficult and result in poor cosmetic outcomes.

Using electron beams, we can customize your treatment with different shapes and a wide range of energies, which allows us to target the precise depth of the lesion, irradiating only as deep as necessary and leaving deeper tissues untouched.

With superficial radiation therapy, no anesthesia is required. The procedure is accurate, safe, pain-free, and highly effective in eliminating certain skin cancers and decreasing the potential for surgery-related cosmetic issues.

4-D CT FOR TUMOR TARGETING

4D CT (computed tomography) represents the next step in imaging. This advanced imaging method makes CT scans much faster and more accurate than ever before. 4D CT uses a new technology that captures the location and movement of your tumor and the movement of your body's organs over time.

This is valuable for accurately treating tumors located on or near organs that move, like in the chest and abdomen.

A 4D CT scan is much like a classic CT scan. During a 4D CT scan:

You lie very still on your back
The scanner spins around you in a corkscrew path, taking constant pictures
It takes about 30 seconds for the scanner to complete its path around your body

The scanner makes a 4D image showing:

Your body's breathing
How the tumor moves
How the movement of nearby organs affects the position of your tumor

The information from the 4D CT scan allows your radiation oncologist to:

Design more precise treatments for moving tumors.
Better target these moving tumors and deliver radiation within a specific interval in the breathing cycle.
Reduce your risk of treatment-related side effects.

For instance, a tumor on the lung will move with each breath as the lung inflates and deflates. Thus, with 4D CT imaging, we can accurately visualize the complete pathway of movement to target the tumor accurately.

VMAT FOR RAPID & ACCURATE TREATMENT DELIVERY

Technology such as the Volumetric Modulated Arc Therapy (VMAT) system keeps the Rio Bravo Cancer Center on the cutting edge of cancer treatment. We have used VMAT regularly to treat prostate, head, and neck tumors, as well as a range of other cancers.

The main advantages of VMAT are precision and speed. VMAT focuses the radiation on the tumor while protecting healthy tissues. Each VMAT treatment is completed in less than two minutes. Faster treatments improve the accuracy of radiation delivery and improve patient convenience and quality of life.

VMAT uses photons (W-rays) generated by a medical linear accelerator. The idea is to deliver the maximum radiation dose to the tumor while reducing the amount of healthy tissue affected. Tiny beams with varying intensities are aimed at a tumor and then rotated 360 degrees around the patient. This results in attacking the target in a complete three-dimensional manner.

The information from the 4D CT scan allows your radiation oncologist to:

Design more precise treatments for moving tumors.
Better target these moving tumors and deliver radiation within a specific interval in the breathing cycle.
Reduce your risk of treatment-related side effects.

For instance, a tumor on the lung will move with each breath as the lung inflates and deflates. Thus, with 4D CT imaging, we can accurately visualize the complete pathway of movement to target the tumor accurately.

GOLD FIDUCIALS FOR TUMOR LOCALIZATION

Gold fiducial markers are tiny, gold seeds, about the size of a grain of rice, that are put in and/or around a tumor to show exactly where it is in the body. Doctors can then target the tumor directly and give higher doses of radiation with less harm to nearby healthy tissue. They are also known as gold fiducial marker seeds, gold seeds, and gold-seed fiducial markers.

MRI, PET/CT FUSION FOR
ACCURATE TUMOR TARGETING

In the multidisciplinary management of patients with cancer, positron-emission tomography (PET) and computed tomography (CT) fusion imaging is an exciting and rapidly evolving technique improving our ability to make better treatment decisions. PET utilizes radioactive sugar molecules, which cancer cells use up faster than normal cells. This causes tumors to emit an activity signal to identify cancerous areas.

PET-CT is useful in the staging of numerous cancers, including:

lung cancer
Hodgkin's disease
head and neck cancer
ovarian cancer
gastrointestinal stromal tumors
gynecologic cancers
colorectal cancers
breast cancer

Studies have shown that PET-CT is useful for target volume delineation during radiation treatment planning.

PET-CT is quickly becoming the standard of care for staging malignancies at specific anatomic sites. Studies have found that PET-CT is more accurate in helping to identify cancer than magnetic resonance imaging (MRI) or PET alone, and PET-CT findings resulted in a change in treatment.

These technologies are not widely available at other outpatient treatment facilities. Rio Bravo Cancer Center is proud to provide patients with the most advanced cancer treatment in a comfortable, personal setting. Our cancer center is staffed by radiation oncologists, physicists, therapists, and office personnel who bring decades of cancer care methodologies experience to each patient.

Our team of cancer specialists will work closely with your other physicians and in conjunction with your overall cancer treatment program to determine the most viable radiation treatment plan for you. Our compassionate staff helps guide each patient through their journey from cancer diagnosis to remission.

CHEMOTHERAPY

Chemotherapy is the use of any drug to treat any disease. But to most people, the word chemotherapy means drugs used for cancer treatment. It’s often shortened to “chemo.”

Surgery and radiation therapy remove, kill, or damage cancer cells in a particular area, but chemotherapy can work throughout the whole body. This means chemotherapy can kill cancer cells that have spread (metastasized) to parts of the body far away from the original (primary) tumor.

If possible, chemotherapy is used to cure cancer, meaning that the cancer is destroyed – it goes away and doesn’t come back.

Most doctors don’t use the word “cure” except as a possibility or intention. So, when giving treatment that has a chance of curing a person’s cancer, the doctor may describe it as treatment with curative intent.

There are no guarantees, and though cure may be the goal, it doesn’t always work out that way. It often takes many years to know if a person’s cancer is really cured.

You and your cancer doctor, called an oncologist, will decide what drug or combination of drugs you will get. Your doctor will choose the doses, how the drugs will be given, and how often and how long you’ll get treatment. All of these decisions will depend on the type of cancer, where it is, how big it is, and how it affects your normal body functions and overall health.

Cancer can be treated with a single chemo drug, but often several drugs are used in a specific order or in certain combinations (called combination chemotherapy). Different drugs that work in different ways can work together to kill more cancer cells. This can also help lower the chance that the cancer may become resistant to any one chemo drug.

Sometimes chemotherapy is the only treatment you need. Chemotherapy is often used with surgery, radiation therapy, or both. Here’s why:

Chemotherapy may be used to shrink a tumor before surgery or radiation therapy. Chemotherapy used in this way is called neoadjuvant therapy.
It may be used after surgery or radiation therapy to help kill any remaining cancer cells. Chemotherapy used in this way is called adjuvant therapy.
It may be used with other treatments if your cancer comes back.

In most cases, the most effective doses and schedules of drugs to treat specific cancers have been found by testing them in clinical trials. It’s essential, when possible, to get the entire course of chemotherapy, the total dose, and keep the cycles on schedule. This gives a person the best chance of getting the maximum benefit from treatment.

However, there may be times when serious side effects require adjusting the chemotherapy plan (dose and/or schedule) to allow you time to recover. Sometimes, you might be given supportive medicines to help your body recover more quickly. Again, the key is to give enough chemo to kill the cancer cells without causing other serious problems.

TO LEARN MORE ABOUT THESE INNOVATIVE THERAPIES OR SCHEDULE YOUR CONSULTATION, PLEASE CALL 661-491-5060

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