Radiation Oncology

Radiation Oncology

The Department of Radiation Oncology at Newark Beth Israel is a regional leader in cancer treatment in New Jersey, offering patients world-class treatment options.

Working as part of a multidisciplinary team in treating patients with cancer, our radiation oncologists, as well as radiation therapists, medical physicists, and dosimetrists, design and deliver optimal treatment plans for each patient’s unique needs and cancer care on an inpatient and outpatient basis. Radiation oncologists work with surgical oncologists and medical oncologists in formulating precise treatment plans to meet individual patient needs.

Our approach to radiation oncology combines compassionate care, state-of-the-art technology, special expertise and innovative treatments for patients with all forms of cancer.

Advanced Treatment Options

Recent advances in radiation therapy provide a wider range of options for patients with cancer than ever before. With tomotherapy, three-dimensional conformal radiation therapy, intensity-modulated radiation therapy (IMRT), stereotactic radiotherapy, high-dose rate brachytherapy, and radioimmunotherapy, powerful radiation can be delivered with pinpoint accuracy, maximizing effectiveness and minimizing radiation exposure of healthy tissue. Treatment time can be greatly reduced, as well, with certain therapies requiring only a single treatment, or an abbreviated course of treatment as a result of advanced radiation technologies. These Include:

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Three-Dimensional Conformal Therapy

External beam radiation uses high energy photons to destroy cancer cells within the body. The photons are in many ways similar to those used in diagnostic x-ray (chest x-ray) or rays from the sun except they are much higher in energy. The beams are generated by a device called a linear accelerator and deposit radiation dose as they pass through a particular portion of the body. The radiation damages the DNA of cells which ultimately leads to their destruction. Normal (non cancerous) cells are much better able to repair this type of damage and therefore survive. Like the light from a flash light, radiation dose is delivered only when the machine is on and the patient is not radioactive once the machine is turned off.

One of the most important advances in the delivery of external beam radiation therapy has been the development of three-dimensional conformal therapy. Traditional conventional radiation therapy is targeted only by the location of bones seen on plain x-rays which cannot show the actual tumor. These bony landmarks do not show the unique anatomy of any particular patient. The fields therefore tend to be large, square shaped and generic. This results in more unnecessary radiation to the surrounding tissues.

Conversely, conformal therapy allows for the customization of treatment for each particular individual. Every person has a unique tumor size, shape, as well as location of nearby normal organs. Conformal radiation is the process of accurately determining this unique anatomy and tailoring the radiation treatment such that it "conforms" to every patient. Where conventional therapy would treat all patients with the same big square beams, conformal radiation treats a round tumor by round beams and an elongated shaped tumor with elongated shaped beams. This technology is now applied to nearly all tumor sites. (Breast/ Gastrointestinal/ Prostate/ CNS/ Lung/ Gyn)

Conformal treatment is a complex process which involves three basic components. The first is patient immobilization. Special body casts are created to improve the reproducibility of the patient’s position on the machine. The second step is computed tomography (CT) assisted organ identification. The precise location and shape of the tumor as well as the surrounding tissues is determined. The final step involves the use of powerful computer tools to generate the specific beams which will differentially deliver the radiation to the tumor while sparing the surrounding normal tissues. Specialized blocks are created to shape the beams which have been generated. This improvement in technology means that the radiation beams can be made the smallest size possible to safely treat the cancer while avoiding normal tissues. The less normal tissue irradiated results in less unwanted side effects.

The treatment process for conformal therapy is as follows:

Simulation: This is the first step of conformal radiation. The total time needed for this first day is about 90 minutes. A custom body mold is made that is customized for each particular area of treatment. By lying in the mold, you will be in the same position on the treatment table every day - up to 67% more accurately than without the cast. Next is the CT scan in our department.

Claustrophobia, a fear of close places, is rarely a problem. Contrast dye is often used during the CT scan to improve the image of the tumor on the film. Please tell your doctor or nurse if you are allergic to contrast dye or iodine. Small tattoos the size of a pencil point are then placed to be used every day for accurate positioning of the treatment beams. They are permanent but small and in locations that will likely not be publicly visible.

3-D Treatment planning: This process takes place behind the scenes over a 1 week period -you do not need to be present. The CT scan taken at simulation is examined by the physician who contours the important body organs which are then inputted into the computer. The physician then directs specially trained physicists and therapists in designing the conformal shape of the radiation beams. This is the custom tailoring - the radiation beams are designed to mimic the shape of the target with the narrowest margin of normal tissue possible.

Set-up: We check the accuracy of your specific treatment on the actual therapy machine before starting radiation.

Radiation Treatments: The time course of conformal radiation depends on the disease site being treated but in general ranges from 5 to 7 weeks, Monday through Friday, except for major holidays. The actual time in the treatment room is 10-15 minutes. Please allow 45-60 minutes total each day for parking, dressing and small delays. Treatment times are flexible from 7:30 - 5:30 - most requests for a specific time of day can be met.

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Intensity Modulated Radiation Therapy (IMRT)

The rapid evolution of computer programs has made possible further advancements in the delivery of conformal 3D radiation treatments called intensity modulated conformal therapy. Radiation beams are manipulated through advanced computer-controlled technology to change the intensity of the beam profile around both tumor and normal tissues. This new approach exploits the additional control that intensity modulation provides in achieving more conformality of the target. The availability of this new approach at Monmouth and Community Medical Centers creates the ability to deliver multiple, more complex conformal treatment fields in a shorter amount of time. Treatments that may have taken 15 minutes to deliver are now completed in 2-3 minutes. Patients can expect lower side effects and more convenient treatment. Because of greater healthy tissue sparing, IMRT can be combined with chemotherapy to improve cure rates.

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High Dose Rate Temporary Implants for Prostate Cancer

High Dose Rate implants for prostate cancer are now offered as an exciting non-surgical alternative for locally advanced disease. This novel approach involves implanting temporary catheters into the prostate, in a minimally invasive one-hour operative procedure. Concentrated high pulsed doses of radiation are then delivered with the aid of computer planning into the prostate, delivered through these catheters.

Treatments are individualized to conform to the prostate shape, in order to spare normal surrounding tissue. Unlike conventional permanent seed implants the dose to the prostate can be individualized through varying the amount of time the radiation source spends in each position in each needle. Additionally this allows the physician to minimize dose to the urethra and rectum which may reduce potential side effects.

Treatments are delivered over a 36 hour period with only a one-night hospital stay. The implant is temporary, and is removed prior to the patient leaving the hospital. This treatment is then supplemented by a short course of conformal external radiation therapy. Side effects are minimal allowing the patient to be treated in an outpatient fashion. Recovery time is quick, with most patients returning to their normal lifestyle routine during therapy. Results with this approach are promising, and appear comparable if not superior to standard external radiation alone for locally advanced disease. HDR has the advantage of shortening the overall course of therapy, while delivering higher doses of radiation to the cancer with greater precision.

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Elekta Synergy™ Digital Linear Accelerator

The Elekta Synergy™ digital linear accelerator enables a multidisciplinary team, including radiation oncologists, nurses, radiation therapists, medical physicists, and dosimetrists, to design customized plans tailored to treat a patient's cancer more aggressively than ever before. It uses 160 interlocking leaves that can be positioned to shape a high resolution beam to target the tumor, minimizing radiation dose to surrounding healthy tissue, organs or structures. The precisely targeted radiation beams are aimed at a tumor in order to shrink or eliminate cancer growth. Its precision is especially useful for treating tumors that are located in sensitive locations like the brain and spinal cord. Radiation therapy is an effective treatment for gynecological, breast, prostate, lung and most other cancers. It can be used alone or in conjunction with other treatments like surgery and chemotherapy.

Main telephone number: 973-926-7320
Parking is Free.

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High Dose Rate Brachytherapy

High Dose Rate Brachytherapy (HDR) is an advanced form of radiation treatment that destroys cancer cells by delivering powerful and precise radiation therapy internally, directly into the tumor itself. Because HDR is delivered under image-guidance and the dose of radiation is determined and administered with pinpoint precision, it has provided excellent outcomes for patients with prostate, breast, gynecologic and other forms of localized cancers. With HDR, specialists deliver the radiation in the form of a temporary implant, which is carefully placed through a tiny tube and inserted directly into the cancerous tissue. Specialists view the implant and can shape the radiation to maximize tumor dose and minimize exposure to normal tissue. Treatment time can range from seconds to minutes, and the source of radiation is removed from the tumor after each treatment. In addition to excellent tumor control rates and greatly reduced side effects, HDR also significantly shortens treatment times.

Radiation oncologists at Newark Beth Israel routinely perform HDR for patients with prostate, breast, and gynecologic cancers. Our prostate cancer program has been leading the way in clinical trials for years, and has treated more patients with High Dose Rate Brachytherapy (as opposed to the older method of radioactive seeds) than any other program in New Jersey. Our distinguished radiation oncologists have presented on HDR for prostate cancer at clinical meetings around the world.

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State-of-the-art Radiation Therapy

Our outstanding physicians and technical staff deliver radiation with the highest level of precision, utilizing state-of-the-art technologies. Patients have access to world-class radiation therapy, including our dedicated Tomotherapy unit, one of only a few in New Jersey. Because radiation therapy treatments vary depending upon the stage and type of cancer, radiation treatment options for cancer are specific and unique:

  • Breast
  • Prostate
  • Head and Neck
  • Lung, Lymphoma
  • Gastrointestinal
  • Gynecologic
  • Central Nervous System

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Clinical Excellence

Our Radiation Oncology department is accredited by the American College of Radiation Therapy and is one of only a few in New Jersey belonging to the Radiation Therapy Oncology Group (RTOG) and the Children’s Oncology Group (COG), which ensures our patients have access to the most cutting edge cancer protocols—protocols that cannot be offered at non-member hospitals.

Our radiation oncologists are fellowship-trained and board-certified in radiation oncology, and are dual-certified by the American College of Radiology. Our radiation technologists are American Registry of Radiologic Technologists (ARRT) licensed and have extensive experience and training in the treatment of patients with cancer.

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