State-of-the-Art Treatments

If you are diagnosed with cancer, the Cancer Institute’s experienced team of professionals works with you and your loved ones to review treatment options and develop a course of action that combines the most effective treatment with your personal preferences.

Surgery

Surgery continues to be one of the most common treatments to remove cancerous tumors, surrounding tissue and lymph nodes. St. John’s Cancer Institute works with general surgeons, as well as specialists in all areas. Surgery is often used in combination with chemotherapy and/or radiation therapy.

St. John’s offers “robotic-assisted” surgery for removal of diseased prostates. This minimally invasive surgery leads to better patient outcomes, less pain and fewer complications.

Whether your surgery is performed on an outpatient basis or requires an inpatient hospital stay, St. John’s is committed to making your experience as comfortable as possible. A child life specialist helps children undergoing surgery feel more relaxed and comfortable in the unfamiliar environment.

Chemotherapy

Chemotherapy uses powerful drugs to kill cancer cells wherever they may be — in body organs, the blood or lymph glands. It may be used alone or in combination with surgery and/or radiation therapy.

Under the direction of a hematologist/oncologist, chemotherapy is delivered through an IV, in pill form or through injections. Patients may be admitted to the hospital for chemotherapy, but in most cases, it is given on an outpatient basis.

Radiation Therapy

Radiation Therapy uses precisely targeted high-energy X-rays to destroy cancer cells. It is a very effective treatment for many cancers and is most commonly used to treat cancers of the lung, breast, brain, prostate and uterus. Radiation Therapy may be the only form of treatment required or it may be combined with surgery and/or chemotherapy.

Radiation therapy is performed under the direction of a Radiation Oncologist. It is most often delivered externally as a patient lies on a table while special equipment is used to deliver X-rays to a specific body part. Treatments last 10-20 minutes and are typically performed on an outpatient basis five days a week for two to eight weeks.

St. John’s offers many advanced form of radiation therapy:

Intensity Modulated Radiation Therapy or IMRT

IMRT delivers radiation in an extraordinarily precise way to shape the dose of radiation directly to the cancerous area while avoiding nearby critical organs. IMRT allows our physicians to precisely deliver radiation to a tumor site while minimize damage to nearby organs and reduce side effects.  IMRT is used to treat many types of cancers, but most often cancers of the prostate, central nervous system, head and neck area, and some breast cancers.

Image Guided Radiotherapy or IGRT

DESCRIPTION AND OVERVIEW

IGRT--or image-guided radiotherapy--is the most advanced form of radiation therapy currently available.  Tumors can move during treatment (usually due to patient respiration) and between treatments (usually due to day-to-day variations in patient setup).  IGRT uses advanced imaging techniques to verify patient position and tumor position at the time of treatment.  Knowing exactly where the tumor is allows clinicians to reduce the volume of tissue irradiated, targeting only the tumor and sparing the surrounding normal tissue.  Irradiating less normal tissue reduces the toxicity of radiotherapy, improving the patient’s quality of life, and may make it possible to deliver higher radiation doses to the tumor and thereby increase the likelihood of local tumor control.

HOW IT WORKS

 When patients are positioned on a treatment couch, an X-ray system mounted on a robotic arm is rotated around the body, to gather images that pinpoint a tumor’s exact location.  These images are then compared with existing images (MRI, CT or other kinds of scans) in order to determine if the tumor has moved since the last treatment.  Because tissues and organs can settle around bones differently each time a patient lies down on a treatment table, tumors can end up in different positions from one treatment session to another. 

In addition, tumors can move several centimeters due to a patient’s normal respiratory cycle.  Trilogy’s advanced imaging capabilities produce low-dose, high-resolution kilovoltage X-ray images that pinpoint tumor position.  The Trilogy system employs other technologies—an electronic portal imaging device and a respiratory gating system—to enable clinicians to verify patient positioning and to account for tumor motion caused by respiration. 

PATIENT BENEFITS

• Through more precise targeting of the beam, dosage levels can be increased and target volumes (the three-dimensional areas to receive treatment) can be reduced--so tumors get a higher dose of radiation and healthy surrounding tissues get very little.  This may increase treatment effectiveness. At the very least, it can reduce treatment times and the possible side effects of radiotherapy.
• Smaller lesions can be treated more easily and effectively.
• State-of-the-art motion management techniques allow patients to breathe naturally during treatment sessions, increasing treatment accuracy, reducing stress and increasing patient comfort.

Brachytherapy

Low Dose Rate Brachytherapy

is a form of Radiation Therapy delivered internally through small radioactive “seeds” permanently implanted into the affected body part.  The seed implants are proving effective in treating prostate and lung cancer. 

High Dose Rate Brachytherapy (HDR)

is also delivered internally; however the radioactive source is inserted for several minutes, and then removed.  HDR is most commonly used to treat cancers of the cervix and early stage breast cancer using the MammoSite (tm) catheter.  The Cancer Institute is proud to offer the latest in 3D treatment planning for Brachytherapy.  This planning technology, available since the spring of 2007, allows the physicians and staff to precisely plan the Brachytherapy radiation dose to the cancer while minimizing the dose to the normal structures.  In addition 3D treatment planning significantly reduces the procedure time.

Stereotactic Radiosurgery (SRS)

Is a type of radiation that delivers an “invisible blade” of precisely targeted radiation to deep-seated brain tumors or other brain abnormalities, while avoiding critical areas of the brain.

Interventional Radiology

Specialists called interventional radiologists use new minimally invasive procedures to destroy certain types of tumors and help control pain. One procedure called radiofrequency ablation delivers high-intensity heat directly to a tumor. A procedure called chemoembolization delivers chemotherapy drugs directly to a tumor. Patients with inoperable liver tumors or other types of cancer that have spread to the liver are excellent candidates for this type of procedure. Another procedure delivers high doses of chemotherapy to head and neck tumors so organs such as the voice box and tongue don’t need to be removed.