"Brachy" is a Greek medical prefix meaning 'short', and therapy means treatment. The success of this treatment is based upon the physics principle that radiation doses fall off very rapidly from the source or seed containing the radiation. Because the surrounding normal tissues can often be spared the harmful effects of doses necessary to kill tumor tissue, the radiation doses achieved using brachytherapy are much higher than is possible with external beam radiation therapy. In appropriate cases, this ability to deliver much higher doses results in higher local control rates, while sparing the surrounding normal tissues and reducing the morbidity or side effects. The Cancer Care Group offers a comprehensive range of brachytherapy services:

Types of Brachytherapy

• Low Dose Rate Brachytherapy - This type of treatment consists of placing radioactive seeds inside a tumor. The activity of this type of seed will last over several weeks to months. The most common application of this technology is in the treatment of prostate cancer. Iodine and palladium seeds are the isotope used most commonly. The dose rate and the limited strength of these seeds generally does not require additional hospitalization or radiation protection for people around the patient.

• Intermediate Dose Brachytherapy - This is the oldest type of brachytherapy. It uses intermediate range radiation particles that can be compacted into pellets. These pellets are placed inside body cavities or in tumorous tissues. Examples of these isotopes include: strontium, gold, cesium, radium, and iridium. Generally these treatments are given over several days requiring hospitalization.

  

• High Dose Brachytherapy - This is the latest brachytherapy technology. It uses a high activity radiation source that can be placed inside a small diameter tube approximately 1mm thick. This radiation source is sufficiently small that it can be placed comfortably in body cavities, such as the lung, the esophagus, the cervix, or the uterus. It can also be placed directly into tumors with guiding tubes. The rapid activity of this radiation allows for treatments to be given over a short period of time (usually several minutes to a half hour) followed by removal of the tubes. The radioactive source in the high dose rate machine is attached to a computer controlled cable which can deliver precise radiation doses in any desired configuration. Common applications for this treatment include: prostate tumors, Gyn tumors, lung tumors, esophageal tumors, head and neck tumors, soft tissue sarcomas, and some itra-op applications.

• Intravascular Brachytherapy - This treatment uses the ability of radiation to prevent scar from forming in the blood vessels that supply blood to the heart. It is done after a stent is placed in a blocked blood vessel to prevent the overgrowth of scar. Use of this treatment often prevents extensive cardiac surgery.

The linear accelerator is the workhorse of radiation cancer medicine. The majority of treatments offered with radiation use a linear accelerator to shoot cancer killing rays at a patient's tumor. Radiation particles are extracted from an electron gun, they are accelerated to light speeds, the particles are transformed into pure energy, and then they are aimed as beams at a patient's cancer. The high energies of this machine make it possible to shoot past the skin and other superficial body structures while giving the tumor full dose. Treatment technologies using this machine include:

• BAT System Technology - The B mode Acquisition Technology is a system of using ultrasound scanning to correct for internal organ movement from day to day. This technology is particularly useful in external beam treatments for prostate cancer, some breast cancers, and pancreas cancers.

• Intra-op Radiation - This type of external beam treatment uses particles of radiation with a short range (electrons) to be placed on a tumor bed at the time of the primary surgery to remove the tumors. This treatment is often useful because many tumors cannot be completely removed at the time of surgery and residual roots of tumor cells may remain in the tumor bed. Radiation placed on these areas will help to kill any remaining cells. Cancer Care Group is one of the world leaders in this technology, with fifteen years of experience.

• Portal Verification - This technology assures that every external beam treatment is precisely aimed before the treatment is given. Older technology relies on an "after the fact" x ray film that can be corrected only after the treatment has been given.

Women who have undergone lumpectomy for early-stage breast cancer receive radiation to the breast internally in contrast to whole breast external beam radiation therapy. MammoSite® delivers partial-breast irradiation through a catheter inserted into the lumpectomy cavity (temporary void following tumor removal). Treatment is twice a day for five days in comparison to seven weeks of external beam radiation therapy. A small radiation source called a "seed" is introduced into the cavity and radiation is directed only to the area of the breast where cancer is most likely to recur.

Tumors located deep within the brain or in other inoperable areas can be irradiated with minimal dosing to surrounding healthy tissue. It is a state-of-the-art radiosurgical system equipped with advanced computer-based imaging techniques that shapes the radiation beam exactly to the contours of the tumor. Novalis® Shaped Beam Surgery™ produces a uniform treatment beam that continuously adjusts to tumor size and shape from several angles delivering an optimal prescription dose of radiation to the tumor while sparing normal tissue.

This cutting edge therapy consists of attacking a radioactive molecule onto an antibody that will attack a tumor specifically. In contrast to other types of radiation treatments where the physician must manually target the tumor. This treatment is generally injected and the antibody/radiation complex will travel through the blood stream and attach itself directly to the tumor in question. This technology is still in its infancy and at this time, only non-Hodgkins B cell lymphomas can be treated.

• Conformal Radiation Treatment - This is a specialized planning technique that uses a computer to aim the radiation beam to "conform" to the cancerous tumors seen on a CAT scan. Treatments using this technique will hit the tumor more accurately and spare normal tissue. Beam Compensators-the radiation beam that comes from the linear accelerator is a uniform strength beam. It often needs to be "softened" or modified to provide a uniform radiation dose to an irregularly shaped portion of the body. This is particularly useful in treating primary breast and Head and Neck Cancers.

• Stereotactic Radiosurgery - This beam refinement therapy uses highly defined, small beams that are carefully aimed in small arcs around a tumor. Historically it was used for tumors or AV malformations in the head. Since very high doses could be given to small areas, generally only one or two treatments are necessary. This technology is most useful as a primary treatment for certain brain tumors and tumors metastatic to the brain, as a boost for other types of brain tumors, to irradicate A-V malformations, and kill seizure focuses in brains with refractory epilepsy. This type of treatment uses a specially modified linear accelerator and shoots small photon beams. New uses for this technology include the treatment of "tic douloureux" (trigeminal neuralgia).

• Gamma Knife - The Gamma Knife is a specialized machine with two hundred and fifty very small cobalt radiation sources that are all aimed to meet in a small area. This machine primarily treats targets in the brain and head. It has many of the same uses as the Stereotactic radiosurgery technology. It uses gamma rays emitted from the small cobalt radioactive sources.