Effective Radiation Therapy

Radiation therapy -- standard treatment for about half of all cancer patients -- is anything but routine.

"We can't just write down a radiation dose like a prescription," says Paula Schomberg, M.D., a Mayo Clinic radiation oncologist. "So much goes into determining the correct dose and how it's given."

Radiation therapy, killing cancer cells with beams of high-energy X-rays, is a technologically challenging and evolving part of cancer care. Patients may be treated with radiation alone, or with radiation and surgery or chemotherapy.

Radiation can be given externally, over several days or on weekdays for up to seven weeks, depending upon the patient, tumor type and previous treatment. Or, in several newer approaches, radiation can be applied internally, using radioactive material in the form of seeds or small rod implants placed near or inside the tumor.

Mayo Clinic, with 28 radiation oncologists, offers a depth of expertise and experience in all aspects of radiation treatment. Each physician focuses on two or three types of cancer.

More than 3,500 Mayo Clinic cancer patients receive some kind of radiation therapy every year. That large patient base means that Mayo Clinic doctors routinely care for patients with rare or very challenging cancers.

"Instead of caring for one child with a rare cancer in a year, I may treat children with the same rare condition many times a year," says Dr. Schomberg.

Patients benefit from that expertise. For example, Mayo Clinic regularly treats patients with specialized radiation services such as:

• Gamma knife radiosurgery, where focused high-dose radiation is used to treat brain tumors.
• Intraoperative electron radiation, a technology where tumors are treated with a powerful radiation beam while exposed during surgery.
• Electronic portal imaging, where the positioning of treatment fields can be checked prior to each daily treatment.

At Mayo Clinic, the same radiation oncologists who care for patients also seek ways to improve care through research. That work has led to improved outcomes for patients at Mayo Clinic and elsewhere. For example, Mayo Clinic researchers have:

• Determined appropriate radiation doses for brain tumors that set a new standard of care.
• Found that the use of internal metal markers helps target radiation more accurately for prostate cancer patients and helps minimize side effects.
• Determined simple and inexpensive pretreatment testing that identified prostate cancer patients who are likely to have serious complications from brachytherapy, where radioactive seeds are placed in or near a tumor. Those patients can be treated other ways.

Radiation therapy is an important and effective cancer treatment, but it's not benign. There can be side effects; short-term or late complications of treatment. Done incorrectly, radiation therapy can permanently damage surrounding organs and even be life threatening. The risk of these injuries can be minimized with appropriate, state-of-the-art radiation therapy.

When seeking radiation therapy, ask about your doctor's experience in your particular type of cancer.

"Specialized care from experienced doctors -- from the beginning of your treatment -- does make a difference in outcomes," says Dr. Schomberg. "A patient's best shot at beating cancer is the first shot."