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IMRT & IGRT: A Closer Look

What is Intensity Modulated Radiation
Therapy (IMRT)?

IMRT is one of the most precise forms of radiation therapy available. This sophisticated treatment approach uses computer-generated images of the affected area to plan and deliver focused radiation beams. IMRT breaks a radiation beam into smaller beamlets, which can be turned on or off. This allows us to shape the beam to the tumor, focus  radiation on the target site and reduce radiation to surrounding healthy tissue.

What is Image-Guided Radiation Therapy (IGRT)?

IGRT adds a technological advance to IMRT by providing imaging prior to each radiation  session to ensure accuracy. Small localizing markers may be placed before treatment, then visualized to guide radiation delivery. Another IGRT option visualizes internal structures and uses those to line up each treatment.

What kind of radiation is used in IMRT/IGRT?

High-energy photons or x-rays are used to deliver IMRT and IGRT.

Who is eligible for IMRT/IGRT?

A physician specializing in Radiation Oncology determines whether a patient is eligible for IMRT and IGRT, based on the type and location of the cancer.

What types of cancers are currently
being treated with IMRT*?

  • Brain
  • Breast
  • Colorectal
  • Esophagus
  • Gynecologic (cervix, uterus [endometrium])
  • Head and neck
  • Lung
  • Pancreas
  • Prostate
  • Sarcomas
  • Thyroid

*Please note that each individual case is different and only your doctor can determine if this treatment is right for you or your loved one.

How does one prepare for treatment?

A physical examination and medical history review will be conducted by the radiation oncologist. Specific recommendations will be made and a treatment plan outlined. You will participate in your treatment plan and have the opportunity to have all your questions answered. In a treatment planning or simulation session, you will have a CT scan in the exact treatment position. Other radiology procedures, such as PET scan and MRI, may also be required for IMRT planning to better delineate the tumor from the surrounding normal tissue.

Because it is important to maintain the same exact position during each treatment,  molded devices may be created to help you stay properly positioned. Your skin may be marked with colored, permanent ink (tattoos) to help align radiation treatment. This ensures our ability to reproduce treatment accuracy on a daily basis. Using advanced treatment planning computer software and a specially equipped linear accelerator, the radiation beam can be modulated to deliver high doses of radiation to the tumor while sparing surrounding areas.

What is the actual treatment like?

Before your first treatment, a "set-up" is done, which films you in the planned position on the treatment machine. Slight adjustments may be made. Physician approval is required prior to the start of radiation.

Once approved, the treatment course will begin, often at set-up or shortly after. Specially trained, board-certified radiation therapists use the marks on your skin to locate the treatment area. A therapist positions you on the table and leaves the room to deliver radiation therapy from a control room. The therapist has the ability to see you on a screen and talk to you by intercom to ease anxiety. Most treatment sessions are 10 to 20 minutes long.

Is there pain associated with treatment?

Treatment is completely painless, similar to getting an x-ray. You will hear a noise from the machine, but nothing will touch you and you will feel nothing. After a few weeks, some patients may experience localized side effects. All likely side effects will be discussed with you during consultation and treatment planning.

How long is a course of IMRT treatment?

Radiation is usually given five days a week for two to eight weeks, depending on various factors. When radiation is used for palliative care, it may be given in a shorter course. Each radiation therapy session lasts about 10 to 20 minutes. The total dose of radiation and the number of treatments is determined by the size and location of the cancer, the type of tumor, your overall health and other factors.

How long have the Radiation Oncologists
been using IMRT?

Drs. Scott Herbert and Wayne Pinover have been using IMRT for more than a decade. They have treated thousands of patients using this technology.

What types of professionals provide radiation therapy?

Under the direct supervision of your radiation oncologist, your team in the Radiation Oncology Department is comprised of radiation physicists, dosimetrists, oncology-certified nurses and nurse practitioners, and board-certified radiation therapists. They  work together to deliver the optimal course of treatment to you. During the course of radiation, you will be seen on a weekly basis by your physician. A physician is available 24 hours a day, seven days a week, for your needs.

Will my insurance plan cover radiation treatments?

Treating cancer with radiation therapy is expensive because of the complex technology and the team of experts required to deliver treatment. Most health insurance policies cover radiation therapy costs, but some may require a co-pay by the patient. Speak with your insurance provider - the phone number should be on your card - to learn if any pre-certifications are needed or if you will incur any costs as a result of treatment.

What if I don't have insurance to help pay for radiation treatments?

Our financial counselor works with patients and their families to help them understand their insurance plans (deductibles, out-of-pocket expenses, copays and more) and financial responsibilities. The counselor will help patients apply for financial assistance (if eligible) or seek financial support from other sources (such as programs that provide assistance for the cost of medication) if needed.  You can meet with the counselor throughout treatment to address ongoing financial concerns.

To make an appointment with a financial counselor for cancer patients, call 215-481-4000.

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