Technology & Treatment Options

Image-Guided Radiation Therapy (IGRT)

St. Dominic’s is the first hospital in Mississippi to utilize Varian’s Dynamic Targeting® image-guided radiotherapy (IGRT), the most advanced – and most precise – form of radiation therapy available. Our new computer-controlled targeting capability means even more precise treatment with fewer side effects than ever before.

With our robotic On-Board Imager,® our radiation therapy team is tracking tumors in up-to-the-
moment realtime. This means:

  • Cancerous tumors receive even more tightly focused and precise radiation while surrounding healthy tissues get very little radiation.
  • Increased chance of eradicating the tumor while minimizing side effects.
  • The exact location of the tumor is pinpointed at the moment of each daily treatment, compensating for body motion and tumor changes that occur as a result of treatment.
     

Intensity-Modulated Radiation Therapy (IMRT)

What is IMRT?
IMRT (Intensity-Modulated Radiation Therapy) is a state-of-the-art cancer treatment method that delivers high doses of radiation directly to the cancer cells in a very targeted way. IMRT can deliver higher radiation doses directly to cancer cells while sparing more of the surrounding healthy tissue.

How is IMRT so precise?
Physicians use IMRT to "paint" the tumor with a precise radiation beam that conforms as closely as possible to the shape of the tumor, while significantly reducing the amount of radiation to surrounding healthy tissues.

St. Dominic’s Cancer Center uses a powerful computer program called BrainLAB to optimize a treatment plan based on a physician's dose instructions, and information about tumor size, shape and location in the body. A linear accelerator, equipped with a special device called an m3® micro-Multileaf Collimator, shapes the radiation beam, and delivers the radiation in accordance with the treatment plan. The equipment can be rotated around the patient to send radiation beams from the most favorable angles for giving the tumor a high does while preserving healthy tissues.

How long does treatment last?
The treatment schedule with IMRT is comparable to that of traditional radiation therapy. Most treatment sessions are scheduled five days a week for six or seven weeks. 
If you have further questions about IMRT, call St. Dominic’s Cancer Center at (601)200-3070 or toll-free 1-888-843-6525.  

BrainLab

BrainLab: Sculpting Tumors Using Shape Beam Surgery
In addition to two linear accelerators for administering radiation therapy, St. Dominic’s Cancer Center has the capability of performing the latest in cancer treatment - conformal stereotactic radiosurgery and radiotherapy.

Using the BrainLab, a complementary system of computer software and hardware attached to our advanced linear accelerator, the staff at the Cancer Center performs very acute conformal stereotactic radiosurgery and sterotactic radiotherapy. The computer adapts the radiation beam to the shape of the tumor from each direction - which targets the highest dose of radiation into the tumor, sparing the healthy tissue around it.

BrainLab offers the complete range for radiosurgery, from cranial to extracranial, from circular to conformal collimation and straightforward treatment planning.

  • Homogenous dose distribution with steep dose gradient
  • Dynamic and conformal arc treatments reducing treatment time and protecting healthy tissues
  • Unique infrared market technology for precise localization, planning and patient positioning.

Speed, Simplicity & Safety
BrainLab’s micro-multileaf collimator (M3) streamlines conformal, radiosurgery treatments, resulting in a higher degree of accuracy and a better outcome for patients.  

Questions & Answers

Q. What is Shaped Beam Surgery
A. Shaped beam surgery uses a focused, very precise high-dosage beam of photon energy to reduce the size of a tumor or reduce its growth. After the treatment is complete, the patient can comfortably return home the same day.

Q. What is the history of Shaped Beam Surgery
A. Shaped beam surgery was first introduced by a company in Germany called BrainLab. It was first used at UCLA in 1998. Currently there are around 15 hospitals in the United States using the BrainLab technology. St. Dominic's acquired this technology in the fall of 2001, and the first patient was treated in November.

Q. What are the advantages of Shaped Beam Radiosurgery
A. Advantages of shaped beam radiosurgery include:

  • Fewer complications
  • Reduced hospital stays
  • Accelerated recoveries
  • Predictable outcome
  • Non invasive

Q. What are the advantages over traditional radiosurgery
A. Traditional radiosurgery can only approximate the shape of a tumor and fire at a tumor from one angle

  • Shaped beam surgery (also called Stereotactic radiosurgery) can precisely target even the smallest or most irregularly shaped tumor from any angle, at any time. Shaped beam surgery delivers doses of radiation that match the size and shape of the tumor in such a way that healthy tissue is untouched.
  • Unlike other cancer treatment modalities here in Jackson, St. Dominic’s radiosurgery approach has extracranial applications. It not only treats brain tumors, it treats other tumors such as breast, ovary, prostate, liver, spine and lung tumors.

Q. What are the typical results of shaped beam surgery?
A. Shaped Beam Surgery does not remove a tumor, it reduces the size and growth of the tumor by damaging the DNA of the tumor cells.

For more information about BrainLab call (601)200-5836.

MammoSite Radiation Therapy

According to the American Cancer Society, breast cancer is the most common cancer among women, other than skin cancer. It is the second leading cause of cancer death in women, after lung cancer.

  • About 215,990 women in the United States will be found to have invasive breast cancer in 2004.
  • About 40,110 women will die from the disease this year.
  • Right now there are slightly over 2 million women living in the U.S. who have been treated for breast cancer.

Breast cancer death rates are going down. This decline is probably the result of earlier detection and improved treatment.

What is MammoSite?
Many women with early-stage breast cancer are able to treat their cancer effectively and preserve their breasts through an option called breast conservation therapy (BCT). Some women have the option of the MammoSite Radiation Therapy System.

MammoSite is a method of partial breast irradiation (PBI) that works by delivering radiation from inside the breast directly to the tissue where cancer is most likely to recur. Radiation Therapy with MammoSite can be completed in five days, with two treatments a day on an outpatient basis.

How Does MammoSite work?  
MammoSite is a small, soft balloon, attached to a thin catheter (tube). The balloon is placed inside the lumpectomy cavity (the space left when a tumor is removed) at the time of lumpectomy or during a separate post-lumpectomy procedure by a surgeon. The balloon is inflated with fluid to variable sizes that fit snugly into the tumor cavity. In order to deliver radiation, a tiny radioactive source, called a seed, is placed within the balloon by a computer-controlled machine. Radiation is delivered from within the lumpectomy cavity, limiting the amount of radiation to healthy tissue and reducing the potential for side effects.

The MammoSite is a simple means of providing the prescribed radiation, with minimal side effects and good cosmetic results, and excellent local control of cancer in appropriate patients.

Who is a candidate for treatment for MammoSite?
MammoSite is recommended for appropriate early-stage breast cancer patients. MammoSite is intended to provide brachytherapy following a lumpectomy.

What are the side effects of MammoSite?
Following treatment, patients might experience minor breast-related side effects, such as redness, bruising, and breast pain. All of these are common side effects of breast surgery and/or radiation therapy and usually last for only a short time. There may also be some drainage from the insertion site, which is normal and will decrease over time.

How long will the device stay in the breast?
The catheter will typically be in the breast for 7 to 10 days. No radiation remains in the body between treatments or after the final treatment is over. The treatment can be completed in 5 days and once concluded, the balloon is deflated and the catheter is removed.

If you have further questions, call St. Dominic’s Cancer Center at (601)200-3070.

PET/CT Scanning

Patients who come to St. Dominic's with illnesses such as cancer, epileptic seizures and coronary artery disease now have available to them a new noninvasive option which can provide a more accurate diagnosis with less need for invasive biopsies.

The new Positron Emission Tomography (PET) scanner provides doctors with unique diagnostic information which may alter patient management and reduce total cost of patient care.

The PET scans are pictures of the actual biological functioning of the human body. Other imaging techniques, like Computerized Tomography (CT) and Magnetic Resonance Imaging (MRI), are limited to showing the structures of the body. Because PET scans are pictures of the body's chemistry, many diseases like cancer, cardiovascular disease and Alzheimer's disease, can be seen with PET.

St. Dominic's new PET is one of the latest generations of scanners - offering CT technology along with the PET technology.

PET/CT is of particular benefit to patients who may have cancer, providing information which can be obtained in no other way. The PET/CT system combines the functional information that can be gained with positron emission tomography with the anatomical information gained from the CT scan, showing exactly where activity is located. It provides physicians a noninvasive method to look for cancer in the body, precisely pinpointing where it is, and in some cases, monitoring patients response to treatment.

Combining these two technologies into a single unit gives clinicians a powerful tool for assessing a variety of disease. In the case of cancer, the PET images can find very small cancers, but it may be hard to tell precisely where they are located because PET displays little anatomy. By fusing the PET images with the anatomic images of the CT, the location can be more precisely determined.

The benefits to patients are tremendous - earlier diagnosis, accurate staging and localization, precise treatment and patient monitoring. With the state-of-the-art imaging that the scanner provides, patients get a better chance at a good outcome and avoid unnecessary procedures. A PET/CT image may also provide early detection of the recurrence of cancer.

High Dose Rate (HDR) Brachytherapy

High dose rate brachytherapy (internal radiation therapy) allows the radiation oncologist to give a higher total dose of radiation in a shorter time than is possible with external treatment. Internal radiation therapy places the radiation source as close as possible to the cancer cells. 

Our high dose rate Varisource machine utilizes a source that is in a sealed thin wire which will be sent through a catheter that has been placed directly into the affected tissue. This is termed an intercavitary radiation treatment. Certain types of cancer such as gynecological and solitary lung cancer can easily be treated using HDR. The radiation oncologist will make the determination of which cases can benefit from this type of treatment.

Radiopharmaceutical Therapy

Certain types of radiation can be delivered in an injectable medication that relieves the bone pain caused by certain types of cancer. These radiopharmaceutical agents locate in areas where bones are absorbing extra calcium and causing pain. The effect lasts for several weeks, steadily providing pain relief in a significant number of patients. This type of therapy is prescribed when it seems likely that it will be the most suitable treatment for pain.

External Radiation Treatment

External radiation treatments are the most common type of treatments prescribed for various types of cancer. St. Dominic's has the ability to plan both two-dimensional and three-dimensional treatments. Through the use of modern tumor imaging and advanced software tools, the radiation oncologist is able to focus the radiation beam on the target structures to make the treatment more efficacious and less toxic.

Radiation in high doses kills the cancer cells or prevents them from growing and dividing. Because cancer cells grow and divide more rapidly than normal cells, radiation is effective in treating the cancer cells. To protect the normal cells, dose fractionation and shielding are used. St. Dominic's has specialized equipment to deliver a precise course of treatment that spares as much normal tissue as possible.

On-Site GE CT For Precise Treatment Planning

St. Dominic’s Cancer Center has a GE LightSpeed Four Slice CT Plus which enables the radiation oncologist to gain valuable insight for 2D,3D, and IMRT (Intensity Modulated Radiation Therapy) treatment planning. The CT is performed in the Cancer Center and then the images are sent directly to the treatment planning computer through the information system network.

Radioactive Seed Implantation

Brachytherapy for prostate cancer is widely becoming a treatment of choice for patients and urologists. Patients are evaluated by both the radiation oncologist and urologist to determine if they are a candidate for seed implantation. It is an alternative to surgery and/or external beam radiation.

Patients with low grade, low PSA, organ confined disease, and average prostate size are candidates for prostate seed implantation. It is performed as an outpatient procedure (less than 23 hours). St. Dominic's utilizes Palladium-103 seeds for implants due to their short half-life of 17 days.

The Lymphedema Therapy Clinic

St. Dominic’s Lymphedema Therapy Clinic provides a proven and effective treatment for lymphedema called Complete Decongestive Physiotherapy, a noninvasive therapy that has been used successfully in Europe for more than 30 years.

Treatments consist of:

  • Manual Lymph Drainage (MLD),
  • Compression bandaging,
  • Skin care and exercise. 

MLD is a gentle treatment that stimulates the superficial lymph vessels by manually delivering fluid toward normally functioning lymph nodes. Compression bandaging assist the flow of lymph fluid from the affected limb and follows MLD treatment.

Complete Decongestive Physiotherapy provides:

  • Return of limbs to near normal size
  • Decreased limb pain
  • Improved limb usage and range of motion
  • Improved quality of life
  • Less chance of costly and frequent episodes of cellulitis which cause further enlargement of limb

Those benefiting from Complete Decongestive Physiotherapy include patient with Primary Lymphedema or Secondary Lymphedema caused by trauma, cancer treatment, venous insufficiency or other factors which cause excessive swelling. St. Dominic’s offers this therapy option on-site at the Cancer Center.
 

RapidArc Radiotherapy Treatment

St. Dominic's is the first cancer center in central Mississippi to offer a new technology called RapidArc radiotherapy treatment. RapidArc radiotherapy delivers powerful and tumor-destroying radiation quickly and accurately. One complete rotation of the treatment machine delivers the required dose of radiation while minimizing exposure of healthy tissue.

RapidArc has numerous benefits, the first of which is the significant reduction in time a patient spends during a daily treatment. A patient can be treated up to eight times faster each day with one complete revolution of the machine. It also increases accuracy in treatment since the patient spends less time holding still during treatment. RapidArc, like Image Guided Radiation Therapy (IGRT), delivers 100 percent of the necessary dose to the target area, while minimizing doses to healthy areas. RapidArc offers cancer patients access to innovative treatment while giving them more time with their family, both now and the future.

Novalis Tx Radiosurgery™

St. Dominic’s Cancer Center has acquired Novalis Tx™ Radiosurgery for image-guided treatment, in order to offer patients fast, accurate non-surgical treatments for cancer and other conditions in the brain, head, neck and body.  Novalis Tx Radiosurgery at St. Dominic’s Cancer Center gives new hope to patients with tumors once considered untreatable. It uses a treatment beam contoured to the exact shape of your tumor, precisely delivering treatment while protecting surrounding healthy tissue. Novalis Tx Radiosurgery is a painless, non-invasive outpatient procedure. Most treatments last just minutes, so you can get back to life.

How Precise?

  • Shapes the cancer-fighting radiation beam around your tumor or lesion, ensuring that the prescribed dose of treatment is delivered to the entire tumor or lesion
  • Protects surrounding healthy tissueAdapts treatment to your breathing and other body movements so that radiation delivery is always safe, complete and accurate
     

How Fast?

  • Delivers treatment in as little as 15-20 minutes for a more comfortable treatment experience when compared with other radiosurgery treatment options
  • Reduces the likelihood of body or tumor movements, ensuring that treatment is delivered with the highest possible accuracy
  • Offers one-time treatment or a series of treatments based on your doctor’s recommendation

How personalized?

  • Flexible treatment options ensure that you receive the best treatment for your condition
  • Delivers one of the highest dose rates to treat tumors deep inside the body or brain
  • Offers hope to those with conditions once considered untreatable and for whom surgery is not an option

Non-Invasive

  • Frameless radiosurgery offers you a more comfortable and non-invasive alternative to other radiosurgery systems which require immobilization with a head ring that attaches to the skull