Patients undergoing cancer treatments at the Lancaster General Cancer Center can feel comfortable knowing they have access to some of the most advanced radiation treatments available.

“I was surprised and impressed that Lancaster General is on the leading edge of prostate cancer treatment,” says Carlton Rintz, a Cancer Center patient. “From what I had read, Intensity Modulated Radiation Therapy (IMRT) and Image Guided Radiation Therapy (IGRT) were available at only a few cancer treatment centers.”

IMRT and IGRT are two of the Cancer Center’s latest advancements. “At the Lancaster General Cancer Center, we are excited to be the first hospital in Lancaster County to offer IMRT in conjunction with IGRT. We are providing our patients with state-of-the-art cancer treatments,” says Jeffrey Eshleman, MD, a Radiation Oncologist at the center.

IMRT is a newer technology that allows high energy x-ray accelerators to deliver precise radiation to a cancerous tumor. Radiation can be used alone, or with surgery and/or chemotherapy, to eliminate certain types of cancer. With standard radiation therapy, doctors administer radiation to the entire target area with a few radiation beams. IMRT uses sophisticated treatment planning computers, in combination with computer-controlled radiation treatment machines, to allow doctors to conform multiple tiny radiation beams to the exact size, shape and location of the tumor. Therefore, IMRT can reduce the amount of healthy tissue harmed by radiation while escalating the dose of radiation to the tumor (increasing the chance of cure).

The Cancer Center radiation oncology team includes radiation oncologists, physicists, radiation therapists, nurses and a dosimetrist (medical professional who determines radiation doses). They are currently using IMRT to treat early stage prostate cancer, cancers of the head and neck, brain tumors and breast cancer. IMRT can also be used to treat tumors located around very radiosensitive organs without directly radiating those areas.

The center uses Acculoc®, a type of IGRT, to localize radiation before each daily treatment for tumors that may shift position. This technique has been particularly useful for men with prostate cancer. Prior to starting radiation therapy, doctors implant tiny gold seeds in the prostate. Before each radiation therapy session, an image is taken to locate the seeds so doctors know exactly where to direct the radiation.

“We know that the prostate can change position within the pelvis from day to day,” Dr. Eshleman says. “Without IGRT, we have to add ‘extra margin’ to ensure the prostate is within the radiation field. With IGRT, we can specifically locate the prostate and reduce the amount of normal tissue receiving high doses of radiation.”

Doctors determine when to use IMRT and IGRT based on the type, stage and location of the cancer, as well as a patients medical history. Diagnostic tools such as computed tomography, magnetic resonance imaging and positron emission tomography help doctors identify the location and shape of the tumor.

Dr. Eshleman explains that if a tumor is relatively simple in shape or if it is located in a non-sensitive area, the patient may be better served by conventional radiation because smaller amounts of healthy tissue are exposed to radiation.

“The key is knowing the radiation tolerance of the different organs, the dose needed to provide the best chance of cure and being able to deliver that dose with minimal exposure to other parts of the body,” Dr. Eshleman says.

IMRT and IGRT are complex treatments that require multiple sessions for optimal results. Patients may undergo IMRT five days a week for up to nine weeks. It is a technically demanding process that requires intensive planning and treatments.

In addition to IMRT and IGRT, the Lancaster General Cancer Center has recently begun offering several other leading-edge advancements including the MammoSite® Radiation Therapy System for early stages of breast cancer and Bexxar® radionuclide monoclonal antibody for certain types of non-Hodgkin’s lymphomas.

For some women with early stage breast cancer, partial breast radiation therapies, such as MammoSite, have shown promising outcomes. Studies have shown results similar to when the entire breast is treated with radiation, which is the traditional method of treatment. With the newer MammoSite technology, doctors can insert a single catheter into the breast after a lumpectomy to deliver high doses of radiation therapy to exactly where the tumor was removed. Because this method involves treating a much smaller amount of tissue with radiation, doctors can safely reduce a patient’s treatment time from six weeks to five days. Currently, the Lancaster General Cancer Center is the only facility in Lancaster County offering MammoSite.

Bexxar is a new biologic therapy specifically designed to target a certain type of lymphoma and has shown impressive results in clinical studies. “In patients with non-Hodgkin’s lymphoma who failed multiple chemotherapy regimens and previous monoclonal antibody therapy, Bexxar eliminated all visible disease in one third of patients, while significantly shrinking tumors in greater than two thirds of patients,” explains Dr. Eshleman.

New technologies such as IMRT, IGRT, MammoSite and Bexxar, along with existing state-of-the-art treatments such as the Gamma Knife®, three dimensional radiotherapy, high dose brachytherapy for breast and gynecological tumors and prostate seed brachytherapy, all combine to give patients confidence in choosing the Lancaster General Cancer Center. The team is constantly searching for treatments with demonstrated outcomes of higher cure rates and lower complications.

The Cancer Center team of full-time radiation oncologists includes Chair of the Division of Radiation Oncology, Kishor Singapuri, MD; Kenneth G. Berkenstock, MD; and Dr. Eshleman. These compassionate, experienced physicians oversee all radiation treatments and work collaboratively with the entire Cancer Center team. They are proud to offer a comprehensive range of radiation services.