A Multidisciplinary Approach to Urology Care

Multidisciplinary Urology Team - Surgery Medical Oncology & RadiationWe are multidisciplinary team of urologists and urologic oncology experts who work with other specialists to provide the best clinical care possible. By involving other oncologists, including experts in radiation oncology, we ensure that our patients have access to greater treatment options, improved clinical outcomes, and answers to all their questions.

Once surgical treatment is completed, radiation may be the next step of your treatment. Radiation works to eliminate cancer cells at the tumor site that may remain after surgery, which is considered a supplement treatment. Radiation planning and treatment is provided at Saint John’s Health Center—a renowned, community-based, hospital in Santa Monica, California. We understand that your treatment is more than medical care, but a complete journey to wellness and improved quality of life.

Why use radiation therapy for urologic cancers?

Dr. Robert Wollman, Radiation Oncologists with the Varian Edge Linac
Dr. Robert Wollman, Board-certified Radiation Oncologist at Saint John’s Health Center, stands next to the Varian Edge Linear Accelerator

Radiation therapy (or radiotherapy) works by disrupting the DNA of cancer cells. Where normal cells can recover after limited doses of radiation, cancer cells lose their ability to replicate, and as a result, shrink over time. Highly advanced imaging and tracking systems are involved with radiotherapy, ensuring that only the tumor site receives the therapeutic dose of radiation.

If radiation is recommended after surgery, or prescribed with other treatments, its function is to reduce the likelihood of cancer spread by treating the immediate area where cancer is likely to recur. Radiotherapy can also be used as a primary treatment where more focused beams are used for curative intent, such as with small, well-defined tumors that are too difficult to remove surgically. The radiation oncologist works with radiation therapists—technicians who prepare the patient and equipment for radiation delivery, as wells as physicists and dosimetrists—individuals who develop the radiation delivery models and dose distribution calculations according to the prescribed treatment.

Is radiation therapy for urologic cancers painless?

Radiation Therapists prepare patients for treatment
Radiation therapists prepare patients for treatment and ensure their comfort

External beam radiation is a painless procedure, which usually takes 5 to 15 minutes. The number of treatments needed will vary for each person, the location of the cancer, and according to the technology used. In some cases, treatment may be daily and last for several weeks. Depending on the location of the tumor and the number of treatments, some patients may experience a condition that is similar to a sunburn on the surface of their skin, which is treated using topical medications. Radiation therapists prepare each patient for treatment, making sure they are comfortable and in the correct treatment position.

Newer treatment innovations have fostered more concentrated forms of radiation delivery, which results in fewer doses, or a single dose, instead of receiving many treatments over several weeks. Radiation can also be used to shrink a tumor before it is removed surgically, which reduces the amount of normal tissue that needs to be removed near the tumor. When cancer has spread, radiation therapy can also be combined with chemotherapy.

Treatment Planning and Simulation

Radiation therapy is globally available and used to treat many types of cancers including lung, breast, prostate, and brain. In recent decades, advances in radiation physics and computer technology have made it possible to tailor the radiation beam and dose more precisely. Conformal Radiation Therapy (CRT), for example, uses CT images to precisely locate and map the treatment area in 3 dimensions, giving the radiation oncologist greater visibility and precision to deliver the most optimal treatment plans.

3D imaging is used for radiation treatment planning and delivery
3D imaging is used for radiation treatment planning and delivery, ensuring precise targeting

Every radiotherapy treatment is preceded by the development of a treatment plan. This process brings together the details of the entire treatment including imaging of the treatment area, identification of critical structures in the body, the dosing distribution, as well as the positioning of the patient and placement of small marks on the body for proper alignment. Treatment planning involves the radiation physicist and dosimetrist who collaborate to ensure effective radiation delivery and dose, while working to maximize curative effect, preserve healthy tissues, and minimize the potential for side effects.

After the treatment plan is developed, a treatment simulation is performed. The simulation is like a radiation treatment test run, which allows the care team to replicate all the motions of treatment without delivering any radiation. The radiation therapists are responsible for performing treatment simulation and treatment delivery, which includes preparing the patient for treatment, helping them into the required treatment position, and aligning the small marks placed on the skin to visual guides projected in the room. Though treatment is delivered from a control console outside of the radiation delivery room, the radiation therapists can always communicate with the patient during treatment.

If you have questions regarding treatments for urologic cancers and conditions, please call today.