What to Expect for Patients

Consultation

The first step is a consultation with a radiation oncologist who works closely with other physicians and medical professionals to coordinate the best possible care for every patient.

Upon arrival, patients are met by a nurse who will bring them to an exam room, ask for a list of current medications, and collect a brief medical history. During a meeting with his or her radiation oncologist, the patient will answer additional questions; have his or her medical records, x-rays, and test results reviewed; and undergo a physical exam. Afterwards, the radiation oncologist will discuss treatment options with the patient in detail and explain radiation treatment and its potential side effects. If additional testing is necessary, it will be arranged.

Patients are encouraged to bring a family member or loved one with them to their consultation appointment. They are encouraged to ask questions and voice concerns. It's a good idea to bring a list of questions to this visit.

Before the consultation is over, the patient will be scheduled for his or her treatment planning session (also known as simulation) and will be given additional information and instructions to take home.

Simulation

After the consultation, the patient returns for a treatment planning session, also known as simulation. If there are any instructions the patient needs to follow prior to coming to this appointment, they will have been given to him or her at the initial consultation.

During simulation, the physician and radiation therapist work together to plan the patient's treatment. Many simulations are performed using the department's CT scanner. The therapist will position the patient on the treatment table and create custom immobilization devices specific to his or her body and treatment site. This is done to help the patient maintain the exact same position throughout each daily treatment. It is essential that radiation treatments be precisely targeted. Therefore, it is important that the patient remains as still as possible during treatment.

Marks may be drawn on the patient's skin to outline the treatment area, and small permanent tattoos, the size of a freckle, will be placed under the patient's skin as reference points for the therapists to use during each daily treatment. Additionally, x-rays, CT scans, MRIs, PET/CT scans, or other state-of-the-art imaging technologies will be taken to assist in planning the course of treatment. These scans are different from the diagnostic scans the patient may have had previously because these will be performed in the treatment position.

After simulation is completed, the information is sent to special computerized treatment planning software, whereby the physicists and dosimetrists will work with the patient's radiation oncologist to formulate and design a personalized treatment plan for the patient. This complex planning process usually takes one to two weeks. Before the patient leaves, he or she will be given his or her treatment appointments and any special instructions.

First Day/Block Verification

Typically, the first treatment will take a little longer than the regular daily treatments and will be used to take x-rays to verify that what was planned during simulation is reproduced exactly. The patient will meet the radiation therapists who will be treating him or her through the course of his or her daily treatments, and a radiation oncologist may come to the treatment room to check the setup and make minor adjustments if necessary.

Daily Treatments

Once a week during the patient's treatment course, he or she will be seen by his or her radiation oncologist. These "on-treatment visits" usually fall on the same day each week, following the day's treatment. Patients should plan to be in the department longer on these days. During the course of treatment, patients may experience side effects from the radiation. Possible associated side effects are discussed in the Frequently Asked Questions section. Patients should bring any side effects, questions, or concerns to the attention of their nurse or radiation oncologist, so they can monitor them and provide specific instructions.

Follow Up

When treatment concludes, the radiation oncologist will continue to follow up closely with the patient. Depending on the physician and the treatment site, patients will be seen two weeks to one month following treatment, so their radiation oncologist can continue to monitor any side effects the patient may have experienced. For many months, patients may continue to experience subtle changes as a result of their treatment. Therefore, it is very important to continue with follow-up appointments. Future follow-up visits will be scheduled every three to six months, so the radiation oncologist can continue to monitor the patient's health. Routine scans may be ordered prior to an appointment. Additionally, the patient's radiation oncologist will continue to work with the patient's medical oncologist and/or primary care physician to ensure good health is maintained.

Contáctenos

Clínicas Especializadas

Oncología médica

El Centro de Cuidados Oncológicos del Boston Medical Center atiende a pacientes con cáncer, y trastornos sanguíneos malignos y no malignos. El Centro ofrece servicios de diagnóstico, tratamientos innovadores y atención integral a los pacientes por parte de un equipo multidisciplinario destacado y reconocido a nivel nacional de hematólogos, oncólogos, oncólogos radioterapeutas, cirujanos, enfermeros de oncología, trabajadores sociales y dietistas.

Oncología quirúrgica

Los cirujanos oncólogos brindan un tratamiento quirúrgico completo y experto para pacientes con una amplia variedad de cánceres. El equipo de cirujanos, enfermeros y personal de servicios de apoyo se encuentran entre los mejores del país, y el enfoque de tratamiento, las instalaciones y la tecnología disponibles son de vanguardia.

Hematology

Los pacientes con trastornos de la sangre reciben consulta y tratamiento para una amplia gama de afecciones benignas, como hemoglobinopatías (anemia falciforme y talasemia), hemocromatosis, trastornos hemorrágicos y trombóticos (enfermedad de von Willebrand y hemofilia), estados de hipercoagulabilidad, trastornos mieloproliferativos, mielodisplasia y anemia y neoplasias como leucemia, linfoma y mieloma.

Tratamientos y Servicios

CyberKnife

CyberKnife emite haces de radiación altamente dirigidos directamente a los tumores, de forma indolora y no quirúrgica. Guiados por un software de imágenes especializado, podemos rastrear y ajustar continuamente el tratamiento en cualquier punto del cuerpo, y sin la necesidad de los marcos de la cabeza y otros equipos que se necesitan para algunas otras formas de radiocirugía.

Lee más

Radioterapia conformada tridimensional

La radioterapia conformada tridimensional (3-D) se basa en una tomografía computarizada de la región del cuerpo que se está tratando. Los oncólogos radioterapeutas utilizan programas informáticos para determinar cómo se verá el paciente desde cualquier ángulo e identificar los mejores caminos para dirigir la radiación.

Lee más

IMRT

La radioterapia de intensidad modulada (IMRT) es un tipo de radioterapia de haz externo que administra haces de radiación personalizados según la forma y el tamaño del tumor. A diferencia de 3D-CRT, que administra la misma cantidad de radiación tanto al tumor como al tejido circundante, la intensidad de los rayos se puede ajustar (modular) para la IMRT, lo que permite al oncólogo de radiación administrar diferentes cantidades de radiación a diferentes áreas del tumor y el tejido circundante. Esto permite que el oncólogo radioterapeuta administre la máxima cantidad de radiación al tumor sin afectar el tejido sano circundante.

Lee más

IGRT

La radioterapia guiada por imágenes (IGRT) se usa junto con la radioterapia conformada tridimensional, la radioterapia de intensidad modulada y la radiocirugía CyberKnife para mejorar la precisión de cada tratamiento de radiación diario. En la radioterapia moderna, es esencial la colocación y la forma precisas de los haces de radiación. IGRT utiliza tecnología de imágenes especial, como rayos X y TC de haz cónico (una versión compacta y más rápida de una TC normal que se adjunta al acelerador lineal y utiliza un haz de rayos X en forma de cono), para tomar imágenes de rayos X antes del tratamiento para garantizar la configuración más precisa antes de la administración del tratamiento. El oncólogo radioterapeuta usa estas imágenes para ajustar los cambios diarios en la posición del paciente y, en algunos casos, el desplazamiento normal de los órganos dentro del cuerpo. La mayoría de los pacientes se benefician de esta tecnología todos los días que reciben tratamiento.

Lee más

Compuerta respiratoria

El cuerpo no siempre permanece quieto durante el tratamiento y, para un tratamiento preciso de los tumores de pulmón o abdomen, incluso la respiración normal puede representar un desafío. En estos casos, se utiliza la compuerta respiratoria, también conocida como TC de 4 dimensiones. El escáner de tomografía computarizada de cuatro dimensiones, equipado con tecnología de compuerta respiratoria, aborda el movimiento del tumor durante el proceso de planificación de la radiación. Se pueden tener en cuenta los movimientos del tumor, por lo que los haces de radiación pueden abarcar el tumor en todas las fases del ciclo respiratorio.

Lee más

Braquiterapia

También conocida como radioterapia interna, la braquiterapia administra radiación directamente en el tumor (llamada braquiterapia intersticial) o en una cavidad quirúrgica o cavidad corporal cercana (llamada braquiterapia intracavitaria). Al administrar la radiación directamente en el tumor o en una cavidad cercana, la radiación solo necesita viajar una distancia corta, causando menos daño al tejido normal circundante. El material radiactivo está sellado en un dispositivo de administración llamado "implante". El implante se inserta en el cuerpo usando un aplicador (a menudo un tubo hueco llamado catéter). Las pruebas por imágenes, como radiografías, tomografías computarizadas o resonancias magnéticas, se utilizan para guiar al oncólogo radioterapeuta en la colocación del implante. Dependiendo de la ubicación del tumor o la cavidad, el paciente recibirá anestesia general (medicamentos que se usan para que el paciente duerma profundamente) o anestesia local (medicamentos que se usan para adormecer el área que se está tratando). Los implantes pueden ser permanentes o temporales. Para el tratamiento de alta tasa de dosis (HDR), el oncólogo radioterapeuta coloca implantes de dosis alta en el tumor o la cavidad durante un período corto de tiempo (generalmente menos de una hora) y luego los extrae. El tratamiento con HDR se administra de forma ambulatoria y puede repetirse durante varios días o varias semanas. Actualmente, el tratamiento HDR se ofrece a pacientes con cánceres ginecológicos, como cáncer de cuello uterino, cáncer de endometrio (útero), sarcoma uterino (cáncer del músculo y tejidos de sostén del útero) y cáncer de vagina.

Lee más

Nuestro Equipo

Radiation Oncologists

Minh T Truong, MD

Presidente y profesor, Departamento de Oncología Radioterápica, Centro Médico de Boston, BUSM

Special Interests

Cabeza y cuello; Sistema nervioso central; Piel; Amiloidosis de las vías respiratorias

standard BMC headshot

Michael A Dyer, MD

Profesor asistente, Departamento de Oncología Radioterápica, Centro Médico de Boston, BUSM

Special Interests

Cánceres de cabeza y cuello, cánceres de piel, cánceres de próstata y otros cánceres genitourinarios, cánceres ginecológicos; y cánceres gastrointestinales. Especializado en radioterapia de intensidad modulada (IMRT), radioterapia guiada por imágenes (IGRT), radiocirugía estereotáctica (SRS) y radioterapia corporal estereotáxica (SBRT) con Cyberknife; y braquiterapia

Ariel E Hirsch, MD

Profesor Asociado y Director de Educación, Oncología Radioterápica, Facultad de Medicina de la Universidad de Boston, Boston MA

Special Interests

Genitourinario; Neoplasias ginecológicas y mamarias; Cáncer de mama

Kimberley S Mak, MD, MPH

Profesor Asistente de Oncología Radioterápica, Boston Medical Center, Boston Massachusetts

Special Interests

Neoplasias torácicas; neoplasias gastrointestinales; resultados; resultados informados por el paciente; investigación de resultados de disparidad; radioterapia de intensidad modulada; radioterapia guiada por imágenes; Radiocirugía estereotáctica CyberKnife; imagen funcional en radioterapia; diseño de ensayos clínicos prospectivos

Physics Team

Xin Zhang, PhD
Physicist, Department of Radiation Oncology

Harry Bohrs, BSc
Senior Dosimetrist, Department of Radiation Oncology

Paul Nettey
Dosimetrist, Department of Radiation Oncology

Radiation Therapy Team

Jordan Yelman, Charles Grant, Jeff McGloin, Deborah Beck, Julie Sullivan, Ashley Rego, Sean Keohan, Deidre Clancy-Hammel, Amanda Donnell and Quyen Duong

Recursos del Paciente

Preguntas frecuentes

La radiación es un tipo de energía creada por ondas o corrientes de partículas entregadas por máquinas especializadas o emitidas por sustancias radiactivas. El uso de estos rayos o partículas de alta energía para tratar enfermedades, con mayor frecuencia cáncer, se denomina radioterapia (o radioterapia). Los médicos que se especializan en este campo se denominan oncólogos radioterapeutas.

Resumen de la Investigación

The Radiation Oncology Department has considerable experience in treating all types of cancers and benign (noncancerous) tumors. Individual staff members concentrate on specific types of cancer, so patients can benefit from their specialized knowledge. BMC radiation oncologists are also actively involved in researching new and promising cancer treatments through clinical trials.

Promising new techniques in the diagnosis, treatment, and care of patients with cancer are tested in research studies called clinical trials. Many patients who participate in clinical trials derive comfort from knowing that the knowledge gained from these trials will make an important contribution to medical science and may help other people with cancer.

BMC is a study site for various cooperative groups, including:

  • CTSU (Cancer Trials Support Unit)
  • NRG Oncology
  • SWOG

Visit the Boston University School of Medicine’s website for a list of currently active clinical trials.

Información Sobre Residencia y Becas

Medical Student Rotations

As a leader in Radiation Oncology education on the medical student level, Boston Medical Center (BMC) Radiation Oncology is a popular site for clinical rotations during the 3rd and 4th year of study at Boston University School of Medicine (BUSM). We offer two electives in the Cancer Education and Research Program: Clinical Radiation Oncology and Clinical Cancer Research. First-year and second-year medical students may also rotate through our department in the Introduction to Clinical Medicine course. Visiting medical students can schedule rotations here through the BUSM Registrar’s Office.

Students are given the opportunity to perfect their ability to take a history and perform thorough physical examinations. They also learn about the natural history of select cancers. Our attendings and residents provide didactic guidance throughout this experience. Students are encouraged to learn how we design radiation treatments and are able to spend time in the radiation physics section working on radiation plans. Students may also spend time at the treatment machines to observe the delivery of radiation therapy. Students are afforded the opportunity to give a presentation to the department on a topic of their choice related to radiation therapy at the end the rotation.

Medical Student Research

BMC has various exciting research opportunities at both BMC and MGH for students with a strong interest in oncology. Students can take on retrospective analyses of clinical data or spend time in basic research related to the repair of DNA damage (which focuses on genes such as p53, BRCA1, BRCA2, Chk2, ATR, and Fanconi Anemia). BMC also offers exciting opportunities for medical students to participate in physics-based or education-based projects.

Students have been very successful in their research endeavors, including presenting their work at various national meetings such as ASTRO, RSNA and ASCO. Additionally, they have won numerous research awards. Examples include the RSNA Trainee Research Award, the Best Student Abstract at the BUSM Medical Education Day, Medical Student Summer Research Fellowships, the Aid for Cancer Research Fellowship, Second Place at the Massachusetts Medical Society Annual Research Symposium for Students, Residents and Fellows, and the Anne & David Mishel Cancer Research Award.

Harvard Radiation Oncology Program

Boston Medical Center is one of the teaching institutions integral to the Harvard Radiation Oncology Program (HROP), along with MGH, BWH, BIDMC, DFCI, & Children’s Hospital. All of the HROP residents rotate through our department at least once before graduation for three-month long clinical rotations. Residents appreciate the diverse patient population and the often unusual spectrum of tumors and clinical issues they encounter at BMC. While here, the residents make presentations for at least one tumor board and give at least one Morbidity & Mortality (M&M) conference. Residents can also participate in BMC-driven research projects during their rotations.

Afiliaciones

Boston University School of Medicine Logo

Como principal afiliado de enseñanza de la Facultad de Medicina de la Universidad de Boston (BUSM), Boston Medical Center se dedica a capacitar a las futuras generaciones de profesionales de la salud. Obtenga más información sobre la Facultad de Medicina de la Universidad de Boston.