Cancers We Treat

Patients presenting with breast cancer may be treated with surgery up front, in the form of lumpectomy (removing the cancer while conserving the breast) or with mastectomy (removal of the breast). Lymph nodes are assessed usually with sentinel node biopsy.

Radiation therapy typically is coupled with lumpectomy to help facilitate breast conservation. We have traditionally treated the whole breast over the course of 5 to 6 weeks, however there are various shorter treatment courses which may be appropriate for you.  Radiation is delivered as an outpatient and can be delivered during a 15 to 30 minute break during your day.

We are now able to offer a convenient 1 week course of radiation known as “APBI” or accelerated partial breast irradiation which uses a special balloon or catheter to facilitate treatment with the use of “HDR” or high dose rate brachytherapy.

Patients with stage I or II lung cancer may be treated for cure with surgery in the form of Lobectomy (removal of lobe of the lung) or non invasive “SBRT” stereotactic body radiation therapy. We specialize in SBRT and have treated hundreds of patients with this technology over the past several years.  SBRT is a powerful ablative tool used to cure early stage lung cancers without going through an invasive procedure.  Ablative radiotherapy is delivered in a few 30 minute sessions over 2 weeks, and is very well tolerated.  Patients have no restrictions during this treatment and are able to drive themselves to and from our facility.

In stage III disease, chemotherapy and radiation are typically used in various formats.  When we have to target lymph nodal regions, radiation must be delivered more slowly, usually over 5 to 7 weeks, sometimes in a concurrent or sequential fashion with chemotherapy.  PPMH Cancer Center has capabilities of using Immunotherapy in patients who have more advanced disease.

Radiotherapy has been considered the backbone in the curative treatment of most H&N cancers for many years.  Chemotherapy is used frequently as a sensitizer to make the radiation more affective.

Physicians at ROA have published several articles highlighting results obtained at PPMH in the management of H&N cancer patients, such as cancers of the oropharynx, larynx, and nasopharynx. Sometimes, surgery up front is recommended- this is something that would be discussed with you by your managing physician.

Chemotherapy and Surgery play major roles in management of GI cancers while radiotherapy is typically considered an adjunct (either given before or after surgery) in many instances.  Radiation therapy is mostly used in cancers of the anal canal, rectum, and esophagus.

Radiation may also be utilized in management of pancreatic cancers, and in special scenarios gastric cancer and colon cancer.

Radiation (and chemotherapy) are the primary treatment for cancers of the cervix.  Endometrial cancer is very common and after surgery (to remove the uterus/ovaries/lymph nodes,) radiation has been used in certain instances to reduce the risk of cancer recurrence.

Brachytherapy (implantation of radioactive sources) is an effective and advantageous way to boost cancers to high doses while reducing side effects.  In 2016, we transitioned almost exclusively from inpatient delivery of “LDR or low dose rate” implants to outpatient delivery of “HDR or high dose rate” implants.  Rather than admitting patients to the hospital for several days, we are able to more conveniently deliver the dose as an outpatient so that you may go home and spend time with your loved ones between treatments.  We use the Elekta flexitron for delivery of HDR technology.

https://www.elekta.com/brachytherapy/flexitron-treatment-delivery/

Chemotherapy is the main treatment for patients with lymphoma, leukemia, and myeloma.

Radiation plays a role in consolidation or in definitive management in patients with certain hematologic diagnosis such as low grade lymphoma (Follicular or MALT) and in solitary plasmacytoma.

Superficial Radiotherapy can be used for definitive management in all skin cancers.  Radiation is an alternative to Mohs surgery or other invasive options.

Radiation is known to control 90% of skin cancers treated, and is preferred in cancers of the face, when surgery may be too risky or leave the patient with an unpleasant defect or scar.

Radiation, coupled with surgery, is used to control cancer within the brain. There are various treatment schemes including ablative radiotherapy, which utilizes Tomotherapy IMRT.