Understanding Radiation Therapy

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Our physicians are all board-certified in radiation Our physicians are allare board-certified in radiation Our physicians all board-certified in radiation oncology and have extensive training and experience oncology andextensive have extensive training and experience oncology and have training and experience with the newest technology. with the newest technology. with the newest technology.

Other team members include: team members include: OtherOther team members include: Board-Certified Medical Physicist Board-Certified Medical Physicist Board-Certified Medical Physicist Board-Certified Medical Dosimetrist Board-Certified Medical Dosimetrist Board-Certified Medical Dosimetrist Board-Certified Radiation Therapist Board-Certified Radiation Therapist Board-Certified Radiation Therapist Board-Certified Nurse Board-Certified Board-Certified NurseNurse Support Staff Support Support Staff Staff

15 Laurel Avenue, Suite 100 15 Laurel Avenue, 15 Laurel Avenue, SuiteSuite 100 100 Cornwall, NY 12518 Cornwall, NY 12518 Cornwall, NY 12518

(845) 458-9000 458-9000 (845)(845) 458-9000

cornwallradiationoncology.com cornwallradiationoncology.com cornwallradiationoncology.com

The Radiation Oncology Process Consultation On your first visit please plan to spend one to two hours with us and bring along any questions you may have.

It’s also a good idea to have a family member or friend accompany you to hear the information discussed.

Upon your arrival, the receptionist will give you some health forms to complete. The nurse will then address your medical history and share what you can expect, which will be followed by a review of your health records with the radiation oncologist. You will then change into a comfortable gown, and the radiation oncologist will perform a physical exam.

What to bring for your consultation?

• All bottles of medications, along with doses and directions, including over-the-counter medications or supplements • Any medical information such as: - Pathology/Lab Report - CAT Scan, MRI Reports - Consultation Reports - Insurance Information/Referral - Photo ID

Once the exam is completed, you will change and be escorted back to the consultation room with your family or friends to discuss treatment options and the planned course of radiation therapy. The radiation therapist will then schedule an appointment for CT Simulation.

You’ll have an opportunity to meet with our private financial representative who can help guide you through the insurance system and answer any questions you may have.

CT Simulation Most radiation oncology patients have at least one simulation prior to starting a course of radiation therapy. At Cornwall Radiation Oncology Services we use a specialized type of Computerized Tomography (CT) scanner called a CT Simulator, which produces 3-D images of the patient’s internal anatomy, helping our doctors to precisely locate the tumor and identify surrounding critical structures. Highly accurate measuring devices are then used to record the treatment site in relation to external markers.

This critical first step is important in defining the area to be treated, as well as determining the immobilization devices to be used to assure the patient is in the same position each day throughout the course of treatment.

Treatment Planning Before beginning TomoTherapy treatment, the doctor will work with the dosimetrist — a specialist who assists with dose calculations and distributions — and the physicist to put together a plan using images from a combination of scanning technologies such as CT, MRI and others.

Special software will be used to establish the precise contours for each tumor and surrounding sensitive organs or tissues. The doctor will then prescribe the level of radiation needed to treat the tumor and to protect the healthy tissue nearby. Based on the doctor’s prescribed dose and your specific needs, the Hi·Art treatment system will calculate the appropriate pattern, position and intensity of the radiation beams to be delivered. Quality assurance will then be performed on the plan prior to your treatment to ensure proper delivery of treatment.

Daily Imaging/Treatment The therapist will coordinate the treatment lasers to your tattoos — small marks placed on your skin to help guide the therapist to the exact location of the tumor — and will ask you to remain still. The therapist will then leave the room, but will continue monitoring you by TV and intercom.

The therapist will then take an image using the unique TomoTherapy unit that integrates your treatment planning CT imaging to the daily treatment CT image. This process helps to guide the radiation oncologist and radiation therapist in accurately delivering your daily treatment. The actual radiation treatment is administered with the help of computer-driven equipment, which ensures accuracy when targeting your treatment area and protecting your healthy tissue. This whole process takes about 20 minutes.