Oncure's radiation therapy centers focus on providing radiation oncology treatment to cancer patients on an outpatient basis. Radiation therapy treatment is performed with a linear accelerator, which uses high-energy photons and/or electrons to destroy the tumor with minimal effect on the area surrounding the tumor site. Treatment courses will usually last from four to eight weeks, during which time the patient is examined and monitored by a radiation oncologist, a radiation therapist (a professional trained in the planning and delivery of radiation therapy), a dosimetrist, a physicist, and an oncology nurse (a professional nurse trained in the care and treatment of patients undergoing cancer therapy). Through the use of our facilities and equipment, the radiation oncology medical groups with which we partner are able to offer a wide array of radiation therapy services for outpatient cancer treatment. The radiation oncologists maintain full control over the provision of medical services at our facilities. Additionally, many of these physician groups own the real estate where they practice. As a result, their interests are aligned with ours in ensuring that the centers operate successfully.
Each of our centers are designed and equipped to provide substantially all of the outpatient programs necessary to treat a cancer patient with radiation therapy. Our centers provide many oncology services, all of which are typically found only at university medical centers, including some or all of the following:
External Beam Therapy involves exposing the patient to an external source of radiation from a linear accelerator, a device that utilizes electricity on subatomic particles to produce a beam of high-energy radiation. After clinical treatment planning is completed, the final configuration of the treatment parameters in the linear accelerators is tested on the patient using a computerized fluoroscopic simulator or by means of computer simulation. The simulator is employed to test the prescribed coordinates of the beam for effective treatment and minimization of exposure (and, therefore, risk of injury) of healthy tissue and critical body structures. Before radiation is administered, custom protective blocks are designed and shaped for each patient to ensure that non-targeted tissue is blocked as thoroughly as possible from radiation.
Intensity Modulated Radiation Therapy (IMRT) is a state-of-the-art cancer treatment method that delivers high doses of radiation directly to cancer cells. Computer-controlled X-ray accelerators deliver precise doses that conform to the 3-D shape of the tumor by modulating the intensity of the beam. By targeting tumors more precisely than is possible with conventional radiotherapy, IMRT can deliver higher radiation doses directly to cancer cells while sparing surrounding healthy tissue.
Image Guided Radiation Therapy (IGRT) combines precise 3-dimensional imaging from computerized tomography scanning or precise X-Ray with highly targeted radiation beams via IMRT. This ultrasound-based technology allows clinicians to locate a tumor target prior to a radiation therapy treatment. This dramatically reduces the need for large target margins, which have traditionally been used to compensate for errors in localization. As a result, the amount of healthy tissue exposed to radiation can be reduced, minimizing the incidence of side effects. The clinical application for expanded treatment sites includes the pancreas, lung and liver.
Positron Emission Tomography (PET/CT) involves the injection of radioactive isotopes into a patient to obtain images of metabolic physiologic processes. The application of PET in the detection of cancer has become significant in the last two years, as it is the first diagnostic procedure that can detect and monitor a patient's metabolic malignancies. PET/CT provides information that is not available with other medical imaging and combines the metabolic cancer cells detection of PET with an anatomical picture of the tumor on a CT.
High Dose Rate Brachytherapy (HDR) involves the use of radioactive materials (isotopes) placed directly in contact with cancer tissues, which are then removed when a lethal dose has been delivered to the cancer.
Simulation, Dosimetry and 3-Dimensional Conformal Treatment Planning involves the use of a computer scan, allowing tumors to be visualized in a 3-dimensional format. This makes it possible to treat the cancer volume with very narrow margins. This technique greatly decreases the amount of normal tissue irradiated and treatment side effects. This technique also permits the delivery of a larger lethal dose of radiation to the cancer.
Prostate Implantation involves the use of palladium and iodine “seeds” and other radioactive implants (radioactive isotopes) in the treatment of prostate cancer while sparing the nearby organs and structures.
B-Mode Acquisition and Targeting (BAT) is a specialized radiation therapy technique that is utilized for daily localization and targeting of anatomic locations. BAT incorporates the use of an ultrasound device to ensure accuracy in anatomic locations where there is organ motion, such as the prostate, thereby minimizing dose delivery to normal tissue structures.
CyberKnife is a radiosurgery device with a linear accelerator (linac) mounted on a robotic arm. Through the use of image guidance cameras, the CyberKnife system locates the position of the tumor. The linac attached to the robotic arm delivers multiple beams of radiation that converge at the tumor site. Thus, the tumor receives a concentrated dose of radiation while minimizing exposure to surrounding normal tissue. With submillimeter accuracy, the CyberKnife is used to treat vascular abnormalities, tumors, functional disorders, and cancers of the body.
Stereotactic Radiosurgery is a noninvasive alternative to surgery that targets deep-seated brain tissues with multiple arcs of accurately targeted radiation. The increased use of IGRT makes SRS procedures more effective and an increasingly equal alternative to normal courses of radiation therapy.
Our existing cancer center network provides many of these services. Furthermore, most of the our centers have community rooms, facilities for patient meetings, patient self-help and support programs, counseling and education areas and training facilities.
We are focused on providing superior patient service to minimize the stress and uncertainty experienced by patients diagnosed with cancer and to assure referring physicians that their patients receive the best care available. Patients are usually seen shortly after referral and typically begin treatment within several days. The radiation oncologist discusses the proposed treatment, the possible side effects and the expected results of treatment with the patient and is available to respond to questions or concerns. Our centers are designed to provide comfortable patient settings at accessible locations with ample parking. We provide other services including van transportation, nutritional counseling and assistance with reimbursement from third party payors. We also use patient satisfaction surveys to identify continuous improvement opportunities. We believe that these additional services enhance the quality of care provided to patients and differentiate our centers from those of other radiation therapy providers.
Ancillary services at Oncure treatment centers include:
Standardized treatment pathways serve to assure uniformity in treatment among the our radiation oncologists and also enable our radiation oncologists to more efficiently and effectively utilize their time to treat and care for patients. Through quality patient care, the radiation oncologists are able to gain the trust and confidence of referring physicians and develop reputations for excellence in the community, thereby increasing the prospects for future referrals.
The first step in radiation oncology services is a consultation with the radiation oncologist. During this visit, the radiation oncologist reviews all of the patient’s records, pathology reports and x-ray films and performs a physical examination. At the end of the exam, he or she discusses the recommendations for radiation treatment with the patient and family. Several appointments are made for the patient so that a plan for the radiation treatment can be developed. These appointments include one or two planning sessions (called simulations) and a date to start treatment.