TUCC is one of the only centers in the U.S. to offer on site, comprehensive radiation therapy for urologic cancers. Our radiation oncologist, Eric Gross, M.D. is board certified in radiation oncology. He is the only radiation oncologist in Colorado whose practice is devoted solely to the delivery of radiation therapy for the treatment of urologic cancers.
TUCC is now treating our radiation oncology patients on the Elekta Versa HD linear accelerator. Versa HD safely delivers radiation beams through conventional techniques, including intensity modulated radiation therapy and image-guided radiation therapy, as well as more advanced volumetric arc therapy (VMAT) and stereotactic body radiotherapy (SBRT).
External beam radiation therapy utilizes a linear accelerator to generate a radiation beam toward the desired treatment area.
Treatment planning and delivery techniques such as 3-D conformal planning and intensity modulated radiation therapy (IMRT), can be utilized to conform the dose of radiation to the planned treatment area. This allows higher doses to be administered to desired treatment areas and reduces the risk of exposure to surrounding normal tissues. Both techniques allow for better control of the radiation beam to the tumor with reduced side effects.
TUCC also offers patients a more advanced form of IMRT, volumetric arc therapy (VMAT), on the Versa HD. With conventional IMRT, the linear accelerator must rotate around the patient a few times to treat the cancerous tumor from several different angles. In contrast, VMAT delivers the radiation dose to the entire tumor in a 360-degree rotation within minutes.
The prostate can change position depending on the volumes of the bladder and rectum. With image guided radiation therapy (IGRT), metallic markers are inserted into the prostate so that their position can be visualized on a daily basis. Daily assessment of the markers and subsequent adjustments enable therapists to deliver more accurate radiation treatments. This reduces the risk of radiation exposure to normal tissues and side effects.
Brachytherapy is a form of radiation therapy administered over a short distance. In select prostate cancer patients, radioactive seeds may be implanted into the prostate. As they decay, radiation is released. The radiation dose is determined by the seed characteristics, the number of seeds implanted and the distribution of the seeds. The seeds remain in the prostate after the radiation dose is released. A combination of brachytherapy and external beam radiation therapy may be used in select patients.
SBRT is an ultra-high dose and precise form of radiation therapy used to eliminate prostate and kidney tumors. This type of treatment is known as hypofractionated radiation therapy, which delivers higher doses of radiation in a more targeted fashion over fewer treatments. Shortened treatment times can improve patient comfort, particularly for older patients who may find it difficult to remain in one position over extended periods of time. The risk of movement by patients who are receiving treatment near important structures is minimized, as well. TUCC is pioneering the use of SBRT in Colorado on the Versa HD.
TUCC is the only urology practice in Denver to offer SpaceOAR to radiation oncology patients. SpaceOAR (OAR stands for “organ at risk”) is a temporary injectable gel that protects the rectum in men undergoing radiation therapy for prostate cancer. TUCC participated in the clinical trial that resulted in SpaceOAR's FDA clearance.
SpaceOAR is placed in a patient prior to radiation therapy through a minimally invasive, outpatient procedure. The SpaceOAR hydrogel is injected through a small needle into the space between the prostate and rectum while the patient is under local or general anesthesia.
SpaceOAR hydrogel creates about 0.5 inch (or 1.3 cm) space between the prostate and rectum, allowing physicians to treat the prostate with much less rectum radiation injury and fewer complications. The gel remains in place for about three months during radiation treatment, and then liquefies, is absorbed and cleared from the body in the patient’s urine.
By separating the prostate from the rectum, SpaceOAR hydrogel reduces radiation exposure to the rectum during treatment and may reduce, or possibly eliminate, damage to the rectum. Learn more about SpaceOAR here or watch this video.
Clarity is a new generation of 3D ultrasound technology used to enhance simulation and treatment of soft tissue targets, such as the prostate. Reliable visualization of the prostate at the time of treatment is critical to accurate delivery of radiation to the targeted tumor.
Clarity offers the ability to more clearly visualize pelvic structures. This confidence may allow Dr. Gross to plan tighter margins around targeted tumors to avoid exposing surrounding tissues, such as the rectum or penile bulb, to radiation during treatment. Learn more about Clarity here.
For more information on radiation therapy at TUCC, please call 303.825.TUCC (8822) or Contact Us today.