TUCC is one of the only urology centers in the U.S. to offer on site, comprehensive radiation therapy for urologic cancers. Our radiation oncologist, Thomas Pugh, 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 (prostate, bladder, testicular, kidney).
TUCC is now treating our radiation oncology patients on the Elekta Versa HD linear accelerator. Versa HD safely delivers radiation beams through sophisticated techniques and is specially designed to visualize and track the target cancer site and surrounding critical structures, which helps minimizes the risk of side effects. With this system TUCC delivers the most advanced radiation therapy techniques while setting the standard in patient safety. These techniques include intensity modulated radiation therapy (IMRT) and image-guided radiation therapy (IGRT), as well as more advanced volumetric arc therapy (VMAT) and stereotactic body radiotherapy (SBRT).
Internal Radiation Therapy
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.
External Radiation Therapy
Stereotactic Body Radiotherapy (SBRT)
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. TUCC is pioneering the use of SBRT in Colorado on the Versa HD.
External Beam Radiation Therapy
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. VMAT delivers the radiation dose to the entire tumor in a 360-degree rotation within minutes.
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.
In April 2015, the Food and Drug Administration (FDA) cleared SpaceOAR hydrogel. In a prospective, randomized, multi-center clinical trial in the United States, patients treated with SpaceOAR hydrogel prior to prostate cancer radiation treatment demonstrated bowel, urinary, and sexual benefits through a median of three years of follow-up. The study found that the patients that did not receive SpaceOAR hydrogel experienced a clinically significant decline in bowel, urinary, and sexual quality of life eight times more often than patients that received SpaceOAR hydrogel. It is a minimally invasive outpatient procedure with local or general anesthesia. Patients can immediately resume their normal activities. The gel stays in place for approximately three months and is then naturally absorbed and cleared in the urine in about six months. (1,2)
Xofigo® is an injection that is used to treat prostate cancer that no longer responds to hormonal or surgical treatment that lowers testosterone. It is for men whose prostate cancer has spread to the bone with symptoms but not to other parts of the body.