Oncology Med, Inc.

Simply put, Radiation Oncology is the study and treatment of cancers using radiation. Radiation is prescribed by a Radiation Oncologist which is a Medical Doctor specially trained in the use of radiation and its biological effect on cells.

A more technical description from The ABR: "Radiation Oncology is that branch of clinical medicine concerned with the causes, prevention, and treatment of cancer and certain nonneoplastic conditions, utilizing ionizing radiation."

For more info, check out Radiation Oncology on Wikipedia.org.

Medical Oncology targets and kills cancer cells through the use of chemicals (hence the name "Chemo"-therapy.) Chemo patients typically receive X number of treatments over the course of Y weeks. The drugs are delivered through a "port" (a temporary catheter that delivers the drug directly to the tumor.) Even though the tumor is targeted, the drugs can make their way throughout the whole body. Most people are familiar with the side effects of Chemotherapy which can include nausea, loss of appetite, and hair loss. Some tumors respond better to Chemo drugs than others which influences whether a patient will receive Chemotherapy, Radiation Therapy, or sometimes both. For more info, check out Chemotherapy on Wikipedia.org.

A Medical Physicist ensures that a patient receives the exact dose of radiation prescribed by the Radiation Oncologist; no more, no less. The Physicist ensures the correct doses are delivered by periodically reviewing patients' charts to ensure daily treatments are correct, performing QA analysis on treatment plans prior to patient treatments, and calibrating the radiation delivery devices such as a Linear Accelerator. Depending on the treatment center's policies, a Radiation Therapy patient may never meet the Physicist but they are usually very active behind the scenes. A Physicst may be called in to lend their expertise for special treatments, such as HDR Brachytherapy or Stereotactic Radio Surgery (SRS,) or for difficult setups. A Physicist may also serve as a Radiation Safety Office (RSO) for a facility in which their role is to protect all workers from unneccessary exposure to radiation in accordance with NRC, OSHA, FDA, and DEP guidelines.

A Medical Physicist must have completed at least a Masters Degree in Physics. A Physicist can also receive board certification through The American Board of Radiology. Board certification is not required to work in a clinic but it does indicate a higher level of recongnition in the technical expertise of the Physicist. Some institutions may require board certification or a PhD level of education for employment as a matter of internal policy.

A Medical Dosimetrist creates treatment plans in accordance with the Radiation Oncologists' prescriptions.

A Medical Dosimetrist typically receives training "on-the-job" (OJT,) especially in cases where a Radiation Therapist would like to cross-train as a Dosimetrist and then move to Dosimetry full-time. Some colleges and universities offer residence classes or a JRCERT program. A Dosimetrist can be certified by taking the Medical Dosimetrist Certification Board offered by MDCB.org. For exam eligibility criteria, click here.

A Radiation Therapist (RT) is responsible for delivering the daily radiation treatments to the patients. For more information, check out Radiation Therapist on Wikipedia.org.

Steps can vary based on the particular clinic, Radiation Oncologist, or type of treatment. This is generally how the process will flow if receiving 3D Conformal or Intensity Modulated Radiation Therapy (IMRT) treatments.

1. Cancer can be detected through routine screenings or physicals with your family Physician. It they detect something abnormal, they will run some tests and may refer the patient to a Radiaiton Oncologist.
2. The Radiation Oncologist will perform a consult with a new patient and determine the best course of treatment.
3. If Radiation Therapy is the chosen course of action, the patient will usually start by getting a CT scan.
4. Upon reviewing the CT images, the Rad Onc will identify and "contour" the tumor volume. Contouring is the process of tracing out the tumor edges on the CT images; this is usually done inside Treatment Planning Software (TPS). The Rad Onc may also contour other "Organs At Risk" (OAR) so the dosimetrist can determine how to limit the dose to those organs as much as possible.
5. The Dosimetrist will create a treatment plan based on the Rad Onc's tumor and OAR volumes. This may take anywhere from a few hours to days to complete based on the complexity of the anatomy being treated and the type of treatments.
6. After the Dosimetrist completes the treatment plan, the plan is usually reviewed by the Rad Onc and the Physicist to ensure it meets the original prescription.
7. The Physicists may have to complete a QA analysis of the treatment plan which may include taking dose measurements in a "Phantom." A QA analysis is almost always performed prior to delivering IMRT treatments due to the complexity of IMRT plans.
8. The patient will usually be "simmed" during their first treatment or prior to their first treatment. During a simulation, the patient will be placed on the treatment table of the LINAC exactly as they would be during an actual treatment. During this process, the Radiation Therapist ensures that the treatment plan can be reproduced in real-life and that the patient is positioned correctly for each treatment. Some clinics have a dedicated "Simulator" machine (an X-ray machine that functions similar to a LINAC for verifying aligment of the patient only, not for actual treatments.)
9. The patient begins treatment. A typical treatment scheme will have the patient receiving daily treatments for a total of 20-40 or more. Treatments are usually delivered Monday through Friday at a scheduled time and the patient will interact mostly with the Radiation Therapists.
10. Periodically, during the course of treatment, the patient will meet with the Rad Onc to determine the effectiveness of treatments and address any side effects such as skin breakdown or abnormal bleeding.