Name of the Procedure:

Radiation Treatment Delivery (3 or More Separate Treatment Areas with Custom Blocking)

Summary

Radiation treatment delivery is a medical procedure where high-energy radiation is used to target and treat cancerous tissues. This particular treatment involves delivering radiation to three or more separate areas using advanced techniques such as custom blocking, tangential ports, wedges, rotational beams, compensators, and electron beams with energy levels of 20 megaelectron volts (MeV) or greater.

Purpose

This procedure is used to treat various types of cancer by damaging the DNA of cancer cells, which hinders their ability to reproduce and spread. The goal is to shrink tumors, eliminate cancer cells, and improve patient survival rates.

Indications

• Diagnosed cancer that requires radiation therapy in multiple areas.
• Tumors located in complex or sensitive regions that necessitate advanced targeting techniques.
• Patients with cancer that has metastasized to multiple sites.

Preparation

• Patients may be advised to fast for several hours before the procedure.
• Medication adjustments may be necessary, particularly anticoagulants or blood thinners.
• Pre-procedure imaging tests such as CT or MRI scans to map the treatment areas accurately.
• A detailed consultation to discuss the procedure, risks, and preparation steps.

Procedure Description

1. Consultation and Planning: Oncologists and radiologists use pre-existing imaging to plan the treatment areas and customize the radiation beams.
2. Positioning: The patient is positioned accurately, often using immobilization devices to ensure precise targeting.
3. Custom Blocking: Special shields or blocks are created to protect surrounding healthy tissues.
4. Delivery: Radiation is delivered to the specific areas using a linear accelerator with techniques like tangential ports (angled beams), wedges, rotational beams (arc therapy), and compensators to adjust the dose distribution.
5. Electron Beam: High-energy electron beams (20 MeV or greater) may be used for superficial tumors.

No general anesthesia is typically required, but local sedation or comfort measures may be applied.

Duration

Each radiation session usually lasts between 15 to 45 minutes. Multiple sessions are often needed over several weeks.

Setting

The procedure is performed in an outpatient radiation therapy center or a hospital radiology department.

Personnel

• Radiation Oncologist
• Medical Physicist
• Dosimetrist
• Radiation Therapist
• Nurse
• Support staff for patient care and comfort.

Risks and Complications

• Common Risks: Skin irritation, fatigue, and localized hair loss.
• Rare Risks: Radiation burn, potential damage to surrounding healthy tissues, and secondary cancers.
• Complications: These include but aren't limited to nausea, difficulty swallowing (for head/neck cancer treatments), and bowel issues (for abdominal/pelvic treatments).

Benefits

• Precise targeting of multiple cancerous areas with minimal damage to healthy tissues.
• Potential reduction or elimination of tumors.
• Improvement in survival rates and quality of life.

Patients may start noticing benefits after several sessions, but full effects might take weeks to months.

Recovery

• Patients can typically go home shortly after each session.
• Follow post-procedure instructions, which may include skin care and managing side effects (e.g., anti-nausea medication).
• Regular follow-up appointments to monitor progress and manage any side effects.
• Patients usually resume normal activities with some possible restrictions, depending on health status and treatment site.

Alternatives

• Surgery: Direct removal of tumors, which might be invasive and require longer recovery.
• Chemotherapy: Uses drugs to kill cancer cells but can have systemic side effects.
• Alternative Radiation Techniques: Including brachytherapy and stereotactic radiosurgery. Each has specific indications, pros, and cons.

Patient Experience

Patients might feel a sense of discomfort from immobilization devices during the procedure but typically do not experience pain during radiation delivery. Post-procedure, common sensations include fatigue and localized skin changes. Pain management involves over-the-counter analgesics or prescription medications as necessary. The medical team ensures patient comfort and support throughout the treatment duration.