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Our radiation oncology physicians will work very closely with your surgeon and your medical oncologist to determine which combination of treatment is best for you.
UW Medicine, together with Fred Hutchinson Cancer Center and Seattle Children’s form the only NCI-designated comprehensive cancer center in the Pacific Northwest. This group of organizations is one of the top-funded cancer centers in the country and is ranked ninth in the nation by U.S. News & World Report for 2020-21.
This deep collaboration across medical disciplines, as well as with our partner institutions, means you can be assured that your care will be tailored specifically for you and will be based on the most proven advances in cancer research.
Our world-class team of physicians has extensive expertise in treating a wide range of cancers—from more common diagnoses to the extremely rare—using the most comprehensive range of radiation technologies available in the world.
You may read more about each cancer type by selecting from the list below. Each button links out to a partner website to view details. To view a full list of cancer types on the Fred Hutch website, click here.
Patients have access to the widest range of radiation treatment technologies available in the world today, including state-of-the-art proton beam therapy and the only hospital-based clinical cyclotron for fast neutron therapy. Our physicians are experts in these and many more radiation oncology therapies and will determine the best course of treatment for you.
To read more about specific treatment options, you can click the items below. You may also read more about the Radiation Treatment Types at the Fred Hutch website.
Brachytherapy is the placement of radioactive sources in or just next to a tumor. The word brachytherapy comes from the Greek “brachy” meaning “close or short distance.” During brachytherapy, the radioactive sources may be left in place permanently or only temporarily, depending upon your cancer.
There are two main types of brachytherapy – intracavitary treatment and interstitial treatment. With intracavitary treatment, the radioactive sources are put into a space near where the tumor is located, such as the cervix, the vagina or the windpipe. With interstitial treatment, the radioactive sources are put directly into the tissues, such as the prostate. These procedures may require anesthesia, a surgical procedure and a brief stay in the hospital. Patients with permanent implants may have a few restrictions at first and then can quickly return to their normal activities. Temporary implants are left inside your body for minutes, hours or days. While the radioactive sources are in place, you will stay in a private room. During the time when radiation is present in your system, doctors, nurses and other medical staff will continue to take care of you, but they will take special precautions to limit their exposure to radiation.
High-dose-rate (HDR) brachytherapy involves the remote placement of the powerful radiation source, accurately directed by your radiation oncologist and team, into the tumor for several minutes through a tube called a catheter, it is usually given in multiple doses once or twice daily, or once or twice weekly. Your doctor and team will control this treatment from outside the treatment room, monitoring you as the therapy is being given. Devices called high dose-rate remote after loading machines allow radiation oncologists to deliver a brachytherapy treatment quickly, in about 10 to 20 minutes. You may be able to go home shortly after the procedure.
Low-dose-rate (LDR) brachytherapy involves the longer placement of the temporary (several days) or permanent radiation source into the tumor area. Most patients feel little discomfort during brachytherapy. If the radio active source is held in place with an applicator, you may feel discomfort from the applicator. There are medications that can relieve this discomfort. If you feel weak or queasy from the anesthesia, ask your radiation oncologist for medication to make you feel better.
Depending on the type of brachytherapy you receive, you may need to take some precautions after you leave your treatment, particularly if you plan to be around young children or pregnant women. Because temporary implants are removed after treatment, these radiation safety precaution apply mainly with permanent implants. Ask your radiation oncologist or radiation oncology nurse about anything special you should know.
Brachytherapy may be used alone or in conjunction with external radiation treatments. Your radiation oncologist will advise you of the sequencing of these treatments that is appropriate for you.
Cancers Treated with Brachytherapy (HDR and LDR)
During external beam radiation therapy, a beam (or multiple beams) of radiation is directed through the skin to the cancer and the immediate surrounding area in order to destroy the main tumor and any nearby cancer cells. To minimize side effects, the treatments are typically given five days a week, Monday through Friday, for a number of weeks. This allows doctors to get enough radiation into the body to kill the cancer while giving healthy cells time to recover.
The radiation beam is usually generated by a machine called a linear accelerator or linac. The linear accelerator is capable of producing high energy X-rays or electrons for the treatment of your cancer. Using treatment planning computers and software, your treatment team controls the size and shape of the beam, as well as how it is directed at your body, to effectively treat your tumor whiles paring the surrounding normal tissue.
Our physicians have access to and expertise in several specialized types of external beam radiation therapy, including:
Each of these therapies is used for specific types of cancer, and your radiation oncologist will recommend one of these treatments if he or she believes it will help you.
Cancers Treated with External Beam Radiation Therapy
Fast neutron therapy is a specialized and very powerful form of external beam radiation therapy. It is often used to treat certain tumors that are radioresistant, meaning they are very difficult to kill using conventional X-ray radiation therapy. It has proven to be very effective at treating salivary gland tumors and certain forms of cancer, such as adenoid cystic carcinoma.
Neutrons have a greater biologic impact on cells than other types of radiation. However, neutrons do not damage all cells to the same extent, and in some cases, are more damaging to cancerous cells than to healthy cells surrounding the cancer. Thus, for the same amount of radiation, a lethal dose can be delivered to the cancer cells, while a sub-lethal dose is delivered to the healthy tissue. Used carefully, this added impact can be an advantage in certain situations.
The UW Medical Cyclotron Facility is the only one of its kind used to treat patients in the United States and one of two available for clinical use in the world.
Cancers Treated with Fast Neutron Therapy
Gamma Knife radiosurgery treats patients with brain abnormalities or abnormalities that are too close to delicate structures and blood vessels. Minimally invasive, it requires little or no anesthesia, offers a fast recovery time, and is safer and less costly than surgery or full-brain radiation.
Gamma Knife technology has been used to treat brain abnormalities and cancers since 1968. Despite its name, it is not a knife or scalpel, and the procedure does not require the opening of the skull. Instead, precisely focused beams of radiation are directed to the area of the brain requiring treatment. Treatment is simple, painless, and straightforward. Patients are usually treated in one session and can normally return home shortly afterward.
UW Medicine, is one of the first sites in the country to offer the latest in Gamma Knife technology – the Leksell Model 4C – at the Gamma Knife Center, located at UW Medicine Harborview Medical Center in Seattle.
Cancers Treated with Gamma Knife
Sometimes tumors of certain types of cancer can move slightly between radiation treatment visits because of difference in organ filling or movement while breathing. With image guided radiation therapy, or IGRT, your radiation oncologist uses imaging from a CT scan, ultrasound or X-rays to better target tumors that may have moved, while avoiding nearby healthy tissue.
With IGRT, all patients first undergo a CT scan as part of the planning process. Just before each daily radiation treatment, additional imaging is taken in the treatment room using either CT, ultrasound or X-ray.
The information from the most recent scan is then transmitted to a computer in the treatment room to allow doctors to compare it to the earlier image . During IGRT, doctors compare these images to see if the treatment needs to be adjusted. In some cases, doctors will implant a tiny marker in or near the tumor to pinpoint it for IGRT. This helps to account for organ/tumor motion even if the body is immobilized by a casting device.
Cancers Treated with Image Guided Radiation Therapy (IGRT)
Intensity modulated radiation therapy, or IMRT, is a specialized form of 3-dimensional conformal radiation therapy (3D-CRT) that allows radiation to be more exactly shaped to fit the tumor. With IMRT, the radiation beam can be broken up into many “beamlets,” and the intensity of each beamlet can be adjusted individually.
Using IMRT, it may be possible to further limit the amount of radiation received by healthy tissue near the tumor. In some situations, this may also safely allow a higher dose of radiation to be delivered to the tumor, potentially increasing the chance of a cure.
Cancers Treated with Intensity Modulated Radiation Therapy (IMRT)
Radiation therapy given during surgery is called intraoperative radiation therapy, which can be helpful when vital normal organs are too close to the tumor. During an operation, a surgeon temporarily moves the normal organs out of the way so radiation can be applied directly to the tumor. This allows your radiation oncologist to avoid exposing those organs to radiation. Intraoperative radiation can be given as external beam therapy or as brachytherapy.
UW Medicine surgeons and radiation oncologists have years of experience with IORT. UW Medical Center is the only hospital in the Pacific Northwest to offer this treatment. A fast and effective form of radiation therapy, IORT is part of the advanced arsenal of treatments available to our patients
When tumors cannot be completely removed from the pelvic or abdominal regions because they are attached to important organs or nerves, or if cancer cells might have been left behind when a tumor was resected, surgeons can move normal structures out of the way during surgery to expose the area to high-dose electron-beam radiation.
Cancers Treated with Intraoperative Radiation Therapy (IORT)
Palliative radiation therapy is intended to improve quality of life. Palliative treatments are not intended to cure.
Instead, palliative radiotherapy relieves symptoms and reduces the suffering for those patients for whom longterm cancer control is not possible. Palliative radiation therapy can also be used to control the symptoms associated with many localized tumors that cannot be treated by other methods (such as surgical removal). These symptoms can include pain, bleeding and decreased function.
In certain circumstances we use our leading technologies, including stereotactic body radiation therapy, Gamma Knife stereotactic radiosurgery and proton therapy, to achieve this goals while minimizing risks and side effects.
Radiation is usually combined with anti-inflammatory and pain medications to maximize the relief of cancer-related symptoms. Radiation therapy is particularly useful in alleviating pain associated with tumors that are arising from, or invading, into bone. About two-thirds of patients have moderate to significant improvement, and the effects can last for a few weeks to several months. Decrease in symptoms can occur as quickly as several days after the first treatment, or it may take a few weeks before improvement is seen.
Proton Beam Therapy is a form of external beam radiation treatment that uses protons rather than electrons or X-rays (photons) to treat certain types of cancer and other diseases. The physical characteristics of the proton therapy beam allow the radiation oncologist to more effectively reduce the radiation dose to nearby healthy tissue.
One of 35 facilities in the U.S. and the only one in the Pacific Northwest, the SCCA Proton Therapy Center opened its doors to cancer patients in March 2013. Our goal is to make this advanced treatment available to approximately 1,400 patients each year at our 60,000-square-foot facility, which is located on UW Medicine Northwest Campus.
Today, proton therapy is widely recognized as beneficial in treating a broad range of cancers, including many pediatric cancers, as well as adult sarcomas and tumors of the brain, central nervous system, GI tract, head and neck, lung, and prostate. Proton therapy is most commonly recommended for patients in treating anatomically complex tumors where avoiding damage to healthy adjoining tissue—particularly critical organs and structures—is imperative.
Proton therapy has been in clinical use in the U.S. since the 1970s; the FDA approved it in 1988. To date, about 75,000 people have received proton therapy in the U.S., and more than 200,000 people have been treated worldwide.
Cancers Treated with Proton Beam Therapy
Stereotactic body radiotherapy (SBRT) is a specialized technique for tumors located outside the brain.
It allows your radiation oncologist to use extremely focused beams of radiation–usually in higher doses than with daily radiation treatment–to destroy certain types of tumors. Beccause the beam is so precise, your radiation oncologist may be able to spare more healthy tissue.
SBRT is given in a few treatments (typically three to eight). Often used for to treat cancers of the lung, spine or liver, SBRT can allow radiation to be delivered in a way that is safer and more effective than other techniques to these regions of the body. Because SBRT treatments are often much higher doses than daily radiation treatment, additional precision and quality assurance is necessary, including very secure immobilization of the head or body or employing techniques that allow the radiation beam to follow organ motion during treatment.
Cancers Treated with Stereotactic Body Radiation Therapy (SBRT)
Stereotactic radiosurgery (SRS) refers to a single or several steretactic radiation therapy treatments of the brain or the spine. It is a specialized technique that allows your radiation oncologist to use extremely focused beams of radiation to destroy certain types of tumors using higher doses than with daily radiation treatments. Since the beam is so precise, your radiation oncologist may be able to spare more healthy tissue. In selected cases, stereotactic treatments can be used to retreat tumors that have received radiation before.
In addition to treating some cancers or benign tumors, radiosurgery can also be used to treat malformations in the brain’s blood vessels and certain noncancerous (benign) neurologic conditions. In some cases, using more than a single dose may help decrease the risk of side effects with stereotactic radiation therapy.
Cancers Treated with Stereotactic Radiosurgery
Tumors are not regular; they come in different shapes and sizes. Three-dimensional conformal radiation therapy, or 3D-CRT, uses computers and special imaging techniques such as CT, MRI or PET scans to show the size, shape and location of the tumor as well as surrounding organs.
In 3D-CRT, the radiation treatment plan is specifically tailored to each patient’s anatomy. At the beginning of the planning process, the radiation therapists performs CT scan of the part of the body being treated. These images are loaded into a specialized computer and used to create the radiation treatment plan. The plan is designed to enable your radiation oncologist to precisely tailor and deliver a beam of radiation that conforms closely to the size, shape, and contours of the tumor. Because the radiation beams are very precisely directed, nearby normal tissue receives less radiation and is able to heal more quickly.
Cancers Treated with Three-Dimensional Conformal Radiation Therapy (3D-CRT)