In radiation oncology, treatment programs are established by Providence Saint John's physicians to standardize optimal care. Treatment programs are reviewed periodically by all physicians in radiation oncology and are based on medical evidence and national standards, ensuring the highest level of care for every patient.

In addition, the radiation oncology department participates in research protocols. A research protocol investigates a new therapy or new way of using existing therapies, or tests one therapy against another.

All medical research at Providence Saint John's requires approval of the Providence Saint John's Institutional Review Board. Participation in research protocols is always voluntary. Providing access to research protocols allows us to make available the latest in cancer care to our patients.

Simulation and treatment planning

Before beginning radiation treatment, the radiation oncologist must plan a customized, targeted treatment program so that all the areas "at risk" (i.e., tumor or areas potentially harboring cancerous cells) are included in the radiation treatment field while sparing as much normal tissue as possible.

The radiation oncologist will work together with a radiation therapist to have a treatment planning session, called a simulation.  During the simulation, the exact location of the affected area is determined and treatment fields are designed and a CT scan is typically performed at that time.

Once the area to be treated has been delineated, the skin over this area may be marked with small ink dots and pinpricks to serve as permanent "landmarks." These assist the radiation therapists in directing the radiation beam precisely to the treatment area. Depending on individual requirements, the simulation may last from 30 minutes to two hours.

Following the simulation, further treatment planning and calculations are made to determine the best method of delivering the exact dose to the affected area. Another simulation may be required or additional imaging procedures, such as CT/PET scans and MRIs, may also be necessary to outline the affected areas and/or to spare normal tissues.

Special shielding devices or blocks may also be custom made for use in the treatment. All this may take up to a week to complete before treatment begins.

The treatment and treatment planning and delivery technologies Providence Saint John's offers includes:

  • Edge® system
  • Intensity Modulated Radiation Therapy (IMRT)
  • Image-Guided Radiation Therapy (IGRT)
  • PET-CT Treatment Planning
  • Brachytherapy
  • 3-D Conformal Radiotherapy
  • Superficial Radiation Therapy