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Treatment Options

Consultation

Each of our board certified radiation oncologists are clinically specialized. This means each doctor focuses exclusively on two to three different types of cancer in order to best serve our patients. This focus on a few of the various types of cancer allows our doctors to develop unparalleled expertise. Patients find this special knowledge invaluable to evaluate and select their plans of therapy. 

Radiation Oncology Center

Appointments can be made to see our physicians in the Siteman Cancer Center in the medical center’s Center for Advanced Medicine. The following list of physicians and their areas of clinical focus should help choose your radiation oncologist:

Radiation Oncologist Cancer Specialty
Dennis Hallahan, M.D., Brain Tumors, Lymphoma Lung Cancer, Sarcoma
Jeffrey Bradley, M.D. Lung, esophagus
Perry Grigsby, M.D. Gynecology (cervix, uterus, ovary), thyroid
Julie Schwarz, M.D. Gynecology (cervix, uterus, ovary), thyroid
Jeff Michalski, M.D. Genitourinary (prostate, bladder, kidney, testicle), pediatric, sarcoma
Joseph Simpson, M.D. Brain, Head and Neck (mouth, throat, nose, sinus)
Wade Thorstad, M.D. Head and Neck (mouth, throat, nose, sinus)
Imran Zoberi, M.D. Gynecology (cervix, uterus, ovary), breast
Hiram A. Gay, M.D. Head and Neck (mouth, throat, nose, sinus) Genitourinary (prostate, bladder, kidney, testicle)
Parag J. Parikh, M.D. Gastrointestinal cancer, rectal cancer, liver cancers. cancer, hepatobiliary cancer, Lung
Jiayi Huang, M.D. Brain tumors, skull base tumors, spinal tumors, lymphoma
Jeffrey R. Olsen, M.D. Gastrointestinal cancer, rectal cancer, liver cancers. cancer, hepatobiliary cancer, Lung
Stephanie Perkins, M.D. Pediatric Radiation Oncology
Clifford Robinson, M.D. SBRT, Gamma Knife, Lung cancer, Esophageal cancer, Brain tumors, Spinal tumors
Maria Thomas, M.D. Radiation Oncology

Multidisciplinary Clinics

Consultations can be made through the Siteman Cancer Center’s multidisciplinary clinics. In these clinics the patient may see physicians from surgery, medical oncology, radiation oncology, and other specialists to get a complete and thorough evaluation and treatment recommendation.

Treatment Options

We offer the widest range of radiation therapy options in the Midwest, allowing our physicians to tailor treatment to each individual patient’s needs. See below for details.

External beam radiation therapy

The majority of our patients are treated with external beam radiation therapy. This treatment is typically delivered with the use of a linear accelerator, a machine that emits high energy x-rays targeted to the tumor or body region at risk. The duration of treatment ranges from two to eight weeks. The number of treatments will depend on the specific diagnosis and the integration of other treatments such as surgery or chemotherapy.
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Traditional or standard radiation therapy

Treatment techniques that have been developed and refined through years of experience are commonly used to treat many of our patients. We constantly review the results of treatment of our patients at the Siteman Cancer Center and periodically refine our treatment policies to maximize cure rates with minimal side effects or toxicity.


3D Conformal Radiation Therapy (3DCRT)

A modern method of planning and delivering radiation therapy, 3D CRT uses patient specific images to create sophisticated treatments aimed at maximizing radiation dose to the areas that need it while sparing adjacent organs and other sensitive tissues. This technology is allowing Siteman Cancer Center oncologists to increase the cure rate for some cancers and reduce side effects for others.


Intensity Modulated Radiation Therapy (IMRT)

IMRT represents a new and increasingly sophisticated method to deliver 3D CRT. Tighter and uniquely shaped radiation dose distributions have the potential to allow greater sparing of critical organs or sensitive tissues. In some cancers of the mouth and throat, IMRT has allowed a high cure rate with sparing of salivary gland function. It is being applied to other cancer sites such as prostate, cervix, soft tissue, lung and brain tumors.


Proton Therapy

Like standard radiation therapy, proton therapy is painless. Protons enter the body and destroy cancer cells and tumors. Protons deliver less radiation to normal tissues than other forms of external radiation.


Brachytherapy

Brachytherapy refers to the placement of radioactive sources directly into the body to treat cancers. Often the procedure involves placement of devices, tubes or catheters to hold the radioactive sources temporarily for a few hours or days. In other circumstances, the sources are placed into a tumor and left there permanently. Brachytherapy allows the radiation oncologist to deliver very high radiation doses to small volumes of cancer without treating adjacent organs or sensitive tissues.
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Gynecologic cancer

Many cancers of the cervix and uterus are treated with combinations of external beam radiation therapy and brachytherapy. Special devices are placed in the uterus or vagina, or adjacent to the location of the cancer. Radioactive sources are then placed inside these devices to deliver a highly focused and controlled dose of radiation to the cancer. In high-dose rate (HDR) radiation treatments, the radioactive sources are placed for just several minutes. These treatments may be repeated 3 to 6 times over the course of a few weeks.


Prostate cancer

An increasingly popular alternative to radical prostatectomy is prostate brachytherapy. Using ultrasound and x-ray guidance, radioactive sources, smaller than a grain of rice, are inserted directly into the prostate gland during anesthesia. These radioactive Iodine or Palladium seeds remain in the gland permanently and give very high radiation doses to the prostate with acceptably low rates of side effects. Cure rates are comparable to radical prostatectomy and external beam radiation therapy for appropriately selected patients. Recently, high dose rate (HDR) brachytherapy has been introduced as an alternative to permanent seed implant. Your radiation oncologist can help decide which treatment is best for you.


Ocular Melamona

This rare form of cancer can effectively be treated with brachytherapy or protons. With the ophthalmologist, a special device or plaque is placed against the eye where these tumors grow. This device is left in place for several days and delivers a high radiation dose to a very small area. This treatment allows the ophthalmologist to cure the melanoma without radical removal of the eye.


Other

Brachytherapy is used in several other types of cancers on an individual basis. Radiation oncologists at the Siteman Cancer Center have successfully used both high dose rate (HDR) and low dose rate (LDR) brachytherapy to treat patients with malignant tumors of the head and neck, brain and soft tissues (sarcomas).


Endocavitary Radiation Therapy

Some patients with early rectal cancers are able to avoid radical surgery and colostomy with the use of endocavitary irradiation. This special treatment is a method of delivering a very high dose of radiation to a small cancer on the surface of the rectum. The treatments are given in very high doses every 2-3 weeks for a total of two outpatient treatments. This treatment is combined with conventional external beam radiation therapy (usually 25 radiation treatments given 7-8 weeks before the endocavitary radiation). In appropriately selected patients, the cure rate for this form of treatment may approach 90% or better. The best candidates for this procedure must have small, minimally invasive cancers.


Stereotactic Body Radiation Therapy (SBRT)

SBRT specifically refers to a procedure whereby x-ray radiation is aimed at a focal point or tumor. The dose distributions achieved by these techniques assure large doses to the target volume and much lower doses to the surrounding normal tissues. Stereotactic body radiation is typically given in 1 to 5 treatments. It has allowed a very high cure rate in early stage cancers of the lung and liver.


Gamma Knife

The Gamma Knife is a dedicated radiosurgery device. It contains nearly 200 focused radioactive Cobalt sources that can be aimed at the tumor of disease center with extremely high accuracy and precision. A team made up of a neurosurgeon, radiation oncologist and medical physicist direct these treatments.
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Hyperthermia

Heat has been known to be an effective treatment against a number of cancers. When combined with radiation therapy, there may be enhancement of the anti-cancer effects. These treatments are being tested in complicated or advanced cases of breast cancer.


Radio-Immunotherapy

Antibodies directed at cancer cells have been linked to radioactive atoms. These antibodies seek and attach themselves to the cancer cells and deliver a toxic radiation dose to the tumor. These treatments are available for some lymphomas. Radiation oncologists and medical oncologists work together in delivering this therapy.


Total Body Irradiation (Bone Marrow Transplantion)

Bone marrow transplantation is used to treat many types of cancer, including leukemia and lymphomas. Total body irradiation (TBI) is frequently used to prepare patients to accept donated marrow. TBI eliminates the patient’s own marrow along with the malignant cells. It also suppresses their immune system to allow safe engraftment of the new healthy bone marrow. A bone marrow transplant specialist will work with our radiation oncology staff to decide when TBI is appropriate for a patient and coordinate the proper timing and radiation dose.