Radiation Therapy at Levine Cancer

Gamma Knife radiosurgery, an advanced type of stereotactic radiosurgery, will be available at Levine Cancer in December 2023. It uses highly focused beams of radiation to treat tumors and other conditions in the brain and skull. 

Because it’s so precise, Gamma Knife treatment can minimize long-term side effects and improve outcomes. 

Starting in December, Levine Cancer will be the first and only program in the Charlotte region to offer this leading-edge technology.  

Learn more about Gamma Knife radiosurgery. 

Brachytherapy is a type of internal radiation therapy that involves placing a radioactive implant inside of the body. A seed, pellet, wire or capsule containing a radioactive substance is inserted into the body through a small tube called a catheter. The radioactive implant is placed inside of the tumor or as close to the tumor as possible. The treatment is highly localized, meaning that the implant targets nearby cancer cells while minimizing damage to healthy tissue.

There are 2 main types of brachytherapy:

• High-dose rate (HDR) brachytherapy – During HDR brachytherapy, a radioactive implant is placed in your body for a short time, from just a few minutes up to 20 minutes.
• Low-dose rate (LDR) brachytherapy – During LDR brachytherapy, the radioactive implant gives off a lower dose of radiation for a longer period. Some implants are left in for days then removed, while others may never be removed. For example, during brachytherapy for prostate cancer, seeds smaller than a grain of rice may be permanently placed inside the prostate gland. The brachytherapy seeds slowly give off radiation until there is none left, so they can safely stay in the body forever.

Learn more about the types of external and internal radiation therapy we offer below.

• External-beam radiation therapy (EBRT) uses a machine outside of the body to aim beams of radiation at cancer cells. EBRT is the most common type of radiation therapy used to treat cancer.
• Internal radiation therapy (IRT) involves placing a radioactive substance inside your body, close to your tumor. IRT may also be referred to as brachytherapy.

Conditions treated

At Levine Cancer, we most commonly use brachytherapy to treat prostate cancer and gynecologic cancer, like cervical cancer and uterine cancer. Unlike many other cancer centers, we offer brachytherapy for prostate cancer without a hospital visit. Instead, patients can come to our radiation oncology clinic for treatment.

We’re also the only radiation therapy program in the region that offers intravascular coronary brachytherapy, which uses radiation to prevent recurrent blockage (restenosis) of a stent inside the heart.

What to expect

The type of brachytherapy you receive and how long the implant stays in your body depend on your specific diagnosis and treatment plan. Your care team will let you know what to expect before, during and after treatment, including the possible side effects of brachytherapy.

3D-CRT is a type of external-beam radiation therapy that uses special computers to create a detailed picture of your tumor and precisely plan the treatment area. This technique allows doctors to tailor radiation beams to the exact shape of your tumor, which helps reduce the amount of radiation that nearby healthy tissue is exposed to.

Conditions treated

At Levine Cancer, our experts have experience using 3D-CRT to treat many types of cancer. In some cases, it’s used as a palliative treatment to help relieve symptoms caused by cancer and improve comfort. Your radiation oncologist will decide if 3D-CRT is the best option for your individual needs.

What to expect

3D-CRT is typically given 5 days a week (Monday through Friday) over several weeks, with treatment sessions that last about 30 minutes each. Your treatment schedule and the total number of treatments needed depend on your specific diagnosis. Your care team will let you know what to expect before, during and after treatment, including the possible side effects of 3D-CRT.

IMRT is an advanced type of 3D-CRT that uses computer programs to fit radiation beams to the shape of the tumor.

With IMRT, the intensity (or strength) of the radiation beams can be changed depending on the area of the tumor that it’s targeting. This helps the radiation oncology team deliver higher, more effective doses of radiation to cancer cells while minimizing exposure to healthy areas.

We also offer Volumetric Modulated Arc Therapy (VMAT), a cutting-edge form of IMRT. During VMAT, the radiation machine moves around you to deliver targeted radiation to your tumor while protecting healthy tissue. Compared to other radiotherapy treatments, VMAT treatment is fast, with treatment sessions as short as 2 minutes.

Conditions treated

At Levine Cancer, IMRT is most often used to treat the following cancers:

• Brain cancer
• Gastrointestinal cancer
• Head and neck cancer
• Lung cancer
• Prostate cancer
• Gynecologic and some genitourinary cancers

What to expect

IMRT is typically given 5 days a week (Monday through Friday) over several weeks, with treatment appointments that last about 30 minutes each (including setup). Your treatment schedule and the total number of treatments needed depend on your specific diagnosis. Your care team will let you know what to expect before, during and after treatment, including the possible side effects of IMRT.

SRS is a type of external-beam radiation therapy that delivers a high dose of radiation to a precise area.

While the name makes it sound like a surgery, SRS is a non-invasive treatment that does not involve any incisions (cuts). During SRS, a machine outside of the body aims many small beams of radiation at the tumor from different angles. This allows a high dose of radiation to reach the cancer while avoiding nearby healthy tissue as much as possible.

Conditions treated

At Levine Cancer, we use SRS to treat tumors in the central nervous system (brain and spine) and facial pain syndromes like trigeminal neuralgia.

What to expect

SRS is often given in one treatment session. However, the treatment schedule can vary depending on your specific diagnosis. Your care team will let you know what to expect before, during and after treatment, including the possible side effects of stereotactic radiosurgery.

Similar to SRS, SBRT is a type of external-beam radiation therapy that aims many small beams of radiation at a tumor. Together, the beams deliver a high dose of radiation to the cancer while avoiding healthy cells.

Conditions treated

At Levine Cancer, we use SBRT to treat different types of cancer, including:

• Liver cancer
• Lung cancer
• Pancreatic cancer
• Prostate cancer

What to expect

SBRT is usually given in 1 to 5 treatment sessions over 1 to 2 weeks. Each treatment session typically lasts 30 minutes to an hour. The total number of treatments needed depend on your specific diagnosis. Your care team will let you know what to expect before, during and after treatment, including the possible side effects of SBRT.

TBI is type of external-beam radiation therapy that’s given to the whole body. Many people have TBI before their bone marrow transplant (also known as a stem cell transplant). TBI helps your body prepare to accept new bone marrow or stem cells.

Conditions treated

At Levine Cancer, a combination of TBI and bone marrow transplant may be used to treat several types of blood cancer, including:

• Leukemia
• Lymphoma
• Multiple myeloma

What to expect

TBI involves delivering radiation to most of the body up to 3 times per day for a few days in a row. You may be admitted to the hospital for your TBI treatment.

While the exact treatment plan depends on your unique needs, you can learn more about the overall transplant process here. Your care team will let you know what to expect before, during and after treatment, including the possible side effects of TBI.

Electron beam radiation therapy (or electron therapy) is a type of external radiation therapy that targets cancer on your skin with particles called electrons. The radiation is strong enough to kill cancer cells but doesn’t go deep in your body, which helps avoid damage to healthy tissue.

Conditions treated

At Levine Cancer, we use electron beam radiation therapy as a non-surgical treatment option for certain types of skin cancer, cutaneous lymphomas and other cancers on or close to the surface of the skin.

What to expect

Electron beam radiation therapy is typically given 5 days a week (Monday through Friday) over several weeks, with treatment sessions that last 20 to 30 minutes each. Your treatment schedule and the total number of treatments needed depend on your specific diagnosis. Your care team will let you know what to expect before, during and after treatment, including possible side effects.

This type of radiation therapy uses radioactive drugs (or radiopharmaceuticals) that can be taken by mouth or injected into a vein. The medicine travels through the body to find areas where there’s cancer and gives off radiation to kill the cancer cells.

We offer cutting-edge radiopharmaceuticals like Pluvicto, a targeted therapy that may benefit men with advanced prostate cancer that hasn’t responded to other treatments.

Conditions treated

At Levine Cancer, we use systemic radiation therapy to treat certain types of cancer, including:

• Bone cancer
• Gastrointestinal cancer
• Prostate cancer

What to expect

Your treatment schedule and how your treatment is given depend on your specific situation and the medication that’s being used. Your care team will let you know what to expect before, during and after treatment, including the possible side effects of the treatment you receive.

These terms are closely related, and sometimes they’re used in the same way. However, they can also be defined differently:

• Radiation therapy (or radiotherapy) is a treatment for cancer and other conditions that uses radiation (strong beams of energy) to target unhealthy cells. About 60% of patients who are treated for cancer will receive radiation therapy. In some cases, radiation may be the only treatment you need. But most of the time, radiation therapy is used in combination with other cancer treatments, like chemotherapy or surgery.
• Radiation oncology is a medical specialty (a branch of medicine) that uses radiation therapy to treat cancer and other conditions. At Levine Cancer, experts in radiation oncology work closely with experts in other specialties (such as medical oncology and surgical oncology) to provide comprehensive care that’s tailored to your needs. A radiation oncologist, a doctor who specializes in treating cancer with radiation therapy, will oversee your treatment.

How treatment is given depends on what type of radiation therapy you receive:

• External-beam radiation therapy, like 3D-CRT, IMRT, SRS and SBRT, uses a machine outside of the body to aim beams of radiation at cancer cells. This machine is called a linear accelerator.
• Internal radiation therapy, or brachytherapy, involves placing a radioactive substance inside your body, close to your tumor.
• Systemic radiation therapy uses special radioactive drugs (or radiopharmaceuticals) that are given by mouth or through an injection.

Your care team will help you understand what to expect before, during and after your radiation treatment.

Chemotherapy (or chemo) and radiation therapy are both cancer treatments, but there are key differences:

• Chemotherapy is a medication that’s used to shrink or destroy cancer cells. It’s typically given through a needle in the vein, though some types of chemotherapy drugs can be taken as a pill. Chemotherapy works through your whole body to prevent the spread of cancer.
• Radiation therapy shrinks or kills cancer cells with high-energy beams, usually from a machine outside of the body. It can also be delivered with an implant inside of the body or medication. Radiation therapy is a local treatment, which means it can be used to treat the area where your cancer is without affecting the rest of your body.

Sometimes these treatments are used together or in combination with other treatments, like surgery or immunotherapy. The type of cancer you have and how far along it is will help your doctor decide which treatment you need.

At Levine Cancer, we use radiation therapy to treat many types of cancer, including but not limited to:

In addition to treating cancer in adults, our radiation oncology experts provide care for pediatric cancer in partnership with Atrium Health Levine Children’s.

We also offer radiation therapy for some non-cancerous conditions, like skull base tumors, thymus tumors, trigeminal neuralgia (a nerve disorder causing chronic facial pain) and coronary restenosis (repeated blockage of a stent in the heart).

While you may not meet every member of your care team, our radiation oncology experts work together to plan and deliver your treatment. This includes:

• Radiation oncologists, doctors who specialize in treating cancer with radiation therapy. Your radiation oncologist will oversee your radiation therapy treatment, from creating a personalized treatment plan to providing follow-up care when your treatment is done.
• Radiation oncology nurses who specialize in caring for people receiving radiation therapy. They can explain your treatment, answer your questions and help you manage side effects.
• Radiation therapists who provide your treatment. They’re specially trained to use radiation machines safely and effectively.
• Medical physicists who are experts at using high-tech radiation equipment to help design your treatment plan.
• Medical dosimetrists who help your radiation oncologist make sure you get the right dose of radiation in the exact place you need it.

Depending on your specific needs, your expert care team may also include medical and surgical oncologists, pathologists, genetic counselors, specialized pharmacists, advanced care practitioners, clinical and research nurses, dietitians, nurse navigators, social workers and other healthcare professionals.

At Levine Cancer, we use state-of-the-art technologies that are designed to keep the side effects of radiation to a minimum.

Still, side effects from treatment can happen, and they vary a lot from person to person. Some people experience no side effects at all, while others have multiple treatment-related symptoms.

The most common side effect with all types of radiation therapy is fatigue (feeling tired). But in general, side effects only affect the area that was treated with radiation. For example, patients receiving radiation in the prostate may experience bladder problems, while patients receiving radiation in the brain may get headaches.

Side effects tend to be worst toward the end of treatment and typically go away within a few months of finishing treatment. Long-term side effects are rare.

Your care team will talk to you about the possible side effects of your treatment. Throughout treatment, they’ll also help you manage side effects and improve your quality of life. In many cases, patients benefit from services like integrative oncology and cancer nutrition, which are part of our comprehensive cancer support and survivorship programs.

For patients receiving radiation for prostate cancer, we offer SpaceOARTM, a temporary injectable gel that’s clinically proven to minimize potential side effects when used before treatment.

No, radiation treatment itself is painless. In most cases, treatment is like having an X-ray. You won’t see or feel the beams of radiation.

Sometimes, the position your body needs to be in during treatment can be uncomfortable, or you may experience side effects that cause discomfort. Your care team will explain what to expect from your specific treatment and will work hard to help you stay as healthy and comfortable as possible.

How long your treatment takes depends on a few factors, like what type of radiation therapy you receive and your specific diagnosis.

In general, treatment visits for external-beam radiation therapy take about 30 minutes. Most patients come in for treatment 5 days a week (Monday through Friday) for 2 to 8 weeks. Taking weekends off from treatment gives the healthy cells in your body time to recover.

Your care team will let you know your treatment schedule what to expect during each step of your care.

The cost of radiation therapy depends on your specific situation, including what type of radiation therapy you get and how many treatments you need.

Talk with your health insurance company about the cost of your treatment. If you need help understanding your insurance coverage or assistance with financial challenges, ask your doctor about financial counseling.