What is the TrueBeam system?
The Bliss Cancer Center's TrueBeam system is an advanced radiotherapy system from Varian Medical Systems. It was engineered to deliver more powerful cancer treatments with pinpoint accuracy and precision. It uniquely integrates advanced imaging and motion management technologies within a sophisticated new architecture that makes it possible to deliver treatments more quickly while monitoring and compensating for tumor motion, opening the door to new possibilities for the treatment of lung, breast, prostate, head and neck, as well as other cancers.
Why would a patient want to be treated with TrueBeam in the William R. Bliss Cancer Center at Mary Greeley Medical Center?
A doctor may prescribe treatment with the TrueBeam system for many reasons. This technology gives medical professionals the tools to treat many different types of cancers.
Also, TrueBeam is fast. Simple treatments that once took 10 to 30 minutes can now be completed in less than two minutes. As well as allowing for a more comfortable experience for the patient with less time on the treatment couch, faster delivery also allows for reduced chances of tumor motion during treatment, which helps protect nearby healthy tissue and critical organs.
The precision of the TrueBeam system is measured in increments of less than a millimeter. This accuracy is made possible by the system’s sophisticated architecture, which synchronizes imaging, patient positioning, motion management, beam shaping and dose delivery, performing accuracy checks every ten milliseconds throughout the entire treatment.
TrueBeam imaging technology can produce the three-dimensional images used to fine-tune tumor targeting in 60% less time than previous Varian imaging technology. Additional functionality makes it possible to create images using 25% less X-ray dose. These images are used to fine-tune a patient’s position prior to and during the treatment process.
For lung and other tumors subject to respiratory motion, TrueBeam offers Gated RapidArc® radiotherapy, which makes it possible to monitor the patient’s breathing and compensate for movement of the tumor while the dose is being delivered in a continuous rotation of the treatment machine.
In addition to its impressive technical specifications, TrueBeam has also been designed with patient comfort in mind. It operates quietly and provides built-in music capabilities so the patient can listen to music during their treatment. The patient is in constant two-way communication with the therapist who operates the system. Plus the therapist will be able to visually monitor and see the patient through two closed-circuit television systems.
How does radiotherapy work?
An effective treatment for cancer, radiotherapy has been used safely for many years—in fact, according to the American Society for Radiation Oncology (ASTRO), nearly two out of every three cancer patients receive some type of radiotherapy during their treatment. In basic terms, radiotherapy works by limiting the ability of cancer cells to grow and spread. Radiation disrupts the DNA of these fast-growing cancer cells and prevents them from replicating.
The radiation is generated by a machine called a medical linear accelerator. This machine shapes beams of energy with varying intensities, which can be aimed at a tumor from multiple angles to attack the target in a complete three-dimensional manner. In fact, TrueBeam’s treatment can be delivered with submillimeter accuracy and varying intensity. The idea is to deliver the lowest dose possible to the surrounding healthy tissue, while still delivering the maximum dose to the tumor.
Does radiotherapy expose people to radioactive substances?
Many people, when they hear the word “radiation,” think immediately of radioactive substances. However, no radioactive substances are involved in the creation of the beam by a medical linear accelerator. When a linear accelerator is switched “on,” radiation is produced and aimed directly at cancer cells. Then, like a flashlight, when the system is switched off, radiation is no longer emitted from the system.
What happens when a person is treated with radiotherapy?
TrueBeam treatment involves several basic steps: diagnosis, the planning of the individual treatment and the delivery of the treatment.
After their diagnosis, the medical physicist generates three-dimensional diagnostic images (usually CT or MRI) of the tumor and the area around it. They then use these images to specify the dose of radiation needed to treat the tumor. A radiation oncologist will work with a physicist to plan an individualized treatment.
After this, the patient receives individualized TrueBeam treatments according to a schedule specific to the treatment plan. The total dose of radiation is usually divided into smaller doses (called fractions) that are given daily over a specific time period.
During a TrueBeam treatment, the linear accelerator can rotate around the patient to deliver the radiation. The radiation is shaped and reshaped as it is continuously delivered from virtually every angle in a 360-degree revolution around the patient. Sometimes a marker block device is used to monitor breathing patterns to compensate for breathing motion during the treatment. Most treatments usually take only a few minutes a day.
X-rays and/or CT scans may be taken in preparation for planning the treatment. Following these scans, the treatment planning process can take several days. When the treatment plan is complete, TrueBeam radiotherapy treatments can begin.
Most cases require a treatment preparation session. Special molded devices that help the patient maintain the same position every day are sometimes developed at this point. The radiation oncologist may request to have the treatment area marked on the patient’s skin to assist in aligning the equipment with the target area.
The first TrueBeam treatment session may sometimes be longer than subsequent ones so that additional images can be acquired to check the positioning of the tumor on the day of the treatment. A typical TrueBeam treatment session lasts only a few minutes.
In the treatment room, the medical team may use the marks on the patient’s skin to locate the treatment area. Then the patient is positioned on a treatment table. Sometimes, special molded devices are used to help the patient stay still and provide correct positioning.
The radiation therapist can use the machine’s imaging capabilities to position the patient for a treatment that is accurate to less than a millimeter. These high-resolution X-rays of the targeted area verify they are in position before administering the treatment.
The radiation therapist then leaves the treatment room before the machine is turned on. The machine rotates around the patient to deliver the radiation beams, which are shaped by a special attachment called a multileaf collimator. This device has 120 computer-controlled mechanical “leaves” or “fingers” that can move to create apertures of different shapes and sizes.
Who are the professionals a patient may typically encounter?
1) A radiation oncologist is a doctor who has had special training in using radiation to treat diseases and prescribes the type and amount of treatment. The radiation oncologist may work closely with other doctors and the rest of the healthcare team.
2) A medical physicist participates in the planning process and ensures that the machines deliver the right dose of radiation.
3) A dosimetrist plans the treatment with the radiation oncologist and the physicist.
4) A radiation therapy nurse provides nursing care and may help the patient learn about treatment or how to manage any side effects.
5) A radiation therapist sets the patient up for treatment and operates the equipment that delivers the radiation.
How long is a course of radiotherapy on the TrueBeam system?
The delivery of a patient’s treatments varies depending on the diagnosis, so the patient should ask their medical professional for information about their specific diagnosis. Generally, radiation therapy usually is given daily over several weeks.
Does a person become radioactive after treatment?
External radiation therapy does not cause anyone’s body to become radioactive. A patient need not avoid being with other people because of treatment. Even hugging, kissing or having sexual relations with others poses no risk to them of radiation exposure.
Side effects of radiation therapy most often are related to the area that is being treated. A patient should consult with their medical professional to discuss the specific diagnosis, prognosis and possible side effects** from radiation treatment.
Is a TrueBeam treatment expensive?
The exact cost of radiation therapy will depend on the type and number of treatments a patient needs. Many health insurance policies cover charges for radiotherapy. It's a good idea for a patient to talk with their insurer or with their doctor's office staff or the hospital business office about their policy and how expected costs will be paid.
What is unique about treatment using the William R. Bliss Cancer Center’s TrueBeam technology?
The main advantages of the TrueBeam system are ease, precision and speed. Thanks to its pinpoint accuracy, the TrueBeam system can be used to treat many different types of tumors, including those in sensitive areas such as the abdomen, liver, lung, breast, and head and neck.
Treatments focus powerful radiation on the tumor while minimizing exposure of surrounding healthy tissues. TrueBeam was designed from the ground up to seamlessly integrate sophisticated imaging and radiation delivery treatments. What this means for patients is accuracy, speed and comfort. What it means for medical professionals is the ability to treat many different types of complex cancer cases.
**The TrueBeam system may not be appropriate for all cancers. Serious side effects can occur, including fatigue and skin irritation. Treatment times may vary. Patients should ask their doctor if TrueBeam is right for their particular case.
Mary Greeley Medical Center is now treating cancer patients with TrueBeam radiotherapy technology, an advanced system that uses noninvasive tumor-destroying radiation to treat cancers throughout the body, while minimizing damage to surrounding healthy tissue.
TrueBeam is provided through the William R. Bliss Cancer Center, a joint service of Mary Greeley Medical Center and McFarland Clinic. Mary Greeley is the second medical center in the state to have the TrueBeam system.
“With TrueBeam, we are able to deliver radiation therapy faster and more precisely,” says Shane Hopkins, M.D., McFarland Clinic radiation oncologist. “This increases the options we have available in caring for our patients.”
One of the primary benefits for patients is that treatment takes less time and is, therefore, much more comfortable. Traditional radiation oncology treatments can take more than an hour to administer and sometimes require daily appointments for weeks. Because radiation therapy requires patients to remain still while treatment is being delivered, the shorter the “table time” – the amount of time the patient spends lying on the table in the treatment room – the better.
TrueBeam can deliver radiation seven times faster than conventional radiotherapy, meaning patients experience reduced table time. This is particularly important for newer therapies in which fewer treatments and a larger dose are used. With the addition of TrueBeam, William R. Bliss Cancer Center now has two linear accelerators available.
“We have always been able to treat patients very effectively, that’s not the issue,” says Hopkins. “This just delivers the dose of radiation so quickly that patient comfort is dramatically improved. And that comfort cannot be understated when you are providing care to cancer patients.”
“This will allow us to treat more complex cancers,” adds Hopkins adds. “Patients we may have had to refer to larger hospitals in the past can now receive leading edge treatment here. Cutting down on travel is a huge benefit for patients and families battling cancer.”
Two out of three people who are diagnosed with cancer undergo some form of radiotherapy as part of their treatment according to the American Society for Radiation Oncology. In simplest terms, radiotherapy uses beams of radiation to destroy cancer cells. TrueBeam offers a number of advanced functions that allow for faster, more accurate treatment, including intensity-modulated radiotherapy (IMRT) and image-guided radiotherapy (IGRT).
IMRT is a treatment technique where doctors customize the radiation dose affecting normal parts of the body by varying the amount of radiation delivered through them. IGRT uses advanced imaging so doctors and clinicians can visualize the tumor. This allows for verification of the exact location of the tumor so it can be precisely targeted.
“Radiation oncology is a proven and very effective therapy,” Hopkins says. “As a result, there has been a tremendous amount of advancement in the technology. But with that, it has been kind of disjointed. Not until the introduction of TrueBeam has there been a linear accelerator that offered hardware and software engineered hand-in-hand, digitally from beginning to end.”
That concerted development truly sets the TrueBeam apart.
“Because of the way the TrueBeam is designed, we can add new treatment options to the machine as they are introduced,” says Brian MacPhail, board certified medical physicist in the William R. Bliss Cancer Center. MacPhail works closely with the physicians and staff to determine the proper amount of radiation to deliver during treatment and is responsible for quality control with the linear accelerators. “This flexibility ensures we can offer state-of-the-art treatment for the life of the machine.”