Rectal cancer originates in the rectum, the last 10-12 inches of the large intestine closest to the anus. Treatment options often include a combination of surgery, radiation therapy, and chemotherapy, with the choice depending on the cancer’s stage and location. Radiation therapy is particularly effective in reducing the risk of cancer recurrence in the pelvic area and can be used before surgery to shrink tumors and make them easier to remove.

Anal cancer, though less common than rectal cancer, affects the anal canal. The primary treatment for anal cancer is a combination of chemotherapy and radiation therapy, known as chemoradiation, which often allows patients to avoid surgery and preserve the anal sphincter’s function.

Pancreatic cancer is known for its aggressive nature and challenging prognosis. It originates in the pancreas, an organ behind the lower part of the stomach. Given its tendency for late detection and rapid spread, treatment usually involves a combination of surgery, if possible, chemotherapy, and radiation therapy to manage symptoms and control disease progression.

Esophageal cancer starts in the esophagus, the tube that connects the throat to the stomach. Treatment options depend on the cancer’s stage and may include surgery, radiation therapy, chemotherapy, or targeted therapy. Radiation therapy is often combined with chemotherapy either as a primary treatment to avoid surgery or as a palliative measure to relieve symptoms in advanced cases.

Stomach cancer begins in the stomach lining and can spread through the stomach wall. Treatment typically involves surgery to remove the cancer, accompanied by chemotherapy and radiation therapy. Radiation therapy helps to target residual cancer cells post-surgery and can be critical in advanced stages for symptom management.

Symptoms of GI cancers can vary widely based on the tumor’s location within the GI tract but may include difficulty swallowing, abdominal pain, weight loss, nausea, vomiting, or changes in bowel habits. Specific symptoms might reflect the cancer’s impact on the function of the affected organ, such as jaundice in pancreatic cancer or rectal bleeding in rectal cancer.

Advanced Radiation Centers utilize a variety of radiation therapy technologies tailored to treat GI cancers effectively:

• Intensity-Modulated Radiation Therapy (IMRT) and Image-Guided Radiation Therapy (IGRT): These technologies allow for precise targeting of the tumor while minimizing exposure to surrounding healthy tissues, crucial for organs clustered in the abdominal and pelvic regions.
• Stereotactic Body Radiation Therapy (SBRT): Offers a highly focused radiation treatment to small, well-defined tumors in the liver or pancreas, delivering high doses in fewer sessions.
• Respiratory Gating: This technique is particularly useful for tumors that move with breathing, such as esophageal and pancreatic cancers, synchronizing radiation delivery with the patient’s respiratory cycle.

The treatment approach for GI cancers is multidisciplinary, often involving a combination of surgical, medical, and radiation oncologists to develop a personalized treatment plan. Radiation therapy plays a crucial role in this integrated approach, either as a primary treatment, adjuvant (after surgery), or neoadjuvant (before surgery) therapy, or for palliation in advanced cases.

The goal is always to maximize the treatment’s effectiveness while minimizing side effects, ensuring patients receive comprehensive care that addresses both the physical and emotional aspects of cancer treatment.

Radiation treatment demands meticulous preparation by a dedicated team, ensuring precision and patient safety throughout the process.   Each step of the radiation treatment process is designed with precision, safety, and your well-being in mind, ensuring that you receive the most effective and personalized care possible.

Simulation

Once a course of radiation is agreed upon a simulation, or treatment planning session is performed over a 45-60 minute period.  During the simulation, the positioning of the body is set, often used customized mold that ensures daily reproducibility in positioning on a day-to-day basis. Small tattoo “freckles” may be placed to aiding in pre-treatment alignment.  An imaging scan is performed to pinpoint the exact location of the cancer or areas at risk relative to the geometric position of the body and treatment room. This step is crucial for designing a treatment plan that maximizes the radiation dose to the cancer while sparing surrounding healthy tissue.

The Planning Process (Behind the Scenes)

For a week or two following the simulation, a multi-disciplinary team composed of the radiation oncologist, medical physicists and dosimetrists, collaborate behind the scenes using advanced software to 3-dimenionally reconstruct the anatomic areas of consideration and map out the precise treatment plan, calculating the optimal radiation dose distribution.  This dosimetry plan is a “blueprint” that will be used to ensure accuracy in the treatment delivery.

Daily Radiation Treatments

Radiation therapy typically involves daily treatments over several weeks using a machine that generates high energy photons called a linear accelerator.  You may be asked to drink water prior to each treatment to increase the bladder size and location away from the prostate. The treatment room is large and is not claustrophobic.  Each session typically takes place in a 10-15 minute appointment slot, with most of this time used in positioning and alignment, while the actual beams of radiation are on for only a few minutes.  The radiation is invisible and not felt. Patients can drive themselves to and from the appointments, continue to work or exercise and maintain their normal daily activities.  Specific restrictions, if any, can be discussed with your radiation oncologist at consultation and during the weekly on-treatment visits.

Weekly On-Treatment Physician Review

Regular meetings with patients undergoing radiation are conducted with the radiation oncologist throughout your treatment course. These check-ins allow the doctor to monitor your progress, briefly exam the area under treatment for any possible side effects, provide any medications or treatment adjustments, and discuss any questions or concerns that may arise during therapy.

Completion of Therapy and Follow-Ups

Upon finishing the radiation treatment course, a final conversation with your radiation oncologist will discuss the next steps, expectations for resolution of side effects, and any further treatment or monitoring needed. Regular follow-up appointments are crucial after completing radiation therapy, and allow the radiation team to monitor your recovery, manage any late side effects, and check for signs of cancer recurrence.