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providing compassionate care to the Greater Harrisburg community

We care. We cure. We're Close to Home.

 

Welcome to Radiation Oncology at the Community Cancer Center




Expertise


At ROCCC, our board-certified physicians and professional staff members are committed to providing compassionate care close to home.



State of the art Technology


ROCCC combines professional expertise and the latest technology to offer patients with complete care, including:



Convenience


We offer all patients complimentary transportation to and from treatment for those without transportation.

Caring for You Like Family

We're here to help

We are a team of Board Certified, Cancer experts  utilizing the most advanced technology to fight Cancer in a private, non-institutionalized setting.   

Many of us are Cancer survivors and are here to help you fight.



Process


Typically, after conducting a physical exam and a medical history review, the radiation oncologist determines an individualized course of treatment for each patient.



Treatment Preparation


Most cases require a treatment preparation session. Special molded devices to help the patient maintain the same position every day are sometimes developed at this point. Colored, semi-permanent ink may be used to mark the patient's skin, to assist in positioning the patient for treatment by aligning the radiation equipment with the targeted area. A special CT scan in the treatment position is sometimes taken for use as a reference image later on in the process. The CT scan session might take from thirty minutes to an hour and the treatment simulation might take an additional 15-30 minutes.

Following the CT scan, the radiotherapy treatment planning process usually takes several days. When the plan is complete, the patient receives an appointment to begin radiation treatments.



Treatment Delivery


The first treatment session is sometimes longer than subsequent ones to allow for additional X-ray images and checks. A typical treatment session lasts about 15-20 minutes.

In the treatment room, the radiation therapist uses the marks on the patient's skin to locate the treatment area. The patient is positioned on a treatment table. Sometimes, special molds or mask devices are used to help with positioning.

The radiation therapist leaves the treatment room and remotely controls the Theraview digital On-Board imaging system to fine-tune the patient's position and move the treatment couch into final position. The Theraview digital On-Board Imager is rotated around the patient to take digital images of the targeted area. Usually two or more images are taken from different angles. These images are then used to guide the final adjustments of the treatment couch.

Although the patient is alone in the treatment room, he or she can be seen on a television screen or through a window in the control room. The therapist can talk with the patient through an intercom. Patients do not see or hear the radiation and usually do not feel anything.



Transportation Service


Complimentary patient transportation is available for ambulatory patients who have no other means of transportation. We will  transport you daily from your home to the center and then return you to the comfort of your home.

Schedule Your Pick-up Today!


FAQ

 Is radiation therapy safe?

Radiation has been used successfully to treat patients for more than 100 years. In that time, many advances have been made to ensure that radiation therapy is safe and effective.

Doctors and radiation therapists carefully tailor treatments to ensure safety and accuracy. They plan treatments that focus on the cancer while avoiding healthy organs in the area. Plans and treatment equipment are carefully monitored and checked to make sure treatments are given properly.

Some patients worry that radiation therapy will cause cancer years after treatment. There is a small risk that radiation can cause a new cancer to occur in the future, however, the goal is to kill the current tumor while reducing the chance of recurrences by preserving more healthy tissue during treatment.

What types of cancer are treated with radiotherapy?


Bladder, brain, breast, colorectal, gynecologic, head and neck, lymphoma, lung, prostate and skin.

High-energy x-rays destroy tumors by killing cancer cells, which are not able to repair themselves. Healthy cells can repair themselves after exposure, provided they don't receive too high a dose. Radiation will kill a tumor every time if sufficient dose can be delivered to the tumor itself, but oncologists are limited in the dose they can deliver because of the need to spare healthy surrounding tissue from over-exposure.

 What types of cancer are treated with radiotherapy?

Bladder, brain, breast, colorectal, gynecologic, head and neck, lymphoma, lung, prostate, skin, High energy x-rays destroy tumors by killing cancer cells, which are not able to repair themselves. Healthy cells can repair themselves after exposure, provided they don’t receive too high a dose. Radiation will kill a tumor every time if sufficient dose can be delivered to the tumor itself, but oncologists are limited in the dose they can deliver because of the need to spare healthy surrounding tissue from over-exposure.

 Will it make you radioactive?

 Will your hair fall out?

 Does radiotherapy hurt?

 Are there other side effects?

 What is IGRT?

 Why would I want IGRT to be used with my treatments?

 Does radiation therapy expose people to radioactive substances?

 What is the IGRT process like?

 Who gives the treatment?

 How long is a course of treatment?

Radiation therapy usually is given five days a week for six or seven weeks. When radiation is used for palliative care, the course of treatment lasts for two to three weeks. For each radiation therapy session, the patient is in the treatment room for about 15 to 30 minutes. These types of schedules, which use small amounts of daily radiation rather than a few large doses, help protect normal body tissues in the treatment area. Weekend rest breaks allow normal cells to recover. The total dose of radiation and the number of treatments a patient needs depend on the size and location of the cancer, the type of tumor, the patient's general health and other factors.

 What are the effects of treatment?

 Is radiation therapy treatment expensive?

You Have a Choice

Let's conquer cancer together

Our Team

Dr. Douglas Colkitt, MD Photo Dr. Douglas Colkitt, MD Hover Photo

Dr. Douglas Colkitt, MD

Radiation Oncologist
Read Bio

Dr. Colkitt is a board certified Radiation Oncologist. He attended University of Pennsylvania and simultaneously completed his MBA and his  Residency at Thomas Jefferson Hospital in Philadelphia, Pennsylvania.  Dr. Colkitt's favorite hobbies include playing golf and spending time with his three grand children.  


Susan McCoy, RT (R) (T) Photo Susan McCoy, RT (R) (T) Hover Photo

Susan McCoy, RT (R) (T)

Chief Therapist/Dosimetrist
Read Bio

Susan McCoy, RT (R) (T)

Chief Therapist/Dosimetrist


Polyclinic Medical Center School of Radiologic Technology - 1981
University of Virginia School of Radiation Technology - 1982

Dr. Paul Castro,  PhD DABR Photo Dr. Paul Castro,  PhD DABR Hover Photo

Dr. Paul Castro, PhD DABR

Medical Physicist
Carrie Lebo, (RT) (CT) R Photo Carrie Lebo, (RT) (CT) R Hover Photo

Carrie Lebo, (RT) (CT) R

CT Scan Technologist
Anne Kelly Photo Anne Kelly Hover Photo

Anne Kelly

Transportation Coordinator
Olivia Lentz Photo Olivia Lentz Hover Photo

Olivia Lentz

Office Manager, Transportation Coordiantor
Patrick Paradzinski Photo Patrick Paradzinski Hover Photo

Patrick Paradzinski

Practice Development Director
Dr. Metha, MD Photo Dr. Metha, MD Hover Photo

Dr. Metha, MD

Radiation Oncologist

Complete Cancer Care

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Cancer Treatment Services


Intensity Modulated Radiation Therapy (IMRT)


Intensity modulated radiation therapy (IMRT) is an advanced type of high-precision radiation that improves the ability to conform the treatment volume to concave tumor shapes.

For example, when the tumor is wrapped around a vulnerable structure such as the spinal cord or a major organ or blood vessel. Our computer-controlled x-ray accelerator delivers precise radiation doses to malignant tumors or specific areas within the tumor. The radiation dose is consistent with the 3-D shape of the tumor by controlling, or modulating, the radiation beam’s intensity. 

The radiation dose intensity is elevated near the gross tumor volume while radiation  among the neighboring normal tissue is decreased or avoided completely. The customized radiation dose is intended to maximize tumor dose while simultaneously protecting the surrounding normal tissue. This results in better tumor targeting, lessened side effects, and improved treatment outcomes.


Image Guided Radiation Therapy (IGRT)


Image Guided Radiation Therapy Image Guided Radiation Therapy (IGRT) is the process of imaging during a course of radiation treatment to direct radiation therapy beams to make sure they coincide with the tumor as outlined using the treatment plan.

The patient is localized in the treatment room in the same position as simulated and checked using matching planar megavoltage (MV) images against the digital reconstructed radiographs (DRRs) from the treatment planning CT. If location of the target has moved relative to the initial treatment plan, the computer can calculate the position difference and show the therapist how to move the table in order to make sure that the radiation is delivered to the target according to plan. 

This process is distinct from the use of imaging to delineate targets and organs in the planning process of radiation therapy (simulation). However, there is clearly a connection between the imaging processes because IGRT relies directly on the imaging modalities from planning as the reference coordinates for localizing the patient. The goal of the IGRT process is to improve the accuracy of the radiation field placement, and to reduce the exposure of healthy tissue during radiation treatments. 

In years past, larger planning target volume (PTV) margins were used to compensate for localization errors or tumor movement during treatment. This resulted in healthy human tissues receiving unnecessary doses of radiation during treatment. By improving precision and accuracy through IGRT, radiation is decreased to surrounding healthy tissues, allowing for increased radiation to the tumor. Currently, certain radiation therapy techniques employ the process of Intensity Modulation Radiotherapy. (IMRT) This form of radiation treatment uses computers and linear accelerators to sculpt a three- dimensional radiation dose map specific to the target’s location, shape, and motion characteristics. 

Because of the level of precision required for IMRT, detailed data must be gathered about tumor locations. The single most important area of innovation in clinical practice is the reduction of the planning target volume margins around the tumor. The ability to avoid more normal tissue and/or employ dose escalation strategies is a direct by-product of the ability to execute therapy with the most accurate geometric precision.

Learn More About IGRT


Virtual Simulation


The CT-simulation process allows for rapid data acquisition, efficient contouring of key structures, and the selection of an isocenter for a particular patient. 

The 3-D reconstruction of a patient model is complete with the generation of a digitally reconstructed radiograph (DRR) with the target volume and/or critical structures superimposed upon the images. The CT-simulation allows the treatment planner/radiation oncologist to draw contours around the tumor, target and normal tissues on a slice-by-slice basis, and, at the same time, view the contours on planar images from both AP and lateral projections. In addition, improved edit functions allow the user to move, scale and rotate a contour in addition to providing tools for rapid corrections, changing the shape of a contour, automatic adjusting of a copied contour to fit a new organ boundary, and copying to inferior and superior slices.

Simulation treatment planning can take minutes or hours, depending upon the complexity desired. The average length of CT-simulation is less than one hour, including patient positioning and CT data acquisition with an average of 40 slices. Physician contouring of target volume can occur at the time of simulation or after the patient has left the facility. Several treatment plans can be generated using the CT data and the various beam angles and portal apertures can optimized after the patient has left the simulation room as long as sufficient fiducial reference marks are made on the patient's skin and immobilization device to allow precise repositioning at the treatment machine. Not only does this virtual simulation allow for the optimal plan to be generated but it is also possible to avoid the selection of beam directions that are untreatable because of complex treatment geometry (i.e., incompatible table and gantry rotations) before the patient returns to the center for treatment.


3D Conformal Radiotherapy


3D conformal radiotherapy (3D CRT) is a technique that permits the radiation oncologist to shape and precisely deliver the high-energy x-ray beam to the cancer disease site while also optimally protecting normal tissues.

At the heart of 3D conformal radiotherapy are high-speed computers capable of extracting the CT/MRI data, performing three-dimensional isodose calculations and overlaying the data for the radiation oncologist and medical physicist to view. Upon acceptance of the physical treatment plan by the radiation oncologist, the tumor targeting and beam delivery data are used for precise positioning of the patient. The result is the ability to deliver relatively larger doses to the tumor while sparing adjacent healthy tissue compared to conventional (i.e., non-3D) techniques. The immediate outcome is improved treatment tolerance by the patient.

3D CRT is used to treat tumors that in the past might have been considered too close to vital organs and structures for radiation therapy. For example, 3DCRT allows radiation to be delivered to head and neck tumors in a way that minimizes exposure of the spinal cord, optic nerve, salivary glands and other important structures. It can be used in the treatment of prostate cancer to reduce dose to critical structures such as the bladder and rectum. It is also used if a cancer recurs; the high energy x-ray beam can be directed to the tumor while avoiding the area that was previously treated.


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Linear Accelerator


Medical linear accelerators are the key equipment used for delivering radiotherapy treatments.

Standing approximately 9 feet tall by nearly 15 feet long and weighing as much as 18,700 pounds, the accelerator consists of four major components: an electronics cabinet called a "stand," housing a microwave energy generating source; a rotating gantry containing the accelerator structure that rotates around the patient; an adjustable treatment couch; and operating electronics. Accelerators are located within specially constructed concrete treatment rooms to provide X-ray shielding.

The radiation produced by the medical linear accelerator strikes human tissue and produces (largely from naturally occurring water in the body) highly energized ions that are lethal to both normal and malignant cells.

While both good and bad cells are damaged by radiation, healthy cells can adapt over successive regenerative cycles. Malignant cells do not possess this adaptation mechanism and do not survive, a fact that generally dictates the practice of administering repeated radiation treatments rather than a single blockbuster dosage.


Multi Leaf Collimators


Multi Leaf Collimators (MLC's) are used to define the shape of the radiation beam. Without this device, the medical linear accelerator can only treat square or rectangular shapes (treatment fields) or else blocks of lead have to be attached in order to shield out the radiation where it is not required.

The MLCs allow the radiation oncologist to define the tumor shape to be treated while minimizing the radiation dose to critical structures. MLCs are used with advanced treatment techniques such as IMRT or 3D conformal radiotherapy. The computer controlled MLC is the most practical way to implement these treatments and it is possible to deliver the treatments quickly and efficiently using this device. The computer moves each leaf individually to match each patient's specific radiotherapy treatment plan.


Eclipse™


Eclipse™ is a comprehensive treatment planning system that simplifies modern radiation therapy planning for all kinds of treatment, including 3D conformal and intensity-modulated radiation therapy (IMRT).

With the rich functionality in Eclipse, the Radiation Oncologist and his staff can efficiently create, select, and verify the best treatment plans for their patients. In addition to ensuring high standards of care and effective protocols, Eclipse provides clinicians with the flexibility to quickly tailor plans for each patient. Designed to meet the needs of modern clinics and evolving technologies, Eclipse supports advanced processes such as Intensity Modulated Radiation Therapy (IMRT) and Image Guided Radiation Therapy (IGRT).

The Eclipse treatment planning system enables growing our clinic to provide advanced radiation therapy techniques and improve the quality of care. When used in conjunction with Varian medical linear accelerators and the AIRATM record and verify system the Eclipse planning system is integrated into the total management of patient care from the initial patient consult to the verification of radiation therapy treatment for each individual patient.


Portal Vision


Portal Vision is a method of electronic digital imaging that allows the Radiation Oncologist to view images of patient anatomy in real time. 

A solid state imaging array is connected to a computer that can transmit images to the Radiation Oncologist via a network so that images can be reviewed as soon as they are acquired.

Digital imaging has been one of the biggest improvements in patient care over the past decade. Cancer patients receiving radiation treatments are frequently subject to X-ray procedures in order to determine proper placement of the radiation fields. Standard X-ray films force the patient to be on the treatment table for long periods of time and thus extend their treatment visit. By implementing digital imaging, the time the patient is on the table has been greatly reduced. The physician can now review images instantaneously without waiting for the film image to develop. This leads to shorter overall treatment times and improves treatment quality.


CT Simulation


The CT-simulation process allows for rapid data acquisition, efficient contouring of key structures, and the selection of an isocenter for a particular patient. 

The 3-D reconstruction of a patient model will be complete with the generation of a digitally reconstructed radiograph (DRR) with the target volume and/or critical structures superimposed upon the images. The CT- simulation allows the treatment planner/radiation oncologist to draw contours around the tumor, target, and normal tissues on a slice-by-slice basis, and, at the same time, view the contours on planar images from both AP and lateral projections. In addition, improved edit functions allow the user to move, scale, and rotate a contour in addition to providing tools for rapid corrections, changing the shape of a contour, automatic adjusting of a copied contour to fit a new organ boundary, and copying to inferior and superior slices.

Simulation treatment planning can take minutes or hours, depending upon the complexity desired. The average length of CT-simulation is less than one hour, including patient positioning and CT data acquisition with an average of 40 slices. Physician contouring of target volume can occur at the time of simulation or after the patient has left the facility. Several treatment plans can be generated using the CT data and the various beam angles and portal apertures can optimized after the patient has left the simulation room as long as sufficient fiducial reference marks are made on the patient's skin and immobilization device to allow precise repositioning at the treatment machine. Not only does this virtual simulation allow for the optimal plan to be generated but it is also possible to avoid the selection of beam directions that are untreatable because of complex treatment geometry (i.e., incompatible table and gantry rotations) before the patient returns to the center for treatment.

You Have a Choice

Let's fight cancer together

Use the form below to contact us. If you need immediate assistance, please call 717-766-7693.