Answers to The Top 4 Questions About Radiation Therapy

Anyone that is starting a new medical treatment has a right to be a little nervous. This article is being written to help ease the anxiety of cancer patients that are scheduled for radiation therapy. Fear comes because of the unknown and common misunderstandings patients have about radiation.

Radiation therapy is delivered using a large piece of medical equipment known as a linear accelerator. With maintenance, repairs, and part replacement linear accelerators can deliver radiation to an average number of patients for between five and ten years. Below we will answer the most commonly asked questions about radiation therapy using a linear accelerator, LINAC.

Is Radiation Therapy Painful?

Thankfully radiation therapy is not painful. Patients often report that they do not experience any sensation when the radiation is delivered from the LINAC. A few patients have reported that they feel a slight warm tingle in the area where the LINAC is delivering radiation. The skin in the area where linear accelerators deliver treatment can become dry and itchy over time. This can cause some discomfort but definitely not enough to stop treatment. Skin reactions due to radiation can be treated with over the counter ointment.

Does Radiation Therapy Cause Me to Be Radioactive?

Radiation therapy only makes patients radioactive when internal radiation is given. Patients are radioactive while the radioactive materials are in them. These patients are secluded in a private hospital room. Patients that are treated using a LINAC through external radiation, will not be radioactive at all. External radiation delivers a precise dose of radiation to the cancerous tissues instantaneously. With external radiation the radiation does not linger. Once the LINAC is turned off the radiation isn’t an issue. In external radiation, patients can continue on their normal routines without worry.

Will I Lose My Hair During Radiation Therapy?

Radiation is considered a localized treatment which means that it focuses directly on the area being treated. This being said you can expect hair loss in the area of treatment however unless treatment is done on your head you shouldn’t experience hair loss. Confusion occurs because people associate radiation and chemotherapy as one in the same therapies. The difference is that chemotherapy is a systemic treatment which means it affects the entire body. During chemotherapy there is a likelihood that patients will lose their hair.

Should I Expect to Experience Nausea and Vomiting?

Radiation therapy doesn’t usually cause patients to feel sick. If treatment is given in areas such as the liver, brain, or gastrointestinal tract patients have more of a risk to experience nausea. Also, patients that are going through chemotherapy and radiation at the same time there is more of a risk for feeling ill.

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Does It Cost Money to Have an Old Linear Accelerator System Removed?

This is a frequently asked questions when healthcare centers are starting the process to budget for the purchase of a new or refurbished Linear Accelerator. It is important to not be surprised when it comes to financial obligations within a medical organization. The answer is Yes, there is a cost to have old LINAC systems removed from your facility. There is a cost to have new equipment installed as well but that is often combined with the price you pay for the equipment itself.

Although linear accelerators are a machine that offers a priceless treatment in the fight against cancer with lifesaving radiation beams treating thousands of patients for countless number of years, they do become worthless. Like most machines, over time the labor and linear accelerator parts cost more to repair the LINAC machine than it is worth. When this occurs, the machine is worth nothing and needs not only to be removed but also properly disposed of.

Another element to add to the mix is the introduction of new technology. This is a reoccurring issue that is seen in medical equipment. Older machines cannot be updated to run properly with the latest and greatest treatments and therefore simple become worthless. Yep, even some LINAC machines with life left in them become obsolete to healthcare providers promoting the latest and greatest treatments. Although these machines are worthless to these facilities they can often be moved and utilized by other facilities such as veterinarians, possible dermatologists, and of course in poverty-stricken locations that would otherwise go without.

When a linear accelerator has been deemed to have little to know value, meaning no one is willing to pay you for it, your facility will face the cost of removal. This cost includes professional and safe dismantling, removal, and disposal of the LINAC. This process often requires the system to be loaded onto a crane as they weigh several thousand pounds. This should be done by professionals to prevent catastrophe. After the machine has been removed from the facility it will be tested for radioactivity and disposed of once they are cleared.

At the end of the day, when all is said and done the cost to have a large scaled piece of medical equipment such as a linear accelerator removed, dismantled, and disposed of ranges between $5,000 and $25,000.

Treating Cancer With Radiation Therapy

There are many parts and components that must be considered when servicing and repairing linear accelerators and other types of radiation therapy equipment. Consider the inner workings of LINAC systems and the process they go through to deliver targeted radiation and you will see why professional servicing and maintenance is required.

External radiotherapy is done with the use of specialized radiation therapy equipment. This equipment is designed to aim beams of radiation at the source of cancer. The most common types of radiation being through the use of high energy x-ray beams. Other types can include particle beams, such as protons and electrons. These beams are used to obliterate the cancerous cells within the are being treated while preventing radiation damage to healthy cells.

Radiotherapy works by harming the DNA within the cancerous cells. The DNA is the genetic code which controls the behavior of the cells. Radiotherapy damages DNA directly on contact or creates charged up particles to damage the DNA. This treatment should stop the growth or kill the cancer. When cells die your body will break them down and get rid of waste substance. Normal cells could be damaged but usually repair themselves.

Before treatment can begin your doctor will want to go over the short- and long-term side effects. Most will be temporary and can be regulated with medication. The team that treats you will use a combination of images including x-rays, CT scans, MRI scans, or PET scans. They will be used to monitor the size of the tumor and measure the shrinkage that is occurring.

Radiotherapy machines, like linear accelerators, are very large and can look extremely intimidating. A LINAC uses electricity in creating radiotherapy beams. The machine will never touch you and the radiation will not be felt. Some discomfort can be expected from the side effects of treatment but can be controlled using medication. For radiotherapy to work the radiation must cover the entire cancerous area and the surrounding border. Physicians will give the lowest dosage possible to prevent damage to the health tissue surrounding the cancer. This will reduce the risks of side effects to the healthy tissue.

The dose of radiation you are prescribed will be divide up into small doses known as fractions. Instead of one large dose, these smaller doses allow the same amount of radiation overtime which helps to alleviate the side effects and allows the healthy tissues time between treatments to heal. Radiation can be given as palliative care which is given to alleviate the pain associated with cancer or as a treatment to cure the cancer.

Installment Two – The Process of Treating Cancer Using Radiation

In our first installment on treating cancer with radiation we took a look in to exactly what radiation therapy was, how it worked, and how treatment is planned and delivered. In today’s installment we will look deeper into what patients can and cannot doing during treatment, how long treatment sessions take, what to expect, and potential side effects.

During treatment are there particular things I should or shouldn’t do?

It is hard to believe however, life as normal can continue while you receive radiation therapy. In fact, the less interruption to your overall schedule, the better. Try to think of radiation as you would any other appointment, don’t make it any more important than any other task in your daily life. Taking the importance away helps to ease anxiety. Consider the following when planning treatment:

Radiation therapy is performed using a linear accelerator. Some Skin tumors require a superficial x-ray unit, however for the most part radiation is delivered using a LINAC system. You will be required to lay still while on the table/couch underneath the linear accelerator while the treatment is occurring. You will feel nothing at all during the procedure. Many times, you don’t even know that treatment has occurred. A myth has circulated that you will be radio active after radiation therapy however this is incorrect. There is not a possibility of this at all.

Treatment can range from a single treatment, one time to multiple treatments a week for several weeks. This depends on a number of different factors including the type of cancer, where it is located, and how it is responding to treatment. Treatment is most often done during the week. The duration of your session will vary as well depending on the LINAC system that is used, and duration set in your treatment plan. Certain linear accelerators operate faster than others and certain cancers require slow and steady treatment. Your radiation oncologist will go over your specific case when reviewing your treatment plan.

During treatment it is important to drink plenty of fluids while eating regularly. A small, balanced meal several times a day will help with energy loss. It is also important to keep up on your regular, daily hygiene regimen. Try to avoid extreme foods of any nature, too spicy, too hot, too cold, and so on are not desirable when receiving treatment. It is also important to avoid extreme sun exposure during radiation as your skin will be more sensitive to burns.

What side effects should I be prepared for?

Radiation therapy provides a localized treatment which means that any side effect will depend on where it is received. You may experience the following:

Nausea: Depending on where treatment is given you may feel nauseous during or after treatment. (This could also be nerves) Whatever the case symptoms can easily be treated with the use of anti-nausea medication.

Diarrhea: As with nausea, diarrhea can be treated with medicine. Depending on severity a dietician can help prepare your diet to prevent future occurrences.

Sore Throat/Mouth: If you are having treatment done on your mouth or throat you can experience some tenderness. Your oncologist will offer suggestions to help prevent chewing and swallowing difficulties.

Increased Urination: Treatment in the lower abdomen and pelvic region can lead to frequently needing to relieve yourself. To prevent discomfort be sure to stay well hydrated by drinking extra water throughout the day. Take note of drastic changes which could be signally an infection verse side effects from treatment.

Hair Loss: This too is localized to the treatment area. Hair loss may occur on your chest, arms, legs, face, and head depending on where the radiation treatment is performed.

Can I continue to work?

As stated earlier, keeping your routine as normal is possible is key. Of course, each treatment plan is different, and your oncologist may recommend rest after treatment. If this is the case, you will want to follow their specific instructions. Once treatment is finished any side effects and symptoms should subside within a few weeks.

Will I need to follow up?

After radiation therapy is performed you will need to follow up with your physician. In most cases, the first time you meet after treatment will be between four and six weeks. This is not true in all cases and therefore it is important to work with your doctor to make these arrangements at the time of or before your last treatment of radiation.

Installment One – The Process Of Treating Cancer Using Radiation

What is radiation therapy anyway?

Radiation therapy is one of the most common ways to treat cancer. Depending on the type and nature of cancer being treated will depend on what method radiation is delivered to your tumor. Most commonly, a linear accelerator is used to deliver external beam therapy. LINAC machines deliver radiation directly to your tumor, externally.

How does radiation therapy work?

When radiation is delivered using a linear accelerator it is delivered to both cancerous cells and healthy cells. Radiation affects cancerous cells more than healthy cells. The highest possible dose of radiation is delivered to kill off the cancerous cells. Smaller doses can be delivered when the aim of treatment is to reduce the size of the cancerous tumor and relieve the symptoms.

Who plans and delivers your treatment?

Cancer oncologists will create a plan of treatment for patients. When the treatment that is planned requires radiation, a radiation oncologist will oversee the treatment and delivery of radiation. A team of cancer experts including nurses, specialists, counselors, dieticians, and assistants will help guide you throughout your treatment.

How is your treatment planned?

All cancer treatments are designed with the patient, the type of, and size of cancer. Radiation therapy is no different. Before radiation treatment is given patients will visit the facility to go over the plan of treatment that has been designed specifically for them. Radiation oncologists and radiation therapists will develop a plan based on x-rays and scans from simulators. Marks are then placed in strategic locations to pin point the areas to be treated. These marks will be placed each and every visit as the cancerous tumor changes. For cancers that are in the head, a guidance mask is created from a mold of the patients heads and is used to stabilize and pin point treatment due to the sensitivity of the area.

Does radiation therapy require hospitalization?

Radiation therapy is most often done on an outpatient basis however in some situations your radiation oncologist may recommend that you be admitted if they think it would enhance the success of your treatment. This is rare and usually does not occur as long as you are able to travel to and from the hospital for treatment.

What tests are performed in conjunction with radiation therapy?

Over the course of radiation treatment your oncologist will want to perform a number of follow up scans and x-rays to make sure the cancer is reacting to the radiation as expected. Occasionally additional lab work is required and is considered normal and nothing to worry about.

In our next installment on radiation therapy we will look deeper into what you can and cannot do during treatment and ways to combat side effects and more.

Replacing Equipment: Age Is Not the Only Factor

There are a number of factors that hospitals, medical facilities, and healthcare organizations must consider before they replace equipment besides age. Each year companies could potentially waste thousands of assets by focusing solely on the age of their equipment.

It wasn’t long ago that healthcare facilities were zealous to add all of the latest surgical equipment to their organization. From robotic surgery systems, linear accelerators, and other large scaled medical equipment were installed to keep physicians happy and be competitive.

However, in recent years budgets have gotten smaller and funds have become more restricted and facilities are seeing that equipment can’t just be discarded on a whim or purchased without advanced planning. Instead equipment needs to be repaired or refurbished and kept at peak performance for longer and a strategic approach needs to be taken to replace not only large scaled equipment but also universal equipment such as beds, linens, and so forth.

Proactive replacement planning is necessary between financial and clinical leaders within organizations need to work together to plan in order to achieve:

A reduction in expenses associated with service, parts, maintenance, and training
A decrease “close call” events that come with the use of older equipment with more precise maintenance schedules
A reallocation of assets that are underutilized throughout the facility
An ability to cross train employees throughout facility locations
An increase in consistency and standardization throughout facilities

When the above objectives can be achieved, a reduction in costs can occur with an increase in the quality of care patients receive.

Instead of the reactive strategy that medical facilities have embraced in the past more proactive approaches are being embraced. When purchasing new or refurbished medical equipment in a proactive approach allows leaders to embrace the situation over a period of time verse the reactive approach which tends to be more mission critical. Being proactive allows financial leaders in medical facilities to work with clinical leaders to plan for the addition of new equipment whether it is brand new or refurbished. When the replacement of equipment no longer is a life or death situation a better decision for the facility can be made.

Proactive planning in medical facilities allows for better outcomes overall. Financial teams and clinical teams can work together, armed with historical data, to have meaningful conversations instead of hypothetical ones. This allows better decisions to made for everyone throughout the facility from administrators and physicians to patients and care givers.

Radiation Therapy: Equipment Used by Veterinarians

When many of us think of cancer and how it affects us and the lives we lead we are more often than not picturing human patients however, we are not the only ones that affected by cancer. Today’s post is all about cancer in our pets and how their treatment includes similar treatment plans and medical equipment. Just like in the treatment of cancer within humans, pets use radiation therapy in various forms to shrink and kill tumors.

Radiation therapy delivered to pets can take various forms with the most common form of radiation treatment being delivered via linear accelerators with multi-leaf collimators. The multi-leaf collimator moves while the radiation treatment is on and being delivered to the patient. This allows the radiation therapist to sculpt the treatment around the tumor with very little damage done to cells outside of the area.

Another form of radiation therapy that is used to administer radiation treatment to pets and humans alike is Cyberknife, a linear accelerator that is paired with a robotic arm. This combination allows the machine to move around the patient. The radiation beam is turned off and on and is able to deliver radiation to the tumor from several angles. This ensures that the treatment conforms to the shape of the tumor within your pet.

Treatment can also be delivered through a Tomotherapy machine. A Tomotherapy unit is best described as a mix between a LINAC and CT scanner. It allows an image to be taken of the tumor right before radiation treatment is delivered. The therapist uses the images that are produced to guide radiation treatment to the tumor.

Tumors of the brain are treated with a very specific method of radiation known as the Gamma Knife. The word knife in the name may lead you to believe that cutting is involved however this is not the case. What occurs in Gamma Knife treatment is that very high doses of radiation are delivered to a very specific location on the brain while avoiding normal brain tissue.

As with humans, radiation therapy can be prescribed to pet patients through a variety of methods. One method is known as hyper-fractionated which means that many small doses of radiation are delivered to the pet with the goal being complete eradication of the tumor. This method is most often considered after surgery has been performed when there are small bits of the tumor left behind. Another method is known as hypo-fractionated in which radiation therapists use large doses of radiation in order to treat tumors that cannot be removed through surgery.

A more advanced scheme of delivering radiation treatment are Stereotactic Radiation Therapy, SRT. This includes both SRS, Stereotactic Radiosurgery, and SBRT, Stereotactic Body Radiation Therapy. These methods both deliver high doses of radiation in one, two, or three treatments.

General Radiotherapy Machines

The most common machine used to distribute external beam radiotherapy treatment is known as a linear accelerator or LINAC for short. LINAC systems generate high energy x-rays that are carefully aimed at the cancerous tumors. This process is done with much care given to direct the rays in a manner that does as little harm as possible to the healthy tissue surrounding the tumor. Linear accelerators are used to treat cancerous tumors on all areas of the body.

Some LINAC systems that are more advanced have the capability to deliver radiation on or near the surface of the skin. In this type of treatment electrons are used in replacement of high energy x-rays.

Newer linear accelerators have the ability to deliver radiation using Intensity Modulated Radiation Therapy, IMRT. These systems use multi-leaf collimators adjust the shape of the radiation beam to match the shape of the tumor. Without these adjustments LINAC systems would only be able to shoot radiation beams in the shape of a square or rectangle.

Radiographers all have different methods that they use to make sure the radiation treatment is targeting the exact location of the cancerous tumor. In its most fundamental form radiation is just a plain x-ray. Most linear accelerators work through digital imaging where the bottom arm of the machine takes an EPI, electronic portal image, or PI, portal image.

The image is compared by radiographers, to images that were generated during the planning process of your treatment as a type of checks and balances before treatment is delivered. The quantity of images that are taken to compare between depends on the departments protocol for imaging. Different types of radiotherapy treatment machines have an On-Board Imager, OBI, that is comprised of a Kv x-ray and detector. Higher quality images are obtained as a verification which allows for another radiotherapy technique known as Image Guided Radiotherapy, IGRT. With IGRT the accuracy of treatment is improved as daily changes are accounted for such as changes in organ location which can in turn reduce unpleasant side effects.

Electrons are generated and speed up to almost as close to the speed of light using electrical fields. The energy continues to increase until it collides with its intended target and then releases the photon energy. These photons enter the patient in an attempt to break down the DNA cells in the cancerous tumor. Healthy cells are most often able to mend themselves where as the cancerous tumors don’t and eventually die.

The Lifespan of a Linear Accelerator Parts

A linear accelerator has a wide range of built-ins that are designed to ensure patients are only given the recommended dose of radiation. The dosage recommended by the physician should never be ignored or changed as each treatment dosage is unique to each patient. Linear accelerators are comprised of several parts and mechanisms that age over time. This article will go over what facilities can expect when it comes to the average lifespan of the parts on LINAC systems, CT scanners, and other radiation oncology devices.

The Lifespan of Linear Accelerator Parts

The lifespan of linear accelerator equipment comes down to two major elements: usage and maintenance. On average medical facilities can expect that large scaled radiation equipment, such as linear accelerators, to last around 5 to 10 years before they begin to break down. Regular maintenance of your LINAC system keeps it running smoother, longer.

Examples of medical equipment lifespans are:

High use parts like Magnetron and iView detectors can last upwards of two to three years and with average use around four to six years.
X-ray tubes with high use last about eighteen months however with low usage can last if four years.
XVI detectors can last up to ten years within linear accelerators that have low usage whereas with high usage XVI parts last around five years.
Thyratron tubes have a lifespan of anywhere between three to five years.

Age and Usage of LINAC Parts

The average life expectancy of most linear accelerator parts depends on the legitimacy of the parts and the amount they are used. There are some parts that need to be replaced yearly with increased use, like the electron gun, however with low usage can last upwards of six years.

Environmental factors cannot be ruled out as it also affects the ion chamber of a linear accelerator, high humidity can cause a reduced lifespan. While an average ion chamber will only need a replacement after four years, one in an environment with high humidity will need a replacement after a year.

When to Replace Aging Parts

Replacing aging parts over time is necessary to avoid causing any damages to the equipment. Some corporation has a habit of considering the price of the equipment and the costs involved in changing the parts over time, and as such delayed the immediate replacement of an overdue or overused equipment. But, this is never a good yardstick of profit maximization, in the long run definitely, a breakdown of significant parts of the system may be disastrous to the equipment.

As a Linear Accelerator stays over time and ages, errors can creep in and this will have an adverse effect on the accuracy of the equipment. It is reasonable to expect a good 5 to 10 years of use out of the linear accelerator, but the maintenance also takes its toll on expenses if it stays much longer.

Companies can often get more usage out of a machine and ensure errors are resolved or controlled just by keeping the software up to date and replacing or upgrading linear accelerator parts as at when needed. Most importantly it is advisable to choose a reputable company to replace your LINAC’s aging parts as the wrong equipment can end up creating more damage to the machine instead of improving its performance. Most companies who sell linear accelerators and parts will have service contracts available that offer varying levels of support.

Preventive Maintenance Increases the Lifespan of LINAC Systems

LINAC systems are just one of the methods that facilities use to administer radiotherapy to patients with cancer. The high cost of this technology necessitates that preventive maintenance be routinely undertaken to extend the life span of linear accelerator parts and other radiation oncology equipment. Linear accelerator parts should be serviced to ensure high quality service delivery to patients. This will go a long way in helping cancer patients to access quality treatment.

The main parts of LINAC systems consist of linear accelerator wave guide and the beam defining system. Other parts include: handle control, couch with controls, touch guard and wall panel to hide stand. Being that it is electrical equipment and it’s in continuous use, the systems will breakdown if not cared for properly which will lead to system breakdown. Therefore, preventive maintenance should be regularly done to ensure that the system works effectively and efficiently. A complex system such as linear accelerators and ct scanners depends on electrical connections, once there is poor connection the machine will malfunction. All parts work in cohesion and if one of them is faulty it will affect other parts.

Linear accelerator parts are expensive and the cost of purchasing a new one is prohibitive. Proper preventive maintenance should be carried out from time to time. Most LINAC systems use water cooling because a constant temperature need to be maintained to ensure harmonious operation. However, there is advanced air-cooled chillers for LINAC cooling. This cooling system is expensive but once it is replaced the system works as if it is a new one.

LINAC parts can be procured from the original equipment manufacturer or through local dealers. There are many advantages to buying parts through companies that offer several parts (and services) instead of a more expensive OEM dealer. Often these companies offer less expensive, refurbished options and OEM parts with warranties. If the parts should malfunction within the period of coverage of warranty, they can help. However, one important decision one must make is that whether one should buy refurbished parts or new OEM parts. Refurbished parts are suitable for repairs and maintenance and the cost is lower than buying new ones. This decision is often mostly decided because of your budget however, just know that refurbished parts are just as reliable and as effective so either way you are getting quality parts.

A lot of factors need to be considered when servicing or maintaining LINAC system. One of such considerations is the response time of maintenance company versus original equipment manufacturer. The response time of maintenance companies tend to be quicker than that of the original manufacturer. Therefore, procuring the service of maintenance company will shorten the downtime of the medical equipment. Associated with this is the high level of expertise of engineers working with servicing and maintenance companies.

In most cases, these engineers were trained by original equipment manufacturers hence, the quality of service delivery. Another advantage of servicing and maintenance of linear accelerator parts is that servicing companies have favorable and flexible contract agreement, and this ensure that servicing of equipment is done comprehensively with minimal costs. This contract agreement includes periodical preventive maintenance without extra costs. Routine service and maintenance of LINAC parts are necessary for optimal functioning of the system and it greatly reduces the amount of downtime of the equipment and elongate its lifespan.

Learn more about Radparts and the variety of services and parts they offer to repair medical equipment including: linear accelerators parts, CT scanners parts, linac parts, and radiation oncology equipment at www.radparts.com. To contact one of our medical equipment repair specialists for parts or service call toll free 877.704.3838 for 24/7/365 support.