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Radiation Oncology

Since 1969, Gundersen radiation oncologists have been stopping or slowing cancer with high-energy X-rays generated by devices called linear accelerators. Through our ongoing efforts to provide the best quality of care, Radiation Oncology offers you the latest technology. These innovations provide many advantages, including:

  • Better cancer detection
  • More targeted treatment
  • Reduced treatment and recovery time
  • Hope for once inoperable cancers
  • Greater protection of healthy tissue

At Gundersen, we prioritize our approach to care, patient outcomes and satisfaction, and continuous improvement. Our Radiation Oncology department is no exception. The goal: quality care, close to home, with fewer treatments.

Our team of experts offers the following technologies:

Radiation therapy treatment delivery

Radiation can come from a machine outside the body (external-beam radiation therapy) or from radioactive material placed in the body near cancer cells (internal radiation therapy, more commonly called brachytherapy).

External-beam radiation therapy is most often delivered in the form of photon beams (either X-rays or gamma rays). Many types of external-beam radiation therapy are delivered using a machine called a linear accelerator (also called a LINAC). A LINAC uses electricity to form a stream of fast-moving subatomic particles. This creates high-energy radiation that may be used to treat cancer.

Patients usually receive external-beam radiation therapy in daily treatment sessions over the course of several weeks. The number of treatment sessions depends on many factors, including the total radiation dose that will be given.

The type of radiation therapy prescribed by a radiation oncologist depends on many factors, including:

  • The type of cancer
  • The size of the cancer
  • The cancer’s location in the body
  • How close the cancer is to normal tissues that are sensitive to radiation
  • How far into the body the radiation needs to travel
  • The patient’s general health and medical history
  • Whether the patient will have other types of cancer treatment
  • Other factors, such as the patient’s age and other medical conditions

Volumetric-modulated arc therapy (VMAT)/Intensity-modulated radiation therapy (IMRT)

Volumetric-modulated arc therapy (VMAT), a type of intensity-modulated radiation therapy (IMRT), shapes a treatment beam to fit the contours of its cancerous target. With computerized "sculpting," high radiation doses can be delivered to a tumor while sparing normal surrounding tissue and organs. This minimizes side effects and means healthy tissue is less likely to be injured. Some cancers we couldn’t have treated before are now eligible for radiation therapy, thanks to these methods.

Stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT)

Stereotactic radiosurgery (SRS) is an outpatient procedure that requires no incision. It eliminates complications and substantial recovery time—think surgery without the knife. When traditional cancer surgery is not an option due to other illnesses, tumor location or unacceptable risk to nearby organs, radiosurgery can give new hope for recovery.

SRS delivers highly focused doses of radiation to a target and has minimal effects on surrounding tissue and organs. This single session treatment has such a dramatic effect on the targeted tissue that changes are considered "surgical."

Like stereotactic radiosurgery, stereotactic body radiation therapy (SBRT) uses advanced imaging to deliver a targeted dose of radiation to a tumor. The highly accurate treatment is limited to the site of the tumor, meaning less healthy tissue surrounding the treatment area is affected by radiation. It is usually delivered in one to five sessions. The most common site treated at Gundersen is the lungs.

Our highly skilled team is very competent in this procedure, as we do well over 200 treatments per year.

Image-guided radiation therapy system (IGRT)

Our image-guided radiotherapy and radiosurgery system is capable of treating complex cancers in areas such as the head and neck, lung, breast, liver and abdomen. Gundersen employs the only True Beam Linear Accelerator radiation therapy system with ExacTrac® image guidance (BrainLab) in La Crosse County. One of its unique features, and an advantage over other radiation treatment models, is the high-intensity delivery mode. Fast delivery allows for reduced chances of tumor motion during treatment, which helps protect surrounding healthy tissues.

Prostate permanent seed implant

Ultrasound-guided radioactive seed implantation in cancerous prostate glands is an effective method of treatment when early stage cancer is confined to the prostate. The procedure, which Gundersen has offered patients for more than 20 years, does not require any surgical incisions.

Low rates of complications such as incontinence and impotence make this method appealing for those who are candidates. An eight-year Gundersen study shows this outpatient procedure allows more rapid return to normal activities with fewer lasting side effects and no significant reduction of projected cure rates.

Respiratory gating

The natural motion of breathing can cause the location of a tumor to change slightly every time a person inhales and exhales. Respiratory gating uses state-of-the-art technology to track a patient’s breathing and how the respiratory cycle shifts the treatment location.

Using detailed measurements, respiratory gating makes sure that the tumor is only treated when it is in the correct position, increasing the accuracy of treatment and reducing potential damage to healthy tissue in the surrounding area.

High dose rate (HDR) brachytherapy

High dose rate (HDR) brachytherapy has shortened radiation treatments for some gynecologic cancers from days to hours. With HDR, we can give higher doses of radiation during a clinic visit to get rid of cancer and reduce the chance of recurrence.

Postoperative brachytherapy for endometrial cancer – Previously, patients were admitted to the hospital for complete bed rest because they had to hold relatively still for two or three days. They were also radioactive during this period. With HDR, treatments are completed in two to five outpatient sessions, each lasting one to two hours. Patients can go home without worrying about exposing family members to residual radioactivity.

Treating inoperable cervical cancer - The previous treatment required two hospitalizations. The much shorter HDR process includes applicator placement, followed by 10 minutes of radiation while the patient is sedated. The patient usually returns home the same day.

Positron emission tomography (PET)

Positron emission tomography can detect cancer and other diseases earlier, more accurately and with less patient discomfort than other diagnostic procedures. Total-body PET imaging can uncover abnormalities other methods might not detect. This information allows medical experts to intervene earlier, plan more specific treatment and monitor effectiveness. PET scans can replace biopsies for certain types of masses and avoid unnecessary diagnostic and therapeutic surgeries.

PET images help the physician distinguish between malignant and benign (non-cancerous) tumors, locate cancer "hot spots," determine the extent and stage of the disease, and track how rapidly tumors are growing. These images also are valuable in monitoring the progress of cancer treatment and the recurrence of cancer.

In addition to using PET images our providers will often use an MRI scan to guide our treatment recommendations and radiation treatment plans, which is also known as image guided radiation therapy (IGRT).

Side effect management

Our innovative technology has reduced the amount and extent of radiation side effects. However, all patients respond differently to treatment. It’s important to talk to your doctor about how you are feeling throughout your treatment process so that he or she can help you manage any discomfort you may be experiencing due to treatment.

While side effects vary by the type of treatment and treatment area, here are some of the most reported and tips on how to relieve them.

  • Nausea and vomiting: Drink plenty of liquids; eat foods that are easy on your stomach such as broth, chicken, crackers, white toast and potatoes; eat smaller meals more frequently throughout the day instead of three larger meals; ask your doctor about medicine that may decrease nausea.
  • Fatigue: If you feel up to it, take a short walk or bike ride to re-energize; nap throughout the day; get at least eight hours of sleep per night; reduce the number of things on your to-do list every day; reach out to your support network when you need help.
  • Hair loss: Join a support group or talk with someone who has experienced what you’re going through; use a mild shampoo; avoid hairdryers and hair clips.
  • Skin changes: Ask your doctor for skin product recommendations such as what lotions or soaps you should use; wear loose clothing; cover your treatment area when outside; bathe in warm water rather than hot; gently pat your skin after washing it instead of rubbing it.
  • Urinary changes or diarrhea: Drink plenty of fluids; avoid drinks that contain alcohol, caffeine and carbonation; limit spicy and fried foods; ask your doctor what medications may help.

For more information about side effect management, contact Radiation Oncology.

American College of Radiation (ACR) accredited

Gundersen Radiation Oncology, a proven leader in this discipline, has been accredited by the American College of Radiology (ACR) since 2002.

What does the accreditation seal mean?

American College of Radiation accredited facility seal

When you see the ACR seal you can rest assured that your treatment will be done at a facility that has met the highest level of quality and radiation safety. The facility and its personnel have gone through a comprehensive review to earn accreditation status by the American College of Radiology (ACR), a national professional organization serving more than 36,000 diagnostic/interventional radiologists, radiation oncologists, nuclear medicine physicians and medical physicists.

What does ACR accreditation mean?

Our facility has voluntarily gone through a vigorous review process to ensure that we meet nationally accepted standards of care.

Our personnel are well qualified through education and certification to administer your radiation therapy treatments.

Our equipment is appropriate for the treatment you will receive, and our facility meets or exceeds quality assurance and safety guidelines.

Why should I be treated at an ACR facility?

A diagnosis of cancer is usually a life-changing experience for patients and their loved ones. As they seek treatment for their disease, cancer patients need to know that they are receiving safe and appropriate care. To achieve ACR accreditation, our facility’s personnel qualifications, equipment requirements quality assurance and quality control procedures have gone through a rigorous review process and have met specific qualifications. It’s important for patients to know that every aspect of the ACR accreditation process is overseen by board-certified, expert radiation oncologists and medical physicists.

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