Valiasr Radiotherapy Oncology Center, Zanjan, Iran
Zanjan Valiasr Radiotherapy Oncology Center:
Zanjan Valiasr Radiotherapy Oncology Center is a charity center provides financial support and services to cancer patients such as screening program and patient training without any charge for diagnosing cancer at the early stage. The aim of our association is to support cancer patients during the whole treatment period by accommodation and medication supply
What is Cancer?
Cancer is abnormal increasing of the number of cells, with the potential to invade or spread to other parts of the body. Not all tumors or lumps are cancerous; benign tumors do not spread to other parts of the body. There are over 100 different known cancers that affect humans. Cancers are often described by originated part of body. However, some body parts contain multiple types of tissue, so for greater precision, cancers are additionally classified by the type of cell that the tumor cells originated from. These types include:
Cancers derived from epithelial cells. This group includes many of the most common cancers, particularly in older adults. Nearly all cancers developing in the breast, prostate, lung, pancreas, and colon are carcinomas.
Cancers arising from connective tissue (i.e. bone, cartilage, fat, nerve), each of which develop from cells originating in mesenchymal cells outside the bone marrow.
Lymphoma and Leukemia:
These two classes of cancer arise from blood cells. Leukemia is the most common type of cancer in children accounting for about 30%. However, far more adults develop lymphoma and leukemia.
Germ Cell Tumor:
Cancers derived from pluripotent cells, most often presenting in the testicle or the ovary (seminoma and dysgerminoma, respectively).
Cancers derived from immature precursor cells or embryonic tissue. Blastomas are more common in children than in older adults.
The Common Cancer that treated in this center
: Breast cancer can occur in both men and women, but it's far more common in women. Substantial support for breast cancer awareness and research funding has helped improve the screening and diagnosis and advances in the treatment of breast cancer. Breast cancer survival rates have increased, and the number of deaths steadily has been declining, which is largely due to a number of factors such as earlier detection, a new personalized approach to treatment and a better understanding of the disease.
: Colon cancer is cancer of the large intestine (colon), the lower part of your digestive system. Rectal cancer is cancer of the last several inches of the colon. Together, they're often referred to as colorectal cancers. Most cases of colon cancer begin as small, noncancerous (benign) clumps of cells called adenomatous polyps. Over time some of these polyps become colon cancers. Polyps may be small and produce few, if any, symptoms. For this reason, doctors recommend regular screening tests to help preventing colon cancer by identifying polyps before they become cancerous.
: Stomach cancer is cancer that occurs in the stomach — the muscular sac located in the upper middle of your abdomen, just below your ribs. Your stomach receives and holds the food you eat and then helps to break down and digest it. Another term for stomach cancer is gastric cancer. These two terms most often refer to stomach cancer that begins in the mucus-producing cells of the stomach (adenocarcinoma). Adenocarcinoma is the most common type of stomach cancer.
Hodgkin and Non-Hodgkin Cancer
: Both Hodgkin's lymphoma and non-Hodgkin's lymphoma are lymphomas — a type of cancer that begins in a subset of white blood cells called lymphocytes. Lymphocytes are an integral part of your immune system, which protects you from germs. The main difference between Hodgkin's and non-Hodgkin's lymphoma is in the specific lymphocyte each involves. A doctor can tell the difference between Hodgkin's and non-Hodgkin's lymphoma by examining the cancer cells under a microscope. If in examining the cells, the doctor detects the presence of a specific type of abnormal cell called a Reed-Sternberg cell, the lymphoma is classified as Hodgkin's. If the Reed-Sternberg cell is not present, the lymphoma is classified as non-Hodgkin's. Additional tests may be used to determine the specific type of lymphoma. Your type of lymphoma helps your doctor determine your prognosis and your treatment options. The types of lymphoma have very different disease courses and treatment choices, so an accurate diagnosis is an integral part of getting the care you need.
: Kidney cancer is cancer that originates in the kidneys. Your kidneys are two bean-shaped organs, each about the size of your fist. They're located behind your abdominal organs, with one kidney on each side of your spine. In adults, the most common type of kidney cancer is renal cell carcinoma. Other less common types of kidney cancer can occur. Young children are more likely to develop a kind of kidney cancer called Wilms' tumor. The incidence of kidney cancer seems to be increasing. One reason for this may be the fact that imaging techniques such as computerized tomography (CT) scan are being used more often. These tests may lead to the accidental discovery of more kidney cancers.
: Liver cancer is cancer that begins in the cells of your liver. Your liver is a football-sized organ that sits in the upper right portion of your abdomen, beneath your diaphragm and above your stomach. The most common form of liver cancer is hepatocellular carcinoma, which begins in the main type of liver cell (hepatocyte). Other types of cells in the liver can develop cancer, but these are much less common. Not all cancers that affect the liver are considered liver cancer. Cancer that begins in another area of the body — such as the colon, lung or breast — and then spreads to the liver is called metastatic cancer rather than liver cancer. And this type of cancer is named after the organ in which it began — such as metastatic colon cancer to describe cancer that begins in the colon and spreads to the liver.
: Lung cancer is a type of cancer that begins in the lungs. Your lungs are two spongy organs in your chest that take in oxygen when you inhale and release carbon dioxide when you exhale. Lung cancer is the leading cause of cancer deaths in the United States, among both men and women. Lung cancer claims more lives each year than do colon, prostate, ovarian and breast cancers combined. People who smoke have the greatest risk of lung cancer. The risk of lung cancer increases with the length of time and number of cigarettes you've smoked. If you quit smoking, even after smoking for many years, you can significantly reduce your chances of developing lung cancer
: Ovarian cancer is a type of cancer that begins in the ovaries. Women have two ovaries, one on each side of the uterus. The ovaries — each about the size of an almond — produce eggs (ova) as well as the hormones estrogen and progesterone. Ovarian cancer often goes undetected until it has spread within the pelvis and abdomen. At this late stage, ovarian cancer is more difficult to treat and is frequently fatal. Early-stage ovarian cancer, in which the disease is confined to the ovary, is more likely to be treated successfully. Surgery and chemotherapy are generally used to treat ovarian cancer.
: Pancreatic cancer begins in the tissues of your pancreas — an organ in your abdomen that lies horizontally behind the lower part of your stomach. Your pancreas secretes enzymes that aid digestion and hormones that help regulate the metabolism of sugars. Pancreatic cancer often has a poor prognosis, even when diagnosed early. Pancreatic cancer typically spreads rapidly and is seldom detected in its early stages, which is a major reason why it's a leading cause of cancer death. Signs and symptoms may not appear until pancreatic cancer is quite advanced and complete surgical removal isn't possible.
: Prostate cancer is cancer that occurs in a man's prostate — a small walnut-shaped gland that produces the seminal fluid that nourishes and transports sperm. Prostate cancer is one of the most common types of cancer in men. Prostate cancer usually grows slowly and initially remains confined to the prostate gland, where it may not cause serious harm. While some types of prostate cancer grow slowly and may need minimal or no treatment, other types are aggressive and can spread quickly. Prostate cancer that is detected early — when it's still confined to the prostate gland — has a better chance of successful treatment.
: Testicular cancer is cancer that starts in the testicles, the male reproductive glands located in the scrotum. Testicular cancer occurs in the testicles (testes), which are located inside the scrotum, a loose bag of skin underneath the penis. The testicles produce male sex hormones and sperm for reproduction. Compared with other types of cancer, testicular cancer is rare. But testicular cancer is the most common cancer in American males between the ages of 15 and 35. Testicular cancer is highly treatable, even when cancer has spread beyond the testicle. Depending on the type and stage of testicular cancer, you may receive one of several treatments, or a combination. Regular testicular self-examinations can help identify growths early, when the chance for successful treatment of testicular cancer is highest.
: Endometrial cancer is a type of cancer that begins in the uterus. The uterus is the hollow, pear-shaped pelvic organ in women where fetal development occurs. Endometrial cancer begins in the layer of cells that form the lining (endometrium) of the uterus. Endometrial cancer is sometimes called uterine cancer. Other types of cancer can form in the uterus, including uterine sarcoma, but they are much less common than endometrial cancer. Endometrial cancer is often detected at an early stage because it frequently produces abnormal vaginal bleeding, which prompts women to see their doctors. If endometrial cancer is discovered early, removing the uterus surgically often cures endometrial cancer.
is the most common form of radiation therapy. It is called “external” because the radiation is beamed from the source outside of the body right through to the tumor tissue. For this purpose, a machine is used to give a dose of energy such as x-rays, to attack the cancer cells. External radiation is usually given daily over several weeks. Usually appointment time is around 20 to 30 minutes but delivering dose of radiation takes several seconds.
At RROC, external beam radiotherapy is usually delivered to the patient via several techniques that have been described below briefly:
3D Conformal Radiotherapy
), we mean treatments that are based on 3-D anatomic information and use treatment fields that conform as closely as possible to the target volume in order to deliver adequate dose to the tumor and minimum possible dose to normal tissue. In 3DCRT, most treatments are delivered with radiation beams that are of uniform intensity across the field. Occasionally, wedges or compensators are used to modify the intensity profile to offset contour irregularities and/or produce more uniform composite dose distributions.
Total Body Irradiation (TBI)
Total Body Irradiation (TBI) is a clinical radiotherapy technique to deliver a prescribed dose to a patient's whole body. This entire body irradiation has been proven to be a suitable treatment for Lymphomas, non-Hodgkin's Leukemia and aplastic anemia. In case of allogeneic bone marrow or stem cell transplant, the patient usually receives a concurrent TBI and chemotherapy for immune system suppression. The purpose of TBI is to: Eradicate remaining cancer cells ،
Cause depression of the immune system (immunosuppression) to help reduce the risk of transplanted tissue being rejected by the body ،
Treat body areas where chemotherapy alone may not eradicate. It will be clinically commissioned by early 2016 for Primus Plus linac (6&15MV) as the machine.
Medical Physics Department
The main responsibility of radiation oncology medical physicists (ROMPs) is to assure the best possible treatment of the patients. To achieve this, the team task allocation was determined for Medical Physics department at RROC into t hree main sections: Linac Dosimetry and Quality Assurance, Treatment Planning and Health Physics.
Linac Dosimetry and Quality Assurance Team Responsibilities
- Performance specification, acceptance testing and commissioning of all the new equipment
- Calibration of radiation producing machines and radioactive sources
- Development and maintenance of a quality assurance program for all treatment modalities and equipment to assure that patients receive prescribed doses and dose distributions within the acceptable level of accuracy
Treatment Planning Team Responsibilities
- Maintenance of all instruments required for source calibration and radiation dose measurements and first order maintenance of the treatment units in conjunction with radiation oncology engineers
- Consultations with radiation oncologists on the physical and radiobiological aspects of patients’ treatments, and the development of treatment plans.
- Calculation of dose distributions and machine settings for patient treatments.
Radiation Protection Team Responsibilities
- Approve the final plans by secondary MU check software (Radcalc software is under commissioning).
- Development and administration of the radiation safety program.
- Administration of a personnel radiation protection and monitoring program.
- Supervision of source preparation and handling during brachytherapy, and the continual maintenance of the brachytherapy source inventory.
- Calculation of shielding required for new or renovated treatment rooms, radioactive-source storage and handling facilities, and brachytherapy patient rooms.