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Where a Radiation Oncologist Fits in Your Pancreatic Cancer Treatment

November 20, 2019

Treating hepatobiliary cancer involves getting the most powerful treatment directly to the source of the disease, which is where the skill of a radiation oncologist often comes in.

Dr. Timothy Boyd, a radiation oncologist with Hartford Hospital and part of the Hartford HealthCare Cancer Institute’s team approach to treating pancreatic cancers that are part of the category called hepatobiliary (HPB), said people with his specialized training on the HPB treatment team is what differentiates the radiation oncology program from others.

“The close interaction with our HPB cancer treatment colleagues – surgical oncologists, hepatobiliary surgeons, medical oncologists, gastroenterologists, radiologists and pathologists — is integral to the comprehensive treatment of patients with hepatobiliary malignancies,” he said in acknowledging Pancreatic Cancer Awareness Month this month.

Radiation oncologists bring expertise in technology that effectively directs radiation beams at the patient’s cancer. Their involvement starts at the HPB Tumor Board meetings with a subspecialty-trained team of experts that also includes gastroenterologists, radiation oncologists and surgical oncologists discussing each patient’s case to determine the best course of action. Navigators also help guide patients through each step of the journey.

“At these meetings, patients with HPB malignancies are presented and the team works together to formulate individualized treatment plans for them,” said Dr. Boyd.

Radiation oncologists also attend monthly Disease Management Team meetings where they:

  • Discuss what Dr. Boyd called “big picture” topics in the field.
  • Review standard operating procedure for different malignancies.
  • Discuss research protocols.
  • Develop patient care flow processes.
  • Present interesting updates from regional and national meetings.

As a specialty, radiation oncology offers HPB patients a host of high-tech treatments for their cancer. At Hartford HealthCare, those include:

  • Intensity modulated radiation therapy (IMRT), which Dr. Boyd explained allows the radiation oncologist to change the intensity of the therapy as it is being delivered from different directions outside of the body. This capability maximizes the dose of radiation that is delivered to the cancer and minimizes the dose of radiation to the normal tissues.
  • Image-Guided Radiation Therapy (IGRT), a technique that allows the radiation oncologist to image the patient with a high-quality X-ray or CT scan immediately before delivering each radiation treatment to assure the treatment’s accuracy.
  • Stereotactic Body Radiation Therapy (SBRT), which allows for the delivery of extremely precise, very intense doses of radiation to a cancer while minimizing damage to healthy tissues and controlling or compensating for organ motion.

“These techniques involve using radiation delivered from outside the body targeting a cancer in a very precise way. This limits the side effects to adjacent tissues,” Dr. Boyd said.

He added that Hartford HealthCare also offers a technique called Selective Internal Radiation Therapy (SIRT), also called radioembolization. For this, the radiation oncologist and interventional radiologist inject tiny microspheres of radioactive material into the arteries supplying a tumor. The spheres lodge in the small vessels of the tumor. The treatment is very useful, he said, for liver cancers or cancers that have spread to the liver.

At Hartford HealthCare, HPB cancer patients are seen by providers specializing in the treatment of such malignancies in locations throughout the community, which makes receiving care more convenient. The providers also provide access to innovative clinical trials through Memorial Sloan Kettering for patients, especially those with pancreatic cancer.

For more information on treatment for HPB cancers at Hartford HealthCare, click here.