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Radiation Therapy

There have been vast improvements in the delivery of radiation therapy for cancer patients over the past 10 years. Radiation therapy for cancer uses focused, high-energy waves to attack tumor cells. Machines used for this today employ multiple beams of radiation, directed at different angles to different parts of the body, and is used to treat is more focused to treat the primary tumor, while limiting radiation exposure to normal, adjacent tissue. The machines used today employ multiple beams of radiation, directed at different angles to different parts of the body. Modern radiation techniques allow for movement in the abdomen while a patient breathes and can better target the tumors during that motion.

Contrary to some patients’ beliefs or fears, radiation therapy is unlikely to burn the skin, to leave red marks, or cause skin toxicity. Similar to an X-ray, the treatment does not cause pain when administered and will not leave patients radioactive.

Standard, conventional radiation therapy is delivered Monday through Friday, once a day, over a five- to six-week period. The treatment takes approximately 15-20 minutes. Often, patients receiving radiation therapy are given an oral chemotherapy that is taken on the days of radiation therapy to help make radiation treatments work better.  In some cases, Johns Hopkins experts offer palliative radiation therapy. This treatment is typically given over a two-week period and is used to relieve pain for patients or slow local tumor growth.

Radiation therapy services, offered through the Department of Radiation Oncology, provide a wide variety of pancreatic cancer therapies and expert consultation.

Stereotactic body radiation therapy (SBRT)

Stereotactic body radiation therapy (SBRT) is a form of focused radiation used successfully to treat brain and lung cancers.  The technique, developed at the Johns Hopkins Kimmel Cancer Center and a few other institutions across the country, is seen as a promising newer treatment for pancreas cancer.

SBRT uses high doses of precisely targeted beams of radiation instead of scalpels to cut through tumors and kill cancer cells. It can be a valuable tool in treating cancer as these targeted beams can reach tumors that are inaccessible by traditional surgical means. However, it is not recommended for every type of cancer. Higher doses of radiation can mean greater toxic side effects to normal tissue; therefore, this type of therapy should only be administered by departments experienced in its delivery. Johns Hopkins is among the leading innovators of new technologies, and our experts are leading the way in collecting and analyzing data from our patients and other institutions to determine the safety and effectiveness of these new medical technologies.

Less is More: A Closer Look at Stereotactic Body Radiation Therapy for Pancreas Cancer

SBRT is an exciting area of radiation therapy that can help advance care for patients with pancreatic cancer. As it only requires five days of therapy, as compared to five or six weeks of traditional radiation therapy, SBRT is more convenient for patients, but it also minimizes time off of chemotherapy and may be more biologically effective against the tumor. One of the difficulties with pancreatic cancer is that the tumors often involve the larger blood vessels around the pancreas. Investigators at the Johns Hopkins Kimmel Cancer Center are learning that SBRT can be helpful in shrinking tumors off of the vessels, allowing surgeons an improved ability to surgically remove the tumor. Studies from our institution, as well as in conjunction with other leading institutions such as Memorial Sloan Kettering Cancer Center and Stanford Cancer Center, have shown with the proper safety checks, this treatment can be safe and efficacious.

Further studies and longer term follow-up are needed to confirm these early results. The next step will be to combine novel drugs and vaccines with stereotactic radiotherapy to try and augment its ability to kill cancer cells.

 

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