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Radiation oncology safety: What you should know

Radiation therapy is a safe, highly effective cancer treatment. However, because radiation is invisible and works inside your body, it can be hard to put your trust into a treatment you can’t see or touch.

At Community Hospital, we have a team of expertly trained clinicians using advanced technology to ensure that you receive the safest, most effective treatment available. Each radiation therapy treatment plan is methodically developed and reviewed, then carried out by a team using many safety checks to ensure that each treatment is given as planned.

Still, we know patients and caregivers have questions about radiation therapy. We encourage you to ask questions about any aspect of treatment, including how it  works, how we ensure the accuracy of targeting, what safety procedures we use, and what side effects you may experience. What, specifically, should you ask? We’ve put together a list of questions you might find helpful, along with responses about radiation therapy at Community Hospital. If you are considering treatment elsewhere, these questions will help you determine the quality of that provider.

Frequently asked questions

Staff training

  • Who is involved in planning my radiation treatment? Our doctors, board-certified radiation oncologists, are the leaders in all aspects of radiation treatment planning. They work with a team of skilled professionals including our board-certified medical physicist, who reviews treatment plans, provides quality control of equipment, consults on radiation dose, and helps ensure radiation safety measures are followed; two medical dosimetrists, who calculate safe and effective radiation doses and develop treatment plans; and radiation therapists.
  • Who will review my treatment plan? At Community Hospital, treatment plans are reviewed by a radiation oncologist and a medical physicist. They review the plan before the first treatment and each week throughout the course of treatment.
  • Is my radiation oncologist certified by the American Board of Radiology (ABR)? Yes, all radiation oncologists at Community Hospital are certified by the ABR.
  • What are the certifications and qualifications of the medical physicist? The physicist holds a master's degree and is also certified by the ABR.
  • What training does staff receive before using new technologies? Staff members are required to demonstrate competency in a defined set of skills and abilities. Before new technologies are used, staff members receive thorough training on the safe use of each device by the company that makes it and must demonstrate competency before using the device.
  • Does all staff regularly participate in continuing medical education? Yes. Radiation therapists are required to complete 24 continuing education hours every 2 years. Registered nurses in Radiation Oncology are  required to complete 30 continuing education hours every 2 years. The doctors in Radiation Oncology must complete 50 continuing education hours annually.
  • Does the staff participate in multidisciplinary tumor boards? Yes. Staff members participate in multidisciplinary tumor boards, in which doctors and other clinicians from a range of medical disciplines review cases and discuss treatment.

Treatment planning

  • How is the treatment plan checked to make sure it is best for me? Every treatment plan is reviewed and put through a series of quality assurance checks that ensure the doctor’s prescription for radiation is followed from the first day of  therapy to the last day of therapy. Those checks include a review by our medical physicist, who ensures that the plan fulfills the intent of the doctor’s prescription. The checks make sure that all of the plan parameters to target the cancer have been correctly transferred from the treatment planning computer to the treatment machine, a linear accelerator. To verify the accuracy, the physicist also performs a second independent calculation of the treatment time needed to deliver the radiation dose. Next, radiation therapists  review  the plan to ensure that all parameters are correct.
  • What other procedures do you have in place so that the treatment team is able to treat me safely? In addition to the checks and balances already discussed, we use a computerized “record and verify system.” This system stores a copy of the treatment parameters in a centralized database and compares what is about to be treated and how with the information in  the database.  This greatly reduces the chance that a patient is treated incorrectly.
  • How can I be assured that my treatment is being done correctly every day? Our record and verify system stores important data about you and your treatment plan. One piece of data is a photo of your face, which is displayed on our computer monitor when your electronic treatment record is opened. Every day before your treatment, the therapists open your electronic record and ask you to confirm that the photo is of you, ensuring that only your treatment plan will be delivered. Patients are also asked to log in with an electronic identification badge daily.
  • What is the difference between a medical error and a side effect? Side effects are a normal and expected consequence of any kind of medical treatment.  Many people go through their radiation treatments without side effects. In most cases side effects can be easily managed by your radiation oncologist. A medical error is an unusual and unexpected event, usually the result of human error or a machine malfunction. A medical error may have no noticeable short- or long- term consequences. We have put into place many layers of safety and quality control, greatly reducing the likelihood of a medical error.

During and after treatment

  • What kinds of safety checks do you perform each day? Every day that we treat patients, our therapy staff performs a series of tests that verify the output of the radiation beam. In addition, they check to make sure that the red positioning lasers on the wall and ceiling are all correctly aligned.
  •  How often does the medical physicist check the machines used during my treatment to ensure they are working properly? Our medical physicist performs quality assurance tests on a monthly and annual basis, as required by the state of California and as recommended by the American College of Radiology.
  • If I have side effects after my treatment, who should I call? We highly recommend that you contact your radiation oncologist. They are trained to diagnose and treat side effects that may result from your treatment. Your radiation oncologist will continue to see you periodically for months after you have completed your therapy. A physician is always available in our department during treatment.
  • I have a question about a radiation treatment I had many years ago. Who should I call? Our radiation oncologists can answer your questions related to previous radiation treatments.

General

  • If the equipment isn't working and my treatment is delayed or postponed, who checks that it is safe to use again? And will this delay affect my cancer?  All repairs to our treatment machines that may have an impact on the delivery of radiation to our patients are reviewed by our medical physicist before the machine is released for clinical use. In most cases, delays related to equipment repair are minor and will have no impact on your outcome.
  • Do you do peer review of cases? Yes. Each week our team of professionals, including our two radiation oncologists, nurses, physicist, dosimetry staff,  dietitian,  social workers, and our radiation therapists discuss the progress of each patient. At this time, films are reviewed to ensure that the tumor is being properly targeted. These sessions give us an opportunity to discuss any changes in the patient’s progress that might require a change in the treatment plan, dietary needs, or any other need the patient may have related to his or her therapy.
  • Will you take imaging scans regularly during my treatment to verify position of the beam during my treatment? Who reviews those scans? Depending on the treatment plan and the proximity of the tumor to critical healthy organs, positioning images may be taken daily or weekly. Those images are reviewed by our radiation oncologists.

If you have additional questions, please contact Radiation Oncology at 625-4630.

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