If you have been diagnosed with cancer and require radiation therapy, you may be referred to us by your medical oncologist (cancer doctor) or surgeon. Your initial appointment is a consultation with your radiation oncologist, who will review your case, examine you and discuss treatment options. Your doctor may also present your case to the Saint Mary's Tumor Board, during which physicians of all specialties will discuss your case and recommend the best course of action.
Depending on the type and location of cancer, Saint Mary's state-of-the-art technology is able to provide the most focused radiation fields to minimize injury to other surrounding body tissues.
Saint Mary’s is home to the region’s first and only CyberKnife, the most technologically advanced radiation delivery system available in the world. CyberKnife is a computer-controlled radiosurgery system that delivers radiation to tumors anywhere in the body. With sub-millimeter accuracy, it avoids damage to surrounding healthy tissue, while its precision allows physicians to reach cancerous and benign tumors that in the past may have been impossible to treat. Patients experience no pain during the noninvasive treatments and are able to immediately return to normal activity.
All simulations start with a special CT scan, which allows us to define the target region three-dimensionally and in relationship to normal tissue that we try to avoid. The CT scanner takes digital pictures of a patient's tumor site for use in planning the radiation treatment. The process usually takes two visits. On the first visit, the area of interest is digitally scanned and the images sent to your radiation oncologist and other treatment planning experts. The radiation oncologist will define in three-dimensional space the area to be treated as well as normal tissues to avoid. Considerable planning and physics calculations are performed by the physics team. On the second visit, the treatment set-up is verified, and reference marks (pinpoint tattoos) are placed on the patient. These marks will be used to assure pinpoint accuracy of the radiation treatment. Altogether, this process takes approximately one-to-two hours.
The ONCORTM Avant Garde Linear Accelerator, manufactured by Siemens Medical Solutions, is used to deliver streams of radiation to a specific part of a patient's body. During each treatment, the patient is positioned on the treatment table, using laser lights and the patient's reference marks to assure pinpoint accuracy. The patient is left alone in the treatment room while radiation is being delivered, but is closely monitored on a video monitor. An audio intercom also keeps the patient in constant contact with the therapist. In general, each treatment visit lasts approximately 15 minutes; however, some treatments may require more time, such as Intensity Modulated Radiation Therapy (IMRT), which focuses multiple radiation beams directly on the tumor itself. The intensity of these very precise beams can vary so that highest possible dose is used with reduced potential damage to surrounding tissues. The difference between IMRT and conventional radiation therapy is that the avoidance of normal tissue, in addition to precisely locating the target region, is taken into account when planning your treatment.
High-Dose-Rate Brachytherapy (HDR)
The HDR machine inserts a small radioactive "seed" (in this case, Iridium-192) into the area of treatment through special applicators placed into body tissues or cavities as an outpatient, or occasionally in the operating room. Each HDR treatment lasts five-to-10 minutes, and the radiation source is removed once treatment is completed. The patient is not radioactive when he or she leaves the treatment room. This form of internal radiation allows the delivery of higher doses to the tumor region while sparing normal tissues more effectively. Accelerated Partial Breast Irradiation (MammoSite) is a form of HDR for certain breast cancer patients. It shortens a six-week course of daily external radiation into 10 outpatient treatments given over five days. HDR replaces inpatient gynecologic procedures lasting several days with three-to-six short outpatient procedures. It is equally effective while increasing convenience for the patient. HDR also is an excellent option for many men with prostate cancer, often in conjunction with external radiation.
Permanent Seed Brachytherapy for Prostate Cancer
This is another form of brachytherapy where 60-100 tiny Iodine 125 or Palladium 103 seeds are inserted into the prostate during an outpatient surgery lasting less than an hour. Most men are able to return to work and resume normal activity within days after this curative cancer treatment. This is an excellent option for many, with proven long-term effectiveness. In some cases, permanent seed brachytherapy may be combined with five weeks of external radiation.
Physicians shown are independent practitioners and not employees of the hospital.
Expert Care from Saint Mary's Radiation Oncology Physicians
Dr. Jonathan Tay
Jonathan Tay, MD, has been medical director of Saint Mary’s Radiation Oncology Department since 2005, and has been instrumental in the establishment of cancer clinical trials at Saint Mary’s and the implementation of the region’s only CyberKnife program. As medical director of Reno Cyberknife, patients are cared for by some of the region’s leading surgeons and radiation oncologists, using the most technologically advanced radiation delivery system available in the world. Dr. Tay's specialties include prostate seed implantation, high-dose-rate and low-dose-rate intracavitary and interstitial brachytherapy, endovascular brachytherapy, 3-D conformal radiotherapy, intensity modulated radiotherapy and stereotactic radiosurgery. Dr. Tay is also chair of the Saint Mary's Cancer Committee. Dr. Tay received his medical doctorate at Michigan State University and completed residencies in internal medicine at Naval Hospital in Oakland, CA, and in radiation oncology at the Saint Mary’s and Integrated Hospitals Program in San Francisco.
Dr. Katie Legarza
Katie Legarza, MD, received her medical doctorate from the University of Nevada School of Medicine. She completed one year of residency in internal medicine at Cottage Hospital in Santa Barbara, CA, before going on to complete four years of residency training in the specialty of radiation oncology at California Pacifica Medical Center in San Francisco. Board-certified in radiation oncology, she is an active member of the Cancer Committee at Saint Mary's Regional Medical Center. She is skilled in intensity modulated radiation therapy techniques and high-dose-rate brachytherapy. She is one of the core team members for the development of the CyberKnife stereotactic cranial and body radiosurgery program.
Dr. Jaime Shuff
Jaime Shuff, MD, received her medical doctorate at the University of Nevada School of Medicine in 2000. She then completed her intern year in Reno before completing her four-year residency in radiation oncology at the Medical College of Wisconsin. She is skilled in intensity modulated radiation therapy techniques and high-dose-rate brachytherapy, and her interests include gynecological and gastrointestinal malignancies.