Fred Hutchinson Cancer Center patients get radiation therapy from leading radiation oncologists who specialize in specific cancers. Your Fred Hutch radiation oncologist knows the most advanced options for treating your disease and will design a personalized treatment plan to target your tumor.
We offer a full range of radiation therapy, including access to the latest and most innovative options through our clinical trials.
You may get radiation therapy at one or more of these locations. Your radiation oncology team will tell you where to go. Our centers feature state-of-the-art equipment so your doctor and care team can deliver the right treatment for you.
Leaders in Radiation Oncology
IORT: UW Medical Center is the only hospital in the Pacific Northwest to offer intraoperative radiation therapy (IORT), a radiation treatment that is done during surgery. Fred Hutch doctors at UW Medical Center have years of experience treating patients with this therapy.
Neutron Therapy: UW Medical Center is the only place in the U.S. that offers neutron therapy, a very powerful type of radiation therapy that works well on salivary gland tumors and some other radiorefractory cancers. UW Medical Center is also the only place in the world that offers a highly conformal neutron therapy called intensity modulated neutron therapy (IMNT). IMNT carefully shapes the radiation beams so they closely fit the area of the cancer. This means that less radiation goes to healthy tissues and organs.
Proton Therapy: Fred Hutchinson Cancer Center – Proton Therapy is led by world-class experts in proton therapy. It is one of only two centers like it in a seven-state region.
Frequently Asked Questions
Radiation oncology is an area of medicine that uses high-energy beams to treat some cancers. The treatment itself is called radiation therapy, or radiotherapy. A radiation oncologist is a medical doctor who specializes in radiation therapy.
Radiation therapy (also called radiotherapy) works by damaging the DNA inside cancer cells using high-energy beams. After enough damage occurs, the cells cannot multiply, and they die.
Yes. There are two main types of radiation therapy: external-beam radiation therapy (EBRT) and internal radiation therapy. EBRT means that radiation comes from a source outside the body, like a high-energy beam. Internal radiation therapy means that a radioactive substance is put inside the body so it can send out radiation. The radiation is delivered either as photons (such as X-rays or gamma rays) or subatomic particles (tiny particles that are smaller than atoms, such as electrons or protons).
People get radiation therapy to cure, stop or slow their disease. It is also used to reduce the risk that cancer will come back or to help with symptoms caused by tumors. The goal of radiation therapy is to destroy as many cancer cells as possible while causing the least amount of damage to healthy cells.
Radiation therapy is used in these ways:
- Primary treatment: As a main treatment to cure, stop or slow the disease.
- Adjuvant therapy: After one or more other treatments, like surgery or chemotherapy, to reduce the risk that the cancer will come back.
- Palliative therapy: To help with symptoms, like pain, by shrinking the tumor.
The exact role of radiation therapy in your care depends on many factors, including the type, size, location and stage of your cancer. Your radiation oncologist will tell you about the type of treatment they recommend for you and explain why they think it is the best choice.
Radiation therapy is used to treat the primary (main) site of certain diseases, such as breast, colon, lung and prostate cancers. It is also used to treat metastases (areas where cancer has spread), such as the bones, brain and other organs. It can be used to treat sarcoma, gynecologic, head and neck, lymphoma, and brain and spine cancers.
External-Beam Radiation Therapy (EBRT)
External-beam radiation therapy (EBRT) is a treatment where radiation beams come from a source outside the body. Usually, it comes from a machine called a linear accelerator (also called a LINAC).
These beams are carefully pointed exactly at your tumor. For example, if you have cancer in your lung, you will only have radiation aimed at your chest, not your entire body. This is the most common type of radiation therapy that people get to treat cancer.
EBRT includes the following types of treatments, which are all offered at Fred Hutch:
Electron therapy is also called electron beam therapy (EBT). It is most often used to treat tumors on or near the surface of the body, like skin cancers. This is because electrons do not go as deeply into the body as other types of radiation, like X-rays or photons.
Three-dimensional conformal radiation therapy (3D-CRT) allows radiation to be customized to the patient’s body. First, the radiation therapist does a computed tomography (CT) scan of the part of the body being treated. These images are loaded into a special computer and used to create the radiation treatment plan.
The plan is designed to send a beam of radiation that closely matches the size and 3D shape of the tumor.
With IMRT, the radiation beam closely matches the patient’s tumor and can be split into smaller beams of different strengths. This helps the radiation oncology team send a higher dose of radiation to the tumor while sending as little as possible to nearby healthy tissue. IMRT is a type of three-dimensional conformal radiation therapy (3D-CRT), which is a computer-based procedure that creates a 3D image of the tumor.
When tumors cannot be removed completely from the pelvis or abdomen because they are attached to organs or nerves, IORT might be used. Also, if there are any cancer cells left over after surgery to remove a tumor, IORT might be used.
To prepare for IORT, a surgeon moves healthy body tissues and organs out of the way before surgery, so the tumor can be exposed to high doses of radiation. Next, a machine called a Mobetron is set up for the patient. It has a special cone that aims the radiation beam at a target, with as little radiation as possible for nearby healthy tissues and organs. Finally, a carefully measured dose of radiation is sent to the tumor. The amount of radiation is a small fraction compared to the total radiation given over a traditional multi-week course of EBRT.
IORT is used to treat:
- Locally advanced rectal cancers that cannot be removed because they are attached to healthy nerves, blood vessels or the pelvic side wall
- Abdominal and pelvic sarcomas that are attached to the back wall of the abdomen
- Locally advanced gynecologic tumors, such as uterine or cervical cancers
- Some pancreatic cancers
- Recurrent tumors (tumors that have come back)
- Some early-stage breast cancers
Neutron therapy is a specialized and very powerful form of external beam radiation therapy (EBRT). It is often used to treat tumors that are difficult to destroy using regular X-ray radiation therapy. Neutron therapy targets cancer cells using neutrons (tiny particles that are smaller than an atom). It puts about 20 to 100 times as much energy into the cancerous tissue as radiation therapy does (like electrons, X-rays or protons).
Proton therapy targets tiny, charged particles called protons at cancer cells. It can send high doses of radiation that are carefully targeted, so as little radiation as possible goes to nearby healthy tissue. Doctors can pinpoint the treatment so most of the radiation goes exactly to the tumor site, no matter whether the tumor is near the surface of the skin or deep inside the body.
Stereotactic body radiation therapy (SBRT) aims many beams of high-dose radiation from different angles at tumors. These tumors can be in areas such as the liver, lungs, adrenal glands and spine. To target the radiation beams exactly, special cushions that fit the shape of your body are used. These help you hold still and are used to position you before each treatment.
Stereotactic radiosurgery sends a high dose of radiation to an exact area from many angles, usually in one treatment session.
Gamma Knife is one type of radiosurgery. It is not an actual knife or scalpel — instead, it uses carefully focused beams of radiation. It is usually used on brain tumors or tumors inside the head. The patient wears a mask during treatment to keep their head still, which allows the radiation to be aimed as precisely as possible.
Total body irradiation (TBI) is radiation therapy given to the whole body to get ready for a blood and marrow transplant (BMT).
The EBRT Process
Here is what you can expect if you are having external-beam radiation therapy (EBRT). If you are having a different type of radiation therapy, your radiation oncology team will explain the steps involved, where you will need to go and what you will need to do.
During your first appointment, you will meet with your radiation oncologist and other members of your radiation therapy team, such as a registered nurse and advanced practice provider. Your radiation oncologist will go over your health history, do a physical exam and discuss the treatment they recommend for you, including what outcomes to expect and any side effects you might have.
Your next visit is usually for simulation. This is when scans and measurements are taken to help plan your treatments. Depending on the treatment, this may involve taking a computed tomography (CT) scan of the part of your body being treated or creating special cushions to help keep your body in the same position every time you are treated.
Our radiation therapists may draw marks on your skin or place small pinpoint tattoos to help make sure you are lined up exactly the same way every time you are treated. If your head is being treated, your team will create a customized positioning mask to help hold your head in place.
Your radiation oncologist, medical dosimetrists and a medical physicist will work together to plan your treatment, using the measurements and images from your simulation. Their goal is to make the radiation work well on your cancer with the least possible effect on the healthy parts of your body. Special computers with state-of-the-art radiation treatment planning software are often used, and the treatment planning process can take several days.
After your doctor has approved your radiation treatment plan, you may need to return to the radiation oncology department for a verification simulation. This is a final check to make sure your positioning on the treatment machine is correct and check other details of your treatment before you begin.
EBRT is usually given in a series of visits that last 20 to 30 minutes each, five days a week. Treatment usually lasts between one day and eight weeks, depending on your tumor type, location and size. Your doctor will see you for a check-up at least once a week while you are having these treatments, too.
After your treatments are complete, you will visit your radiation oncologist to create an individualized follow-up plan.
Internal Radiation Therapy
When a radioactive substance is put inside your body to treat cancer, it is called internal radiation therapy. Often, the substance is a small implant. It could also be a pill that you take by mouth or a fluid that you get intravenously (by injection in your vein). Here are the different types of internal radiation therapy.
Brachytherapy is a treatment where a small radioactive source — such as a seed, pellet, wire, needle or capsule — is put inside the body. A doctor places the source next to or inside the tumor using a tube-like applicator.
Some patients need a high-dose radiation source that stays in the body for a short time (and then is removed), which happens several times. Others might need a low-dose radiation source that is put in once and left for several weeks, months or forever. Depending on the type of brachytherapy, you may need to have a local anesthesia to numb the area being treated so there is no pain, or a general anesthetic, which means you will be unconscious during the treatment.
When radioactive medicines are taken by mouth or injected into a vein, it is called systemic radiation therapy. These medicines collect where there is cancer and give off radiation that kills cancer cells. One example of systemic radiation therapy is radioactive iodine therapy, which is used to treat thyroid cancer.
At Fred Hutchinson Cancer Center, we surround you with experts who focus completely on cancer care. Radiation oncology teams usually include the members described below.
Advanced practice providers have training that is similar to doctors and can see you without your doctor. There are two types: physician assistants (PAs) and advanced registered nurse practitioners (ARNPs). They help provide and plan your treatment and also help manage the effects of your disease and treatment.
This specialist does the calculations needed to deliver your treatment. This helps make sure that you get the exact dose of radiation prescribed by your radiation oncologist in exactly the right places.
This specialist helps plan your treatment and maintains the equipment used to deliver radiation therapy.
This is a doctor who specializes in treating cancer with radiation. This doctor will prescribe, plan and oversee your radiation treatment.
This is a nurse who will explain your treatment, answer your questions and help you manage any side effects you may have because of your radiation treatment.
When you come in for radiation treatment, this specialist will position you for your treatment and operate the machines that deliver the radiation.
Other members of your radiation oncology team may include these professionals who work behind the scenes, helping to fine-tune and operate the radiation technology and equipment used in your treatments.
Managing Side Effects
Radiation therapy can cause side effects. These depend on the type of radiation therapy you have and the part of your body that is treated. Your team will give you details about which side effects may happen and for how long.
You are always at the center of everything we do. Our doctors, nurses and advanced practice providers will work closely with you to manage any side effects and help you take the best possible care of yourself during treatment.
Before you begin treatment, we talk with you about what to expect, based on your treatment plan, and what can help if you have side effects. We have many tools to help you feel better, such as:
- Supportive medications to prevent and treat symptoms, like nausea or constipation
- Antibiotics, steroids and antiviral drugs to prevent or treat infections
- Transfusions, vaccines and medicines that boost the immune system to treat low levels of blood cells (low blood counts)
- Nutrition care and medicines to help with digestive problems
- Physical therapy to help you recover from surgery
- Conventional and integrative therapies for pain
At your appointments, we want you to tell us right away about any side effects you are having. If you have questions or concerns between appointments, you can call us. We will make sure you know how to reach care providers at Fred Hutch after hours, if that is when you need us.
Many of our patients join clinical trials — led by world-class doctors from Fred Hutchinson Cancer Center — to get promising treatments that are not available everywhere.
We are testing hundreds of new therapies for dozens of types of cancer and finding new ways to use current treatments.
Through this work, we are looking for answers to two main questions: How can we do even better at controlling or curing cancer? How can we make treatments easier on patients?
We have clinical trials for all stages of cancer, from early to advanced. When your radiation oncologist designs your treatment plan, they will give you the choice to join clinical trials that match your situation. If you decide to join one, you will see the same doctors and nurses as you would for standard therapy.
Your care team will talk with you about if you might want to join a study and why. This can help you make the decision that is best for you.
Supportive Care Services
Along with treating your cancer, Fred Hutch provides a range of services to support you and your caregiver. This is part of how we take care of you — not just your disease.
Along with your radiation oncologist, radiation therapist, and radiation oncology nurse, you’ll have many others to provide support. From registered dietitians to chaplains to social workers, our experts specialize in caring for people with cancer. We understand this may be one of the most intense and challenging experiences you and your family ever go through. We are here to provide the care you need.
Our registered dietitians have special training in nutrition for cancer prevention, treatment and survivorship. They work together with the rest of your cancer care team.
Our palliative care team is here to support the best possible quality of life for you, no matter what stage your disease is.