Patient Care

Patient Care

The Department of Radiation Oncology and Molecular Radiation Sciences includes radiation oncologists, neurosurgery specialists, medical physicists, dosimetrists, nurses and support staff who are committed to providing the highest quality patient care. As part of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins we are utilizing state of the art technologies in the treatment of cancer and advancement of cancer research.

Patient Process

Patients receiving radiation treatment at Johns Hopkins can typically expect to experience several stages of care. These stages are designed to establish whether a patient is a good candidate for radiation therapy, to diagnose a patient's condition, identify the location of cancerous tissue, and to prescribe and execute a treatment plan.



Patient Animation on Radiation Therapy Information courtesy of Varian Medical Systems of Palo Alto, California. (Macromedia Flash plugin required)

The following is a general description of the step-by-step patient process:

Referral - In many cases a patient that feels pain or discovers something that causes concern will first visit their primary care physician. Their physician may request x-ray imaging or a biopsy for the patient. This may lead to referral to a medical oncologist or a surgeon who would then recommend radiation therapy.

Consultation - Once referred to our department a patient will spend time with one of our resident physicians for a physical examination, and to document their patient history. The resident physician will then discuss the patient's situation with an attending physician that specializes in that type of cancer. The attending and resident physicians will then see a patient together for a physical examination and then develop recommendations for radiation therapy. If the patient accepts the recommendation they will then be scheduled for a treatment planning session.

Simulation - The treatment planning session is administered using a device known as a simulator. It is used to create x-ray images of the patient and pinpoint the exact location of the tumor. These images are then used to create a three dimensional picture of the patient's anatomy.

Treatment Planning - Once computer images of the patient have been obtained sophisticated computer applications are used by the attending physician to design a radiation treatment course, which includes the radiation dose and delivery. The physician, also called the radiation oncologist, will the then refer the treatment course to a dosimetrist and/or a medical physicist, who will then create radiation calculations. Treatment calculations indicate the level of radiation energy to be applied, called the dose, the angle of the treatment beam and the amount of time for a given beam. The calculations are given back to the radiation oncologist for approval or changes, once approved, the patient will be scheduled for their treatment sessions.

Radiation Therapy - Radiation therapy is the treatment of cancer using x-rays and other forms of radiation to destroy cancer cells.The energy of the radiation is absorbed by cancer cells and results in damaging their genetic material so that they can no longer grow. Normal healthy cells are avoided through careful treatment planning and precise radiation delivery. Because x-rays are light energy they pass through the human body. This allows for the treatment of cancers that are deep inside the body or located in areas that may be challenging to reach through surgery. Radiation therapy treatments are usually given daily over a period of several weeks. Each treatment is administered by a certified radiation therapist who monitors the patient's progress. In addition to the radiation therapist, physicians, nurses and support staff are always available to provide the best patient care.

High dose radiation therapy, or brachytherapy, is a technique for delivering radiation to cancer cells in which radioactive implants are placed directly in or around tumorous growth. This technique exposes the tumor to very small amounts of radioactive material that in some cases is so tiny that the material will deliver it's energy until it loses it's radioactive properties over the treatment time.

Another form of radiation treatment is through the use of Gamma rays. Radiation treatment of this kind can be very effective in treating brain cancers. The Leskell Gamma Knife is used to perform stereotactic radiosurgery on complex brain cancer patients.

Follow-up - After treatment the radiation oncologist will follow-up on the patients progress to ensure that they are healthy. Follow-up schedules vary greatly, but in many cases a patient will check with their primary care physician for follow-up.

Patient Safety

At Johns Hopkins we are committed to patient safety. As a leading health care provider we have built a reputation for excellence, and the most important part of that excellence is our commitment to safety.

The Johns Hopkins Comprehensive Patient Safety Program has been established to ensure that maintaining a safe health care environment is an everyday value. The primary goal of this program is to promote awareness of potential problems and to develop proactive methods of avoiding them.

As a result our department continues to maintain a safe environment and looks for ways to improve our safety measures. These measures include regular quality assurance tests of our equipment, precise attention and collaboration in treatment planning, and provision of patient care by highly qualified nurses and support staff.