The tech boom
Radiation therapy came along in the early part of the 20th century and along with surgery and chemotherapy, it stands as “one of the pillars” of cancer treatment today, says Dr. Anthony Zietman, president of the American Society for Therapeutic Radiology and Oncology.

“If you actually look at cancer patients, about 60 percent of them at some stage in the course of their cancer [treatment] will receive some radiation,” says Zietman.
Nearly two decades ago, radiation oncologists relied on conventional linear accelerators to eliminate tumors and had a clear understanding of the role the sophisticated devices played in delivering the treatment.

“Then there was a massive explosion of technology, a huge proliferation of new treatment planning systems and radiation delivery machines,” says Zietman. “Before you knew it, technology had almost outstripped our ability to handle it all.”

The more intricate devices have enabled oncologists to target cancer cells with greater precision and spare the surrounding healthy tissue, but it has also necessitated a shift to a more computerized and automated process.

“We can do a better job of treating patients today and preventing after effects or side effects of radiation than we’ve ever been able to do in the past because of all of the sophisticated technology,” says Hendee. “But the problem is, it sort of takes the treatment out of the hands of the therapist and puts it in the ‘hands’ of the computer.”

Many facilities have multiple radiation delivery systems in their oncology departments, which makes it difficult to figure out how, and even if, the machines work in sync. Oftentimes, such uncertainty invites mistakes.

“There may be software errors buried deep within the system that we’re unaware of,” says Zietman. “It took a few very serious radiation events, which were exposed by The New York Times - quite appropriately - to really focus everyone’s minds on this.”

The intricate modalities are operated by a number of professionals who are involved in the process of planning and delivering the treatment: physicians, medical physicists, therapists, dosimetrists and in some cases, nurses or administrative staff. Not only do several people need to be aware of all the treatment information but they must also understand it. The steps that make up the treatment are multifaceted – and everything from the configuration of the radiation beam in regard to the tumor to the tracking of the patient’s respiratory motion makes the information relay among the radiotherapy team more delicate.

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