City of Hope

Percy Lee

When people think of radiation oncology, they often imagine giant X-ray machines from the last century. So much has changed over the years. While our machinery is still large, it is more precise than ever and radically changing outcomes for cancer care. With enhanced precision and accuracy, many treatments are reduced from many weeks to five or fewer. It’s an exciting era for all of us in this field.

As the medical director of Orange County & Coastal Region Radiation Oncology for City of Hope Orange County, I have the privilege of overseeing radiation oncology at City of Hope Orange County Lennar Foundation Cancer Center in Irvine, Calif. — the most advanced comprehensive cancer center in the nation’s sixth largest county — and our network of advanced cancer care. We are using some of the most advanced radiation oncology technology available, providing each person a tailored treatment plan.

Here are some of the latest advances in our field that have led to improved clinical outcomes for our patients.

Intensity-modulated radiation therapy (IMRT)–My job is to use radiation as an extremely powerful tool to eradicate cancer cells, working closely with experts from other disciplines. The challenge is to only attack cancer and not normal cells. Newer technology, such as Intensity-Modulated Radiation Therapy (IMRT), does just that. This advanced method of radiotherapy delivers precise radiation doses to a malignant tumor or even specific areas within the tumor while minimizing the dose to surrounding healthy tissue. It is ultra-exact and extremely powerful.

Stereotactic Body Radiotherapy (SBRT) – It makes sense that one of our goals is to minimize the number of treatments while being as effective as possible at eliminating cancer. Stereotactic Body Radiotherapy allows us to do this by focusing high-dose radiation onto a small area of the body. It is so effective we can often reduce the number of sessions to five or less, as compared to traditional approaches of 30 or more. This technology is also recommended to treat cancers that are too high risk for surgery.

High-Dose-Rate (HDR) Brachytherapy – With brachytherapy, we deliver high-dose radiation internally via a surgical procedure. By applying these higher doses of radiation directly for a shorter period (often for a few minutes), we can be more effective in treating prostate, gynecological, and other cancers while minimizing the duration of exposure for nearby normal tissues.

"Advanced technology like the TrueBeam also provides a variety of advanced treatment techniques, such as syncing with the patient’s respiration"

TrueBeam by Varian — Many tumors are difficult to target, which is why the state-of-the-art linear accelerator is an integral part of our arsenal. A linear accelerator delivers intense doses of radiation that conform to the tumor’s shape. Advanced technology like the TrueBeam also provides a variety of advanced treatment techniques, such as syncing with the patient’s respiration.

Four-Dimensional Computed (4D CT) Scanning – 4D technology is another tool helping us better target tumors that move within the body. This technology allows us to visualize the motion induced by normal respiration and is particularly useful for treating lung cancer, where the tumor is constantly moving as the patient breathes.

Ethos by Varian - Ethos therapy redefines personalized cancer care by using AI to predict the patient’s daily anatomy changes (tumor shrinkage, weight gain or loss, etc.) and optimizing radiation doses accordingly. By providing the most current view of the patient’s anatomy in exquisite detail, Ethos therapy can help adapt treatment plans for increased precision.

MERIDIAN MR Linac by Viewray - MRI is often the imaging modality of choice because it does not involve radiation. New technology merges MRI capabilities with radiation oncology, providing state-of-the-art and real-time tumor location allowing radiation oncologists to adapt the radiation in near real-time with each session.

As a radiation oncologist, I always seek new modalities and treatments to ensure our patients the best possible outcomes. That is why my team also engages in clinical research and clinical trials. These efforts, combined with extraordinary technological advances, help our field deliver exciting new hope for cancer care and cures.