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How radiation experts personalize cancer treatments

“The role of a radiation oncologist is really interesting to me,” says Adam Nowlan, M.D., a radiation oncologist at Piedmont Cancer Center. “I think it’s the best field of medicine. There’s a great variety of work that we do." If a physician decides a cancer patient may need radiation treatment, he or she will make a referral to a radiation oncologist.

The radiation oncologist then meets with the patient, usually for an hour to an hour and a half, to determine if radiation is an appropriate therapy for their cancer. "From there, we’ll come up with a plan. The plan is essentially a computer program that tells the radiation machine how to behave,” he explains. “The same machine is used to treat almost every patient in the department.

In the same way that an industrial robot could build a Mercedes-Benz in one factory and that same robot could build an Audi in another factory, our machine is the same, but the computer program is different. That’s how radiation works.”

First, the radiation oncologist will create and verify the accuracy of a computer program to meet a patient’s needs. From there, the patient will start a process of radiation therapy typically delivered Monday through Friday for an average of six weeks. “Once a week, we’ll see the patient on a treatment check, so we’ll take that day out of our treatment schedule and we’ll just see the people who are under treatment. That could be somewhere between 15 and 30 patients for the average radiation oncologist,” says Dr. Nowlan.

“You get to see them frequently while they’re under treatment. We’re managing side effects, providing elixirs for the throat and skin creams, as well as offering nursing care and education. It’s a collaborative effort.” The radiation treatment itself is delivered by team members called radiation therapists.

“They are kind of our frontline,” he says. “They are seeing the patients every day and they’ll often alert us to changes in the patient’s status that would require intervention or evaluation by a physician.”

For Dr. Nowlan, the most rewarding part of his job comes in the months of patient follow-up. “Patients will come back for months or even years after treatment for a follow-up,” he says. “We get to see not only the side effects of radiation to make sure those are being managed, but hopefully we get to see a smiling, happy person who is cured. That’s the greatest joy I have.”

For more information about radiation oncology, visit Piedmont Cancer Center.

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