Clinac iX™ and eX™ Linear Accelerator Overview Medical linear accelerators are computerized machines used for delivering radiotherapy treatments. Standing approximately 9 feet tall by nearly 15 feet long and weigh- ing as much as 18,700 pounds, the accelerator consists of five major components: an electronics cabinet called a “stand” housing a microwave energy generating source; a rotating gantry containing the accelerator structure that rotates around the patient; an adjustable treatment couch; an imaging device for pinpointing the targeted tumor just prior to each treatment, and operating elec- tronics. Accelerators are located within specially constructed concrete treatment rooms to provide X-ray shielding.In operation, microwave energy, similar to that used in satellite television transmission, is usedto accelerate electrons to nearly the speed of light (186,000 miles per second). They attain thisvelocity in a short distance, typically one meter or less. As they reach maximum speed theycollide with a metal target, which in turn releases photons, or X-rays, with such energy theyare measured in millions of volts (MV). Certain models can be switched so that the electronsbypass the target for direct electron therapy. This energy is measured in millions of electronvolts (MeV).Radiation oncologists and physicists use electron or photon therapies for different types ofcancer treatments. Generally speaking, photons (X-rays) are used for treating tumors deepwithin the body. Electrons, which cannot penetrate deep tissue, are used for more superficialdisease including some skin cancers and shallow head and neck lesions.As the radiation strikes human tissue it produces (largely from naturally occurring water in thebody) highly energized ions that are lethat to bothnormal and malignant cells. While all cells sufferfrom radiation, healthy cells can adapt oversuccessive regenerative cycles. Malignant cells donot possess this adaptation mechanism and thusdo not survive, a fact that generally dictates thepractice of administering repeated radiationtreatments rather than a single blockbusterdosage.
BrachyTherapyLow Dose Rate (LDR) & High Dose Rate (HDR) Brachytherapy is the temporary or permanent placement of a radioactive source either on or within body tissues or cavaties. Also called internal radiation therapy or implant therapy, brachytherapy allows the delivery of a high dose of radiation to a small area while sparing surrounding normal tissue as much as possible. The most common methods used to deliver the necessary dose of internal radiation therapy include interstitial implants and intra-cavitary implants. Our radiation oncologists are able to provide several types of brachytherapy.Internal radiation may be given as the only radiation treatment or in conjunction with externalbeam radiation. Some implants require hospitalization andothers are performed on an outpatient basis.In an interstitial implant, the radioactive source is containedwithin a needle, seed, wire or catheter that is placed directlyinto the tumor or tumor bed. The implant may be temporaryor permanent (e.g. prostate seed). Temporary implants canbe done with high intensity sources that oscillate within theradiation carrier and are removed within minutes (high doserate or HDR) or with moderate intensity sources that aremaintained within the tumor for hours to days (low dose rateor LDR). Permanent implants, also known as “seed implants”, are LDR brachytherapy treatmentsthat utilize radioactive materials that are implanted permanently within the tumor to providehighly localized radiation.In an intracavitary treatment, the radioactive material is placed directly into the body cavity(such as the uterus) and held in place by an applicator. These are always temporary implants andmay be HDR or LDR brachytherapy treatments.Brachytherapy is often used in the treatment of cancers of the breast, cervix, endometrium, prostate and head and neck area. During the initial consultation with the radiation oncologist, he or she will discuss the treat- ment plan with the patient. If an implant is part of the treat- ment plan, this will be included in the discussion. Before the implant, the radiation oncologist will discuss the procedure with the patient again in full detail. The radiation oncology nurse will meet with them to give them verbal and written instructions regarding how to prepare for the procedure, precautions to take, wher eto report and after-care at home.
Valencia™ Skin Brachytherapy While surgical excision is the most common treatment for skin cancer, primary and post-operative High Dose Rate brachytherapy may be appropriate for certain patients. It can increase cure rates and improve functional and cosmetic results. Patients receiving HDR brachytherapy treatment for skin cancer will require fewer visits to a cancer center and can be treated as early as their first visit. It is a time tested and safe method that allows physicians to treat the cancer with greater precision and less trauma to the patient.This procedure gives physicians and patients the significant advantage of applying a higher doseof radiation directly to the tumor, while sparing healthy tissue and surrounding organs. As aresult, this course of treatment is much shorter and more comfortable than other cancer treat-ments, and is often performed on an outpatient basis within a few minutes per treatment.There are minimal side effects associated to the treatment and minimal recovery time. Thepatient can safely go home and return to normal activities after the procedure. HDR brachy-therapy can be used alone or combined with other treatment modalities.Valencia applicators are used to treat superficial skin cancers, surface, intra-oral, and vaginalcuff treatment. They are particularly useful for treating lesions around the eyelids, ears andnose where electron applicator treatment is not suitable due to set-up and possible damagingexposure to these organs. These applicators are also particularly good for tumors of small sizeand shallow depth.These tungston cup-shaped applicators have a flattening filter to provide a uniform isodose forsuperficial treatments of lesions up to 3 cm in diameter and 4 mm in depth. They limit theamount of radiation to the required area using tungsten shielding and are designed to treat tothe correct depth without overexposing the skin, yielding excellent cosmetic and functionalresults.HDR brachytherapy treatment, using Valenciaapplicators, offers a convenient and non-surgicaloption for patients with small and large superfi-cial skin cancers. Fewer treatments over a shortertime period offer patients convenience and lessdisruption to daily routines. HDR brachytherapy iswell suited for elderly or infirm patients as well asthose on blood thinners or at risk for delayedpost-surgical healing time.
Our Radiation Therapy Physicians Hal Jacobson, M.D. Having experienced his 39-year-old mothers death from cancer when he was twelve, Dr. Jacobson made an early commitment to ease the suffer- ing of cancer patients and their families. Personal history inspired his career as an oncologist as well as his commitment to provide highly individualized patient care. Dr. Jacobsons motto -“I dont treat cancer, I treat people (who have cancer)”- sets the compassionate and compre- hensive standard of care for his own work and that of Intercommunity Cancer Institute (ICCI) as a whole. He and the ICCI team at this community-based center take time to thoroughly educate each patientand understand his or her particular situation.Miami native, Dr. Jacobson graduated from the University of Florida College of Medicine in Gaines-ville, and was then recruited for his residency in radiation oncology by Harvard, Stanford, M.D.Anderson, Washington University, as well as his alma mater. "I chose to turn down the others andcontinue at the University of Florida under world renowned, Dr. Rodney R. Million. U of F was theonly Department combining academic excellence and a hands-on technical experience along withprimary responsibility for direct patient care." In 1985 Dr. Jacobson accepted an appointment tobecome the Founding Medical Director of Intercommunity Cancer Centers (ICCC) in Leesburg,Florida. ICCC and ICCI bring the best of Radiation Oncology to the patients community so thepatient can enjoy the comforts of home with the highest level of medical care available today. Herman Flink, M.D. Intercommunity Cancer Centers radiation oncologist Dr. Flink is a gradu- ate of New Jersey Medical School in Newark. He completed a medical- surgical internship at Tulane/Charity Hospital of Louisiana in New Orleans and the following residencies: diagnostic and therapeutic radiology at Atlantic City Medical Center (New Jersey); therapeutic radiology at University of Miami (Florida); and therapeutic radiology at The Johns Hopkins Medical Center (Baltimore, Maryland). Dr. Flink was also an American Cancer Society Clinical Fellow in Therapeutic Radiology at Johns Hopkins from 1978 to 1979. Dr. Flink is board-certified by TheAmerican Board of Radiology in both Radiation Oncology and Radiology (diagnostics).In January 1979, Dr. Flink became the first physician board certified in radiation oncology to jointhe staff of Florida Hospital Orlando. As Chairman of the Department of Radiation Oncology atFlorida Hospital, Dr. Flink developed the largest radiation oncology group practicing in Orlando. Heobtained a Johns Hopkins Affiliation for the Florida hospital system, and subsequently founded andbuilt the John Hopkins Affiliated Center for Cancer Care in Orlando / Winter Park. He remainedwith the Orlando practice until 1997, at which time he joined the InterCommunity Cancer Center.
Our Radiation Therapy Physician Bobby Evans Harrison, M.D. Dr. Bobby Evans Harrison, an ABR certified Radiation Oncologist, joined the InterCommunity Cancer Institute in August, 2010. Dr. Harri- son is a former BSN registered nurse. She was her high school’s valedictorian and a member of the Golden Key Society (National Honor Society for nursing). She received an epiphany to attend medical school while climbing Mt. Fugi in Japan. “The Lord ordered my steps to become a compassionate physician.” Dr. Harrison received her M.D. degree from East Carolina University Medical School, and graduated from Duke University Medical Center – Radiation Oncology residencyprogram 2002.Dr. Harrison treats patients with all types of cancers with a Holistic approach. She has beentrained in bio-oxidative therapies and sometimes utilizes a complementary approach(conventional therapy and alternative medicine) to give patients the highest level of medicalcare.Dr. Harrison’s radiation therapy expertise includes treatments ranging from 3-D conformal toImage Guided Radiation Therapy (IGRT), various high dose rate brachytherapies (SAVI, Valen-cia, Endobronchial, T&O’s, implants, and vaginal cylinders). Dr. Harrison’s motto is, “Your workis your signature. Sign it with Excellence!”
Insurance and Payor List■ Aetna■ AmeriChoice (Through UHC)■ BCBS of Florida■ Beech Street■ Cigna■ Citrus Healthcare■ CorVel■ FedMed■ Florida Medicaid■ Florida Medicare■ Freedom Health■ Galaxy Health Network■ Golden Rule■ Group Health Incorporated (GHI)■ Health Choice■ Humana / ChoiceCare■ Humana Gold Plus■ Humana Veterans Healtcare Services■ MetCare / AdvantageCore■ Multiplan / PHCS■ Physicians United Plan through Wellmed (PUP)■ RR Medicare■ Secure Horizons■ Staywell■ Sunshine State■ TriCare (Prime and Standard)■ United Healthcare■ UPMC Heath Plan■ Wellcare