Tomotherapy

What is Tomotherapy?

Tomotherapy is a type of radiation therapy whereby patients are scanned using beams combined with image guidance technology to target tumours accurately, thus minimising damage to nearby healthy tissue. Tomotherapy is a form of intensity-modulated radiation therapy (IMRT).

The device used to deliver radiation is combined with a CT scanner and a linear accelerator machine in one single system to provides 3D images in order to precisely target the tumour.

Although somewhat a modern treatment modality, it has been widely regarded as an effective form of treatment and is recognised as being the first of its kind as it features a ‘helical treatment delivery platform,’ and patented beam shaping technology.

Watch Accuray, the company who manufacture Tomotherapy devices explain the system in more detail.

About the Tomotherapy Treatment Device

The device used for Tomotherapy looks much like a large CT scanner with a couch to lay on for the patient. The machine features a linear accelerator that is mounted on a ring gantry with CT technology for image guided radiation.

The radiation is guided by a Binary Multileaf Collimater (MLC) and can be delivered through two therapeutic modes – TomoHelical and TomoDirect .

TomoHelical offers continuous rotational delivery in a helical pattern. The machine rotates around the body through the CT scanner to deliver a distributed dose of radiation across the affected tumour and areas.

TomoDirect delivers beams from a fixed angle with no rotation or movement.

When is Tomotherapy Used?  

Radiation therapy is a common form of treatment used on cancer patients to destroy cancer cells or reduce the size of them. As it is a non-invasive treatment modality, many patients choose to have radiotherapy as part of their treatment plan including in combination with other treatments.

Tomotherapy has been used effectively on prostate cancers however it can sometimes be an option in treating other types of tumours such as brain and spine tumours. It may also be an option if your cancer is recurring or metastases, as it can be used even if you have already reached the maximum dose of radiation from other therapies.

Advantages of Tomotherapy

• Effective but quick treatment time for even complex tumours
• Precise delivery of radiation to minimise damage to surrounding healthy tissue and reduce side effects
• Individualised patient plan. The size, shape and intensity of the beams can be adjusted to precisely target the tumour.
• Patients can resume daily activities before and after treatment sessions
• Can be used in the treatment of recurring cancer or metastases
• No sedation needed

How does Tomotherapy Work?

The treatment process combines treatment planning, CT image-guided patient positioning and treatment delivery into one system.

There are several stages of the treatment process, and your physician team should go through what happens at each stage.

Before Treatment

Before treatment, a radiation therapist will take image scans from you. Image scans can come through CT or PET/CT scans. The images are then taken by your care team so they can plan and calculate the right dose of radiation needed. New CT scans will be taken prior to each session.

During the Treatment

During the treatment itself, MVCT images will be taken just before the treatment is performed so your radiographer can position you on the treatment table in the right place so the radiation is delivered precisely.

Once in position, the machine will then start delivering the radiation beams to target the tumour. You will not feel the radiation however you may hear the device turn on and a buzzing sound. Once the treatment is delivered, you are free to leave the clinic and return to normal daily life between sessions.

If you have any questions about what to expect, you should talk openly with your doctors to ensure you understand what is involved and alleviate any concerns you may have.

How Many Sessions Will I Need?

The number of sessions you may need will vary depending on your circumstances. Often patients will need somewhere around 5 sessions per week for a period of five to eight weeks. Your oncologist should discuss with you how many sessions you will require.

The sessions itself will only take around 10-30 minutes (for the CT scan and delivery of beam radiation). As minimal pain is associated with this type of treatment and no anaesthetic is required, you can continue with daily  activities as normal around your sessions.

What are the Side Effects of Tomotherapy?  

All types of treatment can come with associated side effects. The side effects you may experience will vary depending on the type and stage of your cancer. For example, if the tumour is in the stomach, you may experience nausea and vomiting. 

Your care team should go through any potential side effects prior to undergoing treatment however if the treatment has been recommended it is likely because the benefits outweigh the risks.

Some reported side effects of Tomotherapy are:

• Skin rashes, redness and irritation
• Fatigue
• Nausea
• Headaches and hair loss
• Changes to saliva or dry mouth

Most side effects will be temporary and come on at different stages. If you experience any side effects during or after treatment, you should talk to your team about this as they can help you cope and manage any effects.

Preparing for Tomotherapy

No special steps need to be taken prior to treatment sessions. Food and drink can be consumed as normal however you may need to make childcare or working arrangements when the sessions are due to happen.

To make you feel more relaxed about receiving treatment, you may also want to make arrangements to bring a friend or family member to your sessions.

Signs the Treatment is Working

You should have regular check-ups with your doctor and care team to determine your progress during treatment and after having all the sessions. They will follow your progress and you can also use this an opportunity to address any concerns or talk about any side effects you may be having.

Costs of Tomotherapy

Accuray, the manufacturer behind the Tomotherapy device does not set charges for treatment. Costs for treatment will be set by the clinic you use and should be discussed with them. In some cases, the cost of treatment can be claimed against healthcare insurance however it is important to review your own policy to find out this. If you need to go abroad for treatment and have to stay somewhere while undergoing treatment, this may be a cost that you have to pay for yourself in addition to travel costs. 

Nutrition Advice When Undergoing Tomotherapy

While food and drink can be consumed as normal when undergoing treatment, your doctor may recommend you follow a particular diet to support the radiation treatment and fighting the cancer itself. This may include avoiding certain foods such as spicy curries or food containing high levels of sodium. Following a healthy nutrition plan will likely be encouraged as this can have a number of benefits in building strength, aiding recovery and supporting the treatment to work effectively.  The American Cancer Society provide more guidance on the benefits of a good nutrition during cancer treatment.

The nutrition you need will be highly dependent on your situation. For specific advice for your situation, you should consult with your doctor and nurses who can advise you on which foods to avoid and which foods should definitely be included in your diet.

Explore Your Treatment Options

Tomotherapy is an effective cancer treatment however the most effective treatment for you will take into consideration a range of factors. Oncolomed can help you explore your options and find the right treatment by facilitating second opinions and cancer treatment through our network of leading clinics and oncologists.

See how we can compassionately guide you in your cancer treatment journey by exploring our range of services.

Alternatively, read our patient stories to see how we have helped patients across the globe in their fight against cancer.