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Radiation Oncology

Radiation therapy is one of the most common treatments for cancer. It uses special equipment to aim targeted beams of high doses of radiation at cancer cells. This damages the cancer cells and causes them to die. Radiation therapy machines that can generate, concentrate, and direct photons or charged particles along a specific course (linear accelerators) focus these beams on cancerous tissue. The energy disrupts the DNA of cells that it strikes. Because cancer cells reproduce particularly quickly, they are especially sensitive to this kind of damage, and as a result die more readily than normal cells.

Unlike chemotherapy, which exposes the whole body to cancer-fighting drugs, radiation therapy is usually a local treatment. It targets only the part of the body being treated. The goal of radiation treatment is to damage as many cancer cells as possible, with little harm to nearby healthy tissue.

What’s radiation therapy like?

External beam radiation therapy focuses energy on tumor tissue from a source outside the body. It is much like getting an X-ray but for a longer period of time and with different power intensity to the beam. Before starting such treatments, patients must have a series of imaging studies such as MRIs, CT scans or plain X-rays so that the cancer team can determine the exact location of a tumor within the body. Radiation oncology technicians may mark the patient’s body with ink or use special molded frames to help position the body and guide treatments. External beam radiation lasts only a few minutes and is painless. Areas irradiated may be temporarily sore or inflamed.

Patients at both Virtua Our Lady of Lourdes Hospital, in Camden, NJ, and Virtua Willingboro Hospital, in Willingboro, NJ, have the advantage of care through our Willingboro Radiation Therapy treatment center which offers a sophisticated array of approaches to delivering radiation. These latest technologies are designed to increase cancer-killing effectiveness of treatment while enhancing safety. They seek to protect healthy tissue and organs, and use computers to control angle and intensity of delivery and the shape of radiation beam to get higher doses to cancer tissue to destroy tumors:

  • IMRT (Intensity Modulated Radiation Therapy) uses multiple small radiation beams that vary in intensity to precisely treat tumors and minimize exposure to surrounding normal tissues. IMRT angles radiation beams to essentially wrap the therapeutic effect within the tumor and spare good cells and normal tissues around it.
  • IGRT (Image Guided Radiation Therapy) uses radiologic imaging of the tumor and surrounding normal tissues, taken before radiation treatment, to ensure  that the radiation treatment will be directed precisely to the right location.
  • Stereotactic radiosurgery involves the use of a single or a few intense, high-dose radiation treatments very precisely focused on a small location. This approach is often used for small tumors that would otherwise be difficult to treat or control.
  • High-dose-rate brachytherapy uses a radiation source delivered directly to an area inside the body to treat a cancer. (Brachytherapy refers to bringing the source of therapeutic radiation in direct proximity to cancer tissue.) A surgeon or radiation oncologist places a catheter or device in the area needing radiation. A computer sends the radiation source through the device and delivers the radiation treatment over several minutes, physically positioned next to the targeted location. After the treatment is over, the device is removed from the patient. The approach brings radiation much closer to cancer tissue, increasing the dose received by cancerous areas and without the radiation having to pass through healthy tissue from outside.
Prostate seeds are a form of low-dose brachytherapy used to treat prostate cancer. The treatment team puts the patient under anesthesia in an operating room and then places small radiation sources into the prostate gland. The sources remain in the prostate and treat the cancer over a number of weeks. In this case, because the seeds gradually lose their radioactive properties and there is no evidence that there is a benefit to removal, the seeds are left in the prostate after the treatment period is concluded.

Physicists have developed software that provides the  radiation therapy  team with a unique and highly accurate way to measure the amount of radiation that a tumor is receiving. Called “gamma function,” this sophisticated measurement not only double checks that the radiation was delivered correctly, but also gives immediate feedback regarding changes to treatment that might be necessary because of tumor shrinkage or movement.

The radiation oncologists serve on the cancer committee and tumor boards at both hospitals. These groups of cancer specialists meet with other cancer specialists to review each patient’s case as a team, to determine the best course of care, to schedule each step of treatment with the right sequence and timing and to monitor patient status, progress and outcomes. Radiation oncologists and support staff work in close communication with the each patient’s primary doctor and referring cancer specialist, and have daily contact with the cancer program’s nurse navigator.

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