The MD Anderson Radiation Oncology Center at the American Hospital provides the advanced medical technology and a science-based service approach that has already been demonstrated effectively by the globally renowned radiation oncology department at the University of Texas MD Anderson Cancer Center. The backbone of our treatment system is made up of highly qualified radiation oncologists who were educated at the MD Anderson Cancer Center (and they were also University of Texas faculty members) as well as physics engineers, radiation oncology nurses and radiotherapy technicians who had their clinical training in Houston. 
 
Efficient radiotherapy services are available for cancer and many non-cancerous conditions, while our procedures follow the exemplary standards and guidelines established by the MD Anderson Cancer Center.

The fact that we are the first international satellite clinic of the MD Anderson Cancer Center, which has been conducting groundbreaking scientific studies to eliminate cancer for more than 70 years and is regarded as one of the most globally accomplished specialized medical centers, reveals the significant achievements of the American Hospital not only in our country but on an international level. Our center uses world-class cutting-edge technology to facilitate customized approaches to each patient’s diagnosis and treatment. The collaborative arrangement our department maintains with our Texas partners and our ability to follow international developments ensures optimal specialized care irrespective of diagnosis.

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-3rd.Kat -3rd  Floor
08:00 - 17:00 08:00 - 17:00
Monday - Friday Monday - Friday

FREQUENTLY ASKED QUESTIONS

The divisions we serve and our practical approaches are as follows:
  • Intensity-Modulated Radiotherapy (IMRT) and Volumetric Modulated Arc Therapy (VMAT): This innovative procedure which perfectly reflects in dose modulation cutting-edge technology is defined as a planning method. Typically, combinations of multiple intensity-modulated fields coming from different beam directions produce a customized radiation dose that maximizes tumor dose while also minimizing the dose to adjacent normal tissues. Tiny beams enter the body at various angles focussing on the cancer area with great precision while providing a much more potent dose than comparable radiation treatments while the peripheral healthy tissue is exposed to a very low dose by contrast. The planning phase for this treatment takes longer comparatively speaking, as the IMRT system requires a particularly meticulous approach.
 
  • Stereotactic Radiosurgery (SRS): This method is especially preferred for the treatment of small lesions. It involves the delivery of high radiotherapy doses, ranging from 3 Gy to 24 Gy (Gy, dose unit), at once or in a fractionated manner. The principle of the approach is the delivery of radiation beams at varying angles to the same target in order to minimize the dose delivered to surrounding healthy tissues, while the target is irradiated at maximal dose utilizing exact anatomical locations provided by high-tech imaging modalities. Stereotactic radiotherapy implies treatment divided into fractions, while stereotactic radiosurgery involves delivering radiation doses all at once.
 
  • Stereotactic Body Radiotherapy (SBRT): It implies radiosurgery that is targeted to any organ apart from the brain. This method employs very high doses that are focussed on each lesion target.
 
  • Four-Dimensional Computed Tomography simulator: Big Bore Onco CT is a four-dimensional scanner that acquires 16-slice helical Computed Tomography (CT) images. The Tumor LOC feature enables radiation oncologists to determine the localization of tumors quickly; coordinates of tumors are determined with movable lasers marking the central zone of each tumor. Our CT device is equipped with respiratory gating and thus, tumors and target volumes can still be effectively imaged even if they move which is particularly possible with lesions located in the lungs or upper abdomen.
 
  • Four-Dimensional Radiotherapy (4DRT): Treatment is planned after the target volume is determined with Four-Dimensional Computed Tomography (4DCT). Since the respiratory-gated four-dimensional plan is made at our center, radiotherapy can be administered while the patient is inhaling or exhaling. Integrated volume can be treated in all respiratory phases in small and less mobile tumors.
 
  • Brachytherapy: Brachytherapy (internal radiation therapy) is a form of radiotherapy where a sealed radiation source is placed inside or next to the area requiring treatment. If the radiation is contained in a temporary implant, it is removed from the body at an appropriate time, while permanent radioactive sources lose their potency and turn inactive. Brachytherapy can be utilized as a single curative measure or it can sometimes be combined with radiotherapy to increase the rate of success. Brachytherapy is regarded as a standard radiotherapy method and is included in the majority of high-quality international treatment protocols. The globally popular HDR Brachytherapy device is used regularly at our hospital.
 
  • Dosimetric equipment: MD Anderson Cancer Center quality control programs are performed at daily, weekly, monthly and annual intervals for each therapy device and 4DCT scanner in our unit. We use dosimetric equipment that is approved by the MD Anderson Cancer Center, including specially customized models, for quality checks and dose measurements. All quality control programs are monitored online and meticulously checked by the MD Anderson Cancer Center.
Radiotherapy involves planned and controlled use of ionizing beams at pre-determined regional doses. Radiotherapy is one of the treatment modalities that is required by more than half of patients and it is administered for curative, adjuvant, palliative and prophylactic purposes.

Radiation is generated by LINAC which is a linear accelerator. Electrons are crushed against a metal barrier creating strong X-rays, called photons. Photon beams are delivered to a port that is located on the treatment table which can provide a 360 degrees dispersal. A fraction refers to a single radiation procedure.

Radiotherapy provides an optimal effect in the treatment of tumors while preserving all healthy tissue surrounding the said tumor. For such precision, careful planning is required. Simulation is the first stage of the planning process; this procedure can be defined as testing the immobilization devices that are used to incapacitate the patient during treatment while tomography images are acquired. Simulation can also be considered as the trial phase of the radiotherapy process. Simulator-derived data helps calculate the specific dose before the treatment commences.
Radiotherapy is one of the most vital methods of treating cancer as well as many non-cancerous conditions and is employed in more than half of all cancer cases. Combined with chemotherapy, radiotherapy is preferred by many doctors as a safe and efficient means to cure many varieties of cancer.
 
It can be the first-line option for the treatment of certain tumors, especially existing originating in the lung, prostate, skin and head and neck as well as early-stage Hodgkin’s disease, non-Hodgkin’s lymphoma or cervical cancer. It is also commonly used after surgery in the treatment of breast, endometrial, testicular, bladder, thyroid, pancreatic and brain cancers.

Neoadjuvant radiotherapy is frequently used for rectal and soft tissue cancers.

For pediatric cancers, personalized treatments are planned in line with the aforementioned multidisciplinary approach and guidelines.
The potential side effects of radiotherapy vary according to many variables. Our patients are informed by their primary doctor about the side effects that may develop during and after the treatment. These side effects are mostly transient and they disappear after said treatment is complete. We may use medication that can relieve or alleviate the complaints. Side effects should be regarded as transient problems that develop in almost all patients rather than unfavorable negative indications that the treatment in question is problematic.

Radiotherapy influences the healthy cells that are located within the target volume. Location and dimensions of the target volume are also important and side effects are more common with larger volumes. Daily dose, total dose, and concomitant medications may vary the side effects of radiotherapy. Physical condition and age of the patient as well as employed radiotherapy techniques are all directly linked to the manifested side effects.

Dermal side effects are directly proportional to the dose increase and they develop during the late phases of the treatment. The risk of side effects is higher for armpit, neck, anus and mouth cavity, as the skin tissue in those areas is particularly thin; with the thinner skin folds it is difficult to ensure hygiene and ventilation. Side effects that are initially manifested by mild redness, similar to a sunburn, may develop into open and purulent wounds. Radiotherapy over the head and neck area may negatively influence the teeth and subsequently the risk of caries increases. Therefore, regular dentist visits are very important. Mouth tissues are susceptible to radiation and resulting sores are more likely; this fact indicates the necessity of proper oral care. Other common conditions include dry mouth and difficulty swallowing secondary to decreased production of saliva.

A patient’s taste may be effected and skin wounds can be visible during neck radiotherapy. Alcohol and smoking should be avoided throughout the treatment due to exacerbating effects. Other side effects include lack of appetite, changes in voice, hair loss, difficulty swallowing secondary to radiotherapy of the chest wall, nausea, and vomiting as well as fatigue, tiredness, shortness of breath and dry cough. Diarrhea is among the most common side effect if the radiotherapy is focussed on the stomach, abdomen, and pelvis. Gastric cramps and bloating can be associated with nausea, vomiting, lack of appetite, weight loss and dysuria.
Radiation oncologists plan treatment that involves the total number of treatment days, sessions and the radiation dosages. They will be responsible for determining the medical problems that may develop during the treatment and the elimination of such problems.
High-dose radiotherapy is usually divided into fractions due to the radiobiological features of healthy and cancerous cells. Although this condition varies according to the diagnosis, treatment requires an interval of 4 to 8 weeks on average. Prolongation of the treatment allows us to eliminate the effects of radiation on the body.
A patient is delivered radiotherapy at doses from 20 to 78 Gy (1 Gy = energy of 1 Joule absorbed in 1 kg of tissue) depending on the diagnosis, stage, and purpose of the treatment. It is possible to comprehend relevant aspects of radiotherapy if it is clarified that the dose of X-ray exposed to acquire images in a modern mammography device is approximately 1/10,000 of 1 Gy. The total dose of radiotherapy is given in small daily doses usually for 5 days of the week.
 Doctors, radiotherapy technicians or patient’s family members should leave the patient’s room in order to avoid radiation exposure during radiotherapy. Although the patient stays alone in the room, s/he is followed up on the monitor as the room contains cameras. Patients and doctors can also communicate through a duplex internal microphone system.
Patients do not feel pain or ache secondary to external radiotherapy typically. They do not feel any physical discomfort other than small disturbances caused by brachytherapy. Medical support is always available in close proximity if pains and aches caused by side effects do emerge.