Radiation Oncology

Although it’s called Gamma Knife, there is no blade or blood. Instead, it's a radiosurgical treatment that delivers a dose of gamma radiation to the target with surgical precision and is the most accepted and widely used radiosurgery treatment in the world. The Perfexion Gamma Knife offers state-of-the-art treatment for patients with a wide spectrum of brain tumors and other brain abnormalities.

Gamma Knife Radiosurgery - What you can expect before, during and after treatment.
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What is TrueBeam Cancer Treatment?

TrueBeam® is an advanced cancer treatment system that uses high-energy X-rays or electrons to deliver a broad array of powerful cancer treatments with pinpoint accuracy and precision.

TrueBeam can track and compensate for your physical motion and tumor motion. In many cases, with its high dose delivery rates and technology system, TrueBeam can deliver treatments more quickly, so you can potentially spend less time in treatment.

Together these features open the door to new possibilities for the treatment of lung, breast, prostate, head and neck, and many other cancers.

Why would you want to be treated with TrueBeam?

The TrueBeam system has become a new standard of care. Here are some of its advantages:

• Non-invasive. TrueBeam treatments require no surgery, no incisions, and no post-surgical healing.
• Reduced-Risk. The TrueBeam system’s faster delivery time can also reduce the chance of tumor motion during treatment, which helps protect nearby healthy tissue and critical organs.
• Accuracy. The TrueBeam system treats tumors with pinpoint precision. This accuracy is made possible by the system’s sophisticated architecture, which automatically synchronizes imaging, beam shaping, and dose delivery, performing internal accuracy checks every ten milliseconds throughout the entire treatment.
• Designed for patient comfort. TrueBeam has also been designed with your comfort in mind. It operates quietly and provides built-in music capabilities so you can listen to music during treatments. Closed-circuit television systems with two-way audio allow the radiotherapist to monitor you from outside the treatment room, and interact with you throughout treatment.

SBRT is much like SRS (again imagine a laser pointer) except that we administer the treatment to other areas of the body other than the brain. We are able to focus this same type of SRS treatment to tumors such as lung or liver. The only real difference is that instead of patients getting their treatment all at once, in one day, we administer it over the course of three to five treatments. Again, each treatment only lasts a small amount of time, and most patients can return to their normal daily routines the same day.

How you can benefit from the stereotactic radiosurgery procedure.
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EBRT is another name for the conventional methods of treating patients with high energy x-rays, or radiation, for cancer. This means that the radiation is produced from a large machine and is administered to a patient while lying on a table. Patients do not feel the radiation, the treatment does not hurt, and once the machine is turned off, there is no radiation left in the person's body. This type of treatment typically lasts about 15 to 20 minutes.

IMRT is a beam of radiation (imagine a small flashlight) that allows us to focus a precise amount of radiation to deposit in an area affected with cancer and limit exposure to areas that are without cancer. It allows us to “paint” doses of radiation to various areas within the body. We can “paint” a lot of radiation to the tumor, and “paint” little radiation to the normal tissue and organs. This helps with tumor control and decrease in side effects.

This is usually done with the machine stopping at several different angles (think of angles around a circle) and treating from seven or more stops around this circle. Treatment usually takes from 20 to 30 minutes depending on the area being treated and complexity of the plan.

IGRT is another major advancement in Radiation Oncology. IGRT allows physicians the ability to take a "picture" of the cancer and its location on a daily basis, and then allow for adjustments based on that information. Patients can have physical changes which may affect the location of the tumor. By being able to visually locate the tumor daily, the physicians can make adjustments for those changes and ensure that we are targeting the cancer and minimizing the exposure to normal tissues.

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HDR is a form of therapy that allows radiation oncologists to administer radiation within, close to, or on top of the actual cancer. This allows physicians to treat certain types of cancer with a very intense amount of radiation to a very small and internal area of the body. This type of treatment can be administered to the prostate, breast, the bronchi in the lungs, the esophagus, and the cervix, uterus, and vagina.

• Christopher Goulet, MD
• Michelle Proper, MD (Missoula)
• John Schallenkamp, MD
• Breanne Terakedis, MD
• Robert Beery, Manager
• Physics, Dosimetry, Radiation Therapist, Nursing and Navigation Staff

Three of our radiation oncologists practice in Billings and provide outreach services to Sheridan, Wyoming. In addition, we have a full-time radiation oncologist in Missoula, Montana.

At any given time, our radiation oncologists have access to a variety of clinical trials for the treatment of different cancer diagnoses through our membership in the Montana Cancer Consortium, a NCI Community Oncology Research Program (NCORP).

Three of our radiation oncologists practice in Billings and provide outreach services to Sheridan, Wyoming. In addition, we have a full-time radiation oncologist in Missoula, Montana.