News & Events


News and Events

Frequently Asked Questions

Department of Radiation Oncology

 

 

Will the radiation treatments burn my pet’s skin?

Radiation does not cause thermal injury to the skin. What we may see with radiation patients that have a tumor near the skin’s surface is called “moist desquamation.” Think back to a time that you skinned your knee on the sidewalk when you were playing as a child. The healthy, pink tissue that was exposed gave off a fluid (plasma) that hardened into a crust (scab). With radiation therapy, there is a mild amount of inflammation associated with this same change in the skin surface. Patients benefit from an oral anti-inflammatory medication, which we start at the beginning of treatment.

Moist desquamation is usually observed near the end of radiation therapy, and is generally healed within 2-3 weeks after treatments have completed. It is important to note that this skin effect only happens when surface tissues are targeted for radiation therapy – the same is not true for skin over tumors located deeper in the body.

Is radiation therapy painful?

Radiation therapy is not painful. The overall radiation dose prescribed is divided into small, daily or weekly treatments. Because there is no pain associated with the treatments, we use sedation or light anesthesia only to ensure that there is limited movement during treatment.

Will radiation treatment of my pet have effects on me/my children?

Unlike radiation treatments for a small subset of human and animal cancers, where radiopharmaceuticals (radioactive molecules in liquid form given by injection) are used for treatment, the radiation treatments at VRC are given using “external beam radiation.”  These treatments are provided by a machine called a linear accelerator (Linac), which is a high-power x-ray tube. Similar to creating x-ray pictures, radiation is only given to the patient when the Linac is on. When this machine is off, there is no radiation emitted, and no radioactivity is found at the treatment site on the patient. Feel free to cuddle and play with your pet just as you did before (s)he started radiation treatment.

Can my older pet tolerate multiple days of sedation/anesthesia?

A common phrase in veterinary medicine is “age is not a disease.” As we are more likely to diagnose cancer in older patients, the majority of patients undergoing radiation treatments are advanced in age. Checking baseline blood work is one measure we take to assess individual blood cell lines and organ health, ensuring our patients stay safe during procedures. More than likely, if the results are within normal ranges, your pet will be able to handle the medications we prescribe.

To further ensure safety under sedation or anesthesia, it may be recommended that your pet have chest x-rays or a heart ultrasound. Between the blood work and imaging studies, even mild changes that may be detected in the organs do not prevent treatment, as using sedation or anesthetic medications that are friendly to specific organs is easily accomplished.

Will my pet become sick from radiation therapy?

Radiation therapy is a localized treatment, so your pet should not experience vomiting, diarrhea, lethargy, or other signs of general illness as a direct result of the radiation treatments. Because of daily sedation or anesthesia, your pet may become tired near the end of each week during treatment. Some patients may seem a little tired and play less for 2-3 weeks after radiation therapy; however, most clients tell us that their pets act like a puppy or kitten again, even during treatment.

How long do radiation treatments take?

Overall treatment time is only 10-15 minutes. However, patients typically spend 1.5 to 2 hours with us each day of treatment. During this time, your pet received a daily physical exam, including an updated body weight assessment, a radiation treatment, and supervised recovery from sedation of anesthesia. If the location of your home does not allow for daily travel to our hospital, we offer boarding options for your pet.

What is the difference between definitive and palliative radiation therapy?

Definitive radiation therapy is given as daily treatments over 16-20 days, Monday through Friday. This protocol includes a higher overall dose of radiation for better tumor control, and for certain cancers, a cure.

Palliative therapy is reserved for patients who have a cancer that cannot be completely cured due to a variety of reasons. The goals of palliative radiation therapy are to reduce pain, decrease tumor size, and improve the quality of life for the time an animal has left. Palliative radiation therapy is given as once weekly treatments over four weeks, or daily treatments during one week. The overall prescribed radiation dose is lower as compared to definitive radiation, and palliative radiation offers a chance to treat with positive benefit when a complete cure is not possible.

Radiation Therapy at VRC

When you hear about radiation therapy, your mind may be brought to images of the Toxic Avenger, or news stories about victims of radiation accidents. Radiation therapy and how it works may seem like a mystery, and mystery can lead to apprehension. Rest assured that this treatment for cancer has evolved along with many advances in technology, resulting in highly accurate and safe treatments.

One main goal of radiation therapy is to deposit high doses of radiation in the unwanted tumor tissue, while exposing the surrounding normal tissue to the least amount of radiation possible. It is the normal tissues in the treatment area that limit the overall dose of radiation that we can safely prescribe. Quality of life is of utmost importance, and so the way radiation treatments are planned is to limit the number and severity of radiation side effects as much as possible. As with other treatments in veterinary medicine, there are side effects that must be managed to provide the best experience for the patient.

Perhaps you have heard of “radiation burns” from previous accounts of treatment with radiation therapy. This is a bit of a misnomer, as radiation does not incite a thermal injury. Rather, if tissues close to the skin surface experience some radiation dose, we get what is called “moist desquamation”.

Moist desquamation is when the lower layer of skin cells are affected on the first day of radiation therapy, and it typically takes these cells three or four weeks to rise to the surface during natural skin replenishment. When these cells reach the surface, they turn wet and fall off in a layer, leaving the underlying pink, healthy tissues. This is similar to if you’ve ever scraped your knee on asphalt: the underlying pink tissue gives off a fluid (plasma) that hardens into a crust (scab).

Moist desquamation may occur with mild inflammation. Our patients at VRC are prescribed a non-steroidal anti-inflammatory drug (NSAID) and other low-dose pain medication to help with comfort while this early radiation side effect heals. Whether treated or not, most early effects of radiation therapy are healed within two-to-three weeks after treatment. It has been found that daily cleansing of the radiation site will help to hydrate the crusts that form and allow them to exfoliate naturally, accelerating the healing process.

Many accounts of “radiation burns” from therapeutic radiation come from older treatment plans using orthovoltage. This treatment modality utilized a lower energy beam that had higher radiation dose deposition in skin and preferential radiation dose absorption by bone. The early radiation effects from orthovoltage treatment included severe inflammation of the skin, while the late side effects (effects present 6 months after radiation therapy) included death of bone tissue, scarring of soft tissues, and secondary tumor formation. With the advent of the linear accelerator, which treats with a higher energy radiation beam (megavoltage), there is a skin sparing effect and no preferential bone absorption of radiation dose. This is why our patients look so good after treatment!

Another way to limit radiation dose to the normal surrounding tissues is to dose radiation over multiple beams from different angles. The multiple beams converge on the treated tumor, while the surrounding tissues experience a fraction of the dose. High dose conformity over the tumor is further enhanced by planning with Intensity-Modulated Radiation Therapy (IMRT), which uses individual lead leaves in the machine’s radiation window that are in constant motion during treatment. This action shapes the radiation field, “painting” the dose across the tumor and sparing more normal tissue than is possible with conventional radiation planning. IMRT can be used with nasal tumors, heart base tumors, prostate tumors, and more tumor types are being added to the list.

To learn more about Radiation Therapy at VRC or any other services that we offer, please give us a call at 610-647-2950 or email us at info@vrcmalvern.com.

 

Continuing Education at VRC

Is This Going to Burn? Side Effects of Radiation Therapy

WEDNESDAY, February 3, 2016 AT 7:00 PM

Rick Chetney DVM

A Discourse on Minimizing Side Effects of Therapeutic Radiation in Veterinary Medicine

  • Basic overview of previous radiation therapy delivery methods
  • How current practices in radiation therapy can minimize side effects to normal tissues
  • Types of radiation therapy in current use
  • How current practices in radiation therapy can minimize side effects to normal tissues
  • How to manage radiation side effects once they are observed

1 credit of complimentary CE through RACE and PVMA

LOCATION :

VRC Veterinary Referral Center

340 Lancaster Avenue

Malvern, PA 19355

 

PROGRAM :

Complimentary dinner and meet and greet starts at 7:00 pm. Session begins at 7:30 pm followed by Q & A.

Please contact Dara Longhini to register by January 28: 610-647-2950 or dlonghini@vrcmalvern.com.

Important VRC Announcement

To Our Referring Veterinary Community and Clients,

As we approach the end of 2015, all of us at VRC would like to express our gratitude for the trust and confidence you have placed in us to care for your clients and their pets. We recognize that you have many choices in where to refer your clients or receive specialty care for your pets and we appreciate that you have chosen us.

We have spent the greater part of this year learning and listening to the community and our referring veterinarians. We have heard and understood the importance of having all of our services under one roof to enable better patient care. This is why we are proud to announce the initiation of two changes to occur on January 4 that further elevate our medical offerings and increase client service.

Our first announcement is that we are relocating all of our services to the VRC hospital at 340 Lancaster Avenue in Malvern, PA. We know after 44 years in this community how important it is to have immediate access to all services. Combining the Cancer Center and VRC will create efficiencies, elevate our care and streamline communications for both referring DVMs and pet owners alike.

Our second announcement is that our very own Dr. John Anastasio, the current Director of Emergency and Critical Care will expand his role to become the medical director for the entire hospital. Dr. Kenneth Sadanaga and Dr. Dietrich Franczuszki both look forward to turning their attention fully on their surgical procedures and client communication. They are as eager as I am to see these exciting changes implemented and to witness the enhancements in customer experience that we know will accompany them.

We have always understood the importance of the customer experience, from interactions with our reception to the journey that both our patients and clients undertake while in our care. We also recognize the significance of a strong communication line between a referring veterinarian and the veterinary specialists on our team. These aforementioned changes will create a more unified environment in our hospital that will even further develop the client care and communication with the referral community that we already so deeply value. Under one roof, we will have the ability to work together and hold ourselves to the same high standards that we have in the past, while simultaneously striving to raise the bar and exceed expectations. We hope that these changes even further reinforce the confidence you already have in us as we enter 2016.

From all of us at VRC, we wish you, your staff, and family a happy holiday season and a healthy and prosperous New Year.

Best Regards,

James Gregory
Hospital Director
VRC Veterinary Hospital
340 Lancaster Ave
Malvern, PA 19355