We treat many different types of cancer, including breast, prostate, lung, and colorectal, and gynecological, as well as leukemias, lymphomas, and myeloma. Often, treatment plans include multiple approaches such as chemotherapy, hormone therapy, radiation therapy, and surgery. Our ongoing investigation of new ways to treat cancer allows our doctors to incorporate new therapies rapidly as they become available. Below is a description of the services we offer at our Cancer Center.

• Medical Oncology
• Blood and Marrow Transplantation (BMT) Program
• Chemotherapy
• Hormone Therapy
• Targeted or Molecular Therapies
• Radiation Oncology
• 3D Conformal Treatment Planning
• Brachytherapy
• External Beam Radiation
• Image Guided Radiation Therapy (IGRT)
• Intensity Modulated Radiation Therapy (IMRT)
• MammoSite® Radiation Therapy System
• On-Board Imager (OBI)
• Pediatric Radiation Therapy Program
• Permanent Prostate Seed Implants
• Respiratory Gating
• Stereotactic Body Radiotherapy (SBRT)
• Total Body Irradiation Program
• PsychoSocial Services
• Social Services
• Complementary Therapy & Support Groups
• Integrative Care
• Spiritual Care
• Nutrition

Medical Oncology

The Cancer Center’s medical oncology team includes board certified physicians, registered nurses who are certified by the Oncology Nursing Society, clinical assistants, lab technicians, and pharmacists. The Cancer Center also actively participates in clinical research trials, including large academic cross-country trials.

Back to top

Blood and Marrow Transplantation (BMT) Program

The Comprehensive Cancer Center maintains a bone marrow and stem cell transplantation program called the Blood & Marrow Transplantation Program. The program includes a cryo-preservation laboratory and pheresis unit to provide treatment for patients with leukemia, lymphomas, and myelomas. The BMT program participates in international transplant registries and has received a multi-year accreditation from the Foundation for the Accreditation of Cellular Therapy.

The BMT Program was the first transplanting center in Northern California. It has been modeled after programs typically found in university settings. A close partnership is formed between the patient and the BMT physician who guides treatment from consultation through post transplant care. Patients in the BMT program have access to all of the oncology services provided by the Cancer Center.

Back to top

Chemotherapy

All new chemotherapy patients at Alta Bates Summit Comprehensive Cancer Center attend an extensive New Patient Orientation course, led by a nurse, to help navigate through their treatment process. The course provides an overview of the services and support groups available at the Cancer Center, and detailed instructions on how to take care of yourself before, during, and after treatment. All patients, whether receiving chemotherapy or other forms of therapy, meet with doctors and nurses in one-on-one consultation sessions designed to provide information and support throughout treatment. Of course, your initial consultation is with your physician. In addition, you will meet with your physician’s "practice nurse" at your first consultation. Although you will have access to all the staff at our center, your care will be managed by your physician and his or her specially trained practice nurse. Your team will also collaborate with other staff members such as pharmacists, registered dieticians, social workers, and counselors.

This orientation is held every other Tuesday from 5:00 - 7:00 pm at the Comprehensive Cancer Center at the Herrick Campus in Berkeley. Please call (510) 204-1591 to register and for location details.

Back to top

Hormone Therapy

Like chemotherapy, hormone therapy – also called "endocrine-based therapy" – is a systemic treatment. But unlike chemotherapy, endocrine-based therapy was developed to interfere with certain natural body chemicals – hormones – which may stimulate cancer growth. Cancer types which characteristically may be sensitive to hormones include breast, prostate, ovarian, and endometrial cancers. To slow or prevent the growth of these sensitive cancer cells, hormone therapy drugs are chemically structured to interfere with the growth of such types of cancer, for example by decreasing the amount of hormone that the body produces or by blocking its action on the cancer cells directly.

Where chemotherapy agents may affect many other general cell types such as white blood cells, hormonal agents are more limited in their effects. They are the first type of systemic treatment directed at a specific target – the hormone-dependent cancer cell – and may be referred to as "targeted therapy."

Their benefits and their side effects relate only to the natural effects of the hormone itself and the hormone-cancer cell interaction. For that reason, the typical side effects seen with chemotherapy are not present with hormone or endocrine-based therapies. Hormone therapy may be used alone or in combination with radiation therapy. It is rarely used simultaneously, but is often used following chemotherapy.

Back to top

Targeted or Molecular Therapies

Normal cell growth and division are mostly under the control of a network of chemical and molecular signals that give instructions to cells. When this signaling process is disrupted, cells no longer grow, divide, or die normally when they should. Scientific discoveries related to these biochemical signals and their targets have resulted in numerous advances in the treatment of cancer. Cancer therapy that is directed to a specific target or signaling pathway is commonly called "targeted therapy" or "molecular therapy."

Targeted cancer therapies use drugs that block the growth and spread of cancer by interfering with cancer cell growth and division in different ways and at various points during the development, growth, and spread of cancer. By focusing on molecular and cellular changes that are specific to cancer, targeted cancer therapies provide effective treatment for cancer while sparing healthy tissues.

The medical oncologists at Alta Bates Summit Medical Center use the most current FDA-approved therapies and are committed to using the most recent discoveries in cancer therapies on behalf of their patients.

Back to top

Radiation Oncology

Radiation therapy, or radiation oncology, is a true targeted therapy with treatment directed precisely at the site of the cancer. It may be used as part of a larger treatment strategy that includes a systemic therapy – either chemotherapy or endocrine-based therapy – or it may be administered alone. The science behind radiation oncology continues to make rapid advances in scope and technique, thus reducing side effects and sparing healthy tissues by targeting the disease more precisely.

At Alta Bates Summit, we offer the following current radiation therapies:

Back to top

3D Conformal Treatment Planning

3D conformal treatment planning uses computer generated, three-dimensional images of the patient’s tumor, surrounding tissue, and the tumor’s exact position in the body, to make radiation therapy more accurate. Using the computer, the radiation oncologist develops a precise plan to deliver radiation to the tumor from a number of angles. Radiation physicists with expertise in medical radiation issues are an important part of this planning team.

Because of the degree of accuracy and precision that 3D conformal treatment planning allows, higher doses of radiation can be delivered to the tumor. Treatment is more effective, treatment time is shortened, and healthy tissue is spared. This approach is especially valuable to treat complex tumors such as cancers of the brain, lung and prostate or to treat children with cancer.

Back to top

Brachytherapy

Unlike external beam radiation, which treats the tumor from the outside in, brachytherapy treats cancer from the inside out by using radioactive implants placed into or a short distance from the tumor. Brachytherapy, though, is often combined with external radiation, surgery, or other treatments as part of an integrated care strategy.

High Dose Rate (HDR) Brachytherapy
Traditionally, low dose rate brachytherapy techniques have required two to five days of hospitalization for certain disease sites, such as gynecologic malignancies. Now, high dose rate techniques can deliver a therapeutic dose in minutes rather than days. High dose rate (HDR) brachytherapy delivers radiation directly into tumors through fine needles that are deployed from computer controlled "afterloaders" that move the radiation source on a wire within the needle accordingly to a carefully customized treatment plan developed by your doctor, a physicist, and a radiation therapist.

Back to top

External Beam Radiation

Radiation therapy uses either beams of radiation delivered from outside the body, called external beam radiation, or radiation emitted from "seeds" planted inside the body, either temporarily or permanently, called brachytherapy. New radioisotopes are in use that can be administered in liquid format for certain diseases as well (radioimmunotherapy). Radiation oncologists use the state-of-the-art tools to improve accuracy, reduce treatment time and side effects, and produce better overall results, as described below.

Back to top

Image Guided Radiation Therapy (IGRT)

Our Cancer Center uses the latest "cone beam" technology to produce a three-dimensional, computed tomography (CT) image to guide treatment of all parts of the body, without using invasive procedures. To maximize the effectiveness of IMRT treatments, the tumor, or target, must be accurately located each day. Even a slight change in a patient’s position from day to day can affect the delivery of the treatment. New image-guided techniques are being used to verify the location of the tumor before the treatment session begins.

Back to top

Intensity Modulated Radiation Therapy (IMRT)

Used after 3D conformal treatment planning, Intensity Modulated Radiation Therapy (IMRT) delivers pencil thin beams of radiation to target tumors while it spares healthy tissue. Very simply, IMRT gives the radiation oncologist more control over where and how much radiation is delivered. Importantly, IMRT allows the doctor to “paint” or conform the dose to a tumor’s irregular shape, while “sculpting” the dose to avoid critical structures such as nerves or glands.

Back to top

MammoSite® Radiation Therapy System

The MammoSite® Radiation Therapy System (RTS) offered at Alta Bates Summit is a minimally invasive, short-duration form of brachytherapy used in breast cancer after lumpectomy procedures. By internally delivering radiation directly to the tissue surrounding the original tumor, exposure to the rest of the breast, skin, ribs, lungs, and heart is limited.

The MammoSite RTS consists of a balloon catheter that is inserted into the space where the tumor was removed, either during the lumpectomy or shortly thereafter. An applicator shaft, which is a tube connected to the balloon, remains outside the breast. A radioactive “seed” is inserted into the balloon, through the applicator shaft over a one to five-day series of treatments. When the therapy is complete, the balloon is deflated and the catheter is easily removed. No source of radiation remains in the patient’s body.

The MammoSite RTS makes it easier for women to consider lumpectomies rather than mastectomies, promoting the practice of breast conservation therapy. However, this type of treatment is not for everyone. Talk to your doctor to see if you are a candidate.

Back to top

On-Board Imager (OBI)

An On-Board Imager™ produces both excellent quality kilovoltage images as well as high quality Cone-Beam Computed Tomography (CBCT) images in less than a minute. Tumors are located quickly and precisely at the beginning of each session, allowing treatments to be completed quickly. The ability to target the tumor and avoid the normal tissues is extremely important in certain disease sites, and the ability to use the linear accelerator as a CT scanner allows for excellent refinement.

Back to top

Pediatric Radiation Therapy Program

In conjunction with the pediatric oncology team at Children’s Hospital and Research Center in Oakland (CHO), Alta Bates Summit radiation oncologists provide radiation services for all children with malignancies who require radiation as part of their curative treatment. This includes treatment for a wide array of leukemias, lymphomas, soft tissue tumors and brain tumors in children from birth to age 18. The recent addition of an active pediatric anesthesia program allows the safe and highly focused delivery of radiation to infants who must be sedated for each daily treatment. These pediatric patients are treated based on active, national, Children’s Oncology Group (COG) protocols, and our pediatric radiation therapy program has received accreditation through the national Quality Assurance Review Center.

Back to top

Permanent Prostate Seed Implants

Implanting "seeds" of radioactive iodine or palladium directly into the cancerous area of the prostate gland is a treatment that offers a cost-effective alternative to surgery. This technique allows a much shorter treatment time than external beam radiation.

The seeds are inserted into the prostate through hollow needles, which are removed after the procedure is complete. The patient is typically discharged after several hours, or the next day at the latest. The seeds release their energy for a period of time after the procedure and before their radioactive properties decay. After a carefully planned interval, the radioactivity contained within the seeds is delivered to the site and they become inactive. The treatment is then complete. Talk to your doctor to see if you are a candidate for permanent prostate seed implants.

Radiolabeled Antibody Therapy
Although radiation therapy itself is a targeted therapy, there is an even newer type of treatment which combines radiation with a systemic agent, enabling the radiation to be delivered in the body directly to the cancer cells through bloodstream. In this instance, the systemic therapy is an antibody with a radioactive medication attached to it, directed against certain lymphomas. An antibody is a protein which the body makes to fight against a target, usually a bacteria or another infectious agent. In this circumstance, however, the target is the surface of the lymphoma cell itself. One of these combination drugs is called “Zevalin” and consists of an antibody with an attached radioactive agent called “Yttrium” which is delivered to the lymphoma cells, thus sparing healthy tissues.

Although Zevalin treats only certain types of lymphomas, it is likely that the use of this type of therapy will become more widespread as more agents and combinations are developed.

Back to top

Respiratory Gating

Respiratory gating is a technology that matches the delivery of radiation to a patient’s breathing pattern. When you breathe, your chest wall moves in and out, and your organs and tissue in the chest and upper abdomen move as well. With respiratory gating, the radiation beam is only on at certain times to ensure that the beam is delivered to the proper target. This allows your doctor to treat a smaller area, with improved accuracy.

Respiratory gating is useful in treating tumors that may move with respiration during the radiation treatment, such as cancers in the liver and tumors in the outer regions of the lung. This technique also protects the heart during treatments for some types of breast cancer. The ability to localize dosage and protect healthy tissues in this manner allows treatment of lesions in the liver that could not previously be treated with radiation.

Respiratory gating is not for everyone. It requires the patient’s cooperation and ability to follow specific breathing instructions. Talk to your doctor to determine if respiratory gating is appropriate for you.

Back to top

Stereotactic Body Radiotherapy (SBRT)

For certain disease sites, such as small lesions in the liver, lung or along the spine, treatment plans can be designed that will treat the tumor in three to five periods over the course of a week as an outpatient. This can only be accomplished with highly conformal radiation beams that minimize risk to nearby structures. The advent of the cone beam CT, on board imagers, and respiratory gating now make this possible for certain individuals. This is an effective alternative to surgical resection under the appropriate circumstances. Talk to your oncologist to ask if Stereotactic Body Irradiation is right for you.

Back to top

Total Body Irradiation Program

As part of the adult/pediatric stem cell transplant programs, the Radiation Department has been performing total body irradiation for over 15 years. A variety of radiation protocols are available for different disease sites, with the availability of anesthesia for the young children as well.

Back to top

PsychoSocial Services

As part of Cancer Center’s goal of treating the whole patient, we offer a number of psychological and social support services ranging from individual and family counseling to support groups, nutrition, financial counseling, and spiritual care. All services are provided by professionals who understand the unique needs of cancer patients and their families.

Back to top

Social Services

Cancer creates its own unique set of issues for patients and their families. Our social workers serve as advocates, bringing together information and support from internal and external resources. They facilitate better communication between patients and their doctors and provide referrals to psychologists and chaplaincy services. They are an integral part of our program from the very start of your evaluation
Back to top

Complementary Therapy & Support Groups

We believe that an integrated approach to cancer care depends on a number of supportive care options. The medical center medical staff includes individuals who are board certified in acupuncture and Chinese herbal medicine. We also provide complementary therapy workshops on yoga, Jin Shin Jyutsu, therapeutic massage, guided imagery and more.

Support groups offer patients an opportunity to discuss their experiences with other patients – people who understand their experiences. Research has shown that people who participate in support groups often have less anxiety, distress, and pain.

A number of different support groups are available - several are also open to spouses and family members. Click on the Complementary Therapy & Support Groups link for information about all our programs.

Back to top

Integrative Care

We believe that optimal cancer treatment must align a patient’s spiritual and emotional needs with their medical treatment. Our goal is to enhance each patient’s quality of life and facilitate healing by using multidisciplinary resources to integrate complementary therapies into traditional oncology care.

Back to top

Spiritual Care

Our Psycho-Social Services group also helps address the spiritual and religious needs of patients, their caregivers, and family members. Our staff begins by understanding a patient’s beliefs and then facilitates appropriate care. A medical center chaplain may provide spiritual care and emotional support directly or provide referrals to other faith communities. More about the Alta Bates Summit Spiritual Care Services Department.

Back to top

Nutrition

Nutritional support during and after treatment helps patients cope with their treatments. A healthy diet can improve strength and energy, and increase your ability to fight disease. The Cancer Center’s registered nutritionists, experienced in oncology care, work with patients to design nutritional plans that specifically address individual needs and the side effects brought about by cancer treatment.

Back to top