The radiation oncologist is not the one pulling the switch on the IMRT or other radiation machines. They have highly trained and licensed techs and operators for that. Most centers have full time RN's on duty too for medical complications or issues. The radiation doctor is the one that determines the dosage, mapping, and the millions of details that go into determining the "how to" part of one's radiation treatment.
They do monitor daily and weekly, how it is being administered, and if needed, they can modify or adjust things along the way, though my doctor told me that was a rare event, as they put so much time into the mapping and planning part themselves.
My rad doctor went as far as reading every surgical note I had in the past 10 years, including non PC related surgeries, she read the entire file on my previous 3 episodes of porocarcinoma, and how it was operated upon and the subsequent radiation treatment I had 10 years ago.
I feel she really did her due dilligence in deciding what was best for my situation.
As I was being treated, she was in constant touch and communications with my uro/surgeon, and no, there is no connection in any way between the two of them.
For salvage radiation, you typically will have anywhere from 30-45 daily treatments, so yes, it can spread it out to as much as 9 weeks. I lived within 15-20 minutes of my clinic, so that was handy during the 2 months I went. Going to one far off would only add a lot of expenses I would think, and keep you away from home and the things you like to be around. My opinion.
So you want a really good radiation oncologist at the least, mine had over 25 years experience, and she said that perhaps 80% of her patients are men with prostate cancer, so that sounded pretty experienced to me.
But despite that, in the end, all my treatments were being delivered by people with 2-4 year college degrees, and varying amounts of machine time experience. My main operator had been with the clinics big Novalis IMRT machine since it was installed 4 years before, so that gave me a comfort factor too.
David in SC
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence: 1 Month ED: Non issue at any point post surgery
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA:
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out 38 days, 9/9 - met 3rd rad. oncl., mapped 9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 in place