General Q&A
Radiation Therapy (to be inserted on the For Patients general webpage)
Does low dose rate radiation therapy hurt?
No, low dose rate radiation therapy does not hurt. The device may be implanted during a surgical procedure. Healing from surgery takes time and can be painful. However, you should not feel the radiation working inside your body.
Will my hair fall out?
No, low dose rate radiation from CivaString, CivaSheet, and CivaDerm does not cause your hair to fall out. These are not systemic therapies and therefore do not impact hair growth. When CivaDerm is applied to your scalp, it may require a small area to be shaved for the bandage to adhere properly. The hair will grow back in most cases.
Can I still work?
Your doctor will advise you on approved activities. Yes, you can work with CivaString and CivaSheet, which are permanently implanted. You may wear CivaDerm to work as long as your job does not entail excessive sweating or submerging the device in water.
How do you know if radiation therapy is working?
In most cases, you will not feel the radiation working. You will return to the hospital or clinic for follow up imaging to assess your treatment site.
How long until radiation is out of your system?
Palladium-103 (Pd-103) is the radiation used for this therapy. The radiation dissipates over time. The half-life of Pd-103 is 17 days. For CivaString and CivaSheet, the therapeutic timeline is about 60 days. These implants are permanent and become inert over time.
Can you hug people after radiation therapy?
Yes, hugging people is acceptable after having radiation therapy with CivaString, CivaSheet, or CivaDerm.
How long do you have to stay away from people after radiotherapy?
Your doctor will advise about the appropriate precautions to take for your individual therapy. Many of our patients have no restricted interactions with others.
What is the difference between IORT and EBRT?
IORT is intraoperative radiation therapy while EBRT is external beam radiation therapy. The main difference is that IORT occurs during a surgical resection procedure while EBRT occurs as outpatient therapy over many weeks. IORT is a one-time treatment. EBRT involves many treatments.
With radiation delivered during surgery, the surgeon will judge the observe areas the cancer could spread, such as the surgical margins. CivaSheet goes to work immediately delivering the optimal dose. On the other hand, radiation dose delivered by EBRT is added over multiple treatments and optimal dose is achieved in about 3 weeks. EBRT treatments can require up to 6 weeks of treatment.
How does radiation kill cancer?
Radiation kills cancer in two ways: 1) radiation interacts with the cell DNA to break it to prevent cell proliferation and 2) radiation interacts with the water in the cell to create free radicals that kill the cell.
CivaSheet (to be inserted on the For Patients CivaSheet webpage)
How long does it take to implant CivaSheet?
Implanting CivaSheet adds less than 30 minutes to the overall surgery time for most patients.
How long does it take to complete the radiation therapy?
CivaSheet is implanted at the same time as your surgery for tumor removal. Post implant, CivaSheet radiation decays over time. The therapeutic timeframe is about 60 days.
How many visits are required to complete CivaSheet therapy?
CivaSheet is implanted during the surgery to remove your tumor. If you are not scheduled for a CT scan during your hospital stay, you may be asked to return for a CT scan to confirm the placement of the device. Typically, there are no additional follow up visits for CivaSheet. You will have follow up visits for monitoring your surgical recovery related to your diagnosis.
What are the side effects of radiation therapy with CivaSheet?
There are no known side effects directly related to CivaSheet radiation because it has a targeted, low dose delivery and it is shielded on one side to protect surrounding healthy tissues. Your physician can advise if you have risk factors related to your medical condition or history.
What is the prescription dose for CivaSheet?
A qualified physician tailors each CivaSheet prescription according to the patient’s medical history and diagnosis.
How is CivaSheet a directional device?
Gold is embedded on one side of a CivaSheet to block radiation from being emitted from that direction. The other side of the CivaSheet is considered “hot.” CivaSheet will be ordered by your Radiation Oncologist and implanted by your surgeon.
Will the CivaSheet be removed after radiation is complete?
No, the CivaSheet will not be removed.
Do the parts migrate after being implanted?
CivaSheet does not have a history of migrating after implant and this is confirmed in clinical trials.
Is CivaSheet compatible with follow up imaging, like MRI and CT?
Yes, CivaSheet is compatible with MRI and CT.
How is CivaSheet implanted?
CivaSheet is implanted during your tumor removal surgery. CivaSheet can be implanted in an open surgery or a minimally invasive or robotic surgery.
CivaString (to be inserted on the For Patients CivaString webpage)
How long does it take to implant CivaString?
Typically, the overall procedure to implant CivaString is less than an hour. CivaString is typically implanted in one minute per source with 14 to 24 sources implanted.
How long does it take to complete radiation therapy?
CivaString implants are delivered in a one-time procedure. The sources are permanent implants that remain in your body. The radiation strength fades over time and the therapeutic period is about 60 days.
How many visits are required to complete CivaString therapy?
Typically, three visits are required to complete CivaString procedures. The first visit is a consultation with your physician to confirm that this is the right therapy for you. The second visit is the implant procedure where the sources are inserted into the prostate. The last visit is an imaging visit in which a CT scan of the prostate will confirm and document the radiation therapy.
What are the side effects of radiation therapy with CivaString?
Side effects from CivaString implants are similar to other prostate procedures. The procedure will likely cause some discomfort immediately following the procedure. In the months following, as the radiation is treating the prostate, patients may experience some discomfort when urinating. Your physician will advise you if additional side effects are expected. CivaString has demonstrated in clinical trials that patients return to baseline (or normal) quickly and significantly less needles are required to place them in the prostate.
Will CivaString devices be removed after radiation therapy is completed?
No, CivaString procedures use permanent implants and will not be removed.
Do CivaStrings migrate outside of the prostate?
CivaStrings are not known to migrate outside of the prostate.
Are CivaStrings compatible with follow up imaging, like MRI and CT?
Yes, CivaStrings are compatible with MRI and CT imaging.
CivaDerm (to be inserted on the For Patients CivaDerm webpage)
How long does it take to attach CivaDerm for non-melanoma skin cancer?
The CivaDerm will be attached to the skin surface during an office visit. Typically, the office visit is scheduled for 30 minutes. During this time, your medical history will be reviewed and the treatment plan confirmed. Typically, attaching the device is accomplished in 5 to 10 minutes.
How many days do I wear the CivaDerm bandage?
The length of time to wear the bandage is determined by your physician. Most patients wear the CivaDerm bandage for 4 days.
How many visits are required for CivaDerm therapy?
Most patients will schedule 3 total visits. At the first visit, your physician will determine the best method for treating your skin lesion. During the second visit, the CivaDerm bandage will be applied to your skin. At the third visit, the CivaDerm bandage will be removed. During the second or third visit you may also have a CT or x-ray to document the radiation treatment delivered by the CivaDerm.
What will happen to my skin while wearing the CivaDerm bandage?
Typically, patients do not feel anything while wearing the CivaDerm. You may experience irritation from the adhesive in the bandage. The skin will look normal immediately following removal.
What side effects are expected on my skin?
Approximately, 18 to 20 days after the device is removed, the treated skin will turn pink and blisters may form. These normal effects may be treated with topical creams and will resolve on their own in 7 to 10 days.
What should you avoid during CivaDerm radiation therapy?
Patients wearing CivaDerm should not engage in activities that cause excessive sweating or movement of the bandage. Patients should avoid being submerged in water and sun exposure. Your doctor will advise you of activities you should limit while wearing the bandage. In general, it is not advised to hold children while wearing the bandage.