Radiation Oncology (Radiotherapy) is the branch of clinical medicine that uses ionizing radiation either alone or in combination with other treatment modalities, for the treatment of patients with malignant or benign diseases. Radiation Oncology can be practiced as an independent oncological specialty, or it may be integrated into the broader medical practice of oncology, e.g. clinical oncology.
Radiation Oncology includes responsibility for the diagnosis, treatment, follow-up and supportive care of the cancer patient, and forms an integral part of the multidisciplinary management and investigations of patients.
Radiation Oncology daily practice is characterised by a significant technological component related to the design and delivery of radiotherapy.
The three commonly used radiotherapy technologies are
- External beam radiation therapy (EBRT or XRT or teletherapy)
- Brachytherapy or sealed source radiation therapy
- Systemic radioisotope therapy or unsealed source radiotherapy
The main differences between the latter techniques relate to the location and type of the radiation source; for external beam radiation therapy the source is located outside the body, usually a linear accelerator delivering photons or electrons; brachytherapy uses sealed radioactive sources temporally or permanently placed precisely in the area under treatment, and systemic radioisotopes are given by infusion or oral ingestion.
Other highly specialized radiotherapy technologies include also
- Particle therapy using protons or heavy particles
- Intraoperative radiation therapy delivering radiotherapy during the peri-operative period at time of the surgical removal of the tumour and
- Stereotactic radiation therapy delivering very high radiation dose called ablative dose to a well-defined small tumour.
Managing cancer patients requires an enquiring mind, a secure general medical background, good practical skills, communication abilities and a strong commitment to patient care. Additionally the radiotherapy component requires knowledge and competency in the technological area, secured by a strong knowledge in medical physics and radiobiology.
Type of Work
In daily practice Radiation oncologists utilise radiotherapy, chemotherapy, hormone therapy, radioactive isotopes and other special techniques to treat patients with cancer.
Radiation oncology is one of the three primary specialties, the other two being surgical and medical oncology, involved in the treatment of cancer. Radiation can be given as a curative modality, either alone or in combination with surgery and/or chemotherapy, or as a palliative modality to relieve symptoms in patients with incurable cancers.
Radiation oncologists work in a multidisciplinary environment with other physicians such as surgical oncologists, interventional radiologists, internal medicine subspecialists, and medical oncologists, as well as with other non-medical professionals such as medical physicists and radiation therapists.
Given the extent of the indications of radiotherapy and the rapid and significant development of new technologies the present trend is towards a sub-specialisation:
- Organ or system-based subspecialisation: Head & Neck tumours, Brain tumours, Gastro-intestinal tumours, Lung and Mediastinal tumours, Bone and Soft Tissue tumours, Skin tumours, Breast tumours, Gynaecological tumours, Genito-urinary tumours, Eye tumours, Lymphomas & Leukaemias, Paediatric Tumours, Retreatment, Palliative Radiotherapy, Benign diseases, oncological emergencies
- Radiotherapy technique subspecialisation. With the expansion of new radiotherapy technologies, the present trend is radiation oncologist to specialised in a limited number of techniques
|Step 1||Step 2||Step 4||Step 5|
|Training Level||Medical School||Intern Year||2 years clinical experience||Higher Specialist Training in Radiation Oncology|
|Duration||4-6 years||1 year||2 years||5 years|
|Entry Process||Graduate or direct entry||Entry through the HSE Intern Match||N/A||Entry based on competitive interview|
|Mandatory Examinations||As per curriculum||N/A||N/A||Fellowship of Faculty of Radiologists|
|Application Date||CAO process opens in November||Application process opens in October||N/A||Application process open in November|
|Programme Operated by:||Undergraduate Universities||Intern Networks||N/A||Faculty of Radiologists|
The Faculty of Radiologists, Royal College of Surgeons in Ireland is the body responsible for provision of postgraduate training in Diagnostic Radiology and Radiation Oncology in Ireland.
At present, there are 17 Radiation Oncologist Specialist Registrars in full time training with the Faculty of Radiologists. They are spread across three accredited Radiation Oncology training centres (Cork University Hospital, Galway University Hospital and St Luke’s Radiation Oncology Network-Dublin).
A Radiation Oncologist requires:
Knowledge in :
- Basic Sciences, including Physics, Cancer Biology & Radiobiology, Clinical Pharmacology, Medical Statistics
- Clinical radiology
- Research and clinical audit
Competencies in :
- Organ or system-based specialities: Head & Neck tumours, Brain tumours, Gastro-intestinal tumours, Lung and Mediastinal tumours, Bone and Soft Tissue tumours, Skin tumours, Breast tumours, Gynaecological tumours, Genito-urinary tumours, Eye tumours, Lymphomas & Leukaemias, , Paediatric Tumours, Retreatment, Palliative Radiotherapy, Benign diseases, Oncological emergencies
- Radiotherapy Techniques: external beam radiation therapy (including IMRT), brachytherapy, systemic radioisotope therapy