Designed to put patient comfort first
At the Cancer Center of Hawaii, we’re here to make you feel comfortable and confident in your cancer treatment plan. We’re the only radiation oncology cancer treatment centers on Oahu with two convenient locations: The Cancer Center of Hawaii Liliha in Honolulu and The Cancer Center of Hawaii Leeward in Ewa Beach.
As the premier oncology treatment group in Hawaii, we offer the most advanced treatment planning, cutting-edge radiation therapy and a compassionate, caring team who treats you like family. Our expert radiation oncology team of physician specialists and support team offer high quality, personalized care for many different types of cancer. We are dedicated to making your cancer treatment at The Cancer Center of Hawaii as comfortable, productive, safe and efficient as possible — so you can get back to a healthy and happy life. Our end goal is to achieve the best possible quality of life for each patient we treat.
A patient is typically referred to The Cancer Center of Hawaii by a medical oncologist, family physician, internist, pediatrician, gynecologist, surgeon, pulmonologist, gastroenterologist or other specialist. When you are referred to our Cancer Center, you will be given an immediate appointment. Make sure you bring all the relevant films or medical records requested by our Cancer Center staff when they confirmed your appointment. Many reports also have been sent to us by your referring physicians. Feel free to contact us before your appointment for questions or additional information.
Your First Visit
Your first visit with The Cancer Center of Hawaii includes a consultation and initial evaluation with one of our board-certified radiation oncologists, who will examine you and reconfirm your diagnosis. This appointment includes a health history, physical examination and discussion of treatment recommendations and options based on information from your physicians, your diagnosis, health history and the results of diagnostic tests.
During this consultation, the radiation oncologist reviews your medical history and physical examination as well as your pathology report and imaging studies provided by your referring physicians. Your primary doctor may order more tests, await results of other tests or have further discussions with your physicians to ensure the proper course of treatment. If your diagnosis calls for radiation therapy, the treatment will be described and discussed with you, including what you might expect from the treatments. A complete report of our radiation oncologist’s evaluation and treatment recommendations will be sent to your referring physician and any other physician you request. You will be asked to sign a consent form before any treatment is provided.
Please arrive 15 minutes early and bring a photo identification of yourself, all your insurance cards and medicines you are taking, or a list of medications. You will be asked to complete a few forms prior to seeing the physician and nurse. You may wish to prepare a list of questions before this first visit to ensure your questions are answered. Many patients bring a family member, loved one or supportive friend to participate in the physician and nurse consultation as well as accompany the patient for treatment appointments. You may wish to ask the person accompanying you to stay or leave during the physical examination. Feel free to call us to clarify any of the information shared during the consultation or ask further questions.
Cancer Treatment Simulation Sessions
After consultation with our radiation oncology physician, if radiation therapy is indicated, the patient is scheduled for a planning session, known as a “simulation,” during which time a special CT scan is performed. The purpose of the simulation is to determine how you will be treated. It allows our radiation oncologists to precisely outline the area that requires treatment and is needed for the radiation physicists and dosimetrists to accurately calculate your treatment plan. To be effective, radiation therapy must be aimed precisely at the same target or targets every time treatment is given. Simulation is the process of making scans and measurements of your anatomy to help our Cancer Center team direct the beams of radiation safely and exactly to their intended locations.
Simulation is part of treatment planning and not actual radiation therapy treatment. The simulation procedure is done by our radiation therapists under the supervision of the radiation oncologist. The information from your simulation will be placed in our treatment planning system to help plan your radiation therapy, including the type of treatment field, energy and angle of the beam for your radiation treatments. You will be informed of any special instructions before your CT simulation.
Simulation takes place in a special room at the Cancer Center of Hawaii. During simulation, the scanner helps locate the tumor volume and region to be treated and determines the best arrangement of radiation beams to treat the patient. We use the state’s first Big Bore CT Simulator to accommodate patients in immobilization devices, those with monitoring devices or very large patients unable to fit comfortably or safely in other CT technology.
The technology is used to simulate or “mimic” your radiation treatment without the actual radiation beam. During simulation, images of your body contours may be taken to allow for special computerized treatment planning. The procedure may take from 30 minutes to one hour or more lying flat on your back. At this time, tattoos (tiny skin markings the size of a freckle) are placed on your skin so our clinical team can position you precisely for your treatment. These skin markings showing treatment areas should not be washed off until you are told to do so. If you are marked with permanent tattoos, do not attempt to remove them. These tattoos are a permanent physical record of the location of your treatment. This particular treatment field may need to be identified many months or even years in the future. If a simulation is required before or during your treatment, it is done with our specialized scanner for radiation treatment planning.
Following simulation and before your treatment starts, we are involved in planning for your treatment, outlining the target to be treated and arranging the radiation beams accordingly. Utilizing complex and powerful computer programs, the dose to various structures is computed by our highly trained dosimetrists and radiation oncology physicians, after which our medical physicist performs a variety of quality assurance checks on the treatment machine to ensure the technology output matches the planned dosage from the computer. Treatment planning involves these special computers to calculate the proper radiation dose delivered to the tumor while protecting surrounding normal tissues. The process may use complex three-dimensional conformal radiation therapy or intensity-modulated radiation therapy (IMRT). After all treatment planning is completed and confirmed by our radiation oncology physicians, radiation therapy treatments can begin.
Comprehensive Cancer Treatment Planning
Treatment planning involves special computers to calculate the radiation dose delivered to the tumor while protecting surrounding normal tissues. The process may use 3-D conformal radiation therapy or intensity-modulated radiation therapy (IMRT).
The Linear Accelerator is the technology that is used for radiation therapy treatment. This process can take 10 to 20 minutes each day with most of the time spent positioning the patient for accurate treatment delivery. The patient’s diagnosis determines the total duration of treatment, typically two to ten weeks.
Starting Cancer Treatment
Treatment starts within days after the simulation procedure and following the treatment planning. The number of treatments is determined by the size, location, type and radiosensitivity of the disease or tumor, as well as your general health condition. The length of time for the treatment varies and depends upon the specialized treatment planned by our radiation oncologists. The amount of time for each individual treatment is very short. Our radiation therapists position you on the treatment machine and then leave the room during the actual treatment. It will be important for you to lie very still during the treatment. You will be monitored via an audio-visual system right outside the treatment room for your safety.
The treatment of radiation, or photon beam, is similar to the beam used in typical chest X-rays or CT scans, except it has much more energy. The beam is invisible and you do not feel it passing through you. External beam radiation is a local treatment and only works where the beam is aimed. Radiation does not circulate through the body. There will be no radioactivity in your body when you leave the treatment room and no one will be exposed to any radiation by being near you. Some cancers require an implant to deliver the radiation whereby we may place tiny radioactive seeds in the prostate, for example, for some early prostate cancers; and for some gynecological cancers, we may place temporary radioactive rods within the vagina or uterus.
Treatments are generally given daily, Monday through Friday, at about the same time each day for two to ten weeks. This schedule helps protect healthy body tissue by spreading out the total doses of radiation as indicated by the radiation oncologist. We accommodate any requested specific time of day as best we can. It is important not to miss too many treatments after radiation therapy has started and to be on time every day. Radiation treatments provide optimal outcomes if delivered in succession. Breaks in treatment are not advisable, unless there are medical reasons. If a scheduled treatment must be missed, it is critical to give as much notice as possible to your radiation therapists. Waiting time for treatments is kept to a minimum. Occasionally, an unavoidable delay may occur, and we apologize should this happen. We will do everything possible to keep the treatment schedule on time to get you back to your work, home and family activities.
Prior to your treatment and depending upon the area being treated, patients may be asked by the radiation therapist to put on a special gown in our private dressing rooms with space for changing and secure lockers for your belongings. When you are ready, the therapists escort you into the treatment room. In this room, you will lie on a treatment table that is part of our state-of-the-art treatment units called linear accelerators that perform computer-controlled radiation therapy treatments. The linear accelerator uses electromagnetic waves to accelerate charged particles through a specially designed tube that generates a powerful radiation beam. The radiation therapist aligns the linear accelerator treatment technology with the skin markings to ensure precise treatment and then leaves the room prior to each treatment. During treatment, the radiation therapists continuously monitor your treatment by a camera and audio connection within the treatment room that is shown on a video console just outside the treatment room; and the patient may talk to the therapist through the audio system. While treatment technology does not touch the patient, the patient can hear the machine running during the treatment.
Note: Do not bring valuable jewelry or watches that may need to be removed during your treatment. Do wear comfortable clothing and bring a jacket or sweater as temperatures in the waiting and treatment areas can vary and sometimes be quite cool.
Patients are encouraged to ask questions of the radiation therapists, nurses or physicians at any time. Visits with the radiation oncologist and nurse are scheduled periodically during treatment. Our physicians, nurses, radiation therapists and other staff are available to answer any questions regarding your treatment or symptoms you may have.
Off-Island Cancer Patients
For patients from outside of Oahu, we work with American Cancer Society, your health plan and others to coordinate low-cost housing, transportation and access to many resources. We offer off-island patients staying temporarily on Oahu ground transportation to and from our facilities.
Diet and Nutrition
Nutrition and a sound diet are an important part of your treatment. Follow nutrition guidelines, drink plenty of fluids and maintain your weight. Treatments of some cancers necessitate special diets. Speak with your doctor and nurse about any dietary requirements or needs.
After Treatment Follow-Up
As you near the end of your treatment, your radiation oncologist and nurse will discuss follow-up care and schedule your first follow-up appointment. Follow-up visits are very important to help us watch your progress, ensure recovery is proceeding normally, monitor your health status and keep you and your primary care physician and other referring physician informed on how you responded to treatment. Your radiation oncologist may also order additional diagnostic tests. Your referring physicians will be sent a summary report outlining your course of treatment. While the frequency of visits may change as time goes on, know that your radiation oncology team is available should you need to speak to someone about your treatment or ongoing side effects.
We share the concern over the costs of health care. In an effort to keep costs down, we ask our patients to make co-payments at the time of service. This eliminates expenses associated with mailing out bills for co-payments.
Our staff submits claims for services to insurance companies, Medicare, Medicaid and other payers indicated by you. Please bring with you any referrals or authorizations your insurance plan requires and let us know if your insurance changes any time during your treatment. We are preferred providers for most insurance plans whether fee-for-service, health maintenance organizations (HMOs), preferred provider organizations (PPOs) or other arrangement. We are participating providers for Medicare and Medicaid. We bill primary and secondary insurers directly. To ensure the procedures associated with your care are covered, please check with your insurer prior to treatment. The Cancer Center of Hawaii also accepts credit cards. In cases of financial hardship, payment arrangements can be made. Please direct your questions to our patient care coordinators and billing staff.