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The CHEM Center for Radiation Oncology

The CHEM Center is a unique model of collaboration between many health care facilities. Over 20 years ago, CHEM, Inc. (Community Hospitals of Eastern Middlesex) was incorporated by community hospitals in the north of Boston area to investigate and develop shared service programs. Members were interested in offering state of the art clinical programs to patients in their service area. This innovative consortium was the first of its kind and was a leader in the area of shared medical services. Programs developed over the years include the CHEM Center for MRI and the CHEM Center for Radiation Oncology.

The CHEM Center for Radiation Oncology is a nonprofit program sponsored by Hallmark Health, a regional health system that includes Lawrence Memorial Hospital and Melrose-Wakefield Hospital.


About Us

CHEM, INC. was incorporated in 1981 by community hospitals north of Boston to investigate and develop shared programs to enhance service to their patients. This innovative concept of sharing resources is now considered the model of health care delivery.

Over 50% of cancer patients will receive radiation therapy to treat their disease. Therapy is delivered, on average, for four weeks. Prior to the opening of the CHEM Center, patients would be required to drive significant distances to downtown locations, or be inconvenienced by long waiting times at more local sites.

The CHEM Center was designed to provide its patients with "downtown" expertise in a convenient setting, offering ample parking and a user-friendly facility. The CHEM Center's mission is to continously improve the quality of radiation oncology service to the community. This mission is supported by the Center's highly trained staff and state of the art treatment equipment.


Radiation is a special kind of energy carried by waves or a stream of particles. When radiation is used at very high levels it can be used to treat cancer and other illnesses. High levels of radiation can kill cells or keep them from growing and dividing. Cancer cells grow and divide more rapidly than many of the normal cells around them and so are very vulnerable to radiation.

Radiation therapy is an effective way to treat many kinds of cancer in almost any part of the body. Very special techniques are used to make sure that cancer cells are destroyed by the radiation while healthy tissue is protected. About half of all people with cancer are treated with radiation.

Radiation therapy is given by an expert team, which includes physicists, dosimetrists, nurses and therapists. A physician called a radiation oncologist leads the team

Equipment and Techniques

The CHEM Center specializes in external beam Radiation Therapy (also called Radiotherapy and Radiation Oncology). Radiotherapy is very dependant on specialized equipment and sophisticated computers to deliver therapy.

Linear Accelerator

The majority of Radiation Therapy is delivered by a Linear Accelerator. This is a very powerful machine capable of rapidly moving or accelerating electrons down a long (linear) tube. At the end of the tube, the electrons will strike a small target made of tungsten and their energy, measured in the millions of volts, is converted into x-rays. X-Rays are photons, just like visible light, only far more energetic. When the Linear Accelerator is used in this configuration, we say it is in Photon Mode.

The Linear Accelerator (or Linac as it is sometimes referred to) may also be used in Electron Mode. If the tungsten target were slid aside then the electrons would not be converted into x-rays and a Beam of Electrons would be emitted. An Electron Beam is another form of radiation and it behaves quite differently from Photons. Electrons are quite effective in treatment of shallow tumors, located from 1.5 to 3 inches from the skin surface.

The CHEM Center has 2 Linear Accelerators, one of which is designed to produce electrons as well. These Linacs are located in a special room sometimes called a vault.
Superficial Treatment Unit

Superficial Treatment Unit

CHEM is equipped with a Superficial Treatment Unit. This is a machine which produces x-rays which, while far more energetic than light or microwaves, are much LESS energetic that those produced by the Linac. While the x-rays produced by a Linac can be from a few up to 18 Million Electron Volts (MV) the x-ray beam produced by the superficial unit is "only" a hundred thousand electron volts (100 KV). What this means to the Radiation oncologists is that the beam from this machine is perfectly suited for treating very shallow or Superficial tumors like those of many skin cancers.

CT Scanner

CHEM installed a Computed Tomography (CT) Scanner dedicated to the imaging of cancer patients for the purpose of precise targeting and treatment delivery. The CT Scanner is a computer controlled x-ray unit which rapidly rotates around the patient (inside it's housing and out of view) to produce cross sectional images of great detail. Information such as that provided by the CT scanner is essential to the Radiation oncologist and the Physics staff for their goal of precise and efficacious treatment techniques. The CT scanner produces a series of cross sectional images which a special computer, called the Treatment Planning Computer can stack up like a loaf of bread and reconstruct a 3 dimensional model of the patient.

3D Treatment Planning (conformal therapy)

Radiotherapy often involves aggressive treatment of tumors which are difficult to identify or are located close to sensitve structures. In these cases, the Radiation Oncologists at the CHEM Center will rely on 3 Dimensional (3-D) treatment planning. This advance enables the identification of a tumor on multiple CT scan "slices" and the reconstruction of the tumor in 3-D on a computer screen so that it may be viewed from any angle. Carefully angled beams can then be directed to the tumor while avoiding sensitive structures. With this tool, the physician can confidently design complex treatment schemes using many small beams to reliably irradiate the tumor.


Meet the Staff

Physicians

Paul McKeough, M. D., FACR , Radiation Oncologist, Medical Director
Certification:  1989-American Board of Radiology, Radiation Oncology; 1985- Massachusetts Medical License
Academic Appointments:  Assistant Clinical Professor, Tufts University School of Medicine
Awards:

  • Fellow of the American College of Radiology, 2005
  • Medical Staff Appointments:
  • Melrose Wakefield Hospital
  • Lawrence Memorial Hospital
  • Winchester Hospital
  • Whidden Memorial Hospital - Cambridge Health Alliance
  • Mass Eye and Ear Infirmary
  • Professional Membership:
  • American College of Radiology American Society of Therapeutic Radiology and Oncology
  • Massachusetts Medical Society
  • Massachusetts Radiologic Society: Past President

email:This email address is being protected from spambots. You need JavaScript enabled to view it.

Physics

Ann Hudson, Medical Dosimetrist
Joined CHEM: '06
Education: BA, Heidelberg College, '75; Dosimetry Program, Yale University School of Medicine, '85 
Training:  Massachusetts General Hospital, Radiation Oncology; Harvard Cyclotron Proton Therapy

Nagesh Rao, MS, DABR, Chief Physicist
Joined CHEM: '07
Education: MSc, Physics, Andhra University, India, '77; MS, Applied Physics, University of Massachusetts, '84
Training:  University Hospital, Boston
Certifications:  American Board of Radiology, Therapeutic Radiological Physics, '92
Professional Affiliations:  AAPM, NEAAPM
Awards and Honors:  NEAAPM, Secretary Treasurer, 1996-97

Patty Tuccelli, MS, CMD, Medical Dosimetrist
Joined CHEM: '3
Education: B.S. Physics, Boston College '77; M.S. Radiological Science, University of Massachusetts '92
Training:  Massachusetts General Hospital
Certifications:  American Board of Medical Dosimetry - Certified Medical Dosimetrist (CMD)
Professional Affiliations:  AAPM, NEAAPM, NECHPS
Awards and Honors:  NEAAPM, Secretary Treasurer, 1996-97

Therapists

Glenn Davis RTTR, Chief Therapist
Joined CHEM: '91
Education: Salem Hospital School of Radiologic Technology
Certifications: ARRT, Mass DPH License

Kimberly Halloran, RTTR, Staff Radiation Therapist
Joined CHEM: '09
Education: Labore College
Certifications: ARRT, MA DPH License                                                                              Professional Affiliations:  ARRT; ASRT

Lynn Marcinkowski, RTT, Staff Radiation Therapist
Joined CHEM: '07
Education: University of Vermont; BS Business Management, Lesley University
Certifications: ARRT, MA DPH License                                                                              Professional Affiliations:  ARRT; ASRT 

Donna O'Shea RTTR Staff Radiation Therapist
Joined CHEM: '92
Education: St Francis Hospital School of Radiologic Technology Harvard Joint Center for Radiation Therapy
Certifications: ARRT, Mass DPH license
Professional Affiliations: ARRT


Intensity Modulated Radiation Therapy ( IMRT)

The CHEM Center now offers IMRT treatment to patients who would benefit from its unique ability to treat tumors that are adjacent to very sensitive tissue or oddly shaped tumors. Conventional Radiotherapy is delivered using a large uniform dose of radiation which is shaped to the tumor externally using various devices. IMRT on the other hand, is composed of thousands of very fine beams (beamlets) which vary in intensity.

Key components of this system are an advanced computer program that is used to plan the dose in three dimensions based on the unique body parameters of each patient. Also needed is a specially equipped linear accelerator to shape the dose into pencil sized beamlets.

Patients who benefit from this therapy include prostate patients and head and neck patients whose difficult to reach tumors are adjacent to critical and sensitive tissue. The use of IMRT reduces the incidence of side effects while delivering the most effective radiation dose.

For more information, talk with your physician and ask them to speak with Dr. Paul McKeough about this innovative and effective technique.


IMRT displayIntensity Modulated Radiation Therapy (IMRT) is now offered at the CHEM Center for Radiation Therapy, in Stoneham.

IMRT is a more precise method for treating cancer while sparing surrounding structures. This State-of-the-art technique was pioneered in the 90's in Stockholm, London , Houston and at Memorial in New York. It is a highly precise technique employing hundreds of tiny 'beamlets' in place of the standard 4 or 6 beams to tailor the radiation to the cancerous tissues. This technique became commercially available in 2002 and is currently offered by a very few centers in New England. In the image shown, 110 beam segments (beamlets) are focused on a prostate through 7 beam directions. 2 additional beams serve to stereoscopically localize the prostate with sub millimeter precision. Seen in orange behind the red prostate is the rectum, a sensitive structure which the doctors are able to spare more confidently with this capability. The colored beam cross sections are seen in a 'snapshot' of a treatment - beam size and profile changes throughout this 'dynamic' treatment which lasts about 15 minutes.


When you arrive, check in with the receptionist. A secretary from the front office will register you. The radiation oncologist will review any medical information or x-rays you bring with you before meeting you. A nurse and radiation oncologist will discuss your general health and current health problems.

The radiation oncologist will discuss the treatment with you including what effect you might expect from the treatments. A family member(s) or close friend may be present during this discussion and at all discussions with physicians.

If you are to receive therapy, you will receive a booklet that explains the process. This information is also available at this web site in the "what to expect" section of the site.

Referral Process

Typically, a patient is referred to the CHEM Center by a primary care physician, surgeon, oncologist, or other specialist. Patients who have been told by their physician that radiation oncology is indicated and want to know more about the CHEM Center, should call our business office ( 781 279-0655) and ask for further information.

Before Your First Visit

If you are scheduled to be seen in consult at the Center, please remember to bring any films or medical records that have been requested by the Center when they confirmed your appointment. Please feel free to call us to ask questions about referral authorizations or other information prior to your visit

What to Expect

First Day

When you arrive, check in with the receptionist. A secretary from the front office will register you. The radiation oncologist will review any medical information or x-rays you bring with you before meeting you. A nurse and radiation oncologist will discuss your general health and current health problems.

Consult

The radiation oncologist will discuss the treatment with you including what effect you might expect from the treatments. A family member(s) or close friend may be present during this discussion and at all discussions with physicians.

Simulation

Before beginning treatment, the area to be treated is simulated in order to ensure the radiation treatments will be accurately administered.

The procedure involves having your radiation oncologist and technologist take some diagnostic-quality x-rays of the area and having some marks placed on the skin with a marker. The lines are temporary and will wash off. Some pinpoint black dots, made with indelible ink are placed at the corners of the treatment area. These are permanent and look like small freckles.

Simulation can take as long as 2 hours or as little as ½ hour. After your simulation is completed, a medical physicist or dosimetrist, with the aid of a computer calculates the proper radiation dosage.

Treatment

Please check in with the receptionist upon arrival. You will be asked to be seated in the main waiting area and a therapist will call for you when it is your turn.

Depending on the area being treated, the therapist may ask you to put on a gown and wait in the gowned waiting area. You will be escorted to the therapy machine by a therapist.

We request that relatives or friends accompanying you stay in the main waiting area, unless you require assistance in changing your clothes. This is to ensure other patients’ privacy. We welcome family and close friends, and will be glad to include them in your discussions with the radiation oncologist and nurse, at your request.

Treatments take only a few minutes per day. They are usually given five days a week for two to seven weeks. This schedule helps protect healthy body tissue by spreading out the total does of radiation. Your radiation oncologist will determine the total number of treatments you will need.

On-Treatment Visit

Each week your radiation oncologist will meet with you to discuss your progress. This visit takes place after your treatment. The therapist will remind you not to get dressed until after you have seen the doctor.

A physical exam appropriate to your case will be done. This is a good time to get answers to any questions that you or your family may have.

During your course of treatment we will ask you to get a blood test once or twice to monitor your bloods response to the radiation therapy. This can be done at the location of your choice. The nurse will give you a requisition.

Follow-up

Upon completion of your treatments you will be given an appointment to return for a check-up with your radiation oncologist. This usually takes place in one month. Follow-up visits are important in helping us observe your progress. They keep you and your primary physician informed on how you have responded to treatment.


Patients undergoing therapy at the Center should feel comfortable talking with their physicians, nurses, or therapist about any questions thay may have. Also, educational material is available in waiting areas. Patients may also print out material from this web site and from linked web sites including side effect sheets, special diet sheets and other information.

Side Effects

Side Effects of therapy vary among patients and are site specific. Listed below are the more common body areas treated at the Center and side effect sheets specific to that area. Also, The physicians, nursing and other clinical staff at the Center are available to talk with you in detail about side effects. These sheets are easily printable and are also available at the CHEM Center.

Diet & Nutrition

Nutrition is an important part of your therapy. It is important to follow sound nutrition guidelines, drink plenty of fluids, and maintain your weight.

However, if you are receiving pelvic radiation, it is recommended that you follow a lot fat, low fiber diet. This diet is available at the Center and is also available below.

  • low fat/low fiber diet: Pelvis irradiation only

Researching information about cancer

If you want to research cancer information , you need to know the name of the cancer you are researching and the "stage" of the cancer. You can ask your doctor who will be able to give you the name, stage and sometimes the "grade" of the tumor.

Medical Name

There are a number of different types of cancer, and treatment for different types, even in the same organ, can be very different. For instance, searching for just cancer of the lung will result in too broad a result. It's best to have your medical professional give you the exact name of the cancer and the organ it effects. In the case of metastatic cancer, find out the name of the organ where the cancer originally occurred and the area the cancer is now affecting. (Metastatic refers to cancer that has spread to a different area of the body.)

Stage

Cancer staging describes if and how far the cancer has spread. It is used to describe most forms of cancer (except cancers that involve the blood, like leukemia). There are two cancer staging systems, and knowing the stage of the cancer is important in understanding the prognosis and typical treatment. Your physician will be able to tell you the cancer stage and also describe what each stage designation means.

Grade

For some cancers, knowing the grade is important. The grading refers to how aggressive the cancer cells appear when viewed under a microscope. This information is discovered by the pathologist and will be available in a "path" report.

Prognosis

A prognosis is a general guide or outcome of a cancer stage. But there are many variations among cancers and among individuals. A prognosis is not an infallible prediction. It is wise to discuss information you may have obtained with a medical professional to further clarify your understanding about the subject.

Educational Link


How long does treatment take?

Treatment only takes a few minutes per day and is usually given five days a week for two to seven weeks. This schedule helps protect healthy body tissue by spreading out the total dose of radiation. Your radiation oncologist will determine the total number of treatments you will need.

How does my Doctor know what services I am receiving at the Center?

The CHEM Center Radiation Oncologists are in close contact with your primary and referring physicians throughout your course of therapy. Your physicians will receive written summaries of your first visit and a summary of your entire course of therapy.

What if I can't make it to the Center for my treatment because of bad weather?

It is important to receive all you treatments, but if you do need to cancel because of very bad weather or other reasons, please call us in the morning to let us know.

How do my films and other records get returned to hospital?

Typically, patients bring films to the Center to assist the CHEM physicians in designing the best therapeutic course. The CHEM Center will mail these films back to the originating hospital at the end of your therapy.

What kind of medical professionals work at the Center?

The CHEM Center considers it's staff one of the best reasons to choose the Center for your therapy. Three full time Radiation Oncology physicians participate in the referring hospitals' tumor conferences and hospital based oncology clinics. The physican group has over 60 years of experience in treating cancer patients in both community and teaching hospital settings. All physicians are board certified in Radiotherapy.

Additionally, highly trained and certified nursing, physics and therapy staff are chosen for their ability to work with the patient and patients' family to complete the course of therapy designed by the physicians.

I'm a HMO patient. Why do I owe a co-pay when I see the Doctor?

Copay responsibilities vary from plan to plan but most plans require that you pay when you see your Doctor for a consultative visit ( the first visit) and for your follow up visit ( after treatment is over ). No plan requires a co pay for daily treatment.

Why is my insurance company receiving a bill for a day I was not at the CHEM Center?

Unlike my services you receive, Radiation Oncology provides services to you in preparation for therapy as well as services to you while you are in the building. These charges reflect the work of physicists and dosimetrists in assisting the physician in planning your care and checking the doses and various other critical elements of your treatments.

What is Radiation Therapy?

Radiation is a special kind of energy carried by waves or a stream of particles. When radiation is used at very high levels it can be used to treat cancer and other illnesses.
High levels of radiation can kill cells or keep them from growing and dividing. Cancer cells grow and divide more rapidly than many of the normal cells around them and so are very vulnerable to radiation.

Radiation therapy is an effective way to treat many kinds of cancer in almost any part of the body. Very special techniques are used to make sure that cancer cells are destroyed by the radiation while healthy tissue is protected. About half of all people with cancer are treated with radiation.

Radiation therapy is given by an expert team, which includes physicists, dosimetrists, nurses and therapists. The team is led by a physician called a radiation oncologist.

What insurances does the Center accept?

The Center accepts all major insurances, including Medicare, Medex, Blue Cross, Tufts, Harvard Pilgrim, Secure Horizon, Aetna US Health care, Network Health, Hallmark Advantage and most other insurances. As a courtesy, the Center will verify your insurance and will inform you if you need to obtain a referral from your primary care physician. To check if your insurance is accepted, please call our business office at 781-279-0655.

Why do I receive two bills?

There are two groups that are responsible for your care at the Center. The first is the physicians group which is known as Middlesex East Radiation Oncology, and the second is the facility which is known as Community Hospitals of Eastern Middlesex, Hallmark Health. These groups bill for their service separately.


The Chem Center for Radiation Oncolopgy

48 Montvale Avenue
Stoneham, MA 02180

  • Phone: (781) 279-0655 
  • Fax: (781) 279-0409 
  • Scheduling: (781) 279-0655 
  • Hours: Monday - Friday 8 a.m. - 4:30 p.m.

Convenient Location with Ample Parking: Located off all major routes, with ample free parking. Handicapped accessible.

Driving Directions

  • Route 128: Take exit 38A Stoneham, which is Main Street, Route 28, Stoneham. At the 5th set of lights take a right onto Montvale Avenue. The CHEM Center is a two story brick building 1/4 mile on the left.
  • Traveling Route 93N: Take exit 36. At the lights at the end of the ramp, take a right onto Montvale Avenue. The CHEM Center is a two story brick building 1/2 mile on the right, past the Montvale Plaza.
  • Traveling Route 93S: Take exit 36. At the lights at the end of the ramp, take a left onto Montvale Avenue. The CHEM Center is a two story brick building 1/2 mile on the right, past the Montvale Plaza.

If you have any questions regarding directions, please contact the office at (781) 279-0655. The hours are Monday through Friday 8am - 5pm.

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