What is Radiation Therapy or Radiotherapy?
Radiation therapy or radiotherapy is the use of various forms of radiation to safely and effectively treat cancer. It controls the growth of the cancer or relieves pain. The goal of radiation therapy for cancer is to get enough radiation into the body to kill the cancer cells while preventing damage to healthy tissue. There are different radiotherapy types.
Depending on the location, size and cancer type, high-energy particles or waves (such as X-rays, gamma rays, electron beams or protons) destroy or damage cancer cells. Radiation therapy works by damaging cancerous cells.
Normal cells repair themselves, whereas cancer cells do not.
In this article you will read about: radiotherapy, is radiotherapy safe, types of radiotherapy, side effects of radiotherapy, how one should take care in radiotherapy as well.
Why Radiation Therapy For Cancer?
Radiation may be used to make your primary treatment more effective.
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Curative or Radical treatment:
This is given with the aim of destroying a tumour that has not spread to other parts of the body. Therefore, cures the cancer.
Curative treatment may be given on its own or it may be given before or after surgery or chemotherapy. It can be treated with radiation therapy before surgery. This helps shrink the cancer and allow less extensive surgery.
One can be treated with radiation after surgery. This will destroy small amounts of cancer that may have been left behind.
Sometimes, the overall goal is to slow down the cancer as much as possible.
In some cases, it’s not possible to cure a cancer. The goal is to reduce the symptoms caused by growing tumors and to improve one’s quality of life.
Palliative treatment uses lower doses of radiotherapy. Also, it relieves pain over a shorter period of time to shrink the tumour.
Is Radiation Therapy Safe?
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Radiation therapy is safe and effective. It has been used successfully to treat patients for more than 100 years. Treatment carefully focuses on the cancer while avoiding healthy organs in the area. Special computers monitors and double-checks the treatment machines. This ensures proper treatment.
Radiotherapy uses high-energy rays to treat disease. It involves introducing it either externally or internally. Therefore, there are main two types of radiation therapy for cancer.
- External radiotherapy aims high-energy X-rays at the affected area. During external beam radiation therapy, a beam of radiation directs through the skin to the cancer. Also to the immediate surrounding area. It destroys the main tumor and any nearby cancer cells. This allows doctors to get enough radiation into the body to kill the cancer while giving healthy cells time each day to recover.
- Internal radiotherapy involves placing radioactive material inside the body.
Following are the types of radiotherapy:
Intensity Modulated Radiotherapy (IMRT):
IMRT is an advance mode of high precession radiation. In IMRT, radiation beams are subdivided (modulated) into many beamlets aiming at the tumour from various directions. Also, intensity of each of these beamlet can be adjusted individually. Thus, shapes radiation exactly to fit the tumour.
Using IMRT, further limits the amount of radiation which healthy tissues receives near tumour.
In many situations, this may also allow relatively higher dose of radiation delivering to the tumour. This increases the chances of cure.
This method of treatment delivery is very accurate. Therefore, proper positioning of the patient becomes crucial. The planning of IMRT procedure takes 2-4 days after the immobilization and the imaging procedure.
With a good computer based inverse planning methodology and with rigorous OA, IMRT is complete.
Image Guided Radiation Therapy (IGRT):
Image Guided Radiation Therapy or IGRT helps to improve the delivery of radiation.
IGRT involves conformal radiation treatment guide by a CT scan (Cone Beam CT) in the treatment room. It is done just before introducing the patient with radiation treatment.
This type of radiation therapy is one of the most advance form of radiotherapy. The imaging information from the planning CT scan done earlier overlaps on this Cone Beam CT. This technique tracks the movements of tumour breathing or reduction in size. Also, it instantly detects and corrects even the millimeters variation in daily positioning of the patients.
Treatment with respiratory gating is for tumours that move during respiration such as lung and liver.
Stereotactic Body Radiotherapy (SBRT):
Stereotactic Body Radiotherapy (SBRT) is an immerging image guided radiation method. SBRT is directed to extremely well-defined targets within the body. It delivers very high doses of radiation precisely to tumours sites within the body. Its purpose is to improve local control.
This type of radiotherapy is useful for:
- Small lung cancers or metastasis
- Small liver tumours or bony tumours and
- Tumours in other sites that may not be appropriate for surgical resection or in patients who would not be candidates for surgery.
It generally takes about 3-5 treatment fractions. At times, doctor would implant small gold fiducial markers with minimally invasive techniques. This helps to provide Stereotactic image guidance during radiation therapy. 3D imaging (CT, CT/PET, CT/MR) constructs very precise plans minimizing radiation dose to normal structures.
3 Dimensional Conformal Radiation Therapy:
Tumours are not regular. They are in different shapes and sizes. Three-dimensional Conformal Radiation Therapy (3D-CRT) uses computers and high definition software with special imaging techniques. It helps to map the size, shape and location of the tumour.
Uses Computer Assisted (CT scans), Magnetic Resonance Imaging (MR scans) and / or Positron Emission Tomography (PET scans), individually or by fusion. It therefore creates detailed three dimensional representations of the tumour and of the surrounding organs.
This therapy uses a multileaf collimator (MLC) to precise radiation beam to targeted area. Adjacent normal tissues receives less radiation and are able to heal quickly.
2D simple / 2D complex Radiation Therapy:
It is one of the radiotherapy types. This is conventional treatment offered using linear accelerator. Patients undergo CT scan based planning. Port film with the technique which has the latest high resolution amorphous silicon portal imager.
Brachytherapy also known as internal radiation (type of internal therapy). Involves placing radioactive material into a tumour itself or into its surrounding tissue. The placement of radiation sources are close to the tumour cells. Therefore, a large dose of radiation can be delivered with CT-Scan-image-based 3D planning.
Brachytherapy may cause fewer side effects than does external beam radiation. Also, the time is usually shorter with brachytherapy. Brachytherapy can be used alone or in conjunction with other cancer treatments.
Proton Beam Therapy:
Proton beam therapy is one of the radiotherapy types of external beam radiation treatment. It uses protons rather than X-rays to treat certain cancer types and other diseases.
The physical characteristics of the proton therapy beam allow doctors to more effectively reduce the radiation dose to nearby healthy tissue.
Neutron Beam Therapy:
Like proton therapy, neutron beam therapy is a specialized form of external beam radiation therapy. It is often used to treat certain tumors that are radio-resistant. It means that they are very difficult to kill using conventional X-ray radiation therapy.
Neutrons have a greater biologic impact on cells than other types of radiation. Used carefully, this added impact can be an advantage in certain situations.
Systemic Radiation Therapy:
Treatment of certain cancers may involve swallowing radioactive pills or receiving radioactive fluids in the vein (intravenous). This type of treatment is also known as systemic radiation therapy. Because the medicine go to the entire body.
Doctor would give Radioactive iodine capsules to treat some types of thyroid cancer or to treat pain due to cancer that has spread to the bone.
Stereotactic Radiosurgery and Stereotactic Radiotherapy (SRS/SRT):
Radiosurgery is a now a authenticate alternative to conventional surgery to treat Brain Tumours. Brain Tumour does not necessarily mean cancer. Only 50% of the Brain Tumours are malignant, the rest are benign. Most Brain Tumours needs treatment with surgery or by opening the head. This procedure is done with techniques known as Stereotactic Radiosurgery and Radiotherapy (SRS / SRT).
As compared to conventional methods of treatment, the superior efficacy of Radiosurgery offers:
- Lower risk of complications,
- Shorter hospital stay,
- Reduced morbidity and
- Improved quality of life
Stereotactic radiotherapy is a technique that allows to precisely focus beams of radiation to destroy certain types of tumors. In addition to treating some cancers, radiosurgery can also be used to treat malformations in the brain’s blood vessels. Also, to treat certain noncancerous (benign) neurologic conditions.
Now that you have read about the types of radiotherapy for cancer we will now read the side effects of radiotherapy.
Radiotherapy Side Effects:
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Radiation therapy is usually well tolerable and many patients are able to continue their normal routines but sometimes cause side effects. Many of the side effects of radiation therapy are only in the area being treated. Radiotherapy side effects are temporary. Your doctor and other members of the treatment team can treat these side effects. Side effects usually begin by the second or third week of treatment. Information about how to manage them and prescribed medicines or changes in your eating habits to help relieve your discomfort.
How Should I Care for Myself During Radiation Therapy?
- Seek out support: There are many emotional demands that you must cope with during your cancer diagnosis and treatment. It is common to feel anxious, depressed, afraid or hopeless. It may help to talk about your feelings with a close friend, family member, nurse, social worker, a support group or psychologist.
- Get plenty of rest: Many patients experience fatigue during radiation therapy. So, it is important to make sure you take a good rest. If possible, ask friends and family to help out during treatment, by running errands and preparing meals. This will help you get the rest you need to focus on fighting your cancer.
- Follow doctor’s orders: In many cases, your doctor will ask you to call if you have developed a fever of 101° or higher.
- Eat a balanced, nutritious diet: A nutritionist, nurse or doctor may work with you to make sure you are eating the right foods to get the nutrition you need. Therefore, with certain types of radiation, you may need to change your diet to minimize side effects.
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- Treat the skin that is exposed to radiation with extra care. Since, the skin in the area receiving treatment may become red and sensitive, similar to getting a sunburn.
- Clean the skin daily with warm water and a mild soap.
- Avoid using any lotions, perfumes, deodorants or powders in the treatment area unless approved. Try not to use products containing alcohol and perfumes.
- Avoid putting anything hot or cold on the treated skin. This includes heating pads and ice packs.
- Stay out of the sun. Although, if you must spend time outdoors, wear a hat or clothing to protect your skin. After treatment, use sunscreen with an SPF of at least 15.
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