Radiation Therapy Overview
Radiation therapy which is also known as radiotherapy, is a type of cancer treatment that uses high doses of radiation through beams of intense energy waves to kill cancer cells and shrink tumors.
High-energy radiation is used to damage cancer cells DNA and destroy their ability to divide and grow.
Radiation therapy may be delivered using machines called linear accelerators or via radioactive sources placed inside the patient on a temporary or permanent basis. This may be used to cure cancer, to relieve a cancer patient’s pain or alleviate other symptoms.
The two main types of radiation therapy for treating cancer are external beam radiation and internal radiation therapy. Radiation therapy most often uses X-rays, but protons or other types of energy also can be used.
Radiation therapy treats cancer by using high-energy waves to kill tumor cells. The goal is to destroy or damage the cancer without hurting too many healthy cells.
According to the American Cancer Society (ACS), over 50% of the cancer patients receive radiation therapy as part of their cancer treatment. Doctors use radiation therapy to treat just about every type of cancer. Radiation therapy is also useful in treating some noncancerous or benign tumors.
The type of radiation therapy recommended by a doctor usually depends on the type of cancer a patient, the size and location of the tumor, and the patient’s overall health condition.
Preparation for radiation therapy is focused on targeting the radiation dose to the cancer as precisely as possible to minimize side effects and avoid damaging normal cells. Imaging tests may be used to help determine the exact shape and location of your tumor and define its boundaries.
This treatment can cause side effects, but they’re different for every patient. These side effects depend on the type of radiation you get, how much you get, the part of your body that gets treatment, and how healthy you are overall.
Radiation therapy damages cells by destroying the genetic material that controls how cells grow and divide.
While both healthy and cancerous cells are damaged by radiation therapy, the goal of radiation therapy is to destroy as few normal, healthy cells as possible. Normal cells can often repair much of the damage caused by radiation.
Radiation damages genetic material called DNA inside of cancer cells. If the cancer cell cannot repair the DNA, the cell will not be able to produce new cells and may die.
A cancer patient’s doctors and the treatment team will carefully plan radiation therapy to minimize damage to the normal tissues and the organs.
Types of Radiation Therapy
Following are the two main types of radiation therapy commonly used for the treatments cancers:
External Beam Radiation Therapy (Teletherapy)
External beam radiation therapy, also known ad teletherapy is the most common type of radiation treatment for cancer. In this type of radiation therapy the energy beams come from a machine outside of the body. A healthcare professional precisely aims the beams, which penetrate the body to reach the cancer location.
Internal Radiation Therapy
The second main type of radiation treatment is internal radiation therapy, also known as brachytherapy.
During this treatment, a doctor places an implant containing radiation in or near the cancer site. These implants come in different shapes, including the following:
- Capsule
- Pellets
- Seeds
- Tube
- Wire
Systemic Radiation Therapy
Systemic radiation therapy is another kind of internal radiation therapy. It requires a patient to swallow a radioactive substance, which travels throughout the body to find and kill the cancerous cells. Alternatively, a healthcare professional may inject the radioactive substance into a patient’s vein.
Radiation Therapy to Cure Cancer
A radiation oncologist may use external beam radiation therapy or brachytherapy to treat cancer. External beam radiation therapy can be generated by a linear accelerator, which is a machine that accelerates electrons to produce x-rays or gamma rays.
Proton therapy is another form of external beam radiation therapy that uses cyclotrons or synchrotrons to produce charged atoms that destroy tumors. Radiation therapy given by radioactive sources that are put inside the patient is called brachytherapy.
The radioactive sources are sealed in needles, seeds, wires, or catheters, and implanted directly into or near a tumor on a temporary or permanent basis. Brachytherapy is a common treatment for prostate cancer, breast cancer, cervical cancer and uterine cancer.
Some cancer patients may be treated with radiation as their primary treatment. In some cases, radiation therapy is given at the same time as chemotherapy. Chemotherapy used in combination with radiation therapy can improve the local response and reduce metastatic disease.
In other cases, radiation therapy is given before (neoadjuvant treatment) or after (adjuvant treatment) surgery.
How Radiation Therapy Works
External beam radiation and brachytherapy work similarly. Both are local therapies that work on one part of the body, directing high energy beams at cancer cells to destroy them. However, the two therapies differ in the source of the radiation.
In brachytherapy, the radiation comes from an implant that a doctor places near or in a tumor. In external beam radiation, the radiation comes from a machine outside of the body.
Reasons for Radiation Therapy
Doctors may suggest radiation therapy as an option at different times during your cancer treatment and for different reasons, including the following:
- As the only, primary treatment for cancer
- Before surgery, to shrink a cancerous tumor (neoadjuvant therapy)
- After surgery, to stop the growth of any remaining cancer cells (adjuvant therapy)
- In combination with other treatments, such as chemotherapy, to destroy cancer cells
- In advanced cancer to alleviate symptoms caused by the cancer
Preparation of Radiation Therapy
Before a patient undergo external beam radiation therapy, the health care team guides you through a planning process to ensure that radiation reaches the precise spot in your body where it’s needed.
Planning typically includes the following:
- Radiation Simulation: During simulation, the radiation therapy team works with you to find a comfortable position for you during treatment. It’s imperative that you lie still during treatment, so finding a comfortable position is vital.To do this, you’ll lie on the same type of table that’s used during radiation therapy.Your radiation therapy team will mark the area of your body that will receive the radiation. Depending on your situation, you may receive temporary marking with a marker or you may receive small permanent tattoos.
- Planning scans. Your radiation therapy team will have you undergo computerized tomography (CT) scans to determine the area of your body to be treated.
After the planning process, your radiation therapy team decides what type of radiation and what dose you’ll receive based on your type and stage of cancer, your general health, and the goals for your treatment.
The precise dose and focus of radiation beams used in your treatment is carefully planned to maximize the radiation to your cancer cells and minimize the harm to surrounding healthy tissue.
Side Effects and Risks of Radiation Therapy
American Cancer Society (ACS) website states that the most common side effects from radiation therapy are the following:
- Fatigue
- Loss of appetite
- Skin irritation in the treated area
- Blistering
- Dryness
- Itching
- Peeling
Other side effects of radiation depend on the area being treated, and can include:
Follow up after Radiation Therapy
During the weeks of treatment, your doctor will closely monitor your treatment schedule and dosing, and your general health.
A patient will undergo several imaging scans and tests during radiation so the doctors can observe how well the patients is responding to the radiation therapy treatment. These scans and tests can also tell them if any changes need to be made to the treatment.
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