Sunday, February 18, 2024

The Truth About Radiation Therapy

Are There Side Effects Of The Combination Approach

“The truth about mobile phone and wireless radiation” — Dr Devra Davis

There is a slightly higher chance that patients who receive the combined therapy will have rectal irritation or urinary side effects. This is common with prostate cancer radiation therapy because the radiation can damage cells in the tissues surrounding the prostate. But at MSK, we routinely use sophisticated computer-based planning techniques that help us reduce the dose given to normal tissues such as the rectum, bladder, and urethra, lessening the chances of side effects and complications. We have also found that, when treating with the combined approach, using the high-dose-rate brachytherapy compared to low-dose-rate brachytherapy may have less in the way of side effects.

In addition, at MSK, we routinely use a rectal spacer gel, which we inject between the prostate and the rectum while the patient is under mild anesthesia, to create a buffer between these two tissues. By creating this space, we can further reduce the dose of radiation the rectum is exposed to. This leads to fewer side effects for the patient. The rectal spacer gel is biodegradable and dissolves on its own within the body after a few months.

What Is Radiation Therapy

Radiation therapy is a type of cancer treatment that uses beams of energy to damage the DNA of a cell which controls how it grows and divides. When the DNA of a cancer cell is destroyed, the cell cannot continue to grow and divide. This leads to cell death. While radiation can damage the DNA of both normal and cancerous cells, the goal is to kill the cancer cells while sparing the normal cells as much as possible. Radiation is typically delivered in small doses of radiation each day over the course of many weeks. Healthy cells are capable of repairing some of the damage while the cancerous cells are not. This leads to preferential death of the cancer cells and relative sparing of the normal healthy cells.

What Are The Short And Long

Bronwyn: The short term side effects of radiotherapy are usually mimimal and can be managed with medications and creams. Patients receiving radiation therapy for breast cancer can expect to develop pinkness or redness of the skin in the treatment zone, some mild swelling of the breast and a feeling of mild generalised fatigue. These effects resolve within one to two months of treatment.

At Epworth Radiation Oncology, patients with left sided breast cancer now receive radiation therapy delivered using a special breath-holding technique. This reduces the dose of radiation to the heart and minimises the risk of long-term side effects.

Long term side effects of radiation therapy are uncommon, but they may occur months or even years after treatment. If they do occur, these side effects can be minimised or controlled, so its important to have ongoing follow up with a radiation oncologist. There is a very rare risk of developing a second cancer as a result of radiation therapy . If this does occur, it is usually many years after completion of treatment.

Overall, the most important advice is to have a clear and detailed conversation with a radiation oncologist, who can give a full account of both the expected benefits and the likely side effects of individually tailored radiation therapy.

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What Happens After Treatment Finishes

After radiation therapy has finished, your treatment team will tell you how to look after the treatment area and recommend ways to manage side effects. They will also advise who to call if you have any concerns.

Life after cancer treatment can present its own challenges. You may have mixed feelings when treatment ends, and worry that every ache and pain means the cancer is coming back.

Some people say that they feel pressure to return to normal life. It is important to allow yourself time to adjust to the physical and emotional changes, and establish a new daily routine at your own pace. Your family and friends may also need time to adjust.

Cancer Council 13 11 20 can help you connect with other people who have had cancer, and provide you with information about the emotional and practical aspects of living well after cancer.

For more on this, see Living well after cancer.

Questions Patients Might Be Reluctant To Ask About Radiation Therapy

TrueBeam Radiation Therapy System Blends Precise Cancer Treatment with ...

Getting a recommendation for radiation therapyas part of cancer treatment comes with a learning curve and a lot ofquestions. Morethan half of all patients with cancer receive radiation therapy at somepoint in their care, and patients and their families want to know how radiationworks and how it might affect their lives during and after treatment.

Still, we know some patients feel nervousasking questions about their cancer therapy. In a word: Dont. Asking questionshelps your doctors provide the best care.

Radiationoncologists at the UT Southwestern Harold C. Simmons Cancer Center areleaders in the field, conducting research studies and pioneering advancedradiation techniques such as stereotactic ablative radiotherapy ,brachytherapy, and novel combinations of radiotherapy with chemotherapy.

Were always happy to share the most currentradiation knowledge with our patients. So, here are answers to five of the mostcommon questions patients have said they were nervous to ask but were gladthey did.

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Will Radiation Make Me Sick

The side effects of radiation are variable from one patient to the next and depend on the region of the body being treated. However, a common side effect that can occur regardless of the treatment site is fatigue. This can range from minimal to much more significant and can be difficult to predict.

Nausea and vomiting can occur if the brain or the upper abdomen around the small intestine is being treated. Radiation outside of these regions generally does not cause these symptoms. Fortunately, nausea and vomiting can be prevented and managed with the use of medications that a physician can prescribe.

Who Gives Radiation Treatments

A doctor who has had special training in using radiation to treat disease is called a radiation oncologist. Your radiation oncologist is the person who prescribes the type and amount of treatment that best suits your needs. He or she works closely with other doctors involved in your care and also heads a highly trained health care team. Your radiation therapy team may also include:

  • A radiation physicist, who makes sure that the equipment is working properly and ensures that the machines deliver the right customized dose of radiation for each patient.
  • A dosimetrist, who helps carry out your treatment plan by calculating the number of treatments you will need and how long each treatment should last.
  • A radiation therapy nurse, who provides nursing care and helps you learn about how your treatment works and how to manage side effects.
  • A radiation therapist, who sets you up for your treatments and runs the equipment that delivers the radiation.

Many patients also benefit from the services of a dietitian, a physical therapist, a social worker and other health care professionals.

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Radioprotective Drugs For Reducing Side Effects

One way to reduce side effects is by using radioprotective drugs, but these are only used for certain types of radiation given to certain parts of the body. These drugs are given before radiation treatment to protect certain normal tissues in the treatment area. The one most commonly used today is amifostine. This drug may be used in people with head and neck cancer to reduce the mouth problems caused by radiation therapy.

Not all doctors agree on how these drugs should be used in radiation therapy. These drugs have their own side effects, too, so be sure you understand what to look for.

What Should I Expect On My First Visit

Myths about Radiation Therapy.

When radiation therapy might be of help, a family doctor, surgeon or medical oncologist will refer patients to a radiation oncologist.

The doctor will first review your medical records and X-rays. A physical exam will be done.

The doctors will then talk to you about his/her findings and decide how you should be treated. If radiation will help you, the staff will schedule the needed studies to develop a treatment plan. This is sometimes referred to as simulation.

During simulation, the therapist takes X-rays of the part of your body to be treated to help decide how the radiation will be given. Using the X-ray as a guide to the treatment site, the therapist uses a marker to outline the treatment area on your skin. This area is often called a treatment port or treatment field. These marks are very important. They act as a map of the treatment area and the therapist uses them each day to guide your treatment. Sometimes after a few treatments, tiny permanent dots can be used to replace the painted marks on your skin.

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Myth: Everyone With Cancer Needs Radiation

FACT: More than half of people diagnosed with cancer receive radiation therapy, and its an important part of many patients treatment plans. It works by using high doses of radiation to destroy or damage cancer cells. Radiation makes small breaks inside the DNA of cancer cells, which can stop the cells from growing and, ideally, kill them.

But whether youll need it depends on your individual cancer diagnosis.

Your team of physicians will develop the best plan for you as an individual with your type of cancer. This includes whether you would benefit from radiation, explained Randi Cohen, MD, MS, a radiation oncologist at Fox Chase Cancer Center.

Radiation is most effective at treating cancers with solid tumors , but it can also be helpful for certain types of leukemia and lymphoma. When cancer has spread throughout the body , radiation may still be used to help with symptoms and improve quality of life

Radiation Therapy Works Through In Various Ways To Remove The Cancer Cells

The biological target of radiation in the cell is DNA .

  • Direct effects of radiation: Radiation can directly interact with cellular DNA and cause damage .Figure 2

    Radiation act directly or indirectly on the cellular DNA.

  • Indirect effects of radiation: The indirect DNA damage caused by the free radicals is derived from the ionization or excitation of the water component of the cells .
  • The biological target of radiation in the cell is DNA. Extensive damage to cancer cells DNA can lead to cell death. DNA double-strand breaks are more responsible for most cells killing, even a single DSB is sufficient to kill a cell or disturb its genomic integrity by the radiation treatment.

    Double strand DNA breaks are irreparable and more responsible than the single strand DNA breaks for most of cell killing in cancer as well as surrounding normal cells.

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    What Are The Benefits And Goals Of Radiation Therapy

    For many patients, radiation therapy is the only kind of treatment needed for their cancer. Many others have in combination with other cancer treatments, which include surgery, chemotherapy and biological therapy.

    Radiation therapy can be used before surgery to shrink a tumor. After surgery, radiation therapy may be used to stop the growth of any cancer cells that remain. Your doctor may choose to use radiation therapy and surgery at the same time, delivering both in one session in a procedure known as intraoperative radiation. In some cases, doctors use radiation along with anticancer drugs to destroy the cancer, instead of surgery.

    Even when curing a particular patients cancer is not possible, radiation therapy still can bring relief. Many people find the quality of their lives improved when radiation therapy is used to shrink tumors, which can reduce pressure, bleeding, pain, or other symptoms of cancer. This is called palliative care.

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    Some cancers are very sensitive to radiation. Radiation may be used by itself in these cases to make the cancer shrink or completely go away. In some cases, chemotherapy or other anti-cancer drugs may be given first. For other cancers, radiation may be used before surgery to shrink the tumor , or after surgery to help keep the cancer from coming back .

    For certain cancers that can be cured either by radiation or by surgery, radiation may be the preferred treatment. This is because radiation can cause less damage and the part of the body involved may be more likely to work the way it should after treatment.

    For some types of cancer, radiation and chemotherapy or other types of anti-cancer drugs might be used together. Certain drugs help radiation work better by making cancer cells more sensitive to radiation. Research has shown that when anti-cancer drugs and radiation are given together for certain types of cancer, they can help each other work even better than if they were given alone. One drawback, though, is that side effects are often worse when they are given together.

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    Is Radiation Therapy Safe For Patients And Their Families

    Doctors have safely and effectively used radiation therapy to treat cancer for more than 100 years. Like other cancer treatments, radiation therapy causes side effects. Talk with your health care team about what to expect and what you are experiencing during and after your treatment. While most people feel no pain when each treatment is being delivered, effects of treatment slowly build up over time and may include discomfort, skin changes, or other side effects, depending on where in the body treatment is being delivered.

    Having radiation therapy slightly increases the risk of developing a second cancer later in life. But for many people, radiation therapy eliminates the existing cancer. This benefit is greater than the small risk that the treatment could cause a new cancer in the future.

    During external-beam radiation therapy, the patient does not give off any radiation after treatment sessions. Any radiation remains in the the treatment room.

    However, internal radiation therapy causes the patient to give off radiation. As a result, visitors should follow these safety measures, unless other directions are given by the patient’s doctor:

    • Do not visit the patient if you are pregnant or younger than 18

    • Stay at least 6 feet from the patient’s bed

    • Limit your stay to 30 minutes or less each day

    Will I Lose My Hair From Radiation Treatment

    The side effects of radiation are determined by the part of the body that is receiving radiation. If radiation is being used to treat the brain or scalp, then hair loss is possible. This can be temporary or permanent depending on the amount of radiation required. For radiation treatments to the neck, men with facial hair may lose a portion of their facial hair. For patients receiving pelvic radiation, although there will be no loss of hair from your head, there may be some hair loss in the pubic region.

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    Radiation To The Pelvis

    Radiation therapy to the pelvis can cause bowel and bladder problems in some patients, including:

    • Urinating more than usual
    • Sexual and/or problems getting pregnant or fathering a child

    Management of Side Effects during Pelvic Radiation Therapy

    • Do not eat raw fruits, vegetables or whole grains
    • Eat small, frequent meals
    • Do not drink caffeine or alcohol
    • Drink lots of fluids
    • Drink cranberry juice as part of fluid intake
    • Ask your doctor or nurse for medicine if you have painful urination or to lessen frequent loose stools
    • Use birth control to prevent pregnancy
    • Your doctor may prescribe medicines that decrease the number of bowel movements.

    What Are The Key Differences Between Chemotherapy And Radiation

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    The major difference between chemo and radiation is the way theyre delivered.

    Chemotherapy is a medication given to treat cancer thats designed to kill cancer cells. Its usually taken by mouth or given through an infusion into a vein or medication port.

    There are many different types of chemotherapy drugs. Your doctor can prescribe the type thats most effective at treating your specific type of cancer.

    Chemotherapy can have many side effects, depending on the type that youre getting.

    Radiation therapy involves giving high doses of radiation beams directly into a tumor. The radiation beams change the DNA makeup of the tumor, causing it to shrink or die.

    This type of cancer treatment has fewer side effects than chemotherapy since it only targets one area of the body.

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    Dealing With Feelings Of Sadness

    If you have continued feelings of sadness, have trouble getting up in the morning or have lost motivation to do things that previously gave you pleasure, you may be experiencing depression. This is quite common among people who have had cancer.

    Talk to your GP, as counselling or medication even for a short time may help. Some people can get a Medicare rebate for sessions with a psychologist. Ask your doctor if you are eligible. Cancer Council may also run a counselling program in your area.

    For information about coping with depression and anxiety, call Beyond Blue on 1300 22 46 36. For 24-hour crisis support, call Lifeline on 13 11 14.

    When Is One Therapy Better Than The Other

    Sometimes, one of these treatments can be more effective than the other in treating a particular type of cancer. Other times, chemo and radiation can actually complement each other and be given together.

    When you meet with your cancer care team, your oncologist will give you the options that will be most effective in treating your type of cancer.

    Together with your cancer care team, you can decide on the treatment option thats right for you.

    Chemo and radiation are sometimes used together to treat certain types of cancers. This is called concurrent therapy. This may be recommended if your cancer:

    • cannot be removed with surgery
    • is likely to spread to other areas of your body
    • isnt responding to one particular type of treatment

    With both chemotherapy and radiation, theres a high likelihood of experiencing some side effects. But that doesnt mean you cant do anything about them.

    Here are some tips to cope with the

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