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Types Of External Beam Radiation

Does External Beam Radiation Therapy Hurt

Types of External Beam Radiation Therapies for Prostate Cancer

EBRT is painless. You wont feel the radiation at all.

Still, you may notice things in your environment that seem stressful. For example, the machine will make clicking and whirring sounds as it moves. You may see flashes of light, especially if youre receiving radiation therapy directed at your head. You may notice odd smells from the machine, too.

These experiences are normal.

Ctca Approach To Managing The Side Effects Of Ebrt

At Cancer Treatment Centers of America®, we understand that many patients do not realize how the side effects of cancer treatments may affect them. Thats why we take the time to educate patientsbefore, during and after treatmentabout how their bodies will respond and provide an array of supportive care therapies designed to help them maintain their strength, stamina and quality of life. Evidence-informed therapies that may help manage the side effects of EBRT include:

When Can I Resume My Normal Routine

Everyones experience is different. Some people leave radiation therapy treatments and resume their routine. Others experience fatigue so severe that they must take time off from work to rest.

Often, people experience more side effects as treatment progresses. Radiation therapy doesnt kill cancer cells immediately. It takes days or weeks of treatment before cancer cells are damaged enough to die. Its possible that while you may feel OK in the beginning, you may have to allow more recovery time once cells begin dying.

Similarly, side effects vary after treatment ends. You may take a few weeks to feel back to your old self, or it may take several months before you can resume normal activities.

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What To Wear For Your Treatments

Wear clothes that are comfortable and made of soft fabric, such as fleece or cotton. Choose clothes that are easy to take off, since you may need to expose the treatment area or change into a hospital gown. Do not wear clothes that are tight, such as close-fitting collars or waistbands, near your treatment area. Also, do not wear jewelry, adhesive bandages, or powder in the treatment area.

How Often You Will Have External Beam Radiation Therapy

Treatment Options

Most people have external beam radiation therapy once a day, five days a week, Monday through Friday. Radiation is given in a series of treatments to allow healthy cells to recover and to make radiation more effective. How many weeks you have treatment depends on the type of cancer you have, the goal of your treatment, the radiation dose, and the radiation schedule.

The span of time from your first radiation treatment to the last is called a course of treatment.

Researchers are looking at different ways to adjust the radiation dose or schedule in order to reach the total dose of radiation more quickly or to limit damage to healthy cells. Different ways of delivering the total radiation dose include:

  • Accelerated fractionation, which is treatment given in larger daily or weekly doses to reduce the number of weeks of treatment.
  • Hyperfractionation, which is a smaller dose than the usual daily dose of radiation given more than once a day.
  • Hypofractionation, which is larger doses given once a day or less often to reduce the number of treatments.

Researchers hope these different schedules for delivering radiation may be more effective and cause fewer side effects than the usual way of doing it or be as effective but more convenient.

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Planning Your External Beam Radiation Therapy Treatment

A team of experienced medical professionals will work with you to devise the best possible plan for your external beam radiation therapy treatments. This team includes:

  • A radiation oncologist, who will decide if external beam radiation therapy is the best treatment for you. If so, your radiation oncologist will decide which EBRT treatment you will receive and will oversee its application.
  • A radiation therapist, who will actually deliver your daily treatments. The radiation therapist works closely with the radiation oncologist to ensure the accuracy and effectiveness of every treatment.
  • Physicists and dosimetrists, who oversee the exact dosage of each radiation treatment. These professionals ensure you receive the most radiation with the fewest side effects possible.

Together, these members of your cancer care team will plan your EBRT treatments. Before these treatments begin, youll have an appointment in which your treatment is planned. Next, you will have what is called simulation.

What Is The Meaning Of External Beam Radiation Therapy

External beam radiation therapy is the most common type of radiation therapy that is used for the treatment of cancer. A machine is used for aiming high-energy rays or particles from outside the body into the tumor. External beam radiation therapy is mostly provided in the form of photon or x-ray beams, and less often in the form of particles like protons and neutrons, or electron beams. External beam radiation therapy involves focusing the radiation beam on the exact location to maximize the radiation that reaches cancer and limit the effect of radiation on the surrounding healthy tissues.

In this article, we will be discussing in detail about external beam radiation therapy.

  • What is the purpose of External Beam Radiation Therapy?
  • What are the types of beams used for External Beam Radiation Therapy?
  • What are the different types of External Beam Radiation Therapies?
  • What is the diagnostic procedure before External Beam Radiation Therapy?
  • How to prepare for External Beam Radiation Therapy?
  • What is the procedure for External Beam Radiation Therapy?
  • How to care after External Beam Radiation Therapy?
  • What are the risks of External Beam Radiation Therapy?
  • What is the cost of External Beam Radiation Therapy in India?

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Intensity Modulated Radiation Therapy

Intensity modulated radiation therapy is an advanced radiotherapy technique used to minimize the amount of normal tissue being irradiated in the treatment field. In some systems this intensity modulation is achieved by moving the leaves in the MLC during the course of treatment, thereby delivering a radiation field with a non-uniform intensity. With IMRT, radiation oncologists are able to break up the radiation beam into many “beamlets”. This allows radiation oncologists to vary the intensity of each beamlet. With IMRT, doctors are often able to further limit the amount of radiation received by healthy tissue near the tumor. Doctors have found this sometimes allowed them to safely give a higher dose of radiation to the tumor, potentially increasing the chance of a cure.

Who Performs External Beam Radiation Therapy

External Beam Radiation Therapy explained

EBRT requires a team-based approach. Your radiation oncology team includes:

  • A radiation oncologist, whos in charge of planning and delivering your treatment.
  • Amedical physicist and dosimetrist, who calculate your radiation dose, design your custom energy beams and program the LINAC machine to deliver the radiation.
  • Aradiation therapist, whos in charge of positioning you during treatment, operating the machine and ensuring your comfort during treatment sessions.

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How To Care After External Beam Radiation Therapy

  • Since there is no radiation source placed inside the body, the patient is not radioactive during or after the treatment.
  • The patient usually goes home on the same day after a radiation therapy session.
  • Side effects like skin irritation and fatigue may usually be noticed only after a couple of treatment sessions.
  • The patient is asked to come for regular follow-ups with the doctor after the treatment.
  • During these follow-up sessions, the patient will undergo evaluation, including blood tests or imaging tests, to check if cancer has been eliminated or if additional treatment is needed.
  • Even if cancer has been cured, the patient needs to come for regular follow-ups to check for recurrence of cancer.

External Radiation Therapy Machines Linear Accelerator Is The Most Commonly Used Machine For Giving External Radiation Therapy It Delivers High

CyberKnife is a small compact linear accelerator mounted on a robotic arm that moves around the person to give radiation from many different directions. It also has several x-ray cameras . Computers track a persons position and movement. If a person moves slightly, the robotic system can adjust by repositioning the linear accelerator before the beam of radiation is delivered. CyberKnife is particularly useful for treating tumours of the lung because of movement during breathing. It is most used for treating tumours of the brain, lung, prostate and spine. CyberKnife uses larger doses of radiation for each treatment than a LINAC so fewer treatment sessions are needed. Each session may take 30 to 90 minutes. Not every cancer treatment centre has a CyberKnife.

Gamma Knife is designed to give external radiation therapy to the brain. It delivers about 200 thin beams of high-energy radiation at a tumour. The highest dose of radiation is delivered at the point where the beams cross . It is usually given in a single session and used to treat primary brain tumours or brain metastases. The technique is sometimes called Gamma Knife radiosurgery.

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What Is External Beam Radiation

In cancer treatment, external radiation is the most common type of radiation therapy. External beam radiation therapy can be very carefully delivered with the help of radiation technology. By focusing the radiation beam on the cancer, the machines maximize the radiation reaching the cancer, while minimizing its effects on normal tissues.

Types Of Radiation Therapy

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Our doctors deliver radiation therapy in a variety of forms depending on the type of cancer, the location of the tumor, and whether it has spread.

External-beam radiation therapy is the most common form of the treatment. It is applied to the body by a machine, most often in the form of x-rays but sometimes as charged particles called protons or other types of energy.

Types of external-beam radiation therapy include image-guided radiation therapy, intensity-modulated radiation therapy, stereotactic body radiation therapy, hypofractionated radiation therapy, and proton therapy.

Intraoperative radiation therapy takes place during surgery to deliver radiation directly to a tumor, either as external-beam radiation therapy or as internal radiation therapy. It is currently used at MSK to treat breast cancer and colorectal cancer. This approach allows our surgeons to move healthy tissue out of the way before radiation therapy occurs it may be helpful when important organs are located very close to the tumor.

Because this treatment is conducted during the surgical procedure and can be delivered to a precisely defined area, it is possible to use a higher-than-usual and therefore more effective dose of radiation and to spare nearby healthy tissues.

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Stereotactic Body Radiation Therapy Or Stereotactic Ablative Radiotherapy

This type of therapy is used to deliver high doses of radiation to a precise area in the prostate using specialized techniques not achievable by standard conventional radiation therapy. This allows the total dose of radiation to be given in a shorter amount of time, usually 4 -5 treatments over 1 2 weeks rather than the several weeks used for other types of external radiation therapy.

The radiation beam needs to be extremely accurate in order to limit the side effects on healthy tissue. During treatment, the body immobilization used is often more restrictive than with IMRT due to the high doses of radiation. Fiducials, or internal prostate markers, are often used in this type of treatment.

Cyberknife and Truebeam are two types of LINACs used for SBRT treatment of prostate cancer.

Types Of Beams Used In External Radiation Therapy

Photon beams are the same type of radiation that is used during an x-ray, like a chest x-ray, but at a much higher amount. The radiation is released from the machine as a wave of energy. Photon beams can travel deep into the body to the tumor but can also damage healthy tissue in front of and behind the tumor. Photons are given by a machine called a linear accelerator. The photon beams are invisible and cannot be felt when they are passing through the skin to the cancer.

Particle beam radiation therapy: Particle beams are separate units of energy like a proton or neutron. The radiation is released from the machine as a stream of high-energy particles. Particle beam radiation can also travel deep into the body like photon beams but their energy is released at a certain distance. This means that this type of radiation is often able to deliver more radiation to the tumor while reducing its effects on normal tissues in front of and behind the tumor. Particle beams are given by special types of machines called particle accelerators, like a cyclotron or synchrotron. The particle beams are invisible and cannot be felt when they are passing through the skin to the cancer.

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How Does Radiation Therapy Treat Cancer

Cancer begins when healthy cells change and grow out of control. All cells in the body go through a cycle to grow, divide, and multiply. Cancer cells go through this process faster than normal cells. Radiation therapy damages cell DNA so the cells stop growing or are destroyed.

Unlike other cancer treatments affect the whole body, such as chemotherapy, radiation therapy is usually a local treatment. This means it generally affects only the part of the body where the cancer is located. Some healthy tissue near the cancer cells may be damaged during the treatment, but it usually heals after treatment ends.

There are many different types of radiation therapy, and they all work a little bit differently to destroy cancer cells.

What Happens During Each Treatment Visit

External Beam Radiation Therapy

External radiation is a lot like getting a regular x-ray. The treatment itself is painless and takes only a few minutes. But each session can last 15 to 30 minutes because of the time it takes to set up the equipment and put you in the right position.

External radiation therapy is usually given with a machine called a linear accelerator which delivers a beam of radiation. The machine has a wide arm that extends over the treatment table. The radiation comes out of this arm. The machine can move around the table to change the angle of the radiation, if needed, but it wont touch you. The radiation beams are invisible and you will not feel anything, but the machine will make noise.

Depending on the area being treated, you might need to undress, so wear clothes that are easy to take off and put on. Youll be asked to lie on the treatment table next to the radiation machine.

The radiation therapist might put special heavy shields between the machine and parts of your body that arent being treated to help protect normal tissues and organs.

Once youre in the right position, the radiation therapist will go into a nearby room to operate the machine and watch you on a TV screen. The room is shielded, or protected from the radiation so that the therapist isnt exposed to it. You can talk with the therapist over an intercom. Youll be asked to lie still during the treatment, but you wont have to hold your breath.

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Do We Know Which Treatment Is Better For Prostate Cancer Brachytherapy Or External Beam Radiation

Its not a question of which therapy is better but rather which therapy is the most tailored, pinpointed radiation for the patients specific disease.

When it comes to early stages of disease, patients very frequently do well with either brachytherapy or external beam radiation. Success rates of around 90% or higher can be achieved with either approach. When the disease is somewhat more advanced based on thePSA level or the Gleason score or visible evidence of disease on an MRI we have learned over the years that higher doses of radiation are critical to achieving better results. Some evidence suggests that for patients with intermediate- or high-risk prostate cancer, a combined approach using brachytherapy along with external beam radiation may be best.

Data that we have published recently show that for patients with intermediate-risk disease, the combination of external beam radiation with brachytherapy not only provides better biochemical control, in terms of PSA level, but also reduces the risk of distant metastases, or spread of the disease. Another recent study from Canada, which compared outcomes in patients who were treated with external beam radiation or a combination approach, found superior results when the combined approach was used. These studies provide strong evidence that higher doses of radiation provide an important benefit to patients with intermediate-risk and high-risk prostate cancers.

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If This Uncertainty Would Bother You So Much That It Would Affect Your Quality Of Life Surgery May Be A Better Option For You Phuoc Tran Md Phd

However, if youre okay with waiting for the PSA nadir, and if you dont mind getting treatment over the course of a few weeks instead of in one operation, then radiation may be ideal for you.

What are my options?

Conventional external-beam radiation therapy is given in little doses, a few minutes a day, five days a week, for seven or eight weeks. These small doses minimize the injury risk for the healthy tissue near the tumor. Scientists measure radiation in units called Gy . Most men get a minimum total dose of 75.6 Gy, but could get as much as 81 Gy this works out to 2 Gy or less per day.

The treatment itself is painless just like getting an x-ray at the dentists office. But one big challenge with getting repeated treatments is making sure youre always in the exact same position, so the radiation can hit the target the way its supposed to. Thus, you will be custom-fitted with your own pelvic immobilization device, which will not only keep you from fidgeting, but will make sure youre not slightly higher and to the right on the table one day, and slightly lower and to the left the next.

When you get fitted for your device, you will have a CT scan, so doctors can get a 3D look at your prostate. Then, when you get the radiation, you wont just get it from one side, but from multiple directions, and each beam of radiation will be individually shaped to target the cancer and a 5- to 10-millimeter margin of healthy tissue around the prostate.

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