Radiation therapy

Overview:

Radiation therapy is one of the cancer treatments. It uses X-rays and proton beams to treat the cancer. These rays produce intense energy beams to kill the cancerous cells. Radiation therapy aims at the cancer cells without affecting the adjacent healthy tissues. 

Cancer cells divide continuously and rapidly by multiplying their genetic material. Radiation therapy affects the cancer cells by damaging their genetic material. Cancer cells cannot repair and regrow, unlike the healthy tissues. Radiation therapy is also called Radiotherapy (RT). 

Types of Radiotherapy:

Radiation therapy (RT) is given by internal or external sources of radiation. There are two types:

• External beam RT (EBRT): EBRT is given outside the body and is the most common type of RT. The machine used is a Linear accelerator which directs the high energy radiation towards the tumor. The high-energy rays can be X-radiation, electron beam, or proton radiation. These are given in different ways: 
• 3D conformal RT: A 3D model is constructed using CT scans and computer software. Radiation is targeted by using the 3D model as the guide to spare the healthy tissue. 
• Intensity-Modulted RT: Radiation beams that differ in dose intensity are used to deliver high doses of radiation to the tumor and very little to the healthy tissue. This is an advanced form of RT. Arc-based RT is similar to IMRT except that the energy beams of different intensities are directed in a rotational-arc-like pattern.  
• Image-Guided RT: An image is used as a guide to deliver the radiation doses. These images are produced using traditional X-rays or CT scans. 
• Stereotactic Radiosurgery: This is used when high precision is needed like the small brain tumors. This uses focused radiation to destroy tumor cells and does not require cutting. 
• Stereotactic body RT: This is similar to stereotactic radiosurgery but used outside the brain to other body parts. 
• Internal beam RT (IBRT): IBRT is given inside the body. This is given by brachytherapy or systemic therapy. It treats tumors that are close to the internal organs. Radiation can be obtained through a solid or liquid source. 
• Brachytherapy: This is done by placing seed implants that emit radiation slowly and regularly at the site of the target while exposing the healthy tissues to a very minimal dose of radiation. Another method is by exposing the target area to a high dose of radiation for a short period. 
• Systemic Therapy: This is done by giving a liquid dose of RT in the form of an injection or swallowing as a bolus so that the RT reaches the target tissue. 

Indications: 

Radiotherapy is used to treat any cancer in the body. It can also be used to treat benign tumors that are not cancerous. It is also indicated:

• As a primary treatment for cancer 
• As neoadjuvant therapy before surgery to shrink cancer 
• As an adjuvant therapy after surgery to control the remaining cancer 
• For symptomatic relief in advanced cancers 
• Along with chemotherapy to kill cancer cells 

Before the treatment:

Before undergoing RT, an individual will undergo radiation simulation. Simulation is the process where the healthcare professionals determine the most comfortable position to receive the radiation. An individual is made to lie on the table and using some restraints or immobilizing devices, the best comfortable position to receive the RT will be determined. The area on the body to receive the treatment will be marked using temporary or permanent markers. 

Advanced imaging like the MRI or CT will determine the extent, size, and shape of the tumors and the area of the skin to be treated. Then they calculate the dosage and determine the direction of the beam to the target area. Sometimes tight-fitting masks may be customized to prevent radiation exposure to the vital organs of the body. RT planning helps to get the exact dose and correct radiation beams at the target site without harming the adjacent healthy tissue. 

During the treatment:

An individual will undergo RT for five days in a row in a week for 5-6 weeks with each session lasting about 10-30 minutes. The number of days and dosage will be determined based on the extent of the tumor and the treatment response. An individual is placed on the table based on the previous markings to administer RT. 

The individual's position on the table is confirmed using an X-ray, a CT scan, or a laser to deliver the RT at the same location as planned. The HCP team will be in a console room from which they will be viewing as the RT goes on. RT is administered in the form of X-rays or proton therapy. 

If RT is given as EBRT, the beam of radiation is directed to the exact locations of the tumor using a linear accelerator machine. If it is in the form of brachytherapy it is inserted in the tumor location either as seeds or through a tube using a high dose of radiation. 

After the procedure:

The entire procedure of RT takes a few minutes but the preparation for the PT takes about 30-45 minutes. After the treatment, an individual is subjected to multiple CT or MRI scans to analyze the response of the tumor to the treatment. One can continue their daily activities after the RT. 

Side effects:

Radiotherapy causes many side effects in different parts of the body. They include hair loss, redness, and pain at the treatment site, weakness, nausea, vomiting, and diarrhea. If the head and neck area are treated it can cause a decrease in saliva production, dry mouth, difficulty swallowing, sore throat, mouth ulcers, and tooth decay. If the pelvis area is treated it can cause difficulty in urination, sexual dysfunction, and irritation of the bladder. Cancer developing newly in the irradiated area is one of the complications of RT. 

Conclusion: 

Radiotherapy is a very common treatment for cancer. It can treat any type of cancer and can be done along with other treatments. There are different ways to deliver the RT to the target area to kill the tumor cells. RT can reduce the cancer size or can cure the individual of the cancer and improve the quality of life. 

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