Radiotherapy


 

What is it?
The alternative local therapy to surgery is radiation therapy.This involves the use of high energy, penetrative rays to destroy cancer cells. It also affects cancer cells only in the zones treated. Radiation therapy is also employed for palliation i.e., control of symptoms alone in an advanced prostate cancer.

Radiation therapy can also be used in adjunct to surgery or hormonal or chemotherapy, either before or after.

Radiation Therapy

Radiation therapy is one of the most common treatments for cancer and is used in more than half of all cancer cases. It is the primary treatment for many kinds of cancer in almost any part of the body, such as certain head and neck tumors, early-stage Hodgkin's disease and non-Hodgkin's lymphomas, and certain cancers of the lung, breast, cervix, prostate, testes, bladder, thyroid, and brain. For many patients, radiation therapy is the only treatment needed.

Thousands of people become free of cancer after receiving radiation treatments alone or in combination with surgery, chemotherapy, or biologic therapy. For example, doctors can use radiation before surgery to shrink a tumor so that it can be removed more easily, or after surgery to stop the growth of any cancer cells that remain. Radiation therapy and surgery done simultaneously is called intraoperative radiation.

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How is it done?

Teletherapy or external radiation is given via a machine remote from the body while, brachytherapy or internal radiation is given by implanting a radioactive source within the involved tissues. Patients may or may not require both modalities of radiation.

Radiotherapy, after initial planning, usually takes just 5 to 10 minutes per day, 5 days a week for about 6 weeks. This time period is flexible depending upon the modality of radiation used.

External radiation treatments are painless. The experience is just like having a regular x-ray taken.

Radiation Therapy

Depending on the treatment area, you may need to undress, so it's wise to wear loose-fitting clothes that are easy to take on and off. You will lie on a treatment table positioned under the radiation machine. The radiation therapist may put special shields (or blocks) between the machine and other parts of your body to help protect normal tissues and organs. Although radiation does not distinguish between tumor cells and healthy cells, healthy tissue usually recovers with little or no permanent damage. Nevertheless, you should remain still during the treatment. You don't have to hold your breath-just breathe normally.

Once you are positioned correctly, the radiation therapists will go into an adjacent room to turn on the machine and monitor you on a closed-circuit TV. You will be able to communicate with the therapists over an intercom.X-rays may be taken during treatments to confirm accuracy.

The radiation therapy machine will make clicking and whirring noises, and sometimes sound like a vacuum cleaner as it moves to aim at the treatment area from different angles. The radiation therapist controls the movement and constantly checks to be sure it is working properly. If you are concerned about anything that happens in the treatment room, ask your therapist to explain. If you feel ill or uncomfortable during the treatment, tell your therapist at once. The machine can be stopped at any time.

Treatment of cancer with radiation can be costly. It requires complex equipment and the services of many health care professionals. The exact cost of your radiation therapy will depend on the type and number of treatments you need.

During your radiation therapy, you will be tended to by a team of medical professionals: The radiation oncologist, a physician specially trained to treat cancer patients with radiation, will make many of the decisions regarding your treatment, including whether you should receive radiation in the first place and the type, technique, and amount of treatment that best suits your needs.

The radiation physicist makes sure that the radiation equipment is working properly and ensures that it delivers the right dose of radiation as prescribed by your doctor.

The dosimetrist assists the physician by planning and calculating the number of treatments and how long each treatment should last. He or she is supervised by the radiation physicist.

You also may need the services of a dietitian, a physical therapist, a social worker, and other health care professionals.

To ensure that the radiation beam is aimed correctly, a radiation therapist will outline the field with freckle-sized dots of semipermanent ink. The marks will eventually fade away, but they need to remain until your treatment is completed. Avoid soaping and scrubbing the area.

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Side effects of radiation

  • Nausea and vomiting (although not usually).
  • Abdominal pain, cramps and diarrhea.
  • Low blood counts including anemia (the medical term for a low red blood cell count) which can be a contributing factor to fatigue, or a low white blood cell count, which can make you more susceptible to a fever and infection.
  • Low platelets which can make you more likely to bleed.
  • Skin reaction in the radiation area.
  • Irritated skin and hair loss in the treatment area.
  • Fatigue, which often increases during the treatment itself.
  • A dry, sore throat and difficulty in swallowing.
  • Aching and stiffness in shoulder and chest muscles.
  • Nausea.
  • Irritated skin. During radiation treatments, the skin on and around the treatment area is liable to become very tender and easily irritated. It may look red or darkened ('bronzed'), and hair in this area may fall out (the hair will usually grow back after a few months).

Be very gentle with the affected skin, wash with luke warm water and mild soap. (Remember not to wash off the marks used to guide the radiation therapy). Do not rub, scrub, or scratch the sensitive area. Do not use powders, creams, perfumes, deodorants, body oils, ointments, or lotions on the treatment area during  treatment and for several weeks after treatment is completed. The skin can be exposed to air but should be protected from the sun. Do not wear clothers that rub or irritate this tender skin.

  • Fatigue: People often complain of being very tired while they are getting radiation treatment, especially after several sessions. However, fatigue does not mean your condition is getting worse. This is a normal reaction to the treatment. Resting is obviously a very important, particularly right after a treatment. The tiredness usually wears off a week or two after all the treatments are completed.
  • Sore throat. For a dry, scratchy throat and difficulty in swallowing, eating soft foods and drinking extra liquids will usually help. Milk shakes, cream soups, and prepared liquid supplements are good, nourishing choices. It is also important to remind yourself that these symptoms come from the radiation itself, and not that your cancer is growing in your throat. These symptoms will also usually go away after a week or two.
  • Aches and stiffness. Aching or stiff muscles in your abdomen can be relieved through simple exercises such as slow stretching (be gentle and don't go too far) or light movement exercises that twist or bend your abdominal area.

Fortunately, there are drugs that can help ease these side effects, leaving you in relative comfort and fairly resistant to other diseases.

  • Hair loss. Hair will only fall out in the area of the body being treated. If you receive radiation therapy to your head, you will probably lose some hair from your scalp. If the chest is being treated, then only hair in that region, near the treatment area is likely to fall out. Radiation to the head or scalp can cause permanent hair loss in the treatment area. Depending on where the radiation is directed on your body, you may also experience hair loss on your legs, arms, underarms, pubic area, chest, eyelashes and eyebrows.

After radiation therapy, your hair will usually be back but it might not be as thick as before. Time of regrowth depends on the dose of radiation therapy and the duration of treatment, within six to twelve months of completing your treatment. Occasionally after a large dose of radiation therapy, the hair may not recover completely and new growth can be rather patchy.

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Taking care of your hair and scalp during treatment.

  • The best advice is simple - keep your hair and scalp clean and be gentle with it.
  • Use gentle hair products. Comb or brush your hair gently using hairbrush with soft bristles. This is also helpful if your scalp feels tender.
  • Use a satin, polyester or cotton pillowcase rather than nylon, which can cause irritation.
  • Avoid using a hair dryer as this will dry the hair and make it more likely to break.
  • Avoid plating or braiding your hair as this pulls and stretches the hair.
  • If you have lost all your hair, you may find your scalp becomes flaky. This can be removed by gently rubbing the scalp with moist cotton wool. A mild anti-dandruff shampoo might help.
  • If you have lost hair under your armpits, avoid using perfumed deodorants. Use a small amount of baby powder instead.
  • A gentle scalp massage can be invigorating and make you feel much better.

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Choosing a wig or hair piece
Buy your wig before your hair falls out so you can get a good match to the color of your real hair. If you prefer, buy a turban or head scarf for those times when you do not want to bother putting on the wig - especially when you are at home.

Wigs can be made from real hair or synthetic materials. Human hair wigs tend to be more expensive and need to be dry cleaned and set once a month. Synthetic wigs are less expensive, easier to style, wash easily, dry quickly and need less care. Both look natural. Synthetic wigs only last about nine months, but this may be all you need. Try to get a wig that adjusts to any head size to take into account variations as you lose your hair.

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