Radiation Therapy and Radiation Oncology - Cancer care and treatment

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Are you looking for information on Radiation Therapy, and Radiation Oncology? Read this article about cancer treatment using radiation therapy. Cancer happens when damaged or old cells divide and multiply in an uncontrolled manner. When cells start behaving abnormally the old or damaged cells survive and don’t die. On the other side, new cells are formed when they are not needed. These cancerous cells can divide without stopping.

Such cells form growths which are called tumors. Cancer cells reproduce and multiply uncontrollably even when your body tells them to stop. These cells spread into surrounding tissues and cause cancer. Cancer can start in any part of the body.

Your doctor is the best person to advise you regarding various types of cancer treatment. This article gives an overview of radiation therapy and radiation oncology as general information.

Table of Contents

What is Radiation Therapy?

Radiation Therapy is a procedure for cancer treatment. Radiotherapy uses radiation to kill cancer cells in the affected part of the body. Radiotherapy is also used to shrink tumors.

It uses high-energy X-Rays, Electron Beams and Gamma Rays. Radiation strength is controlled depending upon the severity of cancer. The radiation is targeted to the exact location in the body so that surrounding healthy cells are not exposed to radiation.

These rays damage the DNA of cancerous cells. These damaged cancer cells can’t repair themselves. So radiation kills the cancer cells and therefore stops them from multiplying uncontrollably. The radiation damages the DNA of healthy cells also. But the healthy cells have high chances of recovering after exposure to radiation.

Every cancer patient will not be given radiation therapy. Your doctor will decide the need for radiation therapy based on the following factors:-

Whether radiation therapy is being given for symptom relief or for a cure
Type and stage of the cancer
Location in the body
Whether only radiotherapy is being used or it is being done along with Chemotherapy or Immunotherapy
The condition of patient’s health. The preference of the patient may also be taken into consideration.

Radiation Therapy is a painless procedure. It is the same as having an X-Ray or a CT Scan or MRI.

This type of therapy can be given before or after the removal of the tumor also. Sometimes radiations are given during surgery so that rays reach directly to cancerous cells. It is called Intra-Operative Radiation. This technique provides better protection to the surrounding tissue. During the surgery, the beams do not pass through the skin and focus only on cancer tissue.

Types of Radiation Therapy

A radiation oncologist uses three main types of therapy:

External beam radiation

It is also known as EBT. It is a method of delivering high-energy electron beams or X-rays to tumors or cancerous parts. The beams are generated by a machine called Linear Accelerator. A single beam or several beams may be delivered to the tumor. This type of radiotherapy shrinks the tumor and relieves problems associated with it. It is a local treatment, and only the cancerous organ is treated. The high-energy rays deposit their dose to the cancerous area and destroy the cancer cells.

The main aim of external beam radiation therapy is to eliminate the tumor and prevent the tumor from growing back again. The radiation beam breaks the DNA of cancer cells. So they can’t divide and multiply. Therefore the growth of cancer cells is stopped.

Following types of external beam radiotherapy are commonly used:-

Intensity Modulated Radiation Therapy (IMRT). It avoids exposure to healthy tissue, and therefore the method shows lesser side effects of radiation treatment.
Image-Guided Radiation Therapy (IGRT). It is used to give radiation doses to organs that are moving, like lungs. The oncologist can image the tumor during the treatment.
Stereotactic radiotherapy (SRT). In this procedure, radiation therapy is given from various angles around the body. All the radiation beams meet at the tumor. Therefore, the tumor receives a high dose of radiation, and surrounding healthy cells are protected.
Volumetric Modulated Arc Therapy
3D Conformal Radiation Therapy (3D CRT)

Following types of cancer are treated using external beam radiation:-

Breast cancer
Prostate cancer
Liver cancer
Pancreatic cancer
Gynecologic cancer
Head and neck cancer
Tumors in spine
Colorectal cancer

Brachytherapy

It is internal radiation therapy. A radioactive source is placed inside the patient, near the tumor or cancerous part. This radioactive source kills cancerous cells and also shrinks tumors. A small device (capsule or ribbon) containing a radiation source is placed inside your body near the tumor. It is also a local treatment. It is commonly used to treat cancers of the head and neck, breast, cervix, and prostate. A higher dose of radiation can be delivered in lesser time.

Brachytherapy is used for the following types of cancer:-

Breast cancer
Cervical cancer
Carcinoma of the Endometrium (Uterus)
Head and Neck cancer
Esophageal Cancer
Lung cancer
Prostate cancer
Soft-Tissue Sarcomas
Intravascular Brachytherapy

Systemic radiation therapy

In this type of radiation therapy, a radioactive substance is swallowed or is injected into the body. Some of the radioactive substances used are radioactive iodine or monoclonal antibody. The radioactive substance travels through the blood and kills cancerous cells.

Systemic radiation therapy is used to treat cancer of the prostate, bone, and thyroid. Radioactive iodine is often given after thyroid cancer surgery. It kills the remaining cancer cells and tissues.

This procedure is used when cancer is in an advanced stage and reached bones. Radioactive compounds called radiopharmaceuticals are given as injections through the vein or by the oral route.

The radioactive substance leaves the patient’s body through sweat, saliva, and urine. Therefore special precaution is taken so that other people do not get exposed to radioactive compounds.

What is radiation oncology?

Radiation oncology is a line of cancer treatment. It is also called Radiation Therapy or Radiotherapy. Radiation oncology is a multi-disciplinary approach to cancer treatment. The team consists of Radiation Oncologist who is a doctor qualified in radiation therapy. In addition, the team will have radiation therapists, nurses, and medical doctors. A radiation therapist is a person who delivers the radiation using machines.

Radiation oncology is a special type of cancer treatment. Your doctor (Radiation Oncologist) will expose the cancer body part to radiation. Radiation therapy uses high-energy X-Rays or Gamma-Rays or Photons. This high-energy X-Ray is delivered through a linear accelerator.

Radiation therapy is a specialized treatment. So it has to be planned properly. Radiation therapy is personalized depending on the situation of the patient. The radiation oncologist has to plan your treatment carefully so that there is a minimum side effect and the healthy cells are not damaged by radiation.

Even after completion of radiation treatment, your radiation oncologist may continue to monitor your situation till he is sure that you have been completely cured of cancer and the growth of cancer has been controlled.

What does a radiation oncologist do?

The doctor who gives radiation therapy for cancer is a Radiation Oncologist. This type of doctor uses radiation therapy to treat cancer. She will develop a treatment plan and oversee your radiation therapy with his team.

A radiation oncologist is a doctor who treats cancerous and non-cancerous tumors and growths using a variety of radiation therapy.

A radiation oncologist is different from a radiologist. A radiologist takes a CT scan, X-Ray, Mammography, and other diagnostic images. Radiology helps to locate tumors, their stage, size, and location. After this imaging procedure radiation oncologist steps in for treatment of cancer and tumor using radiation therapy.

Do radiation oncologists perform surgery?

Oncologists give treatment for cancer. Radiation Oncologist specializes in cancer treatment with the use of radiation therapy. A Surgical Oncologist treats cancer by doing surgery. The surgery removes the tumor and nearby cancerous tissues. Radiologists, Surgical Oncologists, Medical Oncologists, and Radiation Oncologists work together to treat cancer patients. Sometimes radiation therapy is given while surgery is being performed.

What is the difference between Surgical Oncologist and Radiation Oncologist?

The oncologist is a doctor who carries out the diagnosis of cancer and provides treatment for cancer. Some oncologists focus on a specific type of cancer and treat it. More oncologists are involved in patient care depending on the type, stage, and location of a tumor.

Video on “Radiotherapy information”

There are three different oncology specialist doctors:-

Medical oncologist – These doctors decide your cancer treatment plan. Whether you need surgery, or chemotherapy, or immunotherapy, or targeted therapy, or hormone therapy is determined by the medical oncologist. These doctors also coordinate with other oncology specialists. You need to continue to see a medical oncologist after treatment and for regular follow-ups for the long-term.

Surgical oncologist – These doctors are surgeons. They perform surgery, remove the tumor from your body, and remove a tissue sample for biopsy and pathological testing. Surgical oncologists use special equipment like robotic surgery and minimally invasive surgery.

Radiation oncologists – They treat your cancer by radiation. These doctors usually coordinate with the medical and surgical oncologist to decide the treatment plan and procedures.

There are many sub-specialties also. For example:

Gynecologic oncologists – These doctors treat cancers of the female reproductive system like the uterus, cervix, or ovaries.

Hematologic oncologists – These doctors diagnose and treat blood cancers like leukemia, lymphoma, and multiple myeloma.

Neuro-oncologists – These doctors treat cancers of the brain, spine, and peripheral nerves.

What is the difference between radiation and chemotherapy?

Chemotherapy and radiation therapy are two different types of cancer treatments.

Following are important points for each type of treatment:-

Radiation Therapy

Radiation therapy uses high-energy beams of radiation like X-Ray, Gamma Ray, Photons, etc. Mostly X-Ray is used. A machine named Linear Accelerator is used. This machine can deliver a precise dose of radiation from several angles.
So radiotherapy is external beam radiation therapy.
Before commencement of this therapy, CT Scan may be done to decide the area of treatment
This high-energy beam is generated by an external machine.
But in radiotherapy called brachytherapy, the radiation source is placed inside the body of the patient.
Your doctor may advise you five days a week of radiation treatment. The complete treatment may cover many weeks. It allows the healthy cells to re-grow between two sessions of radiation.
A session of radiation therapy may take 10 minutes to 30 minutes. It does not cause any pain.
Radiotherapy destroys the DNA of cancerous cells. So they can’t divide and grow uncontrollably.
However, the energy beam also damages healthy cells. But most of these normal cells repair themselves.
Radiotherapy is also used to shrink a cancerous tumor before surgery is done to remove this tumor.
Radiotherapy may be combined with other procedures like chemotherapy
Radiotherapy has side effects

Chemotherapy

Chemotherapy uses drugs to destroy cancer cells
Chemotherapy drugs prevent cancer cells from growing, dividing, and making more cells
Most chemotherapy drugs are given directly into the veins, through injection. It is called intravenous chemotherapy.
The drug may be given from a bag of fluid that is attached to the patient’s vein through a tube and needle.
The frequency and duration of chemotherapy treatment depends on the treatment plan of the patient
Four to eight cycles of treatment are usually given
Chemotherapy has side effects like fatigue, loss of appetite, nausea, bowel issues such as constipation or diarrhea, hair loss, mouth sores, skin and nail problems, etc.
Learn more about Chemotherapy and side effects

Do radiation therapy and chemotherapy cause second cancer?

It is still not known how the cancer survivors treated for cancer develop cancer again. Some studies have analyzed the cause of second cancer as mentioned below:

Chemotherapy and radiation therapy make your immune system weak. So, second cancer develops quickly as your body cannot fight. Chemotherapy used to treat first cancer causes changes in bone marrow cells. This also contributes to the development of second cancer.
Radiation therapy kills cancer cells and also few healthy cells. This damage causes second cancer. It is called radiation-induced second malignancy.
After radiation exposure, there is a possibility of the development of leukemia. It can be like acute myelogenous leukemia, chronic myelogenous leukemia, and acute lymphoblastic leukemia.

Not every cancer survivor will develop second cancer. It is challenging to predict the risk of second cancer.

What to expect while having radiation therapy?

You may get tensed or feel worried when you learn that your doctor advises you radiation therapy. It is a normal feeling. But, if you know more about different cancer treatments, your tension will be relieved, and you will be better prepared to undergo radiation therapy. This article will help you understand and feel comfortable with your radiation treatment.

There will be a team of experts for your radiation therapy. The team will have a Radiation oncologist, Radiation oncology nurse, medical radiation specialist, dosimetrist, radiation therapist, and other staff members.

Radiation therapy side effects

Radiation therapy causes side effects. Each patient may experience different types of side effects. High doses of radiation are used to kill cancer cells. However, this radiation also damages surrounding healthy cells. Side effects depend on which part is being exposed to radiation therapy. Different treatments can cause different side effects. Following are some of the side effects:-

The patients may feel fatigued. You may feel tired all the time.
Dry and itching skin. Blisters on skin
Nausea
Loss of appetite
Bowel crimping
Loose stool
Rectal bleeding in case of pelvis radiation
Irritation in bladder
Mouth and gum sores
Hair loss
Swelling called lymphedema
Difficulty in swallowing
Dry mouth
Stiffness in jaw
Tooth decay
Erectile dysfunction
Menopause symptoms

Some of the side effects are short-term and go away few weeks after the radiation therapy. But there are some long-term side effects also. Sometimes side effects happen after many months or after many years also. So you must consult your doctor to learn more about the possible side effects of radiation therapy.

Video on “What to expect when receiving radiation”

What are the disadvantages of radiation therapy?

You may see some side effects of radiation therapy. Side effects depend on the following parameters:

Type of cancer
Location of cancer
Stage of cancer
The dose of radiation given during treatment and
Your overall health condition.

You need to remember that some patients do not experience any side effects. Every patient reacts to radiation therapy differently. So, you may or may not experience side effects. Local radiation therapy does not cause much damage. Many patients even go to work while they are taking radiation therapy.

General side effects observed for radiation therapy are

Fatigue- You may feel tired physically, mentally, and emotionally.
Skin problems- Your skin may become red and swollen. After a few weeks, the skin may become dry and itchy.
Hair thinning and hair-loss- This problem is observed when your head is exposed to radiation. If radiation is given to your leg, you will not have any hair loss.
Nausea and dry mouth- When the head and neck region is exposed to radiation, the patient may experience nausea, dryness of the mouth, pain in swallowing, and earache.

Radiation therapy for breast cancer treatment — Radiotherapy for breast cancer

Does radiation weaken your immune system?

Cancer treatment weakens your immune system. Like chemotherapy, radiation therapy may make your immune system weak. The effect is seen when bone marrow is exposed to radiation. Bone marrow contains stem cells that produce new red blood cells (RBC) and white blood cells (WBC). WBCs are required to fight against infections. So, when your bone marrow is exposed to radiation, it results in immune suppression. Your ability to fight infections becomes low. You need to take extra precautions to avoid infection and further complications.

How should I boost my immune system after radiation?

You need to build immunity when you are on radiation therapy. Here are quick tips to follow to boost your immune system.

Take ample rest. You should sleep well for a fast recovery.
Eat healthy, nutritious food.
Maintain good hygiene to avoid any infection.
Avoid contact with other patients.
Do not share personal products like towels, pillows, brushes, etc., with other people.
Avoid contact with animals.

What is the qualification of a Radiation Oncologist?

The radiation oncologist is a highly specialized doctor who treats cancer using radiotherapy. The qualification of radiation oncologist is MBBS and MD in Radiation oncology or MD in radiation therapy. Many doctors do MD in other branches of medicine and additionally do following specialized courses like