Radiotherapy In Detail

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Radiotherapy In Detail. In this article, you will get to know about what does radiotherapy consist of, in which cases can radiotherapy be decided, different types of radiotherapy, what is a radiotherapy session like, how long does radiotherapy last, side effects of radiotherapy, can radiotherapy be combined with other treatments, efficiency of radiotherapy, and what does radiotherapy consist of.

Radiotherapy In Detail:

What Does Radiotherapy Consist Of:

Radiation therapy is one of the treatments for cancer. It consists in sending X-rays on the cancerous cells to destroy them while preserving as much as possible the healthy tissues and the surrounding organs. “ X-rays cause breaks in the DNA of tumour cell nuclei. Unlike healthy cells that have the ability to repair themselves, cancer cells cannot repair these breaks, which will lead to their destruction.

Radiotherapy is a locoregional treatment of cancers, that is to say, that it treats an area predefined by a radiotherapist oncologist before the start of treatment. More than half of cancer patients are treated with radiotherapy at some stage in their care pathway.

In Which Cases Can Radiotherapy Be Decided?

Radiation therapy has two main goals. It aims to cure cancer by destroying all the cancer cells. This is called curative radiotherapy. It can also slow down the development of a tumour and treat its symptoms (painful bone lesions, bleeding tumours, etc.). This is then palliative or symptomatic radiotherapy.

Radiation therapy can treat many cancers such as:

Breast cancer.
Gynecological (uterus, cervix, vagina) and urogenital (bladder, prostate) cancer.
Cancers of the ENT sphere (nose, ears, pharynx, larynx).
Mouth cancer.
Certain digestive cancer (rectum, stomach).
Brain tumour.
Lung cancer.
Certain cancers of the blood, bone marrow and lymph nodes (Hodgkin’s disease).

This type of treatment is decided on a case-by-case basis. Several parameters are taken into account before proposing radiotherapies like the type of cancer, its stage of development and the general condition of the patient.

The indication for radiotherapy is made by an oncologist specializing in radiotherapy, often after discussion in multidisciplinary consultation meetings with other specialists such as the medical oncologist, the surgeon or even the pathologist.

Radiotherapy In Detail - chart

Different Types Of Radiotherapy:

-Preoperative or neoadjuvant radiotherapy:

Its purpose is to shrink the tumour, facilitate surgery, and reduce the risk of the disease coming back.

-Postoperative or adjuvant radiotherapy:

Its purpose is to complete the surgery by eliminating any remaining cancer cells to reduce the risk of local recurrence and sometimes improve survival.

-Exclusive radiotherapy:

In this case, radiotherapy is not associated with surgery but can be associated with systemic treatments such as chemotherapy. It concerns inoperable diseases or patients or certain diseases without surgical indication such as small cell lung cancer.

-Stereotactic radiotherapy:

This is a very precise irradiation technique that delivers a high dose of radiation to a small target while preserving adjacent healthy tissue. The duration of the treatment is most often short (1 to 5 sessions) unlike so-called “classic” radiotherapies, but the sessions last longer (20 to 60 min). It is particularly indicated for small tumours measuring less than 3 to 5 cm and for which surgery is not recommended. Stereotactic radiotherapy has an “ablative” effect like surgery, but is a non-invasive technique. It can be decided for primary lung cancer or cerebral or hepatic metastases.

What Is A Radiotherapy Session Like?

-Before starting of treatment:

Before starting the radiotherapy, it is essential to identify the area to be treated using a scanner. The radiation oncologist must identify the target on which the rays will be sent and the organs to be protected. This identification step can last from 30 minutes to over an hour. Several scouting sessions are sometimes necessary. It is during this location step that the position of the patient during radiotherapy is defined.

The second step consists in defining the doses of radiotherapy to be administered to the patient according to the type and stage of the cancer, the organ to be treated, their age and their medical history. This work is carried out by the radiation oncologist in collaboration with a physicist and a dosimetrist.

-During the sessions:

They are most often performed on an outpatient basis, in a hospital or private radiotherapy centre, and by a radiotherapy technician. The latter ensures that the sessions prescribed by the radiotherapist run smoothly. The patient is installed on the treatment table in the position determined during the identification phase. The rays are then directed towards the area to be treated. The device starts sending the rays when all the machine and treatment checks are done. The irradiation time is 5-10 minutes. The device rotates around the patient without ever touching him. Irradiation is invisible and painless. “ Patients can in the vast majority of cases resume their work and daily activities after a radiotherapy session”, indicates the oncologist.

How Long Does Radiotherapy Last?

For curative radiotherapy, the treatment can last from 3 to 7 weeks, with 4 to 5 sessions per week. For symptomatic radiotherapy, 5 to 10 appointments may be necessary. As for stereotactic radiotherapy, 1 to 5 sessions maximum are prescribed.

What Are The Side Effects Of Radiotherapy:

The side effects of radiation therapy will depend on the area being treated. If the area being treated is the breast, possible side effects are skin redness, pruritus and fatigue. If the rays were directed to the nodes located in the neck, then the patient may complain of discomfort when swallowing. If the area treated is the prostate, there may be irritation of the bladder, diarrhea or irritation of the rectum.

When it comes to acute side effects, they occur during and a few weeks after the end of treatment. These usually resolve within a month of the end of treatment. Late side effects, which appear 3 to 6 months after the end of radiotherapy, are linked to cell scarring and are irreversible. But let patients be reassured, they are generally minimal to moderate.

Can Radiotherapy Be Combined With Other Treatments?

Radiation therapy can be combined with chemotherapy or targeted therapy. Several approaches can be combined if this combination does
not present any toxicity for the patient. Some combinations are even being researched because they increase the effectiveness of cancer treatment.

Efficiency Of Radiotherapy:

The effectiveness of radiotherapy varies according to cancers and according to the stages.

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