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What You Should Know about Radiation Therapy

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Along with chemotherapy and surgery, radiation therapy is one of the main treatments for many cancers. Here are some things you should know about this therapy, how it works, and its side effects.

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What You Should Know about Radiation Therapy

  1. 1. What is radiation therapy? • There are two main approaches to radiation therapy: — external-beam radiation therapy, during which a machine called a linear accelerator delivers radiation to the cancer site through multiple beams — internal radiation therapy, or brachytherapy, where tiny pellets of radioactive material are placed directly inside the body near cancer cells • Radiation cannot be felt, seen, heard, or otherwise perceived during treatment
  2. 2. Radiation creates small breaks within the DNA of cancer cells, preventing the cells from growing and dividing, and often causing them to die.
  3. 3. External-beam radiation is given using a linear accelerator (linac) source of radiation robotic table
  4. 4. Radiation oncologists aim beams using “tattoos” on patients Source: xkcd.com/933
  5. 5. Radiation oncologists use regular imaging scans to assure treatment accuracy and precision X-rays for daily verification of positioning CT for weekly Confirmation of target localization
  6. 6. Positioning X-rays CT: Plan CT: Week 5 Example scans in lung cancer
  7. 7. When patients receive radiation, surrounding organs are often at risk for unnecessary treatment, which can cause side effects.
  8. 8. In lung cancer, for example, radiation may reach the healthy lung, esophagus, or spinal cord. right lung left lung esophagus spinal cord
  9. 9. The challenge: unavoidable overlap of target volume and esophagus
  10. 10. Radiation beams come from various angles and at varying intensities to target the tumor and avoid as many other organs as possible.
  11. 11. For lung cancer, side effects caused by radiation reaching other organs may include skin reddening very rare risk of spinal cord injury pain with swallowing lung inflammation
  12. 12. A course of radiation lasts anywhere from a single treatment for symptom relief, up to seven weeks of daily treatment.
  13. 13. Dividing radiation into multiple sessions of lower doses, in a practice called fractionation, spares more healthy issues, but in the long run may decrease survival.
  14. 14. Many patients wonder… Am I radioactive after treatment? Is it safe to be around young children? “Radioactivity” lasts about 0.000000000000000001 seconds after treatment, so you are perfectly safe
  15. 15. Can you tell if the tumor is shrinking? — Daily X-rays and/or weekly CT scans are mostly to verify positioning and tumor targeting — Tumors continue to shrink for weeks after the final treatment — Radiation oncologists typically perform scans about two months after completion of therapy to assess the tumor’s size
  16. 16. Will you be repeating the treatment? — Unlike chemotherapy, radiation oncologists typically administer a single course of treatment — If needed, additional treatment can be given on a case-by-case basis after weighing the benefits and risks with your care team
  17. 17. Is all this radiation, including X-rays and CT scans, safe? — The rate of secondary cancers due to radiation is less than 1 in 100, and likely closer to 1 in 1000 — Side effects depend on the area of the body that is treated; treatment will only be given if the benefits will likely outweigh the risks and the risks are acceptable to both the patient and provider
  18. 18. Resources Dana/Farber/Brigham and Women’s Department of Radiation Oncology American Society for Radiation Oncology How Long Does Radiation Stay in Your Body After Treatment?

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