3 major cancer treatments "Radiation therapy"Reason for multiple sharing
Jul 03, 2024
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Radiation is a specific light (energy) emitted from the nucleus of an atom, which is invisible, odorless, and fine particles that have no feeling on the body. There are alpha rays, beta rays, and gamma rays. Among them, radiation mainly used for radiation therapy is X-rays, gamma rays, neutron rays, and proton rays.
Radiation therapy is a treatment that destroys cancer cells in the human body and stops growth using radiation or radioactive isotopes from devices that generate high energy. When irradiated to the body, chemical denaturation occurs in nucleic acids or cell membranes that are essential for cell proliferation and survival, which effectively treat cancer cells while reducing damage to normal cells. Radiation used in treatment gives cancer cells higher energy than radiation used in diagnostic tests, causing them to die because they can no longer divide and multiply.
Kwak Yoo-gang, a professor of radiation oncology at the Catholic University of Korea's Incheon St. Mary's Hospital, said "Surgery, chemotherapy, and radiation therapy are essentially different treatments, but if properly combined depending on the type of cancer or the patient's condition, the treatment effect can be enhanced."
With the help of Professor Kwak Yoo-gang, we summarized radiation cancer treatment.
▶Difference in treatment depending on purpose such as cure and reduction of pain...proceeding to a regular outpatient clinic
Cancer is characterized by metastasis to other organs over time. In addition, depending on the type of cancer, there is a high risk of spreading to other organs even though it is early. Therefore, it is important to combine local and systemic treatments for cancer treatment. Local treatment includes surgical surgery and radiation therapy, and systemic treatment includes chemotherapy using drugs.
Lung cancer, breast cancer, and colon cancer are at high risk of local recurrence or metastasis even after surgery. Radiotherapy or chemotherapy lowers the recurrence rate. If esophageal cancer and rectal cancer are difficult to operate immediately due to the progression of cancer, surgery after reducing the size of the cancer by preoperative chemotherapy and radiation therapy can increase the effectiveness of treatment. In the case of cancer metastasis to other organs or blood cancer, chemotherapy is applied first. However, if the cancer becomes severe even after chemotherapy, it can be surgically removed or radiotherapy can be performed to increase the local control rate of the tumor.
Radiotherapy includes a 'external irradiation' that irradiates the tumor area in the body from the outside and a 'close irradiation' that injects isotopes directly into the normal area inside the body. The external investigation most patients receive uses a treatment device called a linear accelerator, which is a device that makes X-rays and electron beams of various energies that allows the tumor to be intensively irradiated even if it is deep in the body or near the skin.
Close-up irradiation is a method of inserting a radioactive isotope called iridium-192 into a tumor in the body or the area where the tumor has occurred. It has the advantage of being able to irradiate a large amount of radiation. In Korea, it is mainly used for uterine cancer, and overseas, it is also widely used for the treatment of prostate cancer.
The purpose of radiation therapy can be broadly classified into three categories. The first is to be performed for the purpose of cure, which requires a high dose of radiation and is often accompanied by chemotherapy. The second is when it is performed for auxiliary purposes of surgery. At this time, if performed before surgery, the size of the tumor can be reduced to increase the surgical outcome, and if recurrence is expected after surgery, radiotherapy is added to reduce the likelihood of recurrence. Lastly, it is implemented with the aim of reducing symptoms and pain caused by tumors. In this case, it is treated with a smaller amount of radiation than in the above case, and the period is short. Depending on the condition and progression of the disease, it may be performed together with surgery and chemotherapy. Radiation therapy is performed as outpatient treatment except in special cases.
▶ Minimize side effects by reducing normal tissue surveys...I usually do it 5 times a week, 7 weeks
Radiation therapy is developing in the direction of minimizing side effects and maximizing treatment effects by concentrating radiation on tumors and irradiating normal tissues around them as little as possible. Radiotherapy technology started with two-dimensional radiotherapy and gradually developed into three-dimensional stereoscopic radiotherapy and intensity-controlled radiotherapy. There is also stereotactic radiation therapy or radiation surgery that irradiates relatively small cancers of less than 3 cm with high doses of radiation for a short period of time. In this case, the treatment effect is almost similar to that of surgery.
Professor Kwak Yoo-gang said, `When cancer occurs in many moving organs, normal tissues are often unnecessarily exposed due to the inclusion of tumor movement in the radiation treatment range. Recently, if the tumor is out of the radiation range due to breathing or long-term movement, the radiation is automatically stopped and then irradiated again when the tumor enters the range.'
Radiation therapy is usually performed once a day and five times a week from Monday to Friday, and often takes up to seven or eight weeks. The time required for one treatment varies depending on the patient or disease, but it is about 5 to 30 minutes.
Professor Kwak Yu-gang said, "In radiation therapy, if radiation is irradiated to a sufficient amount and radiation range to kill cancer cells, normal cells around them will also be exposed to radiation, and damage to normal tissues leads to side effects." Fortunately, damaged normal cells are resilient quickly. If you repeatedly irradiate the radiation several times in small amounts, cancer cells will suffer more damage than normal cells, and as a result, the treatment effect will increase and the side effects will decrease."
▶ It depends on the side effects and treatment area, but you don't have to worry too much
The side effects of radiation therapy depend on the area where they are treated. The most severe side effects in head and neck cancer patients with cancer on the face or neck are dry mouth and radiation dermatitis. The skin on the face or neck turns reddish as if it were sunburned in summer, and in severe cases, it peels off. In addition, mouth inflammation or esophagitis makes it difficult to eat food, resulting in weight loss. In order to reduce these side effects, medications to reduce symptoms are prescribed, and oral nutritional supplements are prescribed if necessary.
In the case of radiation therapy on the chest, there are largely breast and lung cancer. Breast cancer can also cause radiation dermatitis, and in rare cases, lymphoma can also occur. When radiotherapy is performed on the lungs, cough symptoms due to airway dryness are the most common, and esophagitis may occur in tumors located close to the esophagus.
Abdominal or pelvic radiation therapy may cause abdominal pain, nausea, vomiting, and diarrhea due to radiation irradiated to the intestine. Radiotherapy near the bladder or prostate often complains of symptoms of cystitis such as frequent urination. However, most of them are adjustable if drugs are used during treatment.
Acute side effects that occur during radiation therapy or immediately after the end of treatment are experienced by most patients, but most of them recover after the end of treatment. However, chronic side effects that occur after more than six months occur in a small number, but recovery takes a long time. Fibrosis occurs in the area that received radiation therapy, making the surrounding areas, including the skin, hard. After a patient with lung cancer undergoes radiation therapy, radiation pneumonia may appear. In addition, in the case of abdominal or pelvic cancer, intestinal bleeding may rarely occur even after 6 months to 1 year.
Professor Kwak Yoo-Kang said, "Side effects of radiation therapy are inevitable depending on the location and size of the tumor, but it can be prevented to some extent through lifestyle or eating habits during treatment, and can be completed without any major problems if it is properly prescribed through the treatment of the radiologic oncology doctor in charge."During radiation therapy, we should refrain from putting a burden on the skin or surrounding organs where we are treated, and we should strive for health and physical management as the treatment period lasts from 6 to 8 weeks."
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