Consequences of radiation therapy. Possible side effects and consequences of radiation

Radiation therapy for cancer

What is radiation therapy?

Radiation therapy (x-ray therapy, telegamma therapy, electron therapy, neutron therapy, etc.) is the use of a special type of energy from electromagnetic radiation or beams of elementary nuclear particles that can kill tumor cells or inhibit their growth and division.

Some healthy cells exposed to radiation are also damaged, but most are able to recover. Tumor cells divide faster than the healthy cells around them. Therefore, radiation is more harmful to them. It is these differences that determine the effectiveness of cancer radiation therapy.

What types of cancer is radiation therapy used for?

Radiation therapy is used to treat a variety of cancers. Currently, more than half of patients suffering from one or another type of cancer are successfully treated with radiation.

Radiation can be used as a stand-alone treatment. Sometimes RT is given before surgery to shrink the tumor or after surgery to kill remaining cancer cells. Quite often, doctors use radiation together with anticancer drugs (chemotherapy) to destroy the tumor.

Even in those patients whose tumor cannot be removed, RT can reduce its size, reduce pain and improve general condition.

Equipment for radiotherapy

To carry out radiation therapy, special complex devices are used that allow directing the flow of therapeutic energy to the tumor. These devices differ in their operating principle and are used for different purposes. Some of them are used to treat superficial cancer (skin cancer), while others are more effective in treating tumors located deep in the body.

Your doctor will decide which device is best to use.

The radiation source can be brought to the diseased area in several ways.

If the source:

• is located at a distance from the patient’s body, irradiation is called remote;
• placed in any cavity - intracavitary;
• injected directly into the diseased area in the form of liquid, wire, needles, probes - interstitial.

Stages of radiation therapy

When carrying out RT, three stages are conventionally distinguished:

1. pre-radial;
2. ray;
3. post-radiation.

Each of these stages has its own characteristics that determine the rules of your behavior. Compliance with them will improve treatment results and reduce the incidence of side effects.

The process of radiation therapy

1. Preparation for treatment

During this period, additional studies are carried out to clarify the localization and assess the condition of healthy tissue surrounding the pathological focus.

Before starting a course of radiation, radiation doses are carefully calculated and its methods are determined, with the help of which it is possible to achieve maximum destruction of tumor cells and protection of healthy tissue in areas of the body subject to exposure.

Your doctor will decide what dose of radiation you need, how to administer it and how many sessions it will take.

A whole group of highly qualified specialists - physicists, dosimetrists, mathematicians - helps to carry out these complex calculations. It sometimes takes several days for a decision to be made. This procedure is called planning.

During the simulation (planning), you will be asked to lie quietly on the table until the doctor uses a special X-ray machine to determine the radiation field. There may be several such areas. The irradiation fields are indicated by dots or lines (marking), using special ink. This marking should remain on the skin until the end of treatment. Therefore, while taking a shower, try not to wash it off. If the lines and dots start to blur, tell your doctor. Don't draw the dots yourself.

Already in the pre-radiation period:

1. do not use tinctures of iodine and other irritating agents on areas of the skin that will be exposed to radiation;
2. should not sunbathe;
3. If there are diaper rashes or rashes on the skin, you should point them out to your doctor. He will prescribe appropriate treatment (powders, ointments, aerosols);
4. If radiation therapy will be carried out to treat a tumor of the maxillofacial area, preliminary sanitation of the oral cavity (treatment or removal of carious teeth) is necessary. This is the most important measure for the prevention of radiation complications in the oral cavity.

2. How the treatment session goes

You will be asked to lie quietly on the table until the radiologist uses a special X-ray machine to determine the radiation field. There may be several such areas. The irradiation fields are designated by dots or lines (marking), using special ink for this.

This marking should remain on the skin until the end of treatment. Therefore, while taking a shower, try not to wash it off. If the lines and dots start to blur, tell your doctor. Don't draw the dots yourself.

Already in the pre-radiation period, you should not use iodine tinctures and other irritating agents on areas of the skin that will be exposed to radiation. You should not sunbathe. If there are diaper rashes or rashes on the skin, you should point them out to your doctor. He will prescribe appropriate treatment (powders, ointments, aerosols).

If radiation therapy is carried out to treat a tumor of the maxillofacial area, preliminary sanitation of the oral cavity (treatment or removal of carious teeth) is necessary. This is the most important measure for the prevention of radiation complications in the oral cavity.

Radiation therapy: how is treatment carried out?

1. Selection of treatment regimen using radiation therapy

Typically the course of treatment lasts 4-7 weeks. In some cases, when radiation therapy is carried out before surgery to reduce the size of the tumor or to alleviate the patient's condition, the course duration is 2-3 weeks.

Typically, radiation therapy sessions are carried out 5 times a week. Sometimes, in order to protect normal tissues in the irradiation zone, the daily dose is divided into 2-3 sessions. A two-day break at the end of the week allows healthy tissue to recover.

The decision on the total radiation dose and the number of sessions is made by the radiologist based on the size of the tumor and the location of the tumor, its type, your general condition and other types of treatment being performed.

2. How the treatment session goes

You will be asked to lie on a treatment table or sit in a special chair. Based on the fields previously marked on the skin, the irradiation zones will be accurately determined. Therefore, you should not move during irradiation. You need to lie calmly, without much tension, breathing should be natural and uniform. You will be in the office for 15-30 minutes.

Before turning on the unit, the medical staff goes to another room and watches you on TV or through a window. You can communicate with him through the loudspeaker.

Some parts of radiotherapy machines may move and make noise during operation. Don't worry - the whole process is controlled.

The irradiation itself is painless. If you feel unwell during radiation exposure, tell your doctor immediately without taking any action on your own. The installation can be turned off at any time.

It is possible that already at the beginning of treatment you will feel a decrease in pain (if any). However, as a rule, the greatest therapeutic effect of radiation therapy occurs after completion of the course of treatment.

To obtain a good therapeutic effect, it is very important that you complete all prescribed treatment sessions.

How to behave during radiation therapy

The body's response to radiation therapy varies from person to person. However, in any case, the radiation therapy process represents a significant burden on the body. Therefore, you may develop a feeling of fatigue during treatment. In this regard, you should rest more. Go to bed when you feel the need.

The sensation usually goes away within 4-6 weeks after completing treatment. However, you should not completely avoid physical activity, which increases the body's defenses and resistance to harmful influences. You can get recommendations on the selection and dosage of physical activity from your doctor and a physical therapy specialist.

During treatment you should follow some rules

1. Eat well. Try to stick to a balanced diet (ratio of proteins, fats and carbohydrates 1:1:4). Along with food, you need to take 2.5-3 liters of liquid per day (fruit juices, mineral water, tea with milk).
2. Give up bad habits (smoking, drinking alcohol), at least for the period of treatment.
3. Do not wear clothing that is tight to the areas of your body being irradiated. Items made from synthetic fabrics and wool are extremely undesirable. Loose, old cotton clothing is preferred. If possible, the areas of skin to be irradiated should be kept open.
4. Get outdoors more often.
5. Carefully monitor the condition of your skin. Irradiated skin sometimes appears tanned or darkened. By the end of treatment, in some cases, the irradiated areas of the body may become excessively moist (especially in the folds). This largely depends on your individual sensitivity to radiation. Tell your doctor or nurse about any changes you notice. They will give appropriate recommendations.
6. Do not use soap, lotions, deodorants, ointments, cosmetics, perfumes, talc or other similar products on the exposed area of ​​your body without consulting your doctor.
7. Do not rub or scratch the area of ​​skin being treated. Do not place warm or cold objects (heating pad, ice) on it.
8. When going outside, protect the exposed part of the skin from the sun (light clothing, a wide-brimmed hat).

What awaits the patient after radiation?

Side effects of radiation

Radiation therapy, like any other type of treatment, can be accompanied by general and local (in the area of ​​​​irradiation on tissue) side effects. These phenomena can be acute (short-term, occurring during treatment) and chronic (developing several weeks or even years after the end of treatment).

Side effects of radiotherapy most often occur in tissues and organs directly exposed to radiation. Most side effects that develop during treatment are relatively mild and can be treated with medication or proper nutrition. They usually disappear within three weeks after the end of radiation therapy. Many patients experience no side effects at all.

During treatment, the doctor monitors your condition and the effect of radiation on body functions. If you experience any unusual symptoms during treatment (cough, sweating, fever, unusual pain), be sure to tell your doctor or nurse.

Common side effects of radiation therapy

Emotional condition

Almost all patients undergoing cancer treatment experience some degree of emotional stress. The most common feelings of depression, fear, melancholy, loneliness, and sometimes aggression are observed. As the general condition improves, these emotional disturbances become dull. Communicate more often with family members and close friends. Don't isolate yourself. Try to take part in the lives of the people around you, help them and do not refuse their help. Talk to a therapist. Perhaps he will recommend some acceptable methods of relieving tension.

Fatigue

Feelings of fatigue usually begin within a few weeks of starting treatment. It is associated with significant physical load on the body during radiation therapy and stress. Therefore, during the period of radiation therapy, you should slightly reduce your overall activity, especially if you are used to working at a strenuous pace. However, do not completely avoid housework; take part in family life. Do things that you enjoy more often, read more, watch TV, listen to music. But only until you feel tired.

If you do not want others to know about your treatment, you can take a vacation during the treatment period. If you continue to work, talk to your manager - he may change your work schedule. Don't be afraid to ask your family and friends for help. They will certainly understand your condition and provide the necessary support. After completing the treatment, the feeling of fatigue gradually disappears.

Blood changes

When large areas of the body are irradiated, the number of leukocytes, platelets and red blood cells in the blood may temporarily decrease. The doctor monitors hematopoietic function using blood tests. Sometimes, with pronounced changes, a break in treatment is taken for one week. In rare cases, medications are prescribed.

Decreased appetite

Radiation therapy usually does not cause nausea or vomiting. However, there may be a decrease in appetite. You must understand that in order to repair damaged tissues, you must eat enough food. Even if you don't feel hungry, you need to make an effort to eat a high-calorie, high-protein diet. It will make it possible to better cope with side effects and improve the results of cancer treatment.

Some nutritional tips during radiation therapy:

1. Eat a variety of foods often, but in small portions. Eat when you want, regardless of your daily routine.
2. Increase the calorie content of food - add more butter if you like its smell and taste.
3. To increase your appetite, use a variety of sauces.
4. Between meals, consume kefir, a mixture of milk with butter and sugar, and yogurt.
5. Drink more fluids, preferably juices.
6. Always have a small supply of foods you like (approved for storage in the clinic where treatment is carried out) and eat them when you feel like eating something.
7. While eating, try to create conditions that improve your mood (turn on the TV, radio, or listen to your favorite music while eating).
8. Talk to your doctor about drinking a glass of beer with meals to increase your appetite.
9. If you have any medical conditions that require you to follow a specific diet, talk to your doctor about ways to vary your diet.

Side effects on the skin

The skin's reaction to radiation is manifested by redness in the area of ​​exposure. In many ways, the development of this phenomenon is determined by your individual sensitivity to radiation. Redness usually appears at 2-3 weeks of treatment. After radiation therapy is completed, the skin in these areas becomes slightly dark, as if tanned.

To prevent an overly pronounced skin reaction, you can use vegetable and animal oils ("Children's", "Velvet" cream, aloe emulsion), which should be applied to the skin after a radiation therapy session.

Before the session, you need to wash off the remaining cream with warm water. However, the skin should be lubricated with appropriate ointments and creams not from the first days of irradiation, but later, when the skin begins to redden. Sometimes, if there is a severe radiation reaction of the skin, a short break in treatment is taken.

For more information about skin care, consult your healthcare professional.

Side effects on the mouth and throat

If you are receiving radiation to the maxillofacial area or neck, in some cases the mucous membrane of the gums, mouth and throat may become red and inflamed, and you may experience dry mouth and pain when swallowing. Usually these phenomena develop in the 2-3rd week of treatment.

In most cases, they go away on their own within a month after completion of radiation therapy.

You can alleviate your condition if you follow the recommendations below:

1. Avoid smoking and alcohol during treatment as they also cause irritation and dryness of the oral mucosa.
2. Rinse your mouth at least 6 times a day (after sleep, after each meal, at night). The solution used must be at room temperature or refrigerated. What solutions are best for rinsing the mouth can be found out from your doctor.
3. Twice a day, gently, without pressing hard, brush your teeth with a soft toothbrush or cotton swab (after use, rinse the brush thoroughly and store dry).
4. Consult your dentist for the right toothpaste. It should not be harsh and irritate the mucous membranes.
5. If you use dentures, remove them before your radiation therapy session. If dentures rub your gums, it is better to temporarily stop using them.
6. Do not eat sour, spicy foods.
7. Try to eat soft foods (baby food, purees, cereals, puddings, jellies, etc.). Soak hard and dry foods in water.

Side effects on the mammary gland

When undergoing radiation therapy for a breast tumor, the most common side effect is skin changes (see section "Side effects on the skin"). In addition to following the above skin care recommendations, you should avoid wearing a bra during the treatment period. If you feel uncomfortable without it, use a soft bra.

Radiation therapy may cause pain and swelling in the breast area, which will disappear or gradually decrease after treatment is completed. The irradiated mammary gland can sometimes become larger (due to fluid accumulation) or smaller (due to tissue fibrosis).

In some cases, these deformations of the shape of the gland can persist for the rest of life. You can find out more about the nature of changes in the shape and size of the mammary gland from your attending physician.

Radiation therapy may impair shoulder motion. Consult a physical therapy specialist about what exercises you should do to prevent this complication.

In some patients, radiation therapy may cause swelling of the arm on the side of the irradiated gland. This swelling may develop even 10 years or more after completion of treatment. Therefore, it is necessary to carefully monitor the condition of your hand and adhere to certain rules of behavior:

1. Avoid heavy lifting (no more than 6-7 kg), vigorous movements requiring excessive effort (pushing, pulling), or carrying a bag over your shoulder on the side of the irradiated breast.
2. Do not allow blood pressure to be taken or injections (blood drawn) into the arm on the side being treated.
3. Do not wear tight-fitting jewelry or clothing on this arm. If you accidentally damage the skin of your hand, treat the wound with alcohol (but not alcohol tincture of iodine!) and cover the wound with a bactericidal plaster or apply a bandage.
4. Protect your hand from direct sunlight.
5. Maintain your optimal weight through a balanced, low-salt, high-fiber diet.
6. If you experience even occasional hand swelling that goes away after a night's sleep, contact your doctor immediately.

Side effects on the chest organs

During radiation therapy, you may have difficulty swallowing due to radiation inflammation of the esophageal mucosa. You can make eating easier by eating small meals more often, thinning thick foods, and cutting solid foods into pieces. Before eating, you can swallow a small piece of butter to make it easier to swallow.

You may develop a dry cough, fever, change in sputum color, and shortness of breath. If you notice these symptoms, tell your doctor immediately. He will prescribe special drug treatment.

Side effects on the rectum

This may occur during radiation therapy for cancer of the rectum or other pelvic organs. With radiation damage to the intestinal mucosa, pain and bleeding may appear, especially with difficult stool.

In order to prevent or reduce the severity of these phenomena, it is necessary to prevent constipation from the first days of treatment. This can be easily achieved by organizing an appropriate diet. It is necessary to additionally include kefir, fruits, raw carrots, stewed cabbage, prune infusion, tomato and grape juice in the diet.

Side effects on the bladder

Radiation therapy sometimes causes inflammation of the lining of the bladder. This can lead to frequent painful urination and increased body temperature. Occasionally, the urine becomes reddish in color. If you notice these symptoms, tell your doctor. These complications require special drug treatment.

How to behave after completion of radiation therapy (post-radiation period)

After completing a course of radiotherapy, it is very important to periodically check the results of your treatment. You should have regular follow-up examinations with a radiologist or the doctor who referred you for treatment. The time of the first follow-up examination will be determined by the attending physician upon discharge.

The schedule for further observation will be drawn up by the doctor at the clinic or dispensary. These same specialists will, if necessary, prescribe further treatment or rehabilitation for you.

Symptoms for which you should consult a doctor without waiting for the next follow-up examination:

1. the occurrence of pain that does not go away on its own within several days;
2. nausea, diarrhea, loss of appetite;
3. increased body temperature, cough;
4. the appearance of a tumor, swelling, unusual rashes on the skin;
5. development of limb edema on the irradiated side.

Care for irradiated skin

After completion of treatment, it is necessary to protect the irradiated skin from injury and sunlight for at least a year. Be sure to lubricate the irradiated areas of the skin with a nourishing cream 2-3 times a day, even when it has healed after treatment. Do not treat your skin with irritating products.

Ask your doctor which cream is best to use. Do not try to erase the marks left after irradiation; they will gradually disappear on their own. Give preference to showering over bathing. Do not use cold or hot water. When taking a shower, do not rub the irradiated areas of the skin with a washcloth. If irritation of irradiated skin persists for a long time, consult a doctor. He will prescribe appropriate treatment for you.

Remember: mild pain in the irradiated area is common and quite common. If it occurs, you can take mild painkillers. If pain is severe, consult a doctor.

Relationships with relatives and friends

Radiation therapy does not make your body radioactive. It should also be clearly understood that cancer is not contagious. Therefore, do not be afraid to communicate with other people, friends and relatives during and after treatment.

If necessary, you can invite those closest to you to have a joint conversation with your doctor.

Intimate relationships

In most cases, radiation therapy does not have a significant effect on sexual activity. The decrease in interest in intimate relationships is caused mainly by the general physical weakness that occurs during this treatment and stress. Therefore, do not avoid intimate relationships, which are an important part of a fulfilling life.

Professional activity

When radiation therapy is performed on an outpatient basis, some patients do not stop working at all during the course of treatment. If you did not work during treatment, you can return to your professional activity as soon as you feel that your condition allows it.

If your job involves strenuous physical activity or occupational hazards, you should consider changing your working conditions or profession.

Leisure

Pay more attention to rest. You will regain your strength over time, so do not return to full physical activity right away. Visit theaters and exhibitions. This will allow you to take your mind off unpleasant thoughts.

Make it a rule to take daily walks in the fresh air (walks in the park, in the forest). Communicate more with friends and family. With the knowledge of your attending physician, consult with a physical therapist and psychotherapist. They will help you choose adequate physical activity (health-improving gymnastics) and suggest ways to overcome stress.

Conclusion

We hope that this information will help you get rid of unnecessary nervous tension, make it easier to undergo radiation therapy, and understand what awaits you after it. All this contributes to your recovery.

For more detailed information on issues related to your health, please contact your physician.

Treatment results. Photos before and after

According to CT data, before treatment it was inoperable and after preoperative chemoradiation therapy it was subsequently successfully operated on.

Rectal tumor. CT scan before treatment

When carrying out radiation therapy of the pelvic organs, IMRT makes it possible to achieve a uniform dose distribution of the irradiation zone and significantly reduce the dose to the bladder and small intestine. Thus, conditions are created to reduce toxicity and improve tolerability of the treatment.

Anal cancer. CT scan before treatment

When carrying out chemoradiation treatment for anal cancer, the VMAT technique makes it possible to achieve a highly conformal isodose distribution and improve treatment tolerability (to avoid the development of reactions from the intestines - diarrhea, bladder - cystitis, genitals).

CT scan after chemoradiotherapy

When conducting postoperative radiation therapy for breast cancer using the IMRT technique, the risk of damage to the heart and lung tissue is reduced.

Radiation (radiation therapy, radiotherapy, radiation therapy) is the use of ionizing radiation (X-rays, gamma radiation, beta radiation, neutron radiation) to damage, destroy, kill cancer cells, and stop the growth and reproduction of new mutated cells. Radiation is a localized treatment that typically affects only the part of the body where the radiation was directed.

As mentioned above, after radiation, cancer cells are damaged, although radiation can affect healthy cells in the body in the same way. Based on this, cancer after radiation may be accompanied by some complications that arise as side effects (depending on the part of the body on which irradiation was performed; on the location of the malignant neoplasm).

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What is radiation treatment for cancer?

Radiation is a method of treating cancer using high-energy radiation (specifically X-rays). The type of radiation, as well as its amount, must be carefully calculated before starting therapy (in such an amount that the radiation can damage abnormal cells) by the treating oncologist team. During the treatment of oncology, irradiation stops the division of cancer cells and, as a result, their number will decrease.

Benefits of Irradiation

As we already know, the goal of radiation therapy is to destroy mutated cells while minimizing damage to healthy cells. Also, radiation can be used to treat any type of cancer, in almost any part of the body. In some cases, irradiation can be carried out separately, but most often it is used in combination with other methods of fighting cancer.

Radiation can be carried out both before and after surgical treatment (before - to reduce the size of the tumor, after - to stop the growth of cancer cells that could remain after surgical excision of the malignant neoplasm). It can also be performed during or after chemotherapy or hormone therapy to improve overall results.

Despite the fact that such treatment is sometimes called radical, radiation therapy is designed to provide a long-term effect for a person with cancer.

This palliative treatment is aimed at reducing the size of the tumor, reducing pain, and relieving other symptoms of cancer. In addition, palliative radiation therapy can prolong the life of a cancer patient.

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Cancer after radiation – what to expect? Consequences and complications

As already mentioned, radiation can damage and destroy normal cells, and also cause some side effects as cancer cells break down. Most of these side effects are temporary, rarely severe and do not pose a particular threat to the general condition and life of the patient. Remember, your doctor will not advise you to undergo radiation if the risks and complications outweigh the benefits. Also, the attending physician is obliged to inform you if this treatment in your case may adversely affect your health and provoke certain consequences. You must receive all necessary information in writing.

If a female is exposed to radiation, she should under no circumstances be in position at the time of therapy, since radiation therapy can greatly harm the unborn child, especially in the first three months of pregnancy. The doctor is obliged to inform you in advance about all the pros and cons of this treatment, about the possible consequences and complications that may arise after irradiation, and also provide written information about this.

Radiation therapy rightfully occupies one of the main places in the treatment of malignant tumors of a wide variety of organs and tissues. This method can significantly increase the survival rate of patients, as well as alleviate their condition in case of advanced stages of the disease.

The discovery of X-rays was a real breakthrough in medical science, because it became possible to “see” the body from the inside, to find out what already known diseases of different organs and systems “look” like. Inspired by the possibilities of using X-ray radiation and experiencing a feeling akin to euphoria, scientists began to use it not only for diagnostic purposes, but also for treatment. This is how it became known about the destructive effect of X-rays on tumors, which decreased in size, and patients felt significant relief.

However, the other side of the coin was the numerous complications and radiation reactions that inevitably plagued irradiated patients. Information about the negative effects of ionizing radiation on healthy tissue accumulated, and criticism of the method grew. For some time, the use of radiation therapy was significantly reduced, but the ability to combat malignant tumors, the number of which only increased every year, did not allow radiation to be completely abandoned. Fighting for the possibility of conducting safe radiation therapy in oncology, physicists and radiologists, together with doctors, developed new devices and methods of irradiation that would reduce radiation exposure, and, therefore, the likelihood of side effects, making the treatment both effective and safe.

Today, radiation therapy is considered one of the main methods of treating cancer, and in some cases it allows one to avoid surgery, leading to a complete cure. The number of side effects has been significantly reduced due to the possibility of targeted radiation on tumor tissue, as well as the use of not only X-rays, but also beams of elementary particles strictly aimed at the tumor. In most cases, such treatment is well tolerated by patients, however, there are still some rules and lifestyle features, and we will consider them further.

Types of radiation therapy and their features

Radiotherapy involves the exposure of tumor tissue to various types of ionizing radiation. Since cancer cells divide very quickly, they are very sensitive to various types of physical influences. Radiation causes damage to the main apparatus of cells - DNA, as a result of which not only their death occurs, but also, which is extremely important in the case of oncological pathology, disruption of the division process. The result of irradiation is a reduction in tumor size due to the death (necrosis) of its constituent elements, as well as stopping the growth of neoplasia. Healthy cells suffer to a much lesser extent, and focusing the beam strictly on the tumor helps to avoid unwanted consequences. In parallel with chemotherapy and surgical treatment, radiotherapy helps to quickly improve the condition of patients, and in favorable cases, completely remove the tumor from the body.

Radiation for cancer is possible both independently, especially in the case of superficially located tumors (skin, for example), and in combination with chemotherapy and surgery. Radiotherapy carried out before surgery helps to reduce the size of the tumor, reduce the risk of cancer cells breaking off and entering the blood and lymph vessels, and, therefore, the effectiveness of treatment in general will be much higher. In the case of advanced forms of cancer, if present, the use of radiation energy makes it possible not only to improve the vital functions of patients and reduce the severity of pain, but also prevents the further spread of cancer cells throughout the body, and existing metastatic nodes undergo regression.

Radiation therapy is often given after surgery when there is a chance that tumor cells may remain at the site of cancer growth. This approach allows you to destroy all cells and avoid relapse of the disease in the future.

The type and method of radiotherapy in each case is chosen by the doctor based on the characteristics of the tumor, its location, stage and general condition of the patient. Since radiation can damage healthy tissue, doses are determined individually, divided into several sessions, unlike chemotherapy, which most often uses standard treatment regimens.

Types of radiation therapy are determined by the radiation used:

• α-particles;
• β-particles;
• γ-radiation;
• neutron;
• proton;
• X-ray.

X-ray radiation was the very first to be used; later, thanks to the efforts of physicists, installations appeared that made it possible to generate beams of elementary particles in special accelerators.

Radiation therapy methods depend on the method of exposure to tumor tissue:

1. External beam radiation therapy, when the machine is located outside and the beam passes through other tissues directly to the tumor;
2. Contact treatment, which involves influencing only the tumor tissue by introducing radiation carriers into it (needles, wires, balls, etc.). It can be interstitial, intracavitary, intravascular, or in the form of applications. An example of interstitial irradiation is brachytherapy for;
3. Radionuclide therapy is the administration of pharmacological preparations containing a radioactive element that can accumulate in strictly defined tissues (iodine).

A very promising and effective method of treating tumors with proton beams. Protons accelerated in special accelerators reach their destination and emit maximum radioactive radiation in the last millimeters of their path. In other words, only a small amount of radiation energy is scattered on the way to the tumor, and it does not spread at all to the tissues located behind the tumor node. This feature makes it possible to minimize the damaging effects of radiation on healthy organs and tissues with high efficiency inside the neoplasm itself.

The ability to focus the proton beam strictly on the tumor tissue and the low likelihood of side effects gives a great advantage in the treatment of children in whom secondary tumors after conventional radiation can become a real problem. In addition, before the use of proton therapy, a tumor such as retinal melanoma inevitably resulted in the removal of the entire eye, which significantly worsened the quality of life after the operation. With the advent of proton therapy, it became possible to treat a tumor while preserving the organ of vision, and the patient does not experience the severe consequences of adaptation, as after surgical treatment.

For many years, this technique was available only in specialized centers conducting research in the field of physics, but recently in North America and Europe there has been significant progress in the use of this type of treatment, as evidenced by the functioning of proton therapy clinics. In Russia and other countries of the post-Soviet space, unfortunately, such methods still have very limited use, and proton therapy centers are only being built. This is due to the high cost of equipment and the need to arrange structures that provide reliable radiation protection, where the thickness of the walls can reach 5 meters or more. Only 1% of patients in Russia have the opportunity to undergo such treatment, but the construction of centers with appropriate equipment gives hope that proton therapy will be available in the future for the majority of oncology patients.

Radiosurgery has been successfully used to treat brain tumors

Another modern and very effective method of radiation therapy is the use of radiosurgery, when a beam of radiation is focused into a strictly defined location, causing cell death and destruction of tumors. Radiosurgery is successfully used to treat not only malignant, but also benign brain tumors (meningioma, pituitary adenoma, etc.), especially those difficult to reach with conventional surgery. Stereotactic radiosurgery (popularly known as “gamma knife”, “cyber knife”) allows you to remove tumors without craniotomy and other surgical procedures, but its effect does not occur immediately, it takes several months or even six months - a year, as in the case of benign tumors. At this time, the patient is under dynamic supervision of specialists.

Stages of radiation therapy

Considering the complexity of the techniques and equipment used, as well as the possibility of radiation reactions and other complications, radiotherapy should be strictly indicated for the patient, and the scheme for its implementation should be precisely verified. The whole complex of procedures consists of three stages:

• Pre-radial.
• Ray.
• Post-radiation.

The patient’s behavior at each stage has its own characteristics, which may determine how effective the treatment will be, and following simple rules will help avoid unwanted side effects.

Pre-radiation period is perhaps the most important, because proper planning of procedures, calculation of the dose and method of influencing the tumor determine the final result. It is important to take care of the condition of healthy tissues, which in one way or another may be affected by radiation.

Radiotherapy planning is carried out simultaneously by several specialists - a radiotherapist, an oncologist, a medical physicist, a dosimetrist, who calculate the required radiation doses, choose the optimal route of introducing it into tissues during brachytherapy (in this case, a brachytherapist is involved), determine the maximum radiation dose and the reserve capacity of surrounding tissues that can be exposed to radiation.

Planning in the pre-radiation period may require not only the efforts of specialists and several days of their hard work. To accurately determine all parameters of radiation therapy, it is impossible to do without additional research and the help of modern computer technology, since only the device can calculate with millimeter accuracy the entire path of the radioactive beam to the tumor cells, using three-dimensional images of the affected organs or tissues obtained using a tomograph .

The important point is marking on the patient’s body, which is carried out based on the results of CT, MRI, and radiography. The doctor marks the boundaries of the tumor and the irradiated area on the body with a special marker, and if it is necessary to switch to another irradiation device, the “shooting” is done automatically according to the existing marks. The patient should be aware that the marks should be kept until the end of treatment, so they should be avoided washing them off when showering, and if this happens, they should inform the nurse or doctor who will correct the situation.

What are the basic rules of behavior in the pre-radiation period? First, you should try to maintain the markings at the irradiation site. Secondly, there is no need to sunbathe or use various creams, irritating substances, perfumes, or iodine in the area of ​​intended irradiation. Finally, if there are lesions on the skin, dermatitis, diaper rash or rash, then you should inform your doctor about this, who will help you get rid of the existing problems. If it is necessary to irradiate the head and throat area, it is worth taking care of the condition of the teeth, curing caries and tidying up the oral cavity as a whole.

Radiation period includes the actual irradiation according to the scheme developed earlier. The course of radiation therapy usually lasts no more than 4-7 weeks, and for preoperative reduction in the size of the tumor, 2-3 weeks are enough. Sessions are conducted daily, five days a week, with a break of two days to restore the skin and tissues involved in radiation exposure. If the daily radiation dose is large, it can be divided into several sessions.

Treatment is carried out in a specially equipped room that is protected from radiation, and the staff leaves it during the procedure, while the patient has contact with the doctor via a loudspeaker. The patient is placed on a table or chair, the radiation source is placed on the desired area, and the surrounding tissue is covered with protective blocks. During the procedure, the table or emitter may move in space or create noise, which should not be scary and is usually warned by the nurse.

The procedure is painless, lasts 5-10 minutes, during which the patient must maintain the accepted body position, not move, breathe calmly and evenly.

Throughout the course of treatment, you must adhere to the following rules:

1. Nutrition during radiation therapy should be complete, high-calorie, containing all the necessary vitamins and microelements. You should not deny yourself carbohydrates, the proportion of which can be 3-4 times higher than the amount of proteins and fats consumed. Since radiation exposure causes the disintegration of tumor tissue and the formation of a large amount of toxins, it is necessary to ensure a good drinking regime (up to three liters of fluid per day), consuming juices, compotes, tea, and mineral water.
2. During treatment, you need to completely eliminate smoking and drinking alcohol, although it is better to get rid of bad habits completely and forever.
3. Particular attention should be paid to areas of the skin located in the irradiation zone. Clothing should be made of natural fabrics (cotton, linen), loose, and not adjacent to areas of radiation exposure. If possible, it is better to keep these areas generally open, but protected from the sun when going outside.
4. It is better to postpone the use of cosmetics and perfumes until later; it is better not to use even soap, so as not to dry out already dry skin. When taking a shower, you need to remember the marks in the irradiation zone.
5. If redness, dryness, itching, or excessive sweating occur, you should not take independent measures, apply cold or hot objects to the skin, it is better to talk about this with your doctor.
6. General recommendations that apply to all cancer patients, such as walks in the fresh air, adequate sleep, and adequate physical activity, also apply to the period of radiation therapy.

Irradiation for different forms of malignant neoplasms has its own characteristics, which patients are usually warned about in advance. Most often, they resort to postoperative external radiotherapy, designed to destroy tumor cells that could remain after removal of neoplasia. In the presence of metastases, the goal is to reduce their size, as well as reduce the severity of pain. During treatment, fatigue and a feeling of tiredness may occur, which should disappear after the end of the course of radiation.

In the case of cancer, radiation before surgery is most effective, and in some cases, chemoradiotherapy is sufficient for cure even without surgical removal of the tumor. In addition to remote exposure, there are techniques that involve introducing a radiation source directly into the rectum. Radiation therapy is not performed for the overlying parts of the large intestine.

Prostate tumors are successfully treated with brachytherapy, where capsules or needles containing a radioactive isotope are injected directly into the tumor tissue. This approach allows you to avoid unwanted reactions from nearby organs (diarrhea, urination problems, etc.).

Neoplasms of the female genital organs require external irradiation of the pelvic area, and with radiation therapy is often of paramount importance. Thus, if in the case of microinvasive cancer irradiation is carried out in the postoperative period, then at stages II-III of the disease it is the main and often the only method of treatment. In the fourth stage of cervical cancer, radiotherapy is palliative in nature, only helping to alleviate the condition of patients.

Post-radiation period begins after the end of the course of treatment. As a rule, most patients feel well, and there are either no side effects at all, or are expressed insignificantly. However, there are still some consequences and you need to be aware of them so as not to get confused and seek the necessary help in time.

Recovery after radiation therapy begins immediately after the end of the radiation sessions and consists of following a gentle regimen, ensuring adequate sleep, and rest during the day. Equally important is the nature of the diet, as well as the emotional state of the patient. At the rehabilitation stage, you may need not only the help of a doctor, but also relatives and close people, whose participation and support are very important during this period.

Due to the presence of a tumor, as well as the need to undergo various studies and treatment procedures, which are not always pleasant for the patient, emotional disorders may occur. This may be apathy, a feeling of melancholy or anxiety, and sometimes depression. It is very important not to withdraw into yourself, try to communicate more with friends and family, if possible, maintain the usual rhythm of life, but reduce your overall activity to such an extent that you do not feel tired. You shouldn’t give up household chores, hobbies, hobbies, and if you want to go to bed to rest, then you can postpone your plans for a while. Walking and socializing help many patients return to their previous lifestyle and improve their mood.

Fatigue often accompanies radiation therapy, since the stress on the body associated with the procedures, as well as the destruction of the tumor, require significant energy expenditure and may be accompanied by metabolic changes. During this period, it is recommended to rest more, take a short nap during the day, and if the patient continues to work, then it makes sense to talk with management about the possibility of switching to lighter work. Many patients even prefer to go on vacation during treatment.

After completing treatment, you should regularly visit your doctor to monitor your condition and the results of the therapy. Observation is usually carried out by an oncologist at a clinic or cancer clinic, who determines the frequency of examinations. In case of sudden deterioration of the condition, development of pain, disturbances in the gastrointestinal tract, fever and other symptoms, you should consult a doctor without waiting for the next scheduled visit.

An important place in rehabilitation after radiotherapy is occupied by skin care, which in most cases is involved in radiation, and almost always suffers during external beam radiation therapy. For at least a year after completing the course of irradiation, you should protect your skin from the sun and various damage. Areas of skin that were in the radiation zone should be lubricated with a nourishing cream, even if there are no longer signs of inflammation or burns. For those who like baths or saunas, it is better to abandon these procedures for a while, replacing them with a shower, and remove products that irritate the skin and hard washcloths away.

Sometimes patients may experience communication difficulties due to lack of awareness among others about oncology and its treatment. Thus, some believe that people who have undergone radiation therapy are capable of emitting radiation themselves, so it is better to stay away from them. This opinion is erroneous: patients at all stages, including rehabilitation, do not pose a danger to others, and the tumor itself is not contagious. If possible, you should not give up intimate relationships, because this is part of a full life. If there are changes in the mucous membranes of the genital tract or discomfort, the doctor will tell you how to deal with it.

To overcome stress, you should diversify your leisure time. This could be visiting the theater, exhibitions, engaging in your favorite hobbies, walking and meeting friends. It is important to distract yourself from painful thoughts that can accompany all stages of treatment for a malignant tumor.

A little about the complications and side effects of radiotherapy

Like any other type of treatment, radiotherapy can cause various side effects, both local and general. Common side effects of radiation therapy include feeling tired, weak, changes in emotional state, and bone marrow abnormalities caused by radiation. If it is necessary to irradiate large areas of the body, the constantly renewed blood cells are somehow affected, their maturation in the bone marrow is disrupted, which is manifested by a decrease in the number of leukocytes, erythrocytes, and platelets. The patient undergoes regular blood tests to monitor its components, and if necessary, appropriate treatment is prescribed or the course of radiation is suspended for a week.

Other common effects of radiation therapy include hair loss, deterioration of nails, decreased appetite, nausea, and even vomiting. These changes are most often associated with irradiation of the head area, gastrointestinal tract organs, as well as with the disintegration of tumor tissue under the influence of radiation. After completing the course of treatment, the patient's condition gradually returns to normal.

Particular attention should be paid to the nutrition of patients undergoing radiotherapy. Changes in appetite and nausea do not contribute to food intake, but, meanwhile, the need for nutrients is quite high. If the feeling of hunger does not arise, then you need to eat, as they say, “because I don’t want to.” Since the list of recommended products is quite large, there is no need to limit yourself to sweets, meat and fish dishes, fruits, and juices. The diet should be high in calories and rich in all necessary substances.

When preparing food you need to follow some rules:

The most common local complications of radiation therapy are skin reactions. After several irradiation sessions, redness of the skin is possible, which disappears over time, leaving behind pigmentation. Some patients complain of a feeling of dryness, itching, burning, and peeling of the skin in the irradiation area. With proper care and careful treatment, the skin recovers within 4-6 weeks after the course of treatment.

Complications may include burns, sometimes severe, with the formation of ulcers or infection of the radiation wound. The likelihood of such a development of events increases with an increase in the radiation dose, the presence of individual sensitivity to radiation, and concomitant pathology, for example, diabetes mellitus.

To avoid such troubles, after the procedure you should treat the irradiation site with moisturizing cream, oils, and protect the skin from sunlight. If your skin is severely damaged, your doctor may recommend medications that contain corticosteroids, so you should inform your doctor if you feel any changes.

When irradiating the organs of the head or neck, radiation may have a damaging effect on the mucous membrane of the mouth and throat, therefore, again, Some recommendations must be followed:

• Quitting smoking, alcohol, irritating foods;
• Using a soft toothbrush and brushing your teeth gently;
• Rinsing the mouth with chamomile decoction or other solutions recommended by your doctor.

Radiation therapy to the chest may cause coughing, difficulty breathing, tenderness, and swelling in the breast area. When treating rectal tumors, there may be a tendency to constipation, blood in the stool, and abdominal pain, so it is important to follow a diet that prevents retention of contents in the intestines.

Any deterioration in well-being or the appearance of these changes must be reported to the attending physician, who will help prescribe additional treatment.

Radiation therapy is an integral part of the treatment of most malignant tumors, the effect of which can be recovery. If all recommendations and rules are followed, it is usually well tolerated, and patients can feel improvement after several radiation sessions.

Thus, even taking into account possible adverse reactions, radiation therapy should not be abandoned, because it gives a chance for a favorable outcome of a disease that without it would doom a person to death. For successful treatment, you should lead a correct lifestyle, follow the recommendations listed above and promptly report any changes in your well-being to your doctor.

Video: report on radiation therapy

The author selectively answers adequate questions from readers within his competence and only within the OnkoLib.ru resource. Unfortunately, face-to-face consultations and assistance in organizing treatment are not provided at the moment.

Is radiation therapy. It has been revealed that young, malignant cells stop multiplying under the influence of radioactive radiation.

Concept

Radiation therapy involves exposure to ionized radiation. His goals:

• damage to malignant cells,
• limiting cancer growth,
• prevention of metastasis.

Used in combination with surgical treatment and chemotherapy.

During radiation exposure, cells do not disintegrate, but their DNA changes. The advantage of the method is that healthy structures do not undergo any changes.

The effect is enhanced due to the fact that the doctor can adjust the direction of the rays. This makes it possible to use maximum doses at the lesion site.

Sometimes this method is also used to treat non-oncological pathologies. For example, to combat bone growths.

Video about pre-radiation preparation:

Indications

The method is used in 60-70% of patients with cancer. It is considered the main treatment for tumors that are characterized by a high degree of radiosensitivity, rapid progression, and also with certain features of the localization of the formation.

Radiation therapy is indicated for cancer:

• nasopharynx and rings of pharyngeal tonsils,
• cervix,
• larynx,
• skin, breast,
• lung,
• language,
• body of the uterus,
• some other organs.

Types of radiation therapy

There are several treatment methods. Alpha radiation involves the use of isotopes, such as radon, thoron products. This type has a wide range of applications; it has a positive effect on the central nervous system, endocrine system, and heart.

Beta therapy is based on the healing effect based on the action of beta particles. Various radioactive isotopes are used. The decay of the latter is accompanied by the emission of particles. There is such therapy as interstitial, intracavitary, or application.

X-ray therapy is effective for the treatment of superficial lesions of the skin and mucous membranes. The X-ray energy is selected depending on the location of the pathological focus.

Radiation therapy is also divided for other reasons.

Contact

This type differs from the others in that the ray sources are located directly on the tumor. It is characterized by a dose distribution so that the main part remains in the tumor.

The method is good if the size of the formation is no more than 2 cm. This type is divided into several types.

Name	Peculiarities
Close focus	Irradiation affects the cells themselves.
Intracavity	The radiation source is introduced into the body cavities. It remains throughout the course of contact radiotherapy.
Interstitial	The radiation source is injected into the tumor. The impact occurs in a continuous mode.
Radiosurgery	Rays are exposed after surgery. The area where the tumor was located is exposed to radiation.
Appliqué	The radiation source is applied to the skin using a special applicator.
Selective accumulation of isotopes	Low-toxic radioactive substances are used.

Remote

It implies that the source of radiation is located at some distance from the human body. the beam enters the body through a certain area.

Gamma therapy is most often used. This method is good because it allows a high dose of radiation to be applied to the formation, while keeping healthy cells intact.

For small cancers, protons and neurons are used. Remote therapy can be static or mobile. In the first case, the radiation source is stationary.

The method is rarely used in modern oncology clinics. The moving technique allows you to direct the source along different trajectories. This ensures the greatest efficiency.

Radionuclide

The specificity lies in the introduction of radiopharmaceuticals into the patient’s body. They affect the lesions. Targeted delivery of substances forms very high doses in the lesions with few side effects and minimal impact on healthy tissue.

Radioiodine therapy is popular. The method is used not only for cancer patients, but also for the treatment of people with thyrotoxicosis. If there are bone metastases, then several compounds are used at once.

Conformal

Radiation exposure where three-dimensional exposure planning is used to obtain the field shape. The method allows adequate doses of radiation to be delivered to tumors. This significantly increases the chance of cure.

To prevent the tumor from leaving the irradiated area, special devices are used, for example, equipment for active breathing control.

Proton

Radiation therapy based on the use of protons, which are accelerated to high values. This allows for a unique dose distribution over depth, with the maximum dose concentrated at the end of the run.

At the same time, the load on other superficial cells is minimal. The radiation is not scattered throughout the patient's body.

Typically, the method is used for small formations, tumors located close to critically radiosensitive structures.

Intracavity

This species has several types. Allows for the prevention of relapses and metastasis. The source is inserted into the body cavity and remains present throughout the entire irradiation session.

Used to create the maximum dose in tumor tissues.

Usually this method is combined with remote. This type of radiation therapy is used to treat cancers of the female genital area, rectum and esophagus.

Stereotactic

This method can reduce cancer treatment time.

Used to treat internal organs and the circulatory system. The rays act very precisely on the tumor.

Photo of stereotactic radiation therapy

It is carried out with full control over the location of the tumor, allowing you to adapt to the patient’s breathing and any other movement.

The result of this effect is not visible immediately, but after several weeks, since the tumor cells die gradually.

Contraindications

There are several situations when radiation therapy is contraindicated:

• general serious condition with signs of intoxication of the body,
• fever,
• extensive damage by cancer cells, accompanied by bleeding,
• radiation sickness,
• severe forms of concomitant diseases,
• severe anemia.

A sharp decrease in leukocytes or platelets in the blood is also a limitation.

How is radiation therapy performed?

First, additional procedures are carried out to accurately determine the location of the tumor and its size. From this the dose is selected. Using a special apparatus, the irradiation field is determined. There may be several such areas.

During radiation treatment, the patient is in a lying position. It is important not to move during radiation, as this may cause the rays to damage healthy tissue. If a person cannot remain still for a long time, the doctor immobilizes the patient or area of ​​the body.

Some machine parts may move and make noise; do not be alarmed. Already at the beginning of treatment, it is possible to reduce pain, but the greatest effect is achieved after completion of the course.

Course duration

Treatment is often carried out on an outpatient basis. The session, depending on the method used, lasts 15-45 minutes.

Most of the time is spent positioning the patient correctly and guiding the radiation device. The process itself lasts several minutes. Staff will leave the premises during this time.

The course lasts from 4 to 7 weeks. in some situations it is reduced to 14 days. This is advisable if it is necessary to reduce the size of the tumor or improve the patient's condition. Sessions are held 5 times a week. Sometimes the dose is divided into 2-3 sessions.

How is the procedure tolerated?

Radiation therapy itself does not cause pain. After the procedure, it is recommended to rest for several hours. This will help restore strength and also reduce the risk of side effects.

If your throat or mouth has been irradiated, then it is recommended to rinse your mouth with herbal decoctions or sea buckthorn oil to relieve discomfort.

Symptoms after irradiation

After a course of radiation therapy, you may experience:

• fatigue,
• mood and sleep disturbances,
• reactions from the skin and mucous membranes.

If the impact was carried out on the chest area, shortness of breath, difficulty breathing, and cough appear.

Consequences

The skin is most often affected. She becomes tender and sensitive. May change color.

The skin's reaction to radiation is approximately the same as with a sunburn, but it develops gradually.

Blistering may occur. If not properly cared for, such areas can become infected.

If the respiratory system was exposed, radiation damage develops over the next three months. An unproductive cough appears, body temperature rises, and general health deteriorates.

Experts note that often side effects include:

• hair loss,
• decreased hearing and vision,
• increase in the number of heartbeats,
• change in blood composition.

Recovery after radiation

The recovery process can take different times, doctors recommend setting yourself up for a long journey.

Treatment of burns

Redness usually appears immediately, but for some people, burns do not begin to be detected immediately. After each session, it should be lubricated with a protective cream.

However, this should not be done before the procedure, as this may reduce the effectiveness of the manipulation. For treatment, D-Panthenol and other drugs are used to relieve inflammation and restore the dermis.

How to raise leukocytes after radiotherapy?

You can increase the number of leukocytes only after permission from your doctor. Be sure to diversify your menu with raw vegetables, buckwheat, fresh fruits, and rolled oats.

Pomegranate and beet juice have a positive effect on blood composition. If these methods do not help, the doctor will prescribe special medications.

What to do if you have a fever?

Fever is a sign of infection in most cases. After radiation therapy, it takes a long time for the immune system to recover.

It is better to immediately consult a doctor who will help identify the cause and prescribe treatment. If this is not possible, stay in bed and use antipyretics that are not contraindicated for your illness.

Pneumonitis

They are treated using high doses of steroids. Then the symptoms disappear after 24-48 hours. The dose is reduced gradually.

Additionally, breathing exercises, massage, inhalations and electrophoresis are used.

The treatment program is drawn up individually, taking into account the type of tumor, its prevalence, and the presence of other complications.

Haemorrhoids

For treatment, it is necessary to strictly follow a diet and bed rest, use medications and traditional medicine. Radiation radiation leads to impaired maturation of the epithelium and inflammatory processes in the mucous membranes.

For treatment, local therapy is used to cleanse the intestines and eliminate inflammatory processes.

Proctitis

To eliminate the problem, laxatives and cleansing enemas are used. Warm showers aimed at the rectal area and baths with potassium permanganate showed high effectiveness.

The doctor may prescribe hormones, rectal suppositories and anesthetics.

Diet food

Adequate nutrition is one of the main methods of treating radiation damage. soft foods must be taken. If the oral cavity has been damaged by irradiation, then it is effective to use oil or novocaine solution.

During radiation therapy itself, patients usually complain of a lack of appetite. At this time, add nuts, honey, eggs, and whipped cream to the menu. They contain many nutrients. To obtain protein, puree soups, low-fat fish and meat broths are added to the diet.

The consumption of foods containing large amounts of cholesterol, fatty meat, mushrooms, tangerines, and sausage is contraindicated.

Answers on questions

• How is chemotherapy different from radiation therapy?

Chemotherapy is the treatment of cancer using drugs. Radiation therapy is based on the principle of destruction of cells under the influence of rays.

World standards provide for a combination of these two methods, since the chance of cure in this case increases.

• Does hair fall out after radiation therapy?

After radiation exposure, hair falls out only in the area where the rays pass. Doctors usually warn about the possibility of baldness. In this case, it is best to have a short haircut.

When caring for your hair from the moment you start treatment, use a wide-tooth comb or buy a baby comb. Before going to bed, use a special sleep net to prevent your hair from being pressed or pulled.

• Is it possible to get pregnant after radiation therapy?

Many treatment methods leave a negative mark and affect reproductive functions. After radiation therapy, it is recommended to use contraception for several years.

This will allow the body to recover and give birth to a healthy child. The period is usually told by the oncologist depending on the stage of the cancer and the results of treatment.

Radiation oncology (interventional radiology) is a field of medicine that studies the use of ionizing radiation to treat cancer. In general terms, the method can be described as follows. Particle or wave radiation is directed to the tumor-affected area of ​​the body in order to remove malignant cells with minimal damage to surrounding healthy tissue. Radiation is one of the three main methods of fighting cancer, along with surgery and chemotherapy.

Classification of radiation oncology methods

First, it is necessary to distinguish between different types of radiation.

• α particles,
• proton beams,
• β particles,
• electron beams,
• π-mesons,
• neutron radiation.

• γ-radiation,
• Bremsstrahlung X-ray radiation.

Secondly, there are different ways to sum it up.

• Contact therapy. With this method, the emitter is brought directly to the tumor. In most cases, surgical intervention is required for implementation, so the method is rarely used.
• Interstitial method. Radioactive particles are injected into the tissue containing the tumor. As an independent treatment, it is mainly used for gynecological and urological oncological diseases. As an additional option - with external (remote) irradiation.

Currently, the scope of application of brachytherapy as an independent or auxiliary method is expanding, new techniques are appearing, for example, SIRT therapy.

External (remote) irradiation :

With this effect, the emitter is located at a distance from the area containing the malignant tumor. The method is the most universal, however, and the most difficult to implement. The development of this area of ​​oncology is closely related to scientific and technological progress. The first significant achievements are associated with the invention and introduction of cobalt radiotherapy (1950s). The next stage was marked by the creation of a linear accelerator. Further development is due to the introduction of computer technologies and various modulation methods (changing beam characteristics). Many innovations have been made in this direction, including:

• three-dimensional conformal radiation therapy (3DCRT),
• intensity modulated radiotherapy (IMRT),
• the emergence of radiosurgery (the use of narrow high-intensity beams),
• technologies combining the use of 3D/4D modeling and intensity modulation (for example, RapidArc).

Modern radiotherapy installations are complex and expensive devices that combine engineering achievements from many technological fields. Today, two areas of remote irradiation can be distinguished.

• Radiation therapy . From the very beginning, radiation oncology has developed in this direction: radiation therapy involves the use of wide beams of ionizing radiation. Traditional RT usually takes place in several sessions. Now there are many implementations of this approach: irradiation technology is constantly being improved and has undergone many changes over time. Nowadays, RT is one of the most common methods of treating cancer. It is used for many types of tumors and stages: either as an independent method of therapy or in combination with others (for example, radiochemotherapy). RT is also used for palliative purposes.
• Radiosurgery. A relatively new area of ​​interventional radiology, which is characterized by the use of highly targeted radiation of high intensity. The procedure takes place in fewer sessions compared to RT. So far, the scope of applicability of radiosurgery is limited and small compared to radiation therapy. However, the direction is actively developing and progressing. The most popular installations: “Cyber ​​Knife” and its predecessors “Gamma Knife”, “LINAC”.

Exposure to radiation

The processes that occur in cells under irradiation are extremely complex; numerous morphological and functional changes in tissue occur. The beginning of these processes is the ionization and excitation of the atoms and molecules that make up the cells. We do not aim to describe these processes in detail, so we will give only a few examples.

The positive effect of radiation is the disruption of self-regulation processes in malignant cells, which over time leads to their death. As a result of the destruction of the DNA structure of cancer cells, they lose the ability to divide. Irradiation destroys the vessels of the tumor, disrupting its nutrition.

The negative effect is that changes can also occur in healthy cells. This leads to radiation complications, which are divided into two groups.

• Radiation reactions. The disturbances are temporary and disappear after a certain time (up to several weeks).
• Radiation damage. Irreversible consequences of radiation.

Each type of cell has its own indicators of radiosensitivity, that is, changes in cells begin at a certain ratio of frequency, type, intensity and duration of radiation. In principle, any tumor can be destroyed by exposure to radiation, but healthy cells will also be damaged. The main task of radiation oncology is to find the optimal balance between the beneficial effects of radiation and minimizing the risk of complications.

The most characteristic side effects and features of radiation are discussed in more detail for specific types of cancer to which radiation therapy is applicable. See the following materials

Minimizing complications

Since the inception of the field, radiation oncology has evolved towards minimizing side effects. Many innovations have been developed along this path. Let's look at the basic techniques used by specialists to reduce the risk of damage to healthy tissue.

X-ray range

High-intensity X-ray radiation allows you to influence deep tissues, while slightly damaging superficial ones: the beam passes through the skin, losing almost no energy on it. By selecting the optimal intensity, the area of ​​the main effect is transferred to the required depth, as a result, a small dose of radiation falls on healthy cells, and the likelihood of getting a burn on the skin disappears.

Currently, X-rays are used in the vast majority of installations, but this is not the only type of radiation used in interventional radiology: for example, proton therapy opens up broad prospects.

Precise positioning

The primary task is to accurately determine the location of the tumor. Often it is necessary to remove not a clearly isolated tumor, but the remains of the tumor after the operation, possible foci of metastasis, which can be multiple, difficult to notice and have a random arrangement. To determine their location, all available means are used: MRI, computed tomography, PET-CT, protocol of the operation. Reliable knowledge about the properties of surrounding tissues is also required: it is necessary to determine where new tumor foci may form and prevent this process.

Today, the use of a computer model of the tumor process has become the gold standard for radiation therapy and radiosurgery: the irradiation strategy is calculated using such models. CyberKnife, for example, uses supercomputer computing to do this.

Considerable efforts are also aimed at maintaining the final accuracy of irradiation: the real position of the patient may differ from the one in which the model was built, so either techniques for recreating the position or correcting the direction of irradiation are required.

• Fixation methods. Radiation therapy often lasts 30-40 courses, and it is necessary to maintain accuracy within half a centimeter. For these purposes, various methods of fixing the patient's position are used.
• Respiratory control. Irradiation of moving organs poses a significant challenge: several techniques have now been developed to monitor the patient’s breathing and either correct the direction of exposure or suspend it until it returns to the acceptable range of positions.

Irradiation from different angles

Except in rare cases when changing the angle at which the beam is directed is impossible, this method must be used. This technique allows you to evenly distribute the side effects and reduce the total dose per unit volume of healthy tissue. Most installations can rotate the linear accelerator in a circle (2D rotation), some installations allow for spatial rotations/movements (not only along one axis).

Fractionation

It is necessary to determine as accurately as possible the properties of healthy and cancer cells affected and to identify differences in radiosensitivity. The intensity and type of treatment are selected individually for each case, thanks to this it is possible to optimize the effectiveness of therapy.

Modulation

In addition to the direction of exposure, the beam has two important cross-sectional characteristics: shape and intensity distribution. By changing the shape of the beam, it is possible to prevent exposure to healthy organs with high radiosensitivity. Due to the intensity distribution, the radiation dose can be reduced for tissues bordering the tumor and, conversely, increased for the tumor focus.

Similar techniques have been used since the 90s. when intensity modulation technology was invented. At first, the devices allowed the use of only several (1-7) irradiation directions (for each of which the optimal beam characteristics were calculated in advance) during one session. Now they have appeared multileaf collimators(beam shaping device) that can quickly recreate different profiles, keeping up with the rotation of the linear accelerator. Thanks to this, it became possible to perform irradiation in an unlimited number of directions during one session (RapidArc technology), which makes it possible to reduce the duration of therapy by almost an order of magnitude.