Complications of the rectum after irradiation. Use of bergenia and nettle

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Contraindications for radiotherapy

Despite the effectiveness radiotherapy ( radiotherapy) in the treatment of tumor diseases, there are a number of contraindications that limit the use of this technique.

Radiotherapy is contraindicated:

In violation of the functions of vital organs. During radiation therapy, a certain dose of radiation will affect the body, which can adversely affect the functions of various organs and systems. If the patient already has severe diseases of the cardiovascular, respiratory, nervous, hormonal or other body systems, radiotherapy can aggravate his condition and lead to the development of complications.

With severe depletion of the body. Even with highly precise radiation therapy methods, a certain dose of radiation affects healthy cells and damages them. To recover from such damage, cells need energy. If at the same time the patient's body is exhausted ( for example, due to damage to internal organs by tumor metastases), radiotherapy can do more harm than good.
With anemia. Anemia is a pathological condition characterized by a decrease in the concentration of red blood cells ( erythrocytes). When exposed to ionizing radiation, red blood cells can also be destroyed, which will lead to the progression of anemia and may cause complications.
If radiotherapy has already been performed recently. In this case, we are not talking about repeated courses of radiation treatment of the same tumor, but about the treatment of another tumor. In other words, if a patient has been diagnosed with cancer in any organ, and radiotherapy was prescribed for its treatment, if another cancer is detected in another organ, radiotherapy should not be used for at least 6 months after the end of the previous course of treatment. This is explained by the fact that in this case the total radiation load on the body will be too high, which can lead to the development of severe complications.
In the presence of radioresistant tumors. If the first courses of radiation therapy did not give absolutely no positive effect ( that is, the tumor has not decreased in size or even continued to grow), further irradiation of the body is impractical.
With the development of complications in the course of treatment. If during the course of radiotherapy the patient has complications that pose an immediate danger to his life ( e.g. bleeding), treatment should be discontinued.
In the presence of systemic inflammatory diseases (e.g. systemic lupus erythematosus). The essence of these diseases lies in the increased activity of immune system cells against their own tissues, which leads to the development of chronic inflammatory processes in them. The impact of ionizing radiation on such tissues increases the risk of complications, the most dangerous of which may be the formation of a new malignant tumor.
When the patient refuses treatment. According to current legislation, no radiation procedure can be performed until the patient gives written consent to this.

Compatibility of radiation therapy and alcohol

During radiation therapy, it is recommended to refrain from drinking alcohol, as this may adversely affect the general condition of the patient.

There is an opinion among the people that ethanol ( ethyl alcohol, which is the active ingredient in all alcoholic beverages) is able to protect the body from the damaging effects of ionizing radiation, and therefore it should also be used during radiotherapy. Indeed, in a number of studies, it was found that the introduction of high doses of ethanol into the body increases the resistance of tissues to radiation by about 13%. This is due to the fact that ethyl alcohol disrupts the flow of oxygen into the cell, which is accompanied by a slowdown in the processes of cell division. And the slower the cell divides, the higher its resistance to radiation.

At the same time, it is important to note that in addition to a slight positive effect, ethanol also has a number of negative effects. So, for example, an increase in its concentration in the blood leads to the destruction of many vitamins, which in themselves were radioprotectors ( that is, they protected healthy cells from the damaging effects of ionizing radiation). Moreover, multiple studies have shown that heavy chronic alcohol consumption also increases the risk of developing malignant neoplasms ( in particular tumors of the respiratory system and gastrointestinal tract). Given the above, it follows that the use of alcoholic beverages during radiation therapy does the body more harm than good.

Can I smoke during radiation therapy?

Smoking during radiation therapy is strictly prohibited. The fact is that tobacco smoke contains many toxic substances ( esters, alcohols, resins, etc.). Many of them have a carcinogenic effect, that is, when in contact with the cells of the human body, they contribute to the occurrence of mutations, the outcome of which can be the development of a malignant tumor. It has been scientifically proven that smokers have a significantly increased risk of developing lung cancer, pancreatic cancer, esophageal cancer, and bladder cancer.

Given the above, it follows that patients undergoing radiation therapy for cancer of any organ are strictly forbidden not only to smoke, but also to be near smokers, since inhaled carcinogens can reduce the effectiveness of the treatment and contribute to the development of the tumor.

Is it possible to perform radiation therapy during pregnancy?

Radiation therapy during pregnancy can cause intrauterine damage to the fetus. The fact is that the effect of ionizing radiation on any tissue depends on the rate at which cells divide in this tissue. The faster the cells divide, the more pronounced will be the damaging effect of radiation. During intrauterine development, the most intensive growth of absolutely all tissues and organs of the human body is observed, which is due to the high rate of cell divisions in them. Therefore, even when exposed to relatively low doses of radiation, the tissues of a growing fetus can be damaged, which will lead to a violation of the structure and functions of internal organs. The outcome in this case depends on the gestational age at which radiation therapy was performed.

During the first trimester of pregnancy, the laying and formation of all internal organs and tissues occurs. If at this stage the developing fetus is irradiated, this will lead to the appearance of pronounced anomalies, which often turn out to be incompatible with further existence. At the same time, a natural "protective" mechanism is launched, which leads to the termination of the fetus's vital activity and to spontaneous abortion ( miscarriage).

During the second trimester of pregnancy, most of the internal organs are already formed, so intrauterine death of the fetus after irradiation is not always observed. At the same time, ionizing radiation can provoke anomalies in the development of various internal organs ( brain, bones, liver, heart, genitourinary system and so on). Such a child may die immediately after birth if the resulting anomalies are incompatible with life outside the mother's womb.

If exposure occurs during the third trimester of pregnancy, the baby may be born with certain developmental anomalies that may persist throughout life.

Given the above, it follows that radiation therapy during gestation is not recommended. If a patient is diagnosed with cancer in early pregnancy ( up to 24 weeks) and radiotherapy is required, the woman is offered to have an abortion ( abortion) for medical reasons, after which treatment is prescribed. If cancer is detected at a later date, further tactics are determined depending on the type and rate of tumor development, as well as on the desire of the mother. Most often, such women undergo surgical removal of the tumor ( if possible – e.g. for skin cancer). If the treatment does not give positive results, you can induce labor or perform a delivery operation at an earlier date ( after 30 - 32 weeks of pregnancy), and then start radiation therapy.

Can I sunbathe after radiation therapy?

Sunbathing in the sun or in a solarium is not recommended for at least six months after the end of the course of radiotherapy, as this can lead to the development of a number of complications. The fact is that when exposed to solar radiation, many mutations occur in skin cells, which can potentially lead to the development of cancer. However, as soon as the cell mutates, the body's immune system immediately notices this and destroys it, as a result of which cancer does not develop.

During radiation therapy, the number of mutations in healthy cells ( including in the skin through which ionizing radiation passes) can increase significantly, due to the negative effect of radiation on the genetic apparatus of the cell. In this case, the load on the immune system increases significantly ( she has to deal with a large number of mutated cells at the same time). If at the same time a person begins to sunbathe in the sun, the number of mutations can increase so much that the immune system can not cope with its function, as a result of which the patient may develop a new tumor ( e.g. skin cancer).

How dangerous is radiation therapy? consequences, complications and side effects)?

During radiotherapy, a number of complications can develop, which may be associated with the effect of ionizing radiation on the tumor itself or on healthy tissues of the body.

Hair loss

Hair loss in the scalp area is observed in most patients who have undergone radiation treatment of tumors in the head or neck area. The cause of hair loss is damage to the cells of the hair follicle. Under normal conditions, it is the division ( reproduction) of these cells and determines the growth of the hair in length.
When exposed to radiotherapy, cell division of the hair follicle slows down, as a result of which the hair stops growing, its root weakens and it falls out.

It should be noted that when irradiating other parts of the body ( such as legs, chest, back and so on) the hair of that part of the skin, through which a large dose of radiation is administered, may fall out. After the end of radiation therapy, hair growth resumes on average after a few weeks or months ( if during the treatment there was no irreversible damage to the hair follicles).

Burns after radiotherapy radiation dermatitis, radiation ulcer)

When exposed to high doses of radiation, certain changes occur in the skin, which, according to external signs, resemble a burn clinic. In fact, no thermal tissue damage ( like a real burn) is not observed in this case. The mechanism of development of burns after radiotherapy is as follows. When the skin is irradiated, small blood vessels are damaged, as a result of which microcirculation of blood and lymph in the skin is disturbed. In this case, oxygen delivery to the tissues decreases, which leads to the death of some cells and their replacement with scar tissue. This, in turn, further disrupts the process of oxygen delivery, thereby supporting the development of the pathological process.

Skin burns may appear:

Erythema. This is the least dangerous manifestation of radiation damage to the skin, in which there is an expansion of superficial blood vessels and redness of the affected area.
Dry radiation dermatitis. In this case, an inflammatory process develops in the affected skin. At the same time, a lot of biologically active substances enter the tissues from the dilated blood vessels, which act on special nerve receptors, causing a sensation of itching ( burning, irritation). Scales may form on the surface of the skin.
Wet radiation dermatitis. With this form of the disease, the skin swells and may become covered with small blisters filled with a clear or cloudy liquid. After the opening of the bubbles, small ulcerations are formed that do not heal for a long time.
Radiation ulcer. characterized by necrosis death) parts of the skin and deeper tissues. The skin in the area of the ulcer is extremely painful, and the ulcer itself does not heal for a long time, which is due to a violation of microcirculation in it.
Radiation skin cancer. The most severe complication after radiation burn. The formation of cancer is promoted by cellular mutations resulting from radiation exposure, as well as prolonged hypoxia ( lack of oxygen), which develops against the background of microcirculation disorders.
Skin atrophy. It is characterized by thinning and dryness of the skin, hair loss, impaired sweating and other changes in the affected area of the skin. The protective properties of atrophied skin are sharply reduced, as a result of which the risk of developing infections increases.

Skin itching

As mentioned earlier, exposure to radiation therapy leads to disruption of blood microcirculation in the skin area. In this case, the blood vessels expand, and the permeability of the vascular wall increases significantly. As a result of these phenomena, the liquid part of the blood passes from the bloodstream into the surrounding tissues, as well as many biologically active substances, including histamine and serotonin. These substances irritate specific nerve endings located in the skin, resulting in a sensation of itching or burning.

To eliminate itching, antihistamines can be used, which block the effects of histamine at the tissue level.

Edema

The occurrence of edema in the leg area may be due to the effect of radiation on the tissues of the human body, especially when irradiating tumors of the abdomen. The fact is that during irradiation, damage to the lymphatic vessels can be observed, through which, under normal conditions, the lymph flows from the tissues and flows into the bloodstream. Violation of the outflow of lymph can lead to the accumulation of fluid in the tissues of the legs, which will be the direct cause of the development of edema.

Swelling of the skin during radiotherapy can also be caused by exposure to ionizing radiation. In this case, there is an expansion of the blood vessels of the skin and sweating of the liquid part of the blood into the surrounding tissue, as well as a violation of the outflow of lymph from the irradiated tissue, as a result of which edema develops.

At the same time, it is worth noting that the occurrence of edema may not be associated with the effect of radiotherapy. So, for example, with advanced cases of cancer, metastases can occur ( distant tumor foci) in various organs and tissues. These metastases ( or the tumor itself) can compress the blood and lymphatic vessels, thereby disrupting the outflow of blood and lymph from tissues and provoking the development of edema.

pain

Pain during radiation therapy can occur in the case of radiation damage to the skin. At the same time, in the area of the affected areas, there is a violation of blood microcirculation, which leads to oxygen starvation of cells and damage to nerve tissues. All this is accompanied by the appearance of a pronounced pain syndrome, which patients describe as "burning", "unbearable" pain. This pain syndrome cannot be eliminated with the help of conventional painkillers, and therefore patients are prescribed other medical procedures ( medicinal and non-medical). Their goal is to reduce swelling of the affected tissues, as well as restore the patency of blood vessels and normalize microcirculation in the skin. This will improve the delivery of oxygen to the tissues, which will reduce the severity or completely eliminate pain.

Damage to the stomach and intestines nausea, vomiting, diarrhoea, diarrhoea, constipation)

Cause of gastrointestinal dysfunction gastrointestinal tract) the radiation dose may be too high ( especially when irradiating tumors of internal organs). In this case, there is damage to the mucous membrane of the stomach and intestines, as well as a violation of the nervous regulation of intestinal motility ( motility). In more severe cases, inflammatory processes may develop in the gastrointestinal tract ( gastritis - inflammation of the stomach, enteritis - inflammation of the small intestine, colitis - inflammation of the large intestine, and so on) or even form ulcers. The process of promoting intestinal contents and digestion of food will be disrupted, which can cause the development of various clinical manifestations.

Damage to the gastrointestinal tract during radiation therapy can manifest itself:

Nausea and vomiting- associated with delayed gastric emptying due to impaired gastrointestinal motility.
diarrhea ( diarrhea) - occurs due to inadequate digestion of food in the stomach and intestines.
Constipation- can occur with severe damage to the mucous membrane of the large intestine.
Tenesmus- frequent, painful urge to defecate, during which nothing is excreted from the intestines ( or passing a small amount of mucus without stool).
The appearance of blood in the stool- This symptom may be associated with damage to the blood vessels of the inflamed mucous membranes.
Pain in the abdomen- occur due to inflammation of the mucous membrane of the stomach or intestines.

Cystitis

Cystitis is an inflammatory lesion of the mucous membrane of the bladder. The cause of the disease may be radiation therapy performed to treat a tumor of the bladder itself or other organs of the small pelvis. At the initial stage of development of radiation cystitis, the mucous membrane becomes inflamed and swells, but in the future ( as radiation dose increases) it atrophies, that is, it becomes thinner, wrinkled. At the same time, its protective properties are violated, which contributes to the development of infectious complications.

Clinically, radiation cystitis can be manifested by frequent urge to urinate ( during which a small amount of urine is excreted), the appearance of a small amount of blood in the urine, a periodic increase in body temperature, and so on. In severe cases, ulceration or necrosis of the mucosa may occur, against which a new cancerous tumor may develop.

Treatment of radiation cystitis is the use of anti-inflammatory drugs ( to eliminate the symptoms of the disease) and antibiotics ( to combat infectious complications).

Fistulas

Fistulas are pathological channels through which various hollow organs can communicate with each other or with the environment. The reasons for the formation of fistulas can be inflammatory lesions of the mucous membranes of internal organs that develop against the background of radiation therapy. If such lesions are not treated, over time, deep ulcers form in the tissues, which gradually destroy the entire wall of the affected organ. In this case, the inflammatory process can spread to the tissue of a neighboring organ. Ultimately, the tissues of the two affected organs are "soldered" together, and a hole is formed between them, through which their cavities can communicate.

With radiation therapy, fistulas can form:

between esophagus and trachea or large bronchi);
between the rectum and the vagina;
honey rectum and bladder;
between intestinal loops;
between intestines and skin;
between the bladder and the skin and so on.

Lung injury after radiotherapy pneumonia, fibrosis)

With prolonged exposure to ionizing radiation, inflammatory processes can develop in the lungs ( pneumonia, pneumonitis). In this case, the ventilation of the affected areas of the lungs will be disturbed and fluid will begin to accumulate in them. This will be manifested by coughing, a feeling of lack of air, pain in the chest, sometimes hemoptysis ( coughing up a small amount of blood with sputum).

If these pathologies are not treated, over time this will lead to the development of complications, in particular, the replacement of normal lung tissue with scar or fibrous tissue ( that is, to the development of fibrosis). Fibrous tissue is impermeable to oxygen, as a result of which its growth will be accompanied by the development of oxygen deficiency in the body. At the same time, the patient will begin to experience a feeling of lack of air, and the frequency and depth of his breathing will increase ( that is, there will be shortness of breath).

In the case of pneumonia, anti-inflammatory and antibacterial drugs are prescribed, as well as agents that improve blood circulation in the lung tissue and, thereby, prevent the development of fibrosis.

Cough

Cough is a common complication of radiation therapy in cases where the chest is exposed to radiation. In this case, ionizing radiation affects the mucous membrane of the bronchial tree, as a result of which it becomes thinner, becomes dry. At the same time, its protective functions are significantly weakened, which increases the risk of developing infectious complications. During respiration, dust particles that normally settle on the surface of the moist mucous membrane of the upper respiratory tract can enter the smaller bronchi and get stuck there. At the same time, they will irritate special nerve endings, which will activate the cough reflex.

Expectorants may be given to treat cough during radiation therapy ( increase the production of mucus in the bronchi) or procedures that help moisturize the bronchial tree ( e.g. inhalation).

Bleeding

Bleeding can develop as a result of the effect of radiotherapy on a malignant tumor that grows into large blood vessels. Against the background of radiation therapy, the size of the tumor may decrease, which may be accompanied by thinning and a decrease in the strength of the wall of the affected vessel. The rupture of this wall will lead to bleeding, the localization and volume of which will depend on the location of the tumor itself.

At the same time, it is worth noting that the effect of radiation on healthy tissues can also be the cause of bleeding. As mentioned earlier, when healthy tissues are irradiated, blood microcirculation is disturbed in them. As a result, blood vessels can expand or even become damaged, and some of the blood will be released into the environment, which can cause bleeding. According to the described mechanism, bleeding can develop with radiation damage to the lungs, mucous membranes of the mouth or nose, gastrointestinal tract, urinary organs, and so on.

Dry mouth

This symptom develops when irradiated tumors are located in the head and neck. In this case, ionizing radiation affects the salivary glands ( parotid, sublingual and submandibular). This is accompanied by a violation of the production and release of saliva into the oral cavity, as a result of which its mucous membrane becomes dry and hard.

Due to the lack of saliva, taste perception is also disturbed. This is explained by the fact that in order to determine the taste of a particular product, the particles of the substance must be dissolved and delivered to the taste buds located deep in the papillae of the tongue. If there is no saliva in the oral cavity, the food product cannot reach the taste buds, as a result of which the taste perception of a person is disturbed or even distorted ( the patient may constantly experience a feeling of bitterness or a metallic taste in the mouth).

Tooth damage

During radiation therapy of tumors of the oral cavity, darkening of the teeth and a violation of their strength are noted, as a result of which they begin to crumble or even break. Also due to impaired blood supply to the dental pulp ( internal tissue of the tooth, consisting of blood vessels and nerves) the metabolism in the teeth is disturbed, which increases their fragility. Moreover, disruption of saliva production and blood supply to the oral mucosa and gums leads to the development of oral infections, which also adversely affects dental tissue, contributing to the development and progression of caries.

Temperature rise

An increase in body temperature can be observed in many patients both during the course of radiation therapy and for several weeks after its completion, which is considered absolutely normal. At the same time, sometimes an increase in temperature may indicate the development of severe complications, as a result of which, if this symptom appears, it is recommended to consult with your doctor.

An increase in temperature during radiation therapy may be due to:

The effectiveness of the treatment. In the process of destruction of tumor cells, various biologically active substances are released from them, which enter the bloodstream and reach the central nervous system, where they stimulate the thermoregulation center. In this case, the temperature can rise to 37.5 - 38 degrees.
The effect of ionizing radiation on the body. When tissues are irradiated, a large amount of energy is transferred to them, which can also be accompanied by a temporary increase in body temperature. Moreover, a local increase in the temperature of the skin can be due to the expansion of blood vessels in the area of irradiation and the influx of "hot" blood into them.
main disease. In most malignant tumors, patients have a constant increase in temperature up to 37 - 37.5 degrees. This phenomenon may persist throughout the course of radiotherapy, as well as for several weeks after the end of treatment.
The development of infectious complications. When the body is irradiated, its protective properties are significantly weakened, as a result of which the risk of infections is increased. The development of infection in any organ or tissue may be accompanied by an increase in body temperature up to 38 - 39 degrees and above.

Decreased white blood cells and hemoglobin in the blood

After performing radiation therapy, there may be a decrease in the concentration of leukocytes and hemoglobin in the patient's blood, which is associated with the effect of ionizing radiation on the red bone marrow and other organs.

Under normal conditions, leukocytes ( cells of the immune system that protect the body from infections) are formed in the red bone marrow and in the lymph nodes, after which they are released into the peripheral bloodstream and perform their functions there. Red blood cells are also produced in the red bone marrow ( red blood cells), which contain the substance hemoglobin. It is hemoglobin that has the ability to bind oxygen and transport it to all body tissues.

During radiation therapy, the red bone marrow can be exposed to radiation, as a result of which the processes of cell division in it will slow down. In this case, the rate of formation of leukocytes and erythrocytes may be disturbed, as a result of which the concentration of these cells and the level of hemoglobin in the blood will decrease. After the cessation of radiation exposure, the normalization of peripheral blood parameters can occur within several weeks or even months, depending on the received radiation dose and the general condition of the patient's body.

Periods with radiation therapy

The regularity of the menstrual cycle may be disturbed during radiation therapy, depending on the area and intensity of radiation.

The allocation of menstruation can be affected by:

Irradiation of the uterus. In this case, there may be a violation of blood circulation in the area of the mucous membrane of the uterus, as well as its increased bleeding. This may be accompanied by the release of a large amount of blood during menstruation, the duration of which can also be increased.
Irradiation of the ovaries. Under normal conditions, the course of the menstrual cycle, as well as the appearance of menstruation, is controlled by female sex hormones produced in the ovaries. When these organs are irradiated, their hormone-producing function can be disrupted, as a result of which various menstrual cycle disorders can be observed ( until the disappearance of menstruation).
Irradiation of the head. In the head region is the pituitary gland - a gland that controls the activity of all other glands of the body, including the ovaries. When the pituitary gland is irradiated, its hormone-producing function may be impaired, which will lead to ovarian dysfunction and menstrual irregularities.

Can cancer recur after radiation therapy?

Relapse ( recurrence of the disease) can be seen with radiation therapy for any form of cancer. The fact is that during radiotherapy, doctors irradiate various tissues of the patient's body, trying to destroy all the tumor cells that could be in them. At the same time, it is worth remembering that it is never possible to exclude the possibility of metastasis by 100%. Even with radical radiation therapy, performed according to all the rules, 1 single tumor cell can survive, as a result of which, over time, it will again turn into a malignant tumor. That is why after the end of the treatment course, all patients should be regularly examined by a doctor. This will allow timely detection of a possible relapse and timely treatment of it, thereby extending the life of a person.

A high likelihood of recurrence may indicate:

the presence of metastases;
germination of the tumor in neighboring tissues;
low efficiency of radiotherapy;
late start of treatment;
improper treatment;
depletion of the body;
the presence of relapses after previous courses of treatment;
non-compliance by the patient with the recommendations of the doctor ( if the patient continues to smoke, drink alcohol or be exposed to direct sunlight during treatment, the risk of recurrence of cancer increases several times).

Is it possible to get pregnant and have children after radiation therapy?

The effect of radiation therapy on the possibility of bearing a fetus in the future depends on the type and location of the tumor, as well as on the dose of radiation received by the body.

The possibility of bearing and giving birth to a child can be affected by:

Irradiation of the uterus. If the purpose of radiotherapy was to treat a large tumor of the body or cervix, at the end of the treatment, the organ itself may be deformed so much that the development of pregnancy will be impossible.
Irradiation of the ovaries. As mentioned earlier, with tumor or radiation damage to the ovaries, the production of female sex hormones may be disrupted, as a result of which a woman will not be able to become pregnant and / or bear a fetus on her own. At the same time, hormone replacement therapy can help solve this problem.
Pelvic irradiation. Irradiation of a tumor that is not associated with the uterus or ovaries, but located in the pelvic cavity, can also create difficulties in planning pregnancy in the future. The fact is that as a result of radiation exposure, the mucous membrane of the fallopian tubes can be affected. As a result, the process of fertilization of the egg ( female sex cell) sperm ( male sex cell) becomes impossible. The problem will be solved by in vitro fertilization, during which germ cells are combined in laboratory conditions outside the woman's body, and then placed in her uterus, where they continue to develop.
Irradiation of the head. Irradiation of the head may damage the pituitary gland, which will disrupt the hormonal activity of the ovaries and other glands of the body. You can also try to solve the problem with hormone replacement therapy.
Violation of the work of vital organs and systems. If during the course of radiation therapy, the functions of the heart were impaired or the lungs were affected ( for example, severe fibrosis developed), a woman may have difficulty during gestation. The fact is that during pregnancy ( especially in the 3rd trimester) significantly increases the load on the cardiovascular and respiratory system of the expectant mother, which, in the presence of severe concomitant diseases, can cause the development of dangerous complications. Such women should be constantly monitored by an obstetrician-gynecologist and take supportive therapy. They are also not recommended to give birth through the birth canal ( the method of choice is delivery by caesarean section at 36-37 weeks of gestation).

It is also worth noting that the time elapsed from the end of radiation therapy to the onset of pregnancy is of no small importance. The fact is that the tumor itself, as well as the ongoing treatment, significantly deplete the female body, as a result of which it needs time to restore energy reserves. That is why it is recommended to plan a pregnancy no earlier than six months after the treatment, and only in the absence of signs of metastasis or relapse ( re-development) cancer.

Is radiation therapy dangerous for others?

During radiation therapy, a person does not pose a danger to others. Even after irradiation of tissues with high doses of ionizing radiation, they ( fabrics) do not release this radiation into the environment. An exception to this rule is contact interstitial radiotherapy, during which radioactive elements can be installed in human tissue ( in the form of small balls, needles, staples or threads). This procedure is performed only in a specially equipped room. After the installation of radioactive elements, the patient is placed in a special ward, the walls and doors of which are covered with radioactive shields. In this chamber, he must remain during the entire course of treatment, that is, until the radioactive substances are removed from the affected organ ( the procedure usually takes several days or weeks).

The access of medical personnel to such a patient will be strictly limited in time. Relatives can visit the patient, but before that they will need to wear special protective suits that will prevent the effects of radiation on their internal organs. At the same time, children or pregnant women, as well as patients with existing tumor diseases of any organs, will not be allowed into the ward, since even minimal exposure to radiation can adversely affect their condition.

After removing the sources of radiation from the body, the patient can return to daily life on the same day. It will not pose any radioactive threat to others.

Recovery and rehabilitation after radiotherapy

During radiation therapy, a number of recommendations should be followed that will save the body's strength and ensure maximum effectiveness of the treatment.

Diet ( food) during and after radiotherapy

When compiling a menu during radiation therapy, one should take into account the peculiarities of the influence of ionizing study on the tissues and organs of the digestive system.

Radiation therapy should:

Eat well processed food. During radiotherapy ( especially when irradiating the organs of the gastrointestinal tract) damage occurs to the mucous membranes of the gastrointestinal tract - the oral cavity, esophagus, stomach, intestines. They can become thinner, inflamed, become extremely sensitive to damage. That is why one of the main conditions for cooking food is its high-quality mechanical processing. It is recommended to give up hard, rough or hard food, which could damage the mucous membrane of the oral cavity during chewing, as well as the mucous membrane of the esophagus or stomach during the swallowing of the food bolus. Instead, it is recommended to consume all products in the form of cereals, mashed potatoes and so on. Also, the food consumed should not be too hot, as this can easily develop a burn of the mucous membrane.
Eat high calorie foods. During radiation therapy, many patients complain of nausea, vomiting, which occurs immediately after eating. That is why such patients are advised to consume a small amount of food at a time. At the same time, the products themselves must contain all the necessary nutrients in order to provide the body with energy.
Eat 5 - 7 times a day. As mentioned earlier, patients are advised to eat small meals every 3 to 4 hours, which will reduce the likelihood of vomiting.
Drink enough water. In the absence of contraindications ( for example, severe heart disease or edema due to a tumor or radiation therapy) the patient is recommended to consume at least 2.5 - 3 liters of water per day. This will help cleanse the body and remove by-products of tumor decay from the tissues.
Eliminate carcinogens from the diet. Carcinogens are substances that can increase the risk of developing cancer. With radiation therapy, they should be excluded from the diet, which will increase the effectiveness of the treatment.

Nutrition during radiation therapy

What can be consumed?
cooked meat; wheat porridge; oatmeal; rice porridge; buckwheat porridge; mashed potatoes; boiled chicken eggs 1 - 2 per day); cottage cheese; fresh milk ; butter ( about 50 grams per day); baked apples ; walnuts ( 3 - 4 per day); natural honey; mineral water ( without gases); jelly.	fried food ( carcinogen); fatty foods ( carcinogen); smoked food ( carcinogen); spicy food ( carcinogen); salty food; strong coffee ; alcoholic drinks ( carcinogen); carbonated drinks; fast food ( including porridge and instant noodles); vegetables and fruits containing a large amount of dietary fiber ( mushrooms, dried fruits, beans and so on).

Vitamins for radiotherapy

When exposed to ionizing radiation, certain changes can also occur in the cells of healthy tissues ( their genetic makeup can be destroyed). Also, the mechanism of cell damage is due to the formation of so-called free oxygen radicals, which aggressively affect all intracellular structures, leading to their destruction. The cell then dies.

In the process of many years of research, it was found that some vitamins have so-called antioxidant properties. This means that they can bind free radicals inside cells, thereby blocking their destructive action. The use of such vitamins during radiation therapy ( in moderate doses) increases the body's resistance to radiation, at the same time, without reducing the quality of the treatment.

Antioxidant properties have:

some trace elements e.g. selenium).

Can you drink red wine while having radiation therapy?

Red wine contains a number of vitamins, minerals and trace elements necessary for the normal functioning of many body systems. It has been scientifically proven that drinking 1 cup ( 200 ml) red wine per day contributes to the normalization of metabolism, and also improves the excretion of toxic products from the body. All this undoubtedly has a positive effect on the condition of the patient undergoing radiation therapy.

At the same time, it is worth remembering that the abuse of this drink can adversely affect the cardiovascular system and many internal organs, increasing the risk of complications during and after radiation therapy.

Why are antibiotics prescribed for radiation therapy?

During irradiation, cells of the immune system are affected, as a result of which the body's defenses are weakened. Along with damage to the mucous membranes of the gastrointestinal tract, as well as the respiratory and genitourinary systems, this can contribute to the emergence and development of many bacterial infections. Antibacterial therapy may be needed to treat them. At the same time, it is worth remembering that antibiotics destroy not only pathogenic, but also normal microorganisms that live, for example, in the intestines of a healthy person and take an active part in the digestion process. That is why after the end of the course of radiotherapy and antibiotic therapy, it is recommended to take drugs that restore the intestinal microflora.

Why is CT and MRI prescribed after radiation therapy?

CT ( CT scan) and MRI ( Magnetic resonance imaging) are diagnostic procedures that allow you to examine in detail certain areas of the human body. Using these techniques, one can not only detect a tumor, determine its size and shape, but also control the process of ongoing treatment, weekly noting certain changes in the tumor tissue. For example, with the help of CT and MRI, it is possible to detect an increase or decrease in the size of a tumor, its germination in neighboring organs and tissues, the appearance or disappearance of distant metastases, and so on.

It should be borne in mind that during a CT scan, the human body is exposed to a small amount of X-rays. This introduces certain restrictions on the use of this technique, especially during radiation therapy, when the radiation load on the body must be strictly dosed. At the same time, MRI is not accompanied by tissue irradiation and does not cause any changes in them, as a result of which it can be performed daily ( or even more often), posing absolutely no danger to the health of the patient.

Before use, you should consult with a specialist.

Radiotherapy uses ionizing radiation to fight cancer cells. This method is often used in the treatment of rectal cancer. It is usually combined with chemotherapy drugs - 5-FU drugs and capecitabine. Cytostatics increase the sensitivity of pathological cells to the effects of radiation.

The Assuta Clinic offers radiotherapy services for rectal cancer at the Institute of Radiation Therapy and Radiosurgery at the clinic. Advantages of choosing:

wide technical capabilities - modern equipment and materials;
high professional training of doctors and extensive experience;
the least undesirable effect on healthy tissues through the use of a wide range of techniques that reduce possible side effects.

Before surgery.
After surgery.
For the treatment of symptoms of a metastatic tumor process.

Preparing for Radiation Therapy for Colon Cancer

The doctor provides the patient with the following information:

the treatment will be internal or external radiotherapy;
the purpose of exposure is curative or palliative;
the required number of sessions;
advantages and disadvantages of radiotherapy;
short-term and long-term side effects;
any risks;
possible alternative procedures.

It will be useful to write a list of questions and ask the team of doctors during the communication.

If the patient is a woman of childbearing age, it is important not to become pregnant during therapy. Irradiation will harm the fetus.

If the patient has a pacemaker, implantable heart devices, or a cochlear implant, the physician should be notified. These devices may be affected by radiation therapy.

External radiotherapy before surgery

Doctors turn to radiation for rectal cancer before surgery to reduce the risk of recurrence and shrink the tumor so that it is easier for the surgeon to remove.

If the malignancy is operable, a short course of 5 radiotherapy sessions will most likely be given a week before surgery. This will destroy a significant number of cancer cells and also reduce the chance that the cancer cells will spread. Simultaneously with radiation therapy can be carried out (5-FU or capecitabine) - chemoradiotherapy.

If the tumor is large, you may need a longer course of treatment before surgery - about 5 months. It may be necessary to simultaneously perform chemotherapy. The operation is performed a few weeks after irradiation, when the tumor shrinks.

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Internal radiation therapy for rectal cancer

This type of radiotherapy involves placing a radioactive source next to a malignant tumor inside an organ - brachytherapy. There are two types of it: high-dose and contact.

High-dose brachytherapy, which delivers radiation directly to the tumor. It is carried out only if the neoplasm is in the middle or lower third of the rectum. Usually before surgery. The task is to reduce its volume in order to facilitate the removal process.

Before the procedure, the patient is given a sedative. The doctor inserts a tube into the rectum, bringing it close to the tumor. The radiologist takes a picture to make sure it is in the correct position. The tube is attached to equipment that provides brachytherapy. With the help of a remote control, the radioactive source is moved along the tube to a predetermined position in order to provide the correct dose of radiation to the tumor. The procedure lasts 10-15 minutes. The operation is carried out in a few weeks.

According to the results of the study, people who received brachytherapy are less likely to need a colostomy than those who received external beam radiation therapy. There is currently no information on whether internal radiotherapy improves survival.

Contact brachytherapy uses low doses of radiation to fight cancer. This technique was called Papillon. It is recommended only for small tumors less than 3 cm at an early stage, when there are contraindications for surgery. Contact brachytherapy may also be offered if the patient refuses surgery and an ostomy. The procedure is performed on an outpatient basis and does not require general anesthesia. This technique is only available in some hospitals.

Treatment is preceded by a diet low in dietary fiber for 3 days. Before the procedure, an enema is given, a local anesthetic is applied around the anus. The doctor examines the rectum with a sigmoidoscope. Gently inserts the applicator, through which a tube is placed that provides radiation. He connects it to the computer, the procedure lasts about a minute, but in general, the stay in the department will be about half an hour.

The next session will be in two weeks. The number of procedures will depend on the reaction of the body. If there is no effect, external radiotherapy with or without chemotherapy is recommended. Or surgery will be suggested.

According to the results of the study, the risk of recurrence is slightly higher compared to surgery. Cancer returns after contact brachytherapy in 10 out of 100 people (10%), after other methods in 1-4 out of 100 (1-4%).

Careful monitoring is required after contact radiotherapy as possible side effects include:

An opening in the rectum or bladder.
Narrowing (stenosis) of the anus.
The occurrence of a fistula between the rectum and the bladder or vagina.

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Radiation therapy for rectal cancer after surgery

Radiotherapy after surgery may be offered in the following cases:

The tumor is difficult to remove.
The surgeon believes that malignant cells remain.
The cancer has grown through the intestinal wall and spread to nearby lymph nodes.

This treatment takes 4 to 5 weeks. Procedures are carried out on weekdays, in total these are 20-25 fractions. Fine fraction radiotherapy reduces unwanted effects on healthy tissue. Chemotherapy may also be recommended at the same time as radiation.

Remote radiotherapy is preceded by careful planning, the amount of radiation and the localization of exposure to rectal cancer are calculated. Planning ensures that the radiation is directed directly at the tumor so that it causes the least amount of damage to the surrounding healthy tissue. Treatment is planned on an individual basis by a clinical oncologist, physicist and radiologist. The first meeting usually takes 30-60 minutes. Staff at the Institute of Radiation Therapy tell you what to expect and prepare the patient in advance.

A CT scan is performed, the scan shows the tumor and the structures around it. This helps the oncologist and physicist plan the exact area for radiation therapy. In the process of CT, a three-dimensional picture is created, if necessary, a dye is used, it makes certain parts of the body clearer. Instead of CT, an MRI or PET is sometimes done.

Special devices or masks may be required to ensure that the patient remains still during irradiation of rectal cancer. Thus, radiation therapy will be as accurate and effective as possible. Forms are used to hold the legs or arms, or other parts of the body, in a fixed position. Special marks are applied to the skin to mark the place where the radiation will be directed.

During radiotherapy, special skin care in the treatment area will be required. Doctors will give advice on how to take care of the skin. It is generally recommended to avoid the use of scented soaps, lotions in the treatment area. Certain foods can make the pain worse.

Radiation therapy is carried out in a special department, on weekdays. Its duration before surgery is 1-5 weeks, the duration is affected by the size and type of tumor. If radiation is performed after surgery, the course is usually 4-5 weeks, sometimes 6-7.

Radiation therapy for advanced rectal cancer

If secondary lesions appear, radiotherapy will not cure the disease. Its task is to reduce the tumor and slow its growth. Radiation can relieve symptoms such as pelvic or rectal pain or bleeding.

For metastases, radiation therapy may include one or more treatments. The fraction lasts for several minutes, it is necessary to lie still.

If the cancer has spread to the liver, specialized methods such as stereotactic radiation therapy or selective internal radiation therapy may be used.

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Possible Undesirable Effects of Radiation Therapy for Colon Cancer

Irradiation can cause some side effects. These effects usually appear gradually and include the following symptoms.

Fatigue. During treatment, the patient may find that he has become more tired. Most often, this symptom is noted during radiotherapy, as a consequence of the treatment itself. It is important to get rest when needed. It will be beneficial to do simple exercises every day.
Diarrhea. Your doctor will prescribe medication to reduce this symptom. You need to drink plenty of fluids.
Nausea. The patient will have no appetite and no desire to drink water if he experiences nausea. If you have problems with food, you can give preference to high-calorie drinks.
Frequent urination. The rectum is very close to the bladder. Therefore, radiation therapy for rectal cancer can irritate the lining of the bladder. It happens that the patient has a condition similar to cystitis, a bladder infection. He may also experience urges when the organ is empty, and burning during urination. It is important to drink as much liquid as possible. Many people believe that drinking cranberry juice can be helpful for bladder problems. However, cranberry juice enhances the effect of warfarin (an anticoagulant). Therefore, if a person is taking warfarin, cranberry juice should not be drunk. After the end of treatment, the inflammation of the bladder will pass. If you experience pain, you must notify the doctor. This may be a sign of an infection and may require antibiotic treatment.
Skin inflammation. Radiation therapy for rectal cancer can cause pain and irritation of the skin around the anus, which is very sensitive. It happens that there is redness and pain during radiotherapy. It is necessary to use normal water, simple soap and a soft towel when leaving. Your doctor will give you creams to protect your skin and help it heal faster. You should not use scented or medicated soaps, any lotions, unless this has been discussed with a specialist in advance. For inconvenience while sitting, you can use a soft cushion. After treatment, pain will gradually decrease over several weeks.

Long-term adverse effects of radiotherapy for rectal cancer

Radiotherapy can cause long-term side effects in some people more than others. Treatment is carefully planned to reduce the number of possible negative consequences.

Not every patient who undergoes radiotherapy will experience these effects. In some cases, the condition returns to normal soon after treatment. But sometimes short-term symptoms continue and become long-term. It happens that temporary manifestations go away, but long-term disorders in the intestines or bladder develop. After completing a course of radiotherapy, they can occur after a few months with a period of up to two years.

The long-term effects of radiation therapy include:

diarrhea
private chair;
stool incontinence;
poor absorption of nutrients in the intestines, leading to weight loss.

Radiotherapy can also affect the bladder, causing:

urinary incontinence;
loss of elasticity of the walls of the bladder, which will lead to frequent urination;
increased fragility of blood vessels, provoking blood in the urine.

Treatment can affect sex life by causing:

early menopause;
erection difficulties;
loss of fertility;
dryness and narrowing of the vagina, which will lead to painful sex.

It is important to communicate with your doctor if any of these side effects develop. There are ways to reduce or manage them. Sometimes other conditions, such as an infection, can lead to symptoms that develop into long-term side effects.

Radiation therapy is one of the most common ways to fight a variety of cancers, along with surgery and drug treatment. Very frequent consequences, side reactions of such treatment are various dyspeptic manifestations (loss of appetite, vomiting, nausea, diarrhea). Adequate nutrition during radiation therapy can reduce the intensity of such symptoms and directly affects the rate of recovery of the human body.

Of course, getting rid of the tumor, or its metastases with the help of one diet, alas, will not work. But without a balanced diet, the recovery period always lasts much longer.

Nutrition during radiation therapy

Basic principles of proper nutrition

Oncological diseases themselves, in most cases, are accompanied by various eating disorders that are associated with metabolic disorders with a pronounced loss of patient body weight. Weight loss induced by malignant neoplasms occurs in approximately 60% of patients. Intensive antitumor therapy, including radiation therapy, supports the treatment of hepatic diseases and supports the liver, has an additional negative effect on the nutritional status of patients.

The mechanism of action of radiation exposure is based on the fact that the sensitivity of tumor cells to different types of radiation is higher than that of healthy cells. However, despite the calculation of the optimal irradiation dose to maximize the preservation of normal cells, irradiation adversely affects various tissues, especially those that have a high rate of growth and renewal.

It should be noted that there is some difference between the daily menu in patients with malignant neoplasms. It all depends on the location of the tumor. If we talk about the bones or the rectum, then there are few significant differences. The main problem is the defeat of the oral cavity, laryngopharynx, stomach and esophagus.

In these cases, care must be taken, as the food passageways are damaged and each meal causes pain.

Currently, there are special tips and recommendations that will help patients alleviate general dyspeptic symptoms and improve taste:

It is better to eat only soft food. Favorite foods must first be soaked in milk or water.
If you experience pain when chewing, rinse your mouth with Almagel or a light solution of novocaine.
It is necessary to mechanically process the food of the diet after irradiation in oncology before eating it. It is better to use a mixer and bring all dishes to a puree state. This will prevent mechanical damage to the mucosa of the digestive organs.
At the time of cooking vegetables or meat, it is imperative to use butter or vegetable oil.
Nutrition for the patient during radiation chemotherapy should also be balanced in all nutrients. Any mono-diets are strictly contraindicated. You need to eat a lot of proteins, carbohydrates and fats, while not forgetting about vitamins and other trace elements.
Avoid hard and rough foods.
It is better to cook food on a slow flame with the addition of a large amount of water. This will certainly make it softer.
Some patients say that cold meals reduce pain. You can add ice to soups and drinks. Natural ice cream is also welcome.
Drink more fluids per day. The optimal volume is 1.5-2 liters of water. True, this item must be agreed with the doctor.

As you can see, there are almost no special restrictions. The main thing that the diet after irradiation pursues is to unload all the organs of the gastrointestinal tract as much as possible. Sparing food normalizes digestion, provides the body with the necessary substances, and also protects the mucous membrane of the intestines and stomach.

Useful Products for Radiation Therapy

Since the diet for radiation therapy patients must be sufficiently balanced for all key nutrients, the following components can be safely included in the menu:

Lean meats (beef, chicken, turkey). The main source of proteins.
Fish. It is better to give preference to marine species. They are easier to eat and contain more iodine.
Quail eggs. There are even articles that talk about the antitumor effect of this product.
Dairy products. Yogurt, cottage cheese, fermented baked milk will replenish casein and calcium.
Proper nutrition during radiotherapy of the female breast, rectum, stomach, or any other localization must necessarily include fruits, and vegetables must be in large enough quantities. They restore the reserves of vitamins that protect cells from the pathological effects of radionuclides and prevent further lipid peroxidation. Vitamins C and E are especially important.
Hazelnuts, almonds, sunflower seeds, walnuts. They are rich in tocopherol and protein - a natural antioxidant.
Vegetable oil. To effectively improve digestion, before each meal, doctors recommend including one teaspoon of sunflower or olive oil in the diet. It envelops the mucous membrane of the digestive tract, and also prevents it from any mechanical damage.
From drinks, all kinds of jelly, natural diluted juices (1: 1 with water), fruit drinks, ordinary still mineral water are recommended. If fruit juice is being prepared, it is imperative to preserve the pulp.

Food to be avoided

There are products that cause irritation of the mucous membrane, increase gas formation and are undesirable on the table of the patient.

These include:

Fatty and rich broths.
Hot spices and seasonings.
Marinades, preserves.
Fast food.
Tobacco and alcohol.
A large number of various confectionery products, as well as sweet carbonated drinks.
Cabbage.
Rough food in large pieces.

Nutrition after radiotherapy

After irradiated cancer tumors, a strict diet is continued for at least two weeks.

Meat (preferably white - chicken, turkey, rabbit) is introduced into the diet gradually. At first, with cervical cancer, it is steamed, then it can be stewed and boiled. On the table there are dishes from zucchini, pumpkin, beets and other products that contain fiber. Puree soups and vegetarian soups are allowed. Doctors recommend eating greens every day.

Nutrition after radiation therapy and its rules:

It is worth expanding the diet gradually, listening to the reaction of your body.
To improve appetite, you can use a decoction of ginger, honey and decoctions of herbs.
If discomfort occurs, you must immediately return to the diet.
It is better to refuse to visit various catering places.

During radiation therapy, the patient, as a rule, loses a lot of weight, therefore, in the intervals between treatment, the main task of the doctor and the patient is to restore all the lost weight.

Proper nutrition should help restore the body and minimize all the bad effects of treatment.

Proper nutrition after radiation therapy is the basis for recovery of the body. If there are any problems with the absorption of food through the larynx, then patients may be temporarily assigned to special parenteral food mixtures that are administered intravenously.

In any case, it is necessary to replenish the reserves of carbohydrates, proteins and fats. The main thing is to improve the patient's well-being and create the best conditions for his rehabilitation.

diet for radiation therapy

General rules

Diet during radiation therapy is an integral part of the treatment of cancer patients. Properly organized nutrition makes it possible to minimize the severity of complications of such therapy, ensure the vital activity of a severely malnourished organism, and also improve the overall quality of life of patients. As such, there is no single diet in this case. It depends on many different factors: the condition of the patient, the affected organ, the stage of development of the disease, the degree of metabolic disorders, specific complications, the nutritional status of the patient.

When cancer is irradiated, in cases of frequent vomiting and nausea, pronounced dehydration and a violation of water-salt metabolism are noted. In these cases, it is recommended:

Before a radiation therapy session, the patient should take food and liquid no earlier than 3 hours before the start of the procedure.
To stop nausea, it is desirable to use salty and acidic foods (cranberries, lemons, pickles).
Do not drink liquids while eating. It should be drunk between meals.
With strong and frequent bouts of vomiting, one should refrain from eating and drinking for 4-8 hours, and then take well-chewed food at room temperature, mostly liquid in small portions, while avoiding overflow of the stomach.
Do not eat food that has a specific taste and a strong smell, spicy and fatty foods, whole milk (it can be included in the diet only after the complete cessation of nausea).

Diet for protein-energy malnutrition

In protein-energy malnutrition, it is necessary to assess the nutritional status of the patient. A practical criterion for protein-energy malnutrition in cancer patients is a loss of body weight of more than 10%, or laboratory data, a decrease in serum albumin less than 2.2 g/l, albumin less than 35 g/l, or transferrin less than 1.9 g/l l.

In these cases, active nutritional support is needed. To maintain a positive nitrogen balance, as well as fat reserves, non-protein calories should exceed basal metabolic rates by 130%. Moreover, the patient's daily protein needs should be at the level of 1.5-2.0 g/kg, energy - at the level of 30-35 kcal/kg.

Diet for stomatitis or esophagitis

When stomatitis, ulcerative stomatitis or esophagitis (inflammation of the esophageal mucosa) appears, dietary nutrition is based on sparing the esophagus and mouth mucosa. Any cold and hot, spicy, salty and sour food is excluded.

The diet should contain only very well-mashed warm food (slimy soups, steamed meat purees, cereals, cookies, omelettes, kissels). It is forbidden to consume alcohol, spices and spicy sauces, coffee, whole-piece and fried foods.

In the acute period, it is desirable to use dietary concentrates for children in the form of vegetable and meat cereals, cottage cheese, mild grated cheeses, and yogurt. As symptoms subside, the diet can be expanded with soups, broths, and pureed dishes.

Diet for diarrhea

A fairly frequent manifestation of the negative effects of radiation therapy is a disorder of the stool, more often diarrhea. The diet in this case should be aimed at sparing the intestines, as well as compensating for nutrients that are lost due to malabsorption.

Cancer is a serious diagnosis with a high mortality rate. In addition to the aggressiveness of organ cancer, early diagnosis plays an important role in saving the patient's life.

The vast majority of malignant tumors detected in the early stages of development are now successfully treated.

Rectal cancer is a neoplasm of a malignant nature of origin, which originates in the mucous membrane of the final section of the large intestine. In oncology, it is called a colorectal tumor.

As a result of the disease, a mutation occurs in the epithelial tissues lining the intestines, which has typical signs of polymorphism and malignancy of cells.

This means that the disease will most likely spread rapidly, and after a while it will grow into neighboring departments and systems of the body. Almost always metastasizes.

What it is

Radiation therapy is the directed effect of ion radiation, which has a detrimental effect on cancer cells.

It is considered one of the most effective and most commonly used methods of treating rectal cancer, and is used both in combination with other methods of treatment, and independently.

As for the disease specifically considered in the article, it is characterized by the appointment of rather high radiation doses, which often makes itself felt by external manifestations on the patient's body. The impact occurs with the help of X-ray and neutron waves, gamma or beta rays.

The origin of this method of treatment did not begin in medical practice, but in physics as a science. At the end of the 19th century, already known at that time for his achievements, Roentgen discovered the essence of the X-ray influence on the world around him. It is in part of it that this phenomenon is named.

The idea was widely supported by nuclear scientists and actively used by them in the process of scientific research. Later, at the beginning of the 20th century, this property of point X-ray action found its application in medicine.

This happened after scientists drew attention to the fact that the body's reaction to such influence is burns. This prompted them to use the innovation in oncology.

The dose (it is also interpreted as a fraction) of radiation is measured in Grays. In oncology, the concept of the following focal doses takes place:

single focal (RO)- this is the number of rays given to the patient in one session;
total focal (SO)- this is the entire dose prescribed by the time of the course of therapy.

Indications and contraindications

Radiation therapy is indicated in the following cases:

as a preparatory measure before surgery;
after surgery - as a way to consolidate the result and in order to prevent complications and relapses;
as a method of prevention with signs of metastasis;
in the presence of recurrence, as a rule, at 2-3 stages of the course of the disease;
when it is impossible or inappropriate to carry out surgical intervention.

This method of treatment is contraindicated if:

the tumor is localized in the connective sections and tissues of the organ;
diagnosed with cachexia;
a similar course of treatment has already been prescribed as a therapeutic method for eliminating pathologies of other departments and systems;
there are concomitant severe diagnoses;
the patient has a fever;
there are abnormal pulmonary processes of a purulent nature;
revealed anemia;
the patient is prone to diathesis or other allergic manifestations.

Target

This method of treatment has the following goals:

in case of preoperative exposure- slightly reduce the size of the tumor and preserve, if possible, more healthy cells of the rectum;
instead of surgery- with large volumes of education, the main task is to reduce its size, with a small value - to completely eliminate it;
after operation- in order to control the clinical picture, to ensure that all affected fragments are localized;
with internal exposure- by the method of point defeat, eliminate as many diseased cells as possible, sometimes up to their 100% elimination.

Appointments

The course of this procedure is prescribed individually and depends on the severity of the disease and the general physical condition of the patient. Duration varies from one week to three months.

As a complex technique, during or after surgery, the course of treatment is about 2-3 weeks. If radiation is the main and only possible way to eliminate the tumor, several courses are used, each of which will include from 5 to 7 sessions. Between each subsequent stage make a break, the period of which is determined individually.

Preparation for the procedure

Before starting treatment, the specialist will necessarily familiarize the patient with the technology of procedures, prescribe a preparatory course of drugs with a directed spectrum of action that stimulate the body and activate the body's immune forces, directing them to fight the tumor.

The patient is required to:

careful observance of hygiene measures;
fulfillment of the daily routine;
eat a balanced and nutritious diet;
drink more fluids;
lead a healthy lifestyle;
stop smoking and drinking alcohol.

Immediately before the start of the manipulation, the patient undergoes a complete bowel cleansing.

Process

In oncological practice, several methods of radiation exposure to cancer cells are used. The choice of a specific method is determined by the purpose of the procedure.

Before and after surgery

Before surgery, manipulation is carried out, as a rule, to reduce the formation, and after - to eliminate tumor fragments.

In its first variant, the dose and duration may be shorter than in the period of postoperative rehabilitation, when the doses are higher, and the number of manipulations may be 6-7 sessions over several months.

External Beam Therapy

The method is effective as a recurrence-preventing factor, as well as to reduce the size of a malignant formation. If it can be operated on, one course will include 5 to 7 single doses before the expected date of the operation.

Thus, a large concentration of diseased cells will be localized, and the irreversible process will be somewhat suspended. Additionally, chemotherapy may be recommended.

Internal radiation therapy of the rectum

In this case, the source that supplies the waves is located directly near the diseased fragment of the organ. Such a technique could be:

contact;
high-dose.

The latter option is indicated when the pathology is located in the middle or lower intestine. The procedure facilitates the work of the surgeon and significantly reduces the size of the tumor.

What does a doctor do

With high-dose therapy, the duration of manipulation is about 15 minutes. The patient is given a sedative and internally, through the intestine, an instrument is brought. With the help of x-rays, they are convinced of the accuracy of its location.

A device is connected to the device and waves are applied. This option minimizes the risk of needing a colostomy.

Contact treatment is carried out in small fractions and is justified only when the oncology is at the initial stage of development and its size is not more than 3 cm. It is suitable for those who are against the surgical solution of the problem and avoid stoma.

The patient is first given an enema, the intestines are completely cleansed, and local, insignificant in time of exposure, anesthesia is given. Then, according to the variant described above, a radiating tube is inserted into the internal cavity of the rectum.

It all takes less than a minute. Repeated procedure - after 14 days.

Effects

This method is aggressive and can cause the following complications:

diarrhea- eliminated by special preparations and plentiful drinking;
fatigue- in principle, it is considered the norm. The patient needs a sparing regimen and rest;
nausea- reduces appetite, so patients are recommended high-calorie liquid drinks;
skin inflammation- pass spontaneously over time;
spontaneous and frequent urination- due to the treatment, the bladder is in the stage of irritation. May be accompanied by minor pain.

Where do

The radiation exposure procedure for rectal cancer is carried out in special oncology centers or municipal specialized institutions licensed to carry out such activities.

Forecast

About the timely treatment and the small size of the pathology, the prognosis is quite optimistic. In numbers, it looks like this: during the procedure at stage 1 of the course of the disease, the percentage of complete recovery is 90%, at stage 2, 75% of patients are completely cured.

Radiation sickness or radiation damage to a number of organs, including the intestines, develops with the use of nuclear weapons (the tragedy in Hiroshima and Nagasaki in 1945), violation of safety regulations and negligence with sources of ionizing radiation (the events at the Chernobyl nuclear power plant), irrational administration of large doses of radiation therapy. With local irradiation of the abdominal cavity and small pelvis, the total dose of which exceeds 40 Gy (4000 rad), pathological changes can develop, mainly in the intestines. Most often, the defeat of the small and large intestines is combined, although an isolated process is often observed in one of these sections of the intestine.

The first clinical report on intestinal damage after radiotherapy of a malignant neoplasm was made in 1917 by K. Franz and J. Orth. As the use of radiotherapy expanded, the number of reports of its complications increased. In particular, it was noted that irradiation of various pelvic, intraperitoneal and retroperitoneal tumors leads to radiation enteritis and colitis in 5-15% of patients. According to D. L Earnest, J.S. Trier (1983), radiation damage to the gastrointestinal tract continues to be one of the main and serious clinical problems.

In the mechanism of occurrence of damage to the intestine under the action of ionizing radiation lies primarily its effect on the epithelium of the mucous membrane, which is very sensitive to radiation exposure. Irradiation contributes to the suppression of cell proliferation in the crypts, which causes characteristic acute disorders. If the radiation dose is low, the proliferation of epithelial cells is restored quite quickly, and damage to the mucous membrane disappears 1-2 weeks after exposure. The effect of repeated doses of radiation depends on the duration of exposure and the stage of cellular renewal of the crypt epithelium. It has been established that epithelial cells are especially radiosensitive in the G1-postmitotic phase and resistant - in the late S-synthetic one. To restore the processes of regeneration of the epithelium of the intestinal mucosa during fractional irradiation, the duration of the intervals between irradiations is of great importance.

As can be seen, the development of acute and chronic changes characteristic of radiation enteritis is influenced not only by the total dose of radiation and the method of its application, but also by the time between courses of therapy.

Radiation therapy first and most often affects the epithelium. It also has an effect on mesenchymal tissue, which is most important in causing long-term effects. For example, the endothelium of the arterioles of the submucosa of the small intestine is very sensitive to the effects of ionizing radiation and reacts with proliferation at high doses. Vascular disorders appear 1 week or 1 month after acute damage to the mucous membrane. The vessel wall undergoes fibrinoid changes, which further facilitates vascular thrombosis. Obliterating endarteritis, endophlebitis develop, leading to ischemic disorders of the intestinal wall with subsequent ulceration and necrosis. The introduction of bacteria into necrotic tissue worsens the condition of the patient and aggravates damage to the intestinal wall, which increases as the blood supply deteriorates.

After massive irradiation, the intestine becomes edematous; activation of fibroblasts is noted, the connective tissue undergoes hyalinosis, in the development of which smooth muscle cells also participate. As a result, extensive fibrosis is formed, which can lead to narrowing of the intestine, as well as destruction of the mucosal surface. Therefore, ionizing radiation can cause both transient changes in the structure of the mucous membrane and function of the intestine, as well as thickening, ulceration and fibrosis of the intestine.

In addition to acute and chronic changes, there are subacute and latent ones. Acute - occur immediately after irradiation, accompanied by a violation of the proliferation and maturation of the epithelium in combination with a decrease in crypt cell mitoses. In the small intestine, there are characteristic shortening of the villi and a decrease in the thickness of the mucous membrane, as well as its hyperemia, edema, and extensive inflammatory cell infiltration. Crypt abscesses containing neutrophils, eosinophils, and desquamated epithelial cells are possible. With prolonged or massive exposure, ulceration may occur.

Subacute changes appear 2-12 months after radiation therapy. They are very varied. During this period, small intestinal arteriole endothelial cells in the submucosal layer may swell, slough off the basement membrane, and eventually undergo necrosis. Thrombi are found in the lumen of the vessel, in some cases their recanalization. Large foamy cells are found in the intima, which, according to some researchers, are considered an important diagnostic sign of radiation vascular injury in humans. The submucosal layer becomes thickened, sclerotic, and often contains large, irregularly shaped fibroblasts. The result of obliterating changes in small arterioles is progressive ischemia. The degree of vascular damage and ischemic fibrosis varies and is not always pronounced, therefore, in the subacute period, blood circulation in the intestine is often not significantly disturbed, unless radiation was preceded by diseases that affected the vessels (hypertension, diabetes mellitus, generalized atherosclerosis, or coronary and heart failure). ). Insufficiency of microcirculation due to radiation vasculitis, representing the greatest danger, often occurs in the sigmoid and rectum. Abscesses and fistulas can form in the tissues connecting the large intestine to the vagina, bladder, and ileum. Intestinal carcinoma is a late and relatively rare manifestation of its radiation injury.