consequences of radiation therapy. Possible side effects and effects 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 of electromagnetic radiation or beams of elementary nuclear particles that can kill tumor cells or restrain their growth and division.

Some healthy cells that enter the radiation area are also damaged, but most of them are able to recover. Tumor cells divide faster than surrounding healthy cells. Therefore, radiation affects them more detrimentally. It is these differences that determine the effectiveness of radiation therapy for cancer.

What types of cancer are treated with radiation therapy?

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

Irradiation can be used as an independent method of treatment. Sometimes RT is done before surgery to shrink the tumor or after it to kill any remaining cancer cells. Quite often, doctors use radiation in conjunction with anticancer drugs (chemotherapy) to destroy a tumor.

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

Radiation therapy equipment

To conduct RT, special complex devices are used that allow you to direct the flow of therapeutic energy to the tumor. These devices differ in principle of operation and are used for different purposes. Some of them are used to treat superficial cancers (skin cancer), others are more effective in treating tumors that are located deep in the body.

Which of the devices is better to use for the decision will be decided by your doctor.

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

If source:

• 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 a liquid, wire, needles, probes - interstitial.

Stages of radiation therapy

Three stages are conditionally distinguished during LT:

1. pre-beam;
2. ray;
3. post-beam.

Each of these stages has its own characteristics that determine the rules of your behavior. Their observance will improve the results of treatment and reduce the frequency of side effects.

The process of conducting radiation therapy

1. Preparation for treatment

During this period, additional studies are carried out in order to clarify the localization and assess the state of healthy tissues surrounding the pathological focus.

Before starting a course of radiation therapy, 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 tissues in the areas of the body to be treated.

What dose of radiation you need, how to carry it out and how many sessions you need for this, your doctor will decide.

A whole group of highly qualified specialists - physicists, dosimetrists, mathematicians - helps to carry out these complex calculations. Sometimes it takes several days to make a decision. This procedure is called planning.

During the simulation (planning) you will be asked to lie quietly on the table until the doctor determines the radiation field using a special X-ray machine. There may be several such areas. Irradiation fields are marked with dots or lines (marking), using special ink for this. This marking must remain on the skin until the end of the treatment. Therefore, while taking a shower, try not to wash it off. If lines and dots begin to fade, tell your doctor. Don't draw the dots yourself.

Already in the pre-beam period:

1. iodine tinctures and other irritants should not be used on areas of the skin that will be exposed to radiation;
2. should not sunbathe;
3. in the presence of diaper rash, rashes on the skin, it is necessary to indicate them to the attending physician. He will prescribe the appropriate treatment (powders, ointments, aerosols);
4. if radiation therapy will be carried out to treat a tumor of the maxillofacial region, preliminary sanitation of the oral cavity is necessary (treatment or removal of carious teeth). This is the most important measure for the prevention of radiation complications in the oral cavity.

2. How is the treatment session

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. Irradiation fields are designated by dots or lines (marking), using special ink for this.

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

Already in the pre-radiation period, tinctures of iodine and other irritants should not be used on areas of the skin that will be exposed to radiation. Should not sunbathe. In the presence of diaper rash, rashes on the skin, it is necessary to indicate them to the attending physician. He will prescribe the appropriate treatment (powders, ointments, aerosols).

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

Radiation therapy: how is the treatment

1. Choice of treatment regimen by radiotherapy

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

Typically, radiation therapy sessions are performed 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 tissues to recover.

The decision on the total dose of radiation 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.

2. How is the treatment session

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

Before turning on the unit, the medical staff moves 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 under control.

The radiation itself is painless. If you feel unwell during the exposure, inform your doctor immediately without taking any independent action. The unit can be turned off at any time.

Perhaps, 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 the completion of the course of treatment.

To obtain a good therapeutic effect, it is very important that you complete all the 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 process of radiation therapy is a significant burden on the body. Therefore, during treatment, you may develop a feeling of fatigue. In this regard, you should rest more. Go to bed when you feel the need to.

The sensation usually resolves 4-6 weeks after treatment is completed. However, physical activity, which increases the body's defenses and resistance to harmful influences, should not be completely avoided. You can get recommendations on the selection and dosage of physical activity from your doctor and exercise therapist.

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). Together with food, it is necessary to take 2.5-3 liters of liquid per day (fruit juices, mineral water, tea with milk).
2. Refuse, at least for the period of treatment, from bad habits (smoking, drinking alcohol).
3. Do not wear tight-fitting clothing on exposed areas of the body. Items made of synthetic fabrics and wool are highly undesirable. Loose old cotton clothing is preferred. Exposed areas of the skin should be kept as open as possible.
4. Be outdoors more often.
5. Take good care of your skin. Irradiated skin sometimes looks tanned or darkened. By the end of treatment, in some cases, the irradiated areas of the body may be excessively moistened (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 make appropriate recommendations.
6. Do not use soap, lotions, deodorants, ointments, cosmetics, perfumes, talcum powder, or other similar products on the exposed body area without consulting a doctor.
7. Do not rub or scratch the exposed skin area. Do not put warm or cold objects on it (heater, ice).
8. When going outside, protect the exposed part of the skin from the sun (light clothing, wide-brimmed hat).

What awaits the patient after irradiation?

Side effect of radiation

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

The side effect of radiotherapy is most often manifested in tissues and organs that have been directly exposed to radiation. Most of the side effects that develop during treatment are relatively mild and are treated with medication or through proper nutrition. They usually disappear within three weeks after the end of radiation therapy. Many patients have no side effects at all.

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

Common side effect of radiotherapy

Emotional condition

Almost all patients undergoing cancer treatment experience some degree of emotional stress. Most often there is a feeling of depression, fear, melancholy, loneliness, sometimes aggression. As the general condition improves, these emotional disturbances become blunted. Communicate more often with family members, close friends. Don't lock yourself in. Try to take part in the lives of the people around you, help them and do not refuse their help. Talk to a psychotherapist. Perhaps he will recommend some acceptable methods of stress relief.

Fatigue

The feeling of fatigue usually begins to be felt a few weeks after the start of treatment. It is associated with a 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 busy pace. However, do not completely withdraw from household chores, take part in family life. Do more things that you like, read more, watch TV, listen to music. But only until you feel tired.

If you do not want other people to know about your treatment, you can take a leave of absence for the period of treatment. If you continue to work, talk to your supervisor - 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 completion of treatment, the feeling of fatigue gradually disappears.

Blood changes

When irradiating large areas of the body in the blood, the number of leukocytes, platelets and erythrocytes may temporarily decrease. The doctor monitors the function of hematopoiesis according to a blood test. Sometimes, with pronounced changes, a break in treatment is made for one week. In rare cases, drugs are prescribed.

Loss of appetite

Radiotherapy 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 should eat enough food. Even if there is no feeling of hunger, it is necessary to make an effort and provide a high-calorie, high-protein diet. It will allow you to better cope with side effects and improve the results of cancer treatment.

A few nutritional tips for radiation therapy:

1. Eat a variety of foods often, but in small portions. Eat when you feel like it, regardless of the daily routine.
2. Increase the calorie content of food - add more butter if you like its smell and taste.
3. Use a variety of sauces to increase your appetite.
4. In between meals, use kefir, a mixture of milk with butter and sugar, yogurt.
5. Drink more liquids, juices are better.
6. Always keep a small supply of foods you like (that are approved for storage in the clinic where you are being treated) and eat them when you have a craving for something to eat.
7. While eating, try to create conditions that increase your mood (turn on the TV, radio, listen to your favorite music while eating).
8. Ask your doctor if you can drink a glass of beer with your meal to increase your appetite.
9. If you have any medical condition that requires you to follow a particular diet, talk to your doctor about how to diversify your diet.

Side effects on the skin

The reaction of the skin to radiation is manifested by its redness in the area of ​​exposure. In many ways, the development of this phenomenon is determined by your individual sensitivity to radiation. Usually redness appears on the 2-3rd week of treatment. After the completion of radiation therapy, the skin in these places becomes a little dark, as if tanned.

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

Before the session, it is necessary 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 turn red. Sometimes, with a pronounced radiation reaction of the skin, a short break in treatment is made.

For more information about skin care, contact your healthcare provider.

Side effects on the mouth and throat

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

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

You can alleviate your condition by following 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 should be at room temperature or refrigerated. What solutions are best to rinse the mouth, you can ask your doctor.
3. Twice a day, gently, without pressing hard, brush your teeth with a soft toothbrush or cotton swab (rinse the brush thoroughly after use and store dry).
4. Consult with your dentist regarding the selection of the right toothpaste. It should not be sharp and irritate the mucous membrane.
5. If you use prostheses, remove them before your radiation therapy session. In case of rubbing gums with prostheses, it is better to temporarily stop using them altogether.
6. Avoid acidic, spicy foods.
7. Try to eat soft foods (baby food, purees, cereals, puddings, jellies, etc.). Soak hard and dry food in water.

Side effects on the mammary gland

When performing 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 recommendations for skin care, you should refuse to wear a bra for the period of treatment. If you are uncomfortable without it, use a soft bra.

Under the influence of radiation therapy in the area of ​​the breast, pain and swelling may occur, which will disappear or gradually decrease after the treatment is completed. The irradiated mammary gland can sometimes increase (due to fluid accumulation) or decrease (due to tissue fibrosis).

In some cases, these deformations of the shape of the gland can persist for the rest of life. For more information about the nature of changes in the shape and size of the breast, you can find out from your doctor.

Radiation therapy can lead to poor movement in the shoulder. Consult with an exercise therapy specialist what exercises should be done to prevent this complication.

In some patients, radiation therapy can lead to swelling of the arm on the side of the treated gland. This edema can develop even 10 or more years after the completion of treatment. Therefore, it is necessary to carefully monitor the condition of the hand and adhere to some rules of conduct:

1. Avoid heavy lifting (no more than 6-7 kg), vigorous movements that require excessive effort (pushing, pulling), carrying a bag over your shoulder on the side of the irradiated breast.
2. Do not allow blood pressure measurements or injections (drawing blood) into the arm on the radiation side.
3. Do not wear tight-fitting jewelry or clothing on this arm. In case of accidental damage to the skin of the hand, treat the wound with alcohol (but not alcohol tincture of iodine!) And seal 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 even experience occasional swelling of your arm that goes away after a night's sleep, contact your doctor immediately.

Side effects on the chest

During the course of radiation therapy, you may find it difficult to swallow due to radiation inflammation of the esophageal mucosa. You can make eating easier by eating more often, in smaller portions, 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, a fever, a change in the color of sputum, and shortness of breath. If you notice these symptoms, tell your doctor immediately. He will prescribe a special drug treatment.

Side effect 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 bloody discharge may appear, especially with difficult stools.

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, prunes 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, an increase in 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 the 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 check-ups with your 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 of further observation will be made by the doctor of the polyclinic or dispensary. The same specialists, if necessary, will prescribe you further treatment or rehabilitation.

Symptoms in 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 a few days;
2. nausea, diarrhea, loss of appetite;
3. fever, cough;
4. the appearance of a tumor, swelling, unusual rashes on the skin;
5. development of limb edema on the irradiation side.

Care for irradiated skin

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

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

Remember: slight pain in the irradiated area is common and fairly common. If it occurs, you can take mild painkillers. In case of severe pain, a doctor's consultation is necessary.

Relationships with relatives and friends

During radiation therapy, your body does not become 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 the closest people for a joint conversation with your doctor.

intimate relationship

In most cases, radiation therapy does not have a pronounced effect on sexual activity. The decrease in interest in intimate relationships is mainly due to 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

In outpatient radiotherapy, 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 activities as soon as you feel that your condition allows you to do so.

If your work is associated with strenuous physical activity or occupational hazards, you should think about changing the working conditions or profession.

Leisure

Pay more attention to rest. Over time, you will restore your strength, so do not return to physical activity in full at once. Visit theaters, exhibitions. This will allow you to distract from 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 a physiotherapist and a psychotherapist. They will help you choose an adequate physical activity (improving gymnastics) and suggest ways to overcome stress.

Conclusion

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

For more information on matters related to your health, please contact your doctor.

Treatment results. Photos before and after

According to CT data, the patient was inoperable before treatment, and after preoperative chemoradiotherapy, she was subsequently successfully operated on.

Tumor of the rectum. CT before treatment

When performing 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 the tolerability of the treatment.

Cancer of the anal canal. CT before treatment

When conducting chemoradiotherapy for anal cancer, the VMAT technique allows achieving a highly conformal isodose distribution, improving treatment tolerance (avoiding the development of reactions from the intestines - diarrhea, bladder - cystitis, genital organs).

CT after chemoradiotherapy

Postoperative radiation therapy for breast cancer using the IMRT method reduces the risk of damage to the heart and lung tissue.

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

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

Leading clinics abroad

What is cancer treatment with radiation?

Irradiation is a method of treating cancer using high-energy radiation (specifically x-rays). The type of radiation exposure, as well as its amount, must be carefully calculated before starting therapy (in such a quantity that 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 as a separate one, but nevertheless, it is most often used in combination with other methods of fighting cancer.

Irradiation 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 done during or after chemotherapy or hormone therapy to improve overall results.

Although this treatment is sometimes called radical, radiation therapy is designed to provide a long-term effect for a person with cancer.

This palliative treatment aims to shrink the tumor, reduce pain, and relieve other symptoms of cancer. In addition, palliative radiotherapy can prolong the life of a cancer patient.

Leading specialists of clinics abroad

Cancer after radiation - what to expect? Consequences and complications

As already mentioned, radiation can cause damage and destruction of normal cells, as well as cause some side effects in the process of cancer cell decay. 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 of doing so would outweigh the benefit. Also, the attending physician is obliged to inform you if this treatment in your case may adversely affect your health and provoke individual consequences. You must receive all necessary information in writing.

If a female is exposed to radiation, then at the time of therapy, she should by no means be in position, 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 various organs and tissues. This method can significantly increase the survival of patients, as well as alleviate their condition in the 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 how already known diseases of various organs and systems “look like”. Inspired by the possibilities of using X-rays and experiencing a feeling akin to euphoria, scientists began to use it not only for diagnostic purposes, but also for treatment. So it became known about the detrimental effect of x-rays on tumors, which decreased in size, and patients felt significant relief.

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

Today, radiation therapy is considered one of the main methods of cancer treatment, and in some cases it allows you to refuse surgery, leading to a complete cure. The number of side effects has significantly decreased due to the possibility of targeted action of radiation on the 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 impact of various types of ionizing radiation on tumor tissue. Since cancer cells divide very quickly, they are very sensitive to various kinds 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 oncopathology, a violation of the division process. The result of irradiation is a decrease in the size of the tumor 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 undesirable consequences. In parallel with chemotherapy and surgical treatment, radiotherapy contributes to the rapid improvement of the condition of patients, and in favorable cases, the complete removal of the tumor from the body.

Irradiation in cancer is possible both independently, especially in the case of superficially located tumors (skin, for example), and combined with chemotherapy and surgery. Radiotherapy performed before surgery helps to reduce the size of the tumor, reduce the risk of detachment and entry of cancer cells into the blood and lymphatic vessels, and, therefore, the effectiveness of treatment as a whole will be much higher. In the case of advanced forms of cancer, if available, the use of radiation energy makes it possible not only to improve the life of patients and reduce the severity of pain, but also prevents further spread of cancer cells throughout the body, and existing metastatic nodes undergo regression.

Often, radiotherapy is given after surgery, when there is a chance of leaving tumor cells at the site of cancer growth. This approach allows you to destroy all the cells and avoid the recurrence 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 tissues, doses are determined individually, divided into several sessions, in contrast to chemotherapy, which most often uses standard treatment regimens.

The types of radiation therapy are determined by the radiation used:

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

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

Methods of radiation therapy depend on the method of exposure to the tumor tissue:

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

The very promising and effective method of treating tumors with proton beams. Accelerated in special accelerators, protons reach their destination and give off a maximum of radioactive radiation in the last millimeters of their run. In other words, only a small amount of radiation energy is scattered along the path to the tumor, and it does not spread to the tissues behind the tumor node at all. This feature allows minimizing the damaging effect of radiation on healthy organs and tissues with high efficiency within the neoplasm itself.

The ability to focus the proton beam strictly on the tumor tissue and the low likelihood of side effects is a great advantage in the treatment of children in whom secondary tumors after conventional irradiation can become a real problem. In addition, before the use of proton therapy, such a tumor as retinal melanoma inevitably ended with 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, while the patient does not experience the severe consequences of adaptation, as after surgical treatment.

For many years, this technique was available only in the conditions of 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 are still of very limited use, and proton therapy centers are only being built. This is due to the high cost of equipment, the need to equip facilities that provide reliable radiation protection, where the wall thickness 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 the appropriate equipment gives hope for the availability of proton therapy in the future for the majority of oncological patients.

Radiosurgery successfully used to treat brain tumors

Another modern and very effective method of radiation therapy is the use of radiosurgery, when the radiation beam is focused in a strictly defined place, causing cell death and destruction of neoplasms. Radiosurgery is successfully used to treat not only malignant, but also benign brain tumors (meningioma, pituitary adenoma, etc.), especially those that are difficult to access for conventional surgical intervention. Stereotactic radiosurgery (popularly known as the "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 case of benign tumors. The patient at this time is under the dynamic supervision of specialists.

Stages of radiation therapy

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

• Preradiation.
• Ray.
• Postradiation.

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

Prebeam period is perhaps the most important, because the correct planning of procedures, the calculation of the dose and method of influencing the tumor determine the final result. It is also important to take care of the condition of healthy tissues, which in one way or another can be exposed to radiation.

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

Planning in the prebeam period may require not only the efforts of specialists and several days of their hard work. To accurately determine all the parameters of radiation therapy, additional studies and the help of modern computer technology are indispensable, since only the device can calculate the entire path of the radioactive beam to tumor cells with an accuracy of a millimeter, 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 according to the results of CT, MRI, radiography. The doctor marks the borders of the tumor and the irradiated area on the body with a special marker, and if it is necessary to switch to another irradiating device, “zeroing” is performed automatically according to the existing marks. The patient should be aware that the marks must be kept until the end of the treatment, so washing them off while showering should be avoided, and if this happens, the nurse or doctor should be informed, who will correct the situation.

What are the basic rules of behavior in the pre-beam period? First, one should try to keep the marking at the irradiation site. Secondly, you do not need to sunbathe or use various creams, irritants, perfumes, iodine in the area of ​​​​the intended exposure. Finally, if there are lesions on the skin, dermatitis, diaper rash or a rash, then it is worth informing the doctor about this, who will help 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 putting the oral cavity in order as a whole.

Beam 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 of the size of the neoplasm, 2-3 weeks are enough. Sessions are carried out daily five days a week, with a two-day break to restore the skin and tissues involved in radiation exposure. If the daily radiation dose is large, then it can be divided into several sessions.

The treatment is carried out in a specially equipped cabinet with radiation protection, and the staff leaves it for the duration of the procedure, while the patient has a connection with the doctor through a loudspeaker. The patient is placed on a table or chair, the radiation source is set to the desired area, and the surrounding tissues are covered with protective blocks. At the time of the procedure, the table or emitter may move in space or create noise, which should not be frightening and which the nurse usually warns about.

The procedure is painless, lasts 5-10 minutes, during which the patient must maintain the accepted position of the body, do 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 minerals. You should not deny yourself carbohydrates, the proportion of which can be 3-4 times 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), using juices, compotes, tea, and mineral water.
2. During treatment, smoking and drinking alcohol should be completely excluded, although it is better to get rid of bad habits completely and forever.
3. Particular attention should be paid to areas of the skin that are in the irradiation zone. Clothing should be made of natural fabrics (cotton, linen), loose, not adjacent to the places of exposure to radiation. If possible, these areas are best kept open at all, but protected from the sun when going outside.
4. It is better to postpone the use of cosmetics and perfumes for later, it is better not to use even soap, so as not to overdry already dry skin. When taking a shower, you need to remember the marks in the radiation zone.
5. If redness, dryness, itching, 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 for all cancer patients, such as walking in the fresh air, good sleep, adequate physical activity, apply to the period of radiation therapy.

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

In the case of cancer, irradiation before surgery is most effective, and in some cases, chemoradiotherapy is sufficient to cure even without surgical removal of the tumor. In addition to remote exposure, there are techniques with the introduction of 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, when 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, impaired urination, etc.).

Neoplasms of the female genital organs involve remote irradiation of the pelvic area, and with radiation therapy is often of paramount importance. So, if in the case of microinvasive cancer, irradiation is carried out in the postoperative period, then at II-III stages 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, helping only 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 side effects are either completely absent, or expressed insignificantly. Nevertheless, there are still some consequences and you need to know about them in order not to get confused and seek the necessary help in time.

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

Due to the presence of a tumor, as well as the need to undergo all kinds of studies and medical procedures that are not always pleasant for the patient, emotional disorders may occur. It can be apathy, a feeling of melancholy or anxiety, and sometimes depression. It is very important not to withdraw into oneself, to try to communicate more with friends and family, if possible, to maintain the usual rhythm of life, but reducing overall activity to such an extent that there is no feeling of fatigue. You should not give up household chores, hobbies, hobbies, and if you have a desire to lie down to rest, then plans can be postponed for a while. Walking and socializing help many patients return to their previous lifestyle and improve their mood.

The feeling of fatigue often accompanies radiation therapy, since the burden on the body associated with the procedures, as well as the destruction of the tumor, require significant energy costs and may be accompanied by metabolic changes. During this period, it is recommended to rest more, arrange a short daytime sleep, 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 the end of treatment, you should regularly visit a doctor to monitor the condition and results of the therapy. Observation is usually carried out by an oncologist at a polyclinic or oncology dispensary, who determines the frequency of examinations. In the event of a sudden deterioration in the condition, the development of pain, disorders of 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 irradiation, and almost always suffers during remote radiation therapy. At least a year after the end of the course of irradiation, the skin should be protected from the sun and various damage. Skin areas that were in the area of ​​​​radiation should be lubricated with a nourishing cream, even if there are no signs of inflammation or burns. It is better for those who like a bath or a bath to temporarily abandon these procedures, replacing them with a shower, and skin-irritating products and hard washcloths should be removed away.

Sometimes patients may experience communication difficulties due to the lack of awareness of others about oncology and its treatment. Thus, some believe that people who have undergone radiation therapy themselves are capable of emitting radiation, 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, do not give up on intimate relationships, because this is part of a fulfilling 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, it is worth diversifying your leisure time. It can be visiting the theater, exhibitions, doing your favorite hobbies, walking and meeting with friends. It is important to be distracted from the painful thoughts that may accompany all stages of the treatment of 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 fatigue, weakness, changes in emotional state, and bone marrow damage caused by radiation. If it is necessary to irradiate large areas of the body, one way or another, constantly renewing blood cells suffer, their maturation in the bone marrow is disturbed, which is manifested by a decrease in the number of leukocytes, erythrocytes, and platelets. The patient regularly undergoes blood tests to monitor its components, and if necessary, appropriate treatment is prescribed or the radiation course is suspended for a week.

Other common effects of radiation therapy include hair loss, nail deterioration, decreased appetite, nausea, and even vomiting. These changes are most often associated with irradiation of the head area, organs of the gastrointestinal tract, as well as with the decay of tumor tissue under the influence of radiation. After the end of 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, nausea do not contribute to eating, and, meanwhile, the need for nutrients is quite high. If the feeling of hunger does not arise, that is, it is necessary, as they say, "through I do not want." Since the list of recommended products is quite large, there is no need to limit yourself to sweets, meat and fish dishes, fruits, juices. The diet should be high in calories and saturated with all the necessary substances.

When cooking, you need to follow some rules:

The most frequently observed local complications of radiation therapy in the form of skin reactions. After several sessions of irradiation, reddening of the skin is possible, which eventually disappears, leaving pigmentation behind. Some patients complain of a feeling of dryness, itching, burning, peeling of the skin in the radiation area. With proper care and respect, 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 dose of radiation, the presence of individual sensitivity to radiation, and comorbidities, such as diabetes mellitus.

To avoid such troubles, after the procedure, treat the irradiation site with a moisturizer, oils, and protect the skin from sunlight. In case of severe skin damage, the doctor may recommend medications containing corticosteroids, so any change in health should be reported to the doctor.

When irradiating the organs of the head or neck, the damaging effect of radiation on the mucous membrane of the mouth and throat is possible, therefore, again, some guidelines must be followed:

• Stop smoking, alcohol, irritating food;
• Using a soft toothbrush and gently brushing your teeth;
• Rinsing the mouth with a decoction of chamomile or other solutions recommended by the attending physician.

With radiotherapy of the chest organs, cough, difficulty breathing, soreness and swelling in the breast area are possible. In the treatment of tumors of the rectum, there may be a tendency to constipation, blood in the feces, abdominal pain, so it is important to follow a diet that prevents retention of contents in the intestines.

Any deterioration in health, the appearance of these changes, it is necessary to inform the attending physician, who will help with the appointment of additional treatment.

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

Thus, even taking into account possible side effects, radiation therapy should not be abandoned, because it gives a chance for a favorable outcome of the disease, which without it dooms 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 health to your doctor.

Video: reportage on radiotherapy

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

Is radiation therapy. It was revealed that young, malignant cells cease to multiply under the influence of radioactive radiation.

concept

In radiation therapy, the effect of ionized learning occurs. His goals:

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

It is used in combination with surgical treatment and chemotherapy.

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

Strengthening the effect is also achieved due to the fact that the doctor can correct the direction of the rays. This makes it possible to use the maximum doses in the lesion.

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

Video about pre-beam preparation:

Indications

The method is used in 60-70% of patients with cancer. It is considered the main one for the treatment of tumors that are characterized by a high degree of radiosensitivity, rapid progression, and also with some 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,
• uterine body,
• some other organs.

Types of radiation therapy

There are several treatments. Alpha radiation involves the use of isotopes, such as radon, thoron products. This type has a wide type of application, positively affects the central nervous system, endocrine system, heart.

Beta therapy is based on a 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 interstitial, intracavitary, application.

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

Radiation therapy is also divided for other reasons.

Contact

The view differs from the rest in that the sources of rays are located directly on the tumor. It is typical for him to distribute the dose so that its main part remains in the tumor.

The method is good if the size of the formation is not more than 2 cm. This type is divided into several types.

Name	Peculiarities
close focus	Irradiation affects the formation cells themselves.
intracavitary	The radiation source is introduced into the body cavities. It remains throughout the course of contact radiation therapy.
Interstitial	The radiation source is injected into the tumor. The impact is continuous.
Radiosurgical	Rays are exposed after a surgical operation. The place where the tumor was located is exposed to radiation.
Application	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 at some distance from the human body. the beam enters the body through a certain area.

Gamma therapy is more commonly used. This method is good because it allows you to bring a high dose of radiation to the formation, while keeping healthy cells intact.

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

In modern oncological dispensaries, the method is rarely used. The mobile technique allows you to direct the source along different trajectories. This provides the most efficiency.

Radionuclide

The specificity lies in the introduction of radiopharmaceuticals into the patient's body. They affect hearths. Targeted delivery of substances generates very high doses in the foci with little side effects and minimal damage to healthy tissues.

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

Radiative forcing when 3D exposure planning is used to obtain the shape of the field. The method makes it possible to deliver adequate doses of radiation to tumors. This greatly increases the chance of a cure.

To exclude the exit of the tumor from the irradiated area, special devices are used, for example, equipment for active control of breathing.

Proton

Radiation therapy based on the use of protons, which are accelerated to large 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 surface cells is minimal. The radiation does not scatter through the patient's body.

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

intracavitary

This species has several types. Allows for the prevention of recurrence and metastasis. The source is introduced into the body cavity and remains during the entire irradiation session.

It is used to create the maximum dose in tumor tissues.

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

stereotactic

This method allows to reduce the time of cancer treatment.

It is used for the treatment of internal organs, the circulatory system. The rays act very precisely on the tumor.

Photo of stereotactic radiotherapy

It is carried out with full control over the location of the tumor, allows you to adjust to the patient's breathing and any other movement.

The result of such exposure is not immediately visible, but after a few weeks, since the tumor cells die off gradually.

Contraindications

There are several situations when radiation therapy is contraindicated:

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

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

How is radiation therapy performed?

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

In the process of radiation treatment, the patient is in the supine position. It is important not to move during radiation, as this can cause the rays to damage healthy tissue. If a person cannot move for a long time, then the doctor fixes the patient or area of ​​the body.

Some parts of the machines can move and make noise, you should not be afraid of it. Already at the beginning of treatment, it is possible to reduce pain, but the greatest effect is achieved after the completion of the course.

Course duration

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

Most of the time is taken by the correct positioning of the patient and the direction of the device for irradiation. The process itself takes several minutes. The staff will leave the premises during this time.

The course is 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, as well as reduce the risk of side effects.

If the throat or mouth was exposed to radiation, then it is recommended to rinse the mouth with decoctions of herbs or sea buckthorn oil to relieve discomfort.

Symptoms after exposure

After a course of radiation therapy, you may experience:

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

If the impact was carried out on the chest area, there is shortness of breath, shortness of breath, cough.

Consequences

The skin is most often affected. She becomes tender, sensitive. Can change color.

The reaction of the skin to radiation is about the same as with a sunburn, but it develops gradually.

There may be blisters. In the absence of proper care, such areas can become infected.

If the organs of the respiratory system were exposed, then radiation injuries develop over the next three months. An unproductive cough appears, body temperature rises, and general well-being worsens.

Experts note that often side effects are:

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

Recovery after radiation

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

Burn treatment

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

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

How to raise white blood cells after radiotherapy?

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

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

What to do with temperature?

Temperature in most cases is a sign of infection. After radiation therapy, it takes a long time to restore immunity.

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

Pneumonitis

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

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

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

Haemorrhoids

For treatment, it is necessary to strictly observe a diet and bed rest, use medicines and traditional medicine. Radiation radiation leads to a violation of the maturation of the epithelium, inflammatory processes on the mucous membranes.

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

Proctitis

To eliminate the problem, laxatives, cleansing enemas are used. High efficiency was shown by a warm shower directed to the area of ​​the rectum, baths with potassium permanganate.

The doctor may prescribe hormones, rectal suppositories, and anesthetics.

Diet food

Good nutrition is one of the main methods of treatment of radiation damage. you need to take soft foods. If the oral cavity has suffered from irradiation, then it is effective to use oil, a solution of novocaine.

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

It is contraindicated to use foods containing a large amount of cholesterol, fatty meat, mushrooms, tangerines, sausage.

Answers on questions

• How is chemotherapy different from radiotherapy?

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

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

• Does hair fall out after radiation therapy?

After exposure to radiation, the hair falls out only at the site of the passage of the rays. Usually doctors warn about the possibility of baldness. It is best in this case to make a short haircut.

For hair care from the start of treatment, use a wide-toothed comb or buy a newborn comb. Before going to bed, use a special sleep net so that the hair is not pressed and pulled out.

• Can you get pregnant after radiation therapy?

Many treatments leave a negative mark, affect reproductive functions. After radiation therapy, it is recommended to protect yourself for several years.

This will allow the body to recover, to give birth to a healthy child. The oncologist usually says the term, depending on the stage of the cancer, the results of the treatment.

Radiation oncology (interventional radiology)- a field of medicine in which the use of ionizing radiation for the treatment of oncological diseases is being investigated. In general terms, the method can be described as follows. Corpuscular 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 tissues. Radiation is one of the three main methods of fighting cancer, along with surgery and chemotherapy.

Classification of methods of radiation oncology

First, different types of radiation should be distinguished.

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

• γ-radiation,
• bremsstrahlung radiation.

Secondly, there are various ways to sum it up.

• contact therapy. In this method, the emitter is brought directly to the tumor. In most cases, implementation requires surgical intervention, 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 oncogynecological and oncourological diseases. As an additional - with external (remote) irradiation.

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

External (remote) exposure :

With such exposure, the emitter is located at a distance from the area containing the malignant tumor. The method is the most versatile, 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 implementation 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 the characteristics of the beam). Many innovations have been made in this direction, including:

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

Modern installations for radiotherapy are the most complex and expensive devices that combine the achievements of engineering from many technological fields. To date, 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: the irradiation technique is constantly being improved and has undergone many changes over time. Currently, RT is one of the most common methods of cancer treatment. 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). Also, LT is used for palliative purposes.
• Radiosurgery. A relatively new direction in interventional radiology, which is characterized by the use of highly focused radiation of increased intensity. The procedure takes place in fewer sessions compared to LT. So far, the field 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 tissues occur. The beginning of these processes are 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 only give a few examples.

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

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

• Beam reactions. Violations are temporary and disappear after a certain time (up to several weeks).
• radiation damage. Irreversible effects of exposure.

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 rational oncology is to find the optimal balance between the beneficial effects of radiation and minimizing the risk of complications.

In more detail, the most characteristic side effects and peculiarities of irradiation are considered for specific types of oncological diseases to which radiation therapy is applicable. See the following materials

Minimizing Complications

Since the field's inception, radiation oncology has evolved in the direction of minimizing side effects. Along the way, many innovations have been developed. Consider the basic techniques that are used by specialists to reduce the risk of damage to healthy tissues.

X-ray range

High-intensity X-ray radiation allows you to influence deep tissues, while slightly damaging the surface ones: the beam passes through the skin, almost without losing 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: proton therapy, for example, opens up wide prospects.

Precise summing

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

Today, the use of a computer model of the tumor process has become the gold standard for RT and radiosurgery: such models are used to calculate the irradiation strategy. In Cyberknife, for example, supercomputer computing is used for this.

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

• Fixing Methods. Often, radiation therapy lasts 30-40 courses, and at the same time it is necessary to maintain accuracy within half a centimeter. For these purposes, various methods of fixing the position of the patient are used.
• Respiratory control. Irradiation of moving organs presents a significant difficulty: several methods have been developed to monitor the patient's breathing and either correct the direction of exposure or suspend it until it returns to the allowable range of positions.

Irradiation from different angles

Except in rare cases where changing the angle at which the beam is directed is not possible, this method is always used. This technique allows you to evenly distribute 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 spatial rotation / movement (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 embrace are selected individually for each case, thanks to which it is possible to optimize the effectiveness of therapy.

Modulation

In addition to the direction of impact, 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 distribution of intensity - to reduce the dose of radiation, for the tissues bordering with the tumor, and, conversely, to increase for the tumor focus.

Similar methods have been used since the 1990s. when intensity modulation technology was invented. At first, the devices allowed the use of only a few (1-7) irradiation directions (for each of which the optimal beam characteristics were calculated in advance) during one session. Now appeared multileaf collimators(beam shaping device), which can quickly recreate various 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.