Radiotherapy consequences in oncology. Radiation therapy in oncology: benefits and consequences

Radiation therapy is the effect of ionizing radiation on the patient’s body. chemical elements, possessing pronounced radioactivity for the purpose of curing tumor and tumor-like diseases. This research method is also called radiotherapy.

Why is radiation therapy needed?

The basic principle that formed the basis of this section clinical medicine, the tumor tissue, consisting of intensively multiplying young cells, became highly sensitive to radioactive radiation. Most Applications received radiation therapy for cancer (malignant tumors).

Objectives radiation therapy in oncology:

Damage, followed by death, cancer cells when affecting both the primary tumor and its metastases to internal organs.
Limiting and stopping the aggressive growth of cancer into surrounding tissues with the possible reduction of the tumor to an operable state.
Prevention of distant cell metastases.

Depending on the properties and sources of the beam beam, there are the following types radiation therapy:

It is important to understand that a malignant disease is, first of all, a change in behavior various groups cells and tissues of internal organs. Various options the relationship between these sources of tumor growth and the complexity, and often unpredictability, of cancer behavior.

Therefore, radiation therapy for each type of cancer gives a different effect: from complete cure without the use of additional treatment methods, to absolutely zero effect.

As a rule, radiation therapy is used in combination with surgical treatment and the use of cytostatics (chemotherapy). Only in this case can you count on positive result and good prognosis for future life expectancy.

Depending on the location of the tumor in the human body, the location near it is vital important organs and vascular highways, the choice of irradiation method occurs between internal and external.

Internal exposure produced by introducing a radioactive substance into the body through the alimentary tract, bronchi, vagina, bladder, by introducing it into blood vessels or by contact during surgical intervention (incision of soft tissues, spraying of the abdominal and pleural cavities).
External irradiation is carried out through skin and it can be general (in very rare cases) or in the form of a focused beam beam on a specific area of the body.

The source of radiation energy can be both radioactive isotopes of chemicals and special complex medical equipment in the form of linear and cyclic accelerators, betatrons, and gamma installations. A common X-ray unit used as a diagnostic equipment can also be used as healing method effects in some types of cancer.

The simultaneous use of internal and external irradiation methods in the treatment of a tumor is called combined radiotherapy.

Depending on the distance between the skin and the source of the radioactive beam, the following are distinguished:

Remote irradiation (teletherapy) – distance from the skin 30-120 cm.
Close-focus (short-focus) – 3-7 cm.
Contact irradiation in the form of application to the skin, as well as external mucous membranes, of viscous substances containing radioactive drugs.

How is the treatment carried out?

Side effects and consequences

Side effects Radiation therapy can be general and local.

Common side effects of radiation therapy:

Asthenic reaction in the form of deterioration in mood, the appearance of symptoms of chronic fatigue, decreased appetite with subsequent weight loss.
Changes in the general blood count in the form of a decrease in red blood cells, platelets and leukocytes.

Local side effects of radiation therapy include swelling and inflammation at the sites of contact of the beam or radioactive substance with the skin or mucous membrane. In some cases, the formation of ulcerative defects is possible.

Recovery and nutrition after radiation therapy

The main actions immediately after a course of radiation therapy should be aimed at reducing intoxication that can occur during the breakdown of cancer tissue - which is what the treatment was aimed at.

This is achieved using:

Drink plenty of water while maintaining the excretory functions of the kidneys.
Eating foods rich in plant fiber.
Applications vitamin complexes With sufficient quantity antioxidants.

Reviews:

Irina K., 42 years old: Two years ago I underwent radiation after I was diagnosed with cervical cancer in the second clinical stage. For some time after treatment there was terrible fatigue and apathy. I forced myself to go to work earlier. The support of our women's team and work helped me get out of depression. The nagging pain in the pelvis stopped three weeks after the course.

Valentin Ivanovich, 62 years old: I underwent radiation after I was diagnosed with laryngeal cancer. I couldn’t talk for two weeks – I had no voice. Now, six months later, hoarseness remains. No pain. There was a slight swelling left with right side throat, but the doctor says that this is acceptable. There was a slight anemia, but after taking pomegranate juice and vitamins, everything seemed to go away.

Thank you

What is radiation therapy?

Radiation therapy ( radiotherapy) is a set of procedures associated with exposure to various types of radiation ( radiation) on fabric human body for the purpose of treatment various diseases. Today, radiation therapy is used primarily to treat tumors ( malignant neoplasms). Mechanism of action this method is the impact ionizing radiation (used during radiotherapy) on living cells and tissues, which causes certain changes in them.

To better understand the essence of radiation therapy, you need to know the basics of tumor growth and development. IN normal conditions every cell in the human body can divide ( multiply) only a certain number of times, after which the functioning of its internal structures is disrupted and it dies. The mechanism of tumor development is that one of the cells of any tissue escapes the control of this regulatory mechanism and becomes “immortal”. It begins to divide an infinite number of times, as a result of which a whole cluster of tumor cells is formed. Over time, new tumors form in the growing tumor. blood vessels, as a result of which it increasingly increases in size, squeezing surrounding organs or growing into them, thereby disrupting their functions.

As a result of many studies, it has been established that ionizing radiation has the ability to destroy living cells. The mechanism of its action is to damage the cell nucleus, in which the genetic apparatus of the cell is located ( that is, DNA is deoxyribonucleic acid). It is DNA that determines all the functions of the cell and controls all the processes occurring in it. Ionizing radiation destroys DNA strands, making further cell division impossible. In addition, when exposed to radiation, it is destroyed and internal environment cells, which also disrupts its functions and slows down the process of cell division. It is this effect that is used to treat malignant neoplasms - disruption of cell division processes leads to a slowdown in tumor growth and a reduction in its size, and in some cases even to a complete cure of the patient.

It is worth noting that damaged DNA can be repaired. However, the rate of its recovery in tumor cells is significantly lower than in healthy cells of normal tissues. This allows the tumor to be destroyed, while at the same time having only a minor effect on other tissues and organs of the body.

What is 1 gray equal to in radiation therapy?

When the human body is exposed to ionizing radiation, part of the radiation is absorbed by the cells of various tissues, which causes the development of the phenomena described above ( destruction of the intracellular environment and DNA). The severity of the therapeutic effect directly depends on the amount of energy absorbed by the tissue. The fact is that different tumors react differently to radiotherapy, as a result of which different doses of radiation are required to destroy them. Moreover, the more radiation the body is exposed to, the greater the likelihood of damage to healthy tissues and the development of side effects. That is why it is extremely important to accurately dose the amount of radiation used to treat certain tumors.

To quantify the level of absorbed radiation, the unit of measurement used is Gray. 1 Gray is a dose of radiation at which 1 kilogram of irradiated tissue receives an energy of 1 Joule ( Joule is a unit of energy measurement).

Indications for radiation therapy

Today, various types of radiotherapy are widely used in various fields of medicine.

For the treatment of malignant tumors. The mechanism of action of the method has been described previously.
In cosmetology. The radiotherapy technique is used to treat keloid scars - massive growths connective tissue formed after plastic surgery, as well as after injuries, purulent skin infections and so on. Hair removal is also performed using irradiation ( depilation) on various areas bodies.
For the treatment of heel spurs. This disease is characterized by pathological growth bone tissue in the heel area. The patient experiences severe pain. Radiotherapy helps to slow down the process of bone tissue growth and subsidence of inflammatory phenomena, which, in combination with other treatment methods, helps get rid of heel spurs.

Why is radiation therapy prescribed before surgery, during surgery ( intraoperatively) and after surgery?

Radiation therapy can be used as an independent treatment strategy in cases where a malignant tumor cannot be completely removed. At the same time, radiotherapy can be administered simultaneously with surgical removal of the tumor, which will significantly increase the patient's chances of survival.

Radiation therapy may be prescribed:

Before the operation. This type of radiotherapy is prescribed in cases where the location or size of the tumor does not allow its removal surgically (for example, the tumor is located near vital organs or large blood vessels, as a result of which its removal is associated with a high risk of death of the patient on the operating table). In such cases, the patient is first prescribed a course of radiation therapy, during which the tumor is exposed to certain doses of radiation. Some of the tumor cells die, and the tumor itself stops growing or even decreases in size, making it possible to surgically remove it.
During the operation ( intraoperatively). Intraoperative radiotherapy is prescribed in cases where, after surgical removal of the tumor, the doctor cannot 100% exclude the presence of metastases ( that is, when the risk of tumor cells spreading into neighboring tissues remains). In this case, the location of the tumor and nearby tissues are subjected to a single irradiation, which makes it possible to destroy tumor cells, if any remain after removal of the main tumor. This technique can significantly reduce the risk of relapse ( re-development of the disease).
After operation. Postoperative radiotherapy is prescribed in cases where, after tumor removal, there remains a high risk of metastasis, that is, the spread of tumor cells to nearby tissues. Also, this tactic can be used when a tumor grows into neighboring organs, from where it cannot be removed. In this case, after removing the main tumor mass, the remnants of the tumor tissue are irradiated with radiation, which makes it possible to destroy the tumor cells, thereby reducing the likelihood of further spread of the pathological process.

Is radiation therapy necessary for a benign tumor?

Radiotherapy can be used for both malignant and benign tumors, but in the latter case it is used much less frequently. The difference between these types of tumors is that a malignant tumor is characterized by rapid, aggressive growth, during which it can grow into neighboring organs and destroy them, as well as metastasize. During the process of metastasis, tumor cells are separated from the main tumor and spread throughout the body through the blood or lymph flow, settling in various tissues and organs and beginning to grow in them.

As for benign tumors, they are characterized by slow growth, and they never metastasize or grow into neighboring tissues and organs. At the same time, benign tumors can reach significant sizes, as a result of which they can compress surrounding tissues, nerves or blood vessels, which is accompanied by the development of complications. The development of benign tumors in the brain area is especially dangerous, since during the growth process they can compress the vital centers of the brain, and due to their deep location they cannot be removed surgically. In this case, radiotherapy is used, which allows you to destroy tumor cells, while at the same time leaving healthy tissue intact.

Radiotherapy can also be used to treat benign tumors of other locations, but in most cases these tumors can be removed surgically, as a result of which radiation remains a backup ( spare) method.

How is radiation therapy different from chemotherapy?

Radiation therapy and chemotherapy are absolutely two different methods, used to treat malignant tumors. The essence of radiotherapy is the effect of radiation on a tumor, which is accompanied by the death of tumor cells. At the same time, during chemotherapy into the human body ( into the bloodstream) certain drugs are administered ( medicines), which reach the tumor tissue through the bloodstream and disrupt the processes of tumor cell division, thereby slowing down the process of tumor growth or leading to its death. It is worth noting that for the treatment of some tumors, both radiotherapy and chemotherapy can be prescribed simultaneously, which speeds up the process of destruction of tumor cells and increases the patient’s chances of recovery.

What is the difference between diagnostic radiation and radiation therapy?

Radiation diagnostics is a complex of studies that allows you to visually study the features of the structure and functioning of internal organs and tissues.

Radiation diagnostics include:

conventional tomography;
research related to the introduction of radioactive substances into the human body, and so on.

Unlike radiation therapy, during diagnostic procedures the human body is irradiated with a negligible dose of radiation, as a result of which the risk of developing any complications is minimized. At the same time, one should be careful when performing diagnostic studies, since too frequent irradiation of the body ( even in small doses) can also lead to damage to various tissues.

Types and methods of radiation therapy in oncology

To date, many methods of irradiating the body have been developed. However, they differ both in the technique of execution and in the type of radiation affecting the tissue.

Depending on the type of radiation exposed, the following are distinguished:

proton beam therapy;
ion beam therapy;
electron beam therapy;
gamma therapy;
X-ray therapy.

Proton beam therapy

The essence of this technique is the impact of protons ( a type of elementary particle) on tumor tissue. Protons penetrate the nucleus of tumor cells and destroy their DNA ( deoxyribonucleic acid), as a result of which the cell loses the ability to divide ( multiply). The advantages of the technique include the fact that protons are relatively weakly scattered in environment. This allows the radiation to be focused precisely on the tumor tissue, even if it is located deep in an organ ( for example, tumor of the eye, brain, etc.). Surrounding tissues, as well as healthy tissues through which protons pass on the way to the tumor, receive negligible small dose radiation, and therefore are practically not affected.

Ion beam therapy

The essence of the technique is similar to proton therapy, but in this case, instead of protons, other particles are used - heavy ions. Using special technologies, these ions are accelerated to speeds close to the speed of light. At the same time, they accumulate in themselves great amount energy. The equipment is then adjusted so that the ions pass through healthy tissue and directly hit the tumor cells ( even if they are located deep in some organ). Passing through healthy cells at enormous speed, heavy ions practically do not damage them. At the same time, when braking ( which occurs when ions reach tumor tissue) they release the energy accumulated in them, which causes the destruction of DNA ( deoxyribonucleic acid) in tumor cells and their death.

The disadvantages of the technique include the need to use massive equipment ( the size of a three-story house), as well as huge costs electrical energy used during the procedure.

Electron beam therapy

With this type of therapy, body tissues are exposed to electron beams charged with large amounts of energy. Passing through tissues, electrons give off energy to the genetic apparatus of the cell and other intracellular structures, which leads to their destruction. Distinctive feature This type of irradiation is that electrons can penetrate tissue only to a small depth ( by a few millimeters). In this regard, electronic therapy is used mainly for the treatment of superficial tumors - cancer of the skin, mucous membranes, and so on.

Gamma radiation therapy

This technique is characterized by irradiating the body with gamma rays. The peculiarity of these rays is that they have high penetrating ability, that is, normal conditions can penetrate the entire human body, affecting almost all organs and tissues. When gamma rays pass through cells, they have the same effects as other types of radiation ( that is, they cause damage to the genetic apparatus and intracellular structures, thereby interrupting the process of cell division and contributing to the death of the tumor). This technique is indicated for massive tumors, as well as in the presence of metastases in various organs and tissues, when to treat using high-precision methods ( proton or ion therapy) impossible.

X-ray therapy

With this method of treatment, the patient’s body is exposed to x-rays, which also have the ability to destroy tumor cells ( and normal) cells. Radiotherapy can be used both to treat superficial tumors and to destroy deeper malignant tumors. The severity of irradiation of neighboring healthy tissues is relatively high, so today this method is used less and less.

It is worth noting that the method of using gamma therapy and radiotherapy may vary depending on the size, location and type of tumor. In this case, the radiation source can be located either at a certain distance from the patient’s body or in direct contact with it.

Depending on the location of the radiation source, radiation therapy can be:

remote;
close-focus;
contact;
intracavitary;
interstitial.

External beam radiotherapy

The essence of this technique is that the radiation source ( X-rays, gamma rays and so on) is located away from the human body ( more than 30 cm from the surface of the skin). It is prescribed in cases where a malignant tumor is located deep in an organ. During the procedure, ionizing rays released from the source pass through healthy tissues of the body, after which they are focused in the tumor area, providing their therapeutic effect ( that is destructive) action. One of the main disadvantages of this method is the relatively strong irradiation of not only the tumor itself, but also healthy tissue located in the path of X-ray or gamma radiation.

Close focus radiation therapy

With this type of radiotherapy, the radiation source is located less than 7.5 cm from the surface of the tissue affected by the tumor process. This allows radiation to be concentrated in a strictly defined area, while at the same time reducing the severity of the effects of radiation on other, healthy tissue. This technique is used to treat superficial tumors - cancer of the skin, mucous membranes, and so on.

Contact radiotherapy ( intracavitary, interstitial)

The essence of this method is that the source of ionizing radiation is in contact with the tumor tissue or is in close proximity to it. This allows the use of the most intense irradiation doses, which increases the patient’s chances of recovery. At the same time, there is minimal impact of radiation on neighboring, healthy cells, which significantly reduces the risk of adverse reactions.

Contact radiation therapy can be:

Intracavity– in this case, the radiation source is introduced into the cavity of the affected organ ( uterus, rectum and so on).
Interstitial– in this case, small particles of radioactive substance ( in the form of balls, needles or wires) are injected directly into the tissue of the affected organ, as close as possible to the tumor or directly into it ( for example, prostate cancer).
Intraluminal– a radiation source can be introduced into the lumen of the esophagus, trachea or bronchi, thereby providing a local therapeutic effect.
Superficial– in this case, the radioactive substance is applied directly to the tumor tissue located on the surface of the skin or mucous membrane.
Intravascular– when the radiation source is introduced directly into a blood vessel and is fixed in it.

Stereotactic radiotherapy

This is the latest method of radiation therapy, which allows irradiation of tumors of any location, while at the same time having virtually no effect on healthy tissue. The essence of the procedure is as follows. After a full examination and precise definition To localize the tumor, the patient lies on a special table and is fixed using special frames. This will ensure complete immobility of the patient’s body during the procedure, which is an extremely important point.

After fixing the patient, the device is installed. At the same time, it is configured in such a way that after the start of the procedure, the emitter of ionizing rays begins to rotate around the patient’s body ( more precisely around the tumor), irradiating it from different sides. Firstly, such irradiation provides maximum effective impact radiation on tumor tissue, which contributes to its destruction. Secondly, with this technique, the radiation dose to healthy tissue is negligibly small, since it is distributed among many cells located around the tumor. As a result, the risk of side effects and complications is minimized.

3D conformal radiotherapy

This is also one of the latest methods radiation therapy, which makes it possible to irradiate tumor tissue as accurately as possible, while at the same time having virtually no effect on healthy cells of the human body. The principle of the method is that during the examination of the patient, not only the location of the tumor is determined, but also its shape. The patient must also remain stationary during the radiation procedure. High-precision equipment is adjusted in such a way that the emitted radiation takes the form of a tumor and affects exclusively the tumor tissue ( with an accuracy of a few millimeters).

What is the difference between concomitant and combined radiation therapy?

Radiotherapy can be used on its own healing technique, as well as in conjunction with other therapeutic measures.

Radiation therapy can be:

Combined. The essence of this technique is that radiotherapy is combined with other therapeutic measures - chemotherapy ( introducing chemicals into the body that destroy tumor cells) and/or surgical removal of the tumor.
Combined. In this case, simultaneously apply various ways exposure to ionizing radiation on tumor tissue. For example, for the treatment of a skin tumor growing into deeper tissues, close-focus and contact ( superficial) radiation therapy. This will destroy the main tumor focus, as well as prevent further spread of the tumor process. Unlike combination therapy, other treatments ( chemotherapy or surgery) do not apply in this case.

How does radical radiation therapy differ from palliative radiation therapy?

Depending on the purpose of administration, radiation therapy is divided into radical and palliative. Radical radiotherapy is spoken of when the goal of treatment is the complete removal of the tumor from the human body, after which a complete recovery should occur. Palliative radiotherapy is prescribed in cases where it is not possible to completely remove the tumor ( for example, if a tumor grows into vital organs or large blood vessels, its removal can lead to the development of serious complications incompatible with life). In this case, the goal of treatment is to reduce the size of the tumor and slow down its growth process, which will alleviate the patient’s condition and prolong his life for some time ( for several weeks or months).

How is radiation therapy performed?

Before prescribing radiation therapy, the patient must be comprehensively examined, which will allow the most effective treatment method to be selected. During a radiotherapy session, the patient must follow all the doctor’s instructions, as otherwise the effectiveness of treatment may be reduced and various complications may occur.

Preparing for radiation therapy

The preparatory stage includes clarification of the diagnosis, selection of optimal treatment tactics, as well as a full examination of the patient in order to identify any concomitant diseases or pathologies that could affect the results of treatment.

Preparation for radiation therapy includes:

Clarification of tumor localization. For this purpose, ultrasound is prescribed ( ultrasonography) , CT ( CT scan ), MRI ( Magnetic resonance imaging) and so on. All these studies allow us to “look” inside the body and determine the location of the tumor, its size, shape, and so on.
Clarification of the nature of the tumor. The tumor may consist of different types of cells, which can be determined using histological examination ( during which part of the tumor tissue is removed and examined under a microscope). Depending on the cellular structure The radiosensitivity of the tumor is determined. If it is sensitive to radiation therapy, several courses of treatment can lead to a complete recovery of the patient. If the tumor is resistant to radiotherapy, treatment may require large doses of radiation, and the result may not be sufficiently pronounced ( that is, the tumor may remain even after an intensive course of treatment with the maximum permissible doses of radiation). In this case, it is necessary to use combined radiotherapy or use other treatment methods.
Anamnesis collection. At this stage, the doctor talks with the patient, asking him about all existing or previously suffered diseases, operations, injuries, and so on. It is extremely important that the patient honestly answers the doctor’s questions, since the success of the upcoming treatment largely depends on this.
Collection of laboratory tests. All patients must undergo a general blood test, biochemical blood test ( allows you to evaluate the functions of internal organs), urine tests ( allow you to evaluate kidney function) and so on. All this will help determine whether the patient will withstand the upcoming course of radiation therapy or whether it will cause him to develop life-threatening complications.
Informing the patient and obtaining his consent to treatment. Before starting radiation therapy, the doctor must tell the patient everything about the upcoming treatment method, the chances of success, alternative methods treatment and so on. Moreover, the doctor must inform the patient about all possible side effects and complications that may develop during or after radiotherapy. If the patient agrees to treatment, he must sign the appropriate papers. Only after this can you proceed directly to radiotherapy.

Procedure ( session) radiation therapy

After a thorough examination of the patient, determining the location and size of the tumor, computer modelling upcoming procedure. Data about the tumor is entered into a special computer program, and the necessary treatment program is also set ( that is, the power, duration and other parameters of irradiation are set). The entered data is carefully checked several times, and only after that the patient can be allowed into the room where the radiotherapy procedure will be performed.

Before starting the procedure, the patient must remove outer clothing and leave it outside ( outside the room where treatment will be carried out) all personal items, including phone, documents, jewelry and so on, to prevent their exposure to radiation. After this, the patient must lie down on a special table in the position indicated by the doctor ( this position is determined depending on the location and size of the tumor) and don't move. The doctor carefully checks the patient’s position, and then leaves the room to a specially equipped room, from where he will supervise the procedure. At the same time, he will constantly see the patient ( through a special protective glass or via video equipment) and will communicate with him through audio devices. Medical personnel or relatives of the patient are prohibited from remaining in the same room with the patient, as this may also expose them to radiation.

After the patient is positioned, the doctor starts the machine, which is supposed to irradiate the tumor with one or another type of radiation. However, before irradiation begins, the patient's position and the location of the tumor are checked again using special diagnostic instruments. Such a thorough and repeated check is due to the fact that a deviation of even a few millimeters can lead to irradiation of healthy tissue. The irradiated cells will die, and part of the tumor may remain unaffected, as a result of which it will continue to develop. The effectiveness of treatment will be reduced, and the risk of complications will be increased.

After all preparations and checks, the irradiation procedure itself begins, the duration of which usually does not exceed 10 minutes ( on average 3 – 5 minutes). During radiation, the patient must lie absolutely still until the doctor says that the procedure is over. If any discomfort occurs ( dizziness, darkening of the eyes, nausea and so on) should be reported to your doctor immediately.

If radiotherapy is performed in outpatient setting (without hospitalization), after completion of the procedure the patient must remain under observation medical personnel for 30 – 60 minutes. If no complications are observed, the patient can go home. If the patient is hospitalized ( receiving treatment in hospital), he can be sent to the ward immediately after the session is completed.

Does radiation therapy hurt?

The irradiation procedure itself cancerous tumor takes a few minutes and is absolutely painless. If diagnostics and equipment adjustment are carried out correctly, only the malignancy, while changes in healthy tissues are minimal and almost imperceptible to humans. At the same time, it is worth noting that when a single dose of ionizing radiation is significantly exceeded, various pathological processes can develop in tissues, which can manifest as pain or other adverse reactions several hours or days after the procedure. If any pain occurs during the course of treatment ( during breaks between sessions), this should be reported to your doctor immediately.

How long does a course of radiation therapy last?

The duration of the course of radiotherapy depends on many factors that are assessed for each patient individually. On average, 1 course lasts about 3 – 7 weeks, during which radiation procedures can be performed daily, every other day or 5 days a week. The number of sessions during the day can also vary from 1 to 2 – 3.

The duration of radiotherapy is determined:

The purpose of treatment. If radiotherapy is used as the only method of radical treatment of a tumor, the treatment course takes on average 5 to 7 weeks. If the patient is prescribed palliative radiation therapy, treatment may be shorter.
Time of treatment. If radiotherapy is given before surgery ( to reduce tumor size), the course of treatment is about 2 – 4 weeks. If irradiation is carried out in the postoperative period, its duration can reach 6–7 weeks. Intraoperative radiotherapy ( irradiation of tissue immediately after tumor removal) is carried out once.
The patient's condition. If, after starting radiotherapy, the patient’s condition sharply worsens and life-threatening complications arise, the course of treatment can be interrupted at any time.

Before use, you should consult a specialist.

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

Concept

Radiation therapy involves exposure to ionized radiation. His goals:

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

Used in combination with surgical treatment and chemotherapy.

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

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

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

Video about pre-radiation preparation:

Indications

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

Radiation therapy is indicated for cancer:

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

Types of radiation therapy

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

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

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

Radiation therapy is also divided for other reasons.

Contact

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

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

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

Remote

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

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

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

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

Radionuclide

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

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

Conformal

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

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

Proton

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

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

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

Intracavity

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

Used to create maximum dose in tumor tissues.

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

Stereotactic

This method can reduce cancer treatment time.

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

Photo of stereotactic radiation therapy

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

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

Contraindications

There are several situations when radiation therapy is contraindicated:

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

The limitation is a sharp decline in the blood of leukocytes or platelets.

How is radiation therapy performed?

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

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

Some machine parts may move and make noise; do not be alarmed. Already at the beginning of treatment, a decrease in pain, but the greatest effect is achieved after completing the course.

Course duration

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

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

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

How is the procedure tolerated?

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

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

Symptoms after irradiation

After a course of radiation therapy, you may experience:

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

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

Consequences

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

The skin reaction to irradiation is approximately the same as with sunburn, but it develops gradually.

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

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

Experts note that often side effects include:

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

Recovery after radiation

The recovery process may occur different time, doctors recommend setting yourself up for a long journey.

Treatment of burns

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

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

How to raise leukocytes after radiotherapy?

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

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

What to do if you have a fever?

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

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

Pneumonitis

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

Additionally used breathing exercises, massage, inhalation and electrophoresis.

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

Haemorrhoids

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

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

Proctitis

To eliminate the problem, laxatives and cleansing enemas are used. High efficiency showed a warm shower aimed at the rectal area, baths with potassium permanganate.

The doctor may prescribe hormones rectal suppositories and anesthetics.

Diet food

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

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

The use of products containing a large number of cholesterol, fatty meat, mushrooms, tangerines, sausage.

Answers on questions

How is chemotherapy different from radiation therapy?

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

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

Does hair fall out after radiation therapy?

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

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

Is it possible to get pregnant after radiation therapy?

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

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

Radiation therapy often helps

Radiation therapy along with surgical intervention has become a proven and routine treatment for cancer patients. At chronic diseases(leukemia, lymphoma) it, in combination with chemotherapy, often achieves a cure. As an accompanying method, radiation can successfully complement surgery because it attacks cancer cells that survive surgery. For inoperable tumors, for example in lung cancer or in the case of metastases in the bones or brain, the prognosis for the results of radiation is encouraging. Sometimes, as for stomach cancer, radiation therapy is given during surgery.

After surgery for breast cancer, unless it is completely removed (breast conserving surgery), radiation therapy is almost always given to prevent recurrences. This reduces the likelihood of local recurrence by approximately 30%, but does not exclude distant metastases. With local radiation therapy, side effects are very minor, so it is prescribed to all patients.

Depending on the type of cancer they are used different types radiation therapy. Most often, large devices (“ray guns”) are used. The radiation source covers the entire body of the patient or one side of it. This way, the radiation will more accurately reach the tumor, but it will penetrate through healthy tissue in different places and thereby reduce the harm it causes. Radiation to the breast seeks to protect the sensitive tissues of the lungs, so the radiation is directed only to the mammary gland, which is often called the mammary gland.

In other forms of radiation therapy, a small source of radiation is directly applied to the area of the diseased organ, as for ovarian cancer. The radiation has limited penetrating ability, so healthy tissue is preserved. A radiation “cocktail” is also used. The patient drinks radioactive liquids. - Radioactive substances reach the tumor tissue. This technique is used for cancer thyroid gland, and in diagnostic purposes to detect bone metastases. This method is called scintigraphy.

Side effects during radiation therapy

With the help of various technical tricks and computer control of radiation, medicine strives to minimize the side effects of radiation therapy. It cannot be completely eliminated, since radiation almost always affects healthy tissue. The severity of the side effect depends on the dose of radiation, the sensitivity of the affected area of the body, as well as individual endurance.

Serious complications rarely occur with irradiation after breast surgery, since the fatty tissue that primarily makes up the breast is very insensitive to radiation. Targeted irradiation of bone tissue in most cases is also well tolerated if it is not accompanied by effects on the mucous membranes of internal organs, for example, in the pelvis, chest or neck.

Irradiation of internal organs leads to severe and often painful consequences. They are covered with a mucous membrane, which reacts to such influences very painfully. The harm caused by radiation therapy primarily consists of the following:

Damage to the mucous membranes leads to painful irritation or even acute or chronic inflammation,

The consequence of damage to the mucous membranes can be a functional disorder of organs located in the irradiated area. When the abdominal area is irradiated (for intestinal cancer), diarrhea often occurs. If the kidneys or bladder, as well as those adjacent to them, are irradiated
parts of the body, this can lead to To difficulty urinating; irradiation of the lungs leads to shortness of breath, and irradiation of the pharynx complicates swallowing, which prevents intake
solid food.

The damage caused by radiation to hematopoiesis is not as great as with chemotherapy. The rays only affect blood cells and protective cells passing through the bloodstream through the irradiated area. These cells are replenished relatively quickly by the body.

The skin becomes irritated and signs of a burn appear, in most cases a mild one. During radiation therapy, the skin requires special care.

Irradiation always places an additional burden on the body; it debilitates and causes fatigue.

Side effects are usually observed during radiation therapy and disappear a few days or weeks after its completion. But 5-10% of patients may experience late disorders, especially as a consequence of intense radiation exposure to the lower abdomen, abdominal area, lungs, throat area and pharynx. arise chronic inflammation, scars and areas of tissue death (necrosis) are formed. The sensitive mucous membranes of the intestines, urinary tract, and genitals become thinner, the tissues become wrinkled or baked, and fistulas or ulcers appear. These effects appear months after exposure and are difficult to treat.

How to reduce the unwanted effects of radiation therapy is described on the pages of our website.

Dietrich Beiersdorff

Cancer is the most unpleasant prognosis that a doctor can offer. There is still no medicine that guarantees a cure for this disease. The insidiousness of cancer is that it affects almost all known organs. In addition, cancer can spread its “tentacles” even into the body of domestic animals. Is there a way to fight this enemy? Radiation therapy in oncology is considered one of the most effective methods. But the point is that many refuse this prospect.

Let's go through the basics

What do we know about cancer? This disease is almost incurable. Moreover, the incidence is growing every year. The French are most often affected by the disease, which is explained by the aging population, since the disease often affects older people.

In essence, cancer is a disease of cells, during which they begin to continuously divide, forming new pathologies. By the way, cancer cells do not die, but simply transform into a new stage. This is the most dangerous moment. Our body a priori has a certain supply of cancer cells, but they can grow quantitatively due to external factors, such as bad habits, abuse of fatty foods, stress or even heredity.

However, the tumor that is formed by these cells can be benign if it grows outside the organ. In such a situation, it can be cut out and thereby eliminate the problem. But if the tumor grows on the bone or it has grown through healthy tissue, then cutting it out is almost impossible. In any case, if the tumor is removed surgically, then radiation therapy is inevitable. This method is quite common in oncology. But more and more sick people are abandoning this practice due to fear of radiation exposure.

Types of treatment

If there is a disease, then it is worth considering the main methods of treatment. These include surgical removal of the tumor. By the way, it is always removed with a reserve to eliminate the risk of possible tumor growth into healthy tissue. In particular, for breast cancer, the entire gland is removed along with the axillary and subclavian lymph nodes. If you miss a certain part of the cancer cells, the growth of metastases accelerates and chemotherapy is required, which is effective method against rapidly dividing cells. Radiotherapy, which kills malignant cells, is also in use. In addition, cryo- and photodynamic therapy, immunotherapy, providing assistance immune system in the fight against tumors. If the tumor is detected at an advanced stage, it may be prescribed combination treatment or taking drugs to relieve pain and depression.

Indications

So, when is radiation therapy needed in oncology? When talking with a sick person, the most important thing is to rationally explain the need for this method of treatment and clearly formulate the goal that you want to achieve in this way. If the tumor is malignant, then radiation therapy in oncology is used as the main method of treatment or in combination with surgery. The doctor expects the treatment to reduce the size of the tumor, temporarily stop growth, and relieve pain. For two thirds of cancer cases, radiation therapy is used in oncology. The consequences of this method are expressed in increased sensitivity of the diseased area. For some types of tumors, radiation therapy is preferable to surgical method, as it is characterized by less trauma and the best cosmetic result in open areas.

For epithelial tumors, combined radiation and surgery, and the primary one is radiation, as it helps to reduce the tumor and suppress its growth. If the operation was not effective enough, then postoperative radiation is indicated.

For forms with distant metastases, a combination of radiation and chemotherapy is indicated.

Contraindications

When is radiation therapy clearly inappropriate in oncology? The consequences are not the most pleasant if there is lymphopenia, leukopenia, thrombocytopenia, anemia, as well as any diseases accompanied high temperature and feverish condition. If chest irradiation is to be performed, the risk factor will be cardiovascular or respiratory failure, as well as pneumonia.

Radiation therapy in oncology after surgery is indicated for those people who have excellent central nervous system health and genitourinary system. They shouldn't endure acute diseases, have pustules, allergic rashes or inflammation of the skin. There are also conditions, for example, anemia cannot be considered a contraindication if the bleeding is coming from a tumor. After all, after the first sessions of therapy, bleeding may stop.

Unexpected risk

Radiation therapy in oncology after surgery may be an unjustified risk if the patient's medical history contains a record of a tuberculosis process. The fact is that irradiation makes it likely that a dormant infection will worsen from latent foci. But at the same time, closed forms of tuberculosis will not be considered a contraindication, although they will require drug treatment during radiation therapy.

Accordingly, exacerbation will be possible subject to the existing inflammatory process, purulent foci, bacterial or viral infections.

Based on all of the above, it can be revealed that the use of radiation therapy is determined by specific circumstances based on a set of arguments. In particular, the criteria will be the expected time frame for the manifestation of results and the likely life expectancy of the patient.

Specific Goals

Tumor tissue is very sensitive to radiation exposure. And that's why I got it widespread radiation therapy. Oncology treatment with radiation therapy is carried out with the aim of damaging cancer cells and their subsequent death. The impact is carried out on both the primary tumor and the isolated metastases. The goal may also be to limit aggressive cell growth with the possible transfer of the tumor to an operable state. Also, to prevent the occurrence of metastases in cells, radiation therapy in oncology may be recommended. The consequences, reviews and mood of sick people differ polarly, since, in essence, it involves irradiating the body in order to destroy damaged cells. How will this affect your health? Unfortunately, it is impossible to predict with accuracy, since everything depends on individual characteristics body.

Types of therapy

With an eye to the properties and sources of the radiation beam, various types of radiation therapy in oncology are distinguished. These are alpha, beta, gamma therapies, as well as neutron, pi-meson and proton. There is also X-ray and electron therapy. For every type of cancer radiation exposure gives unique effect, since cells behave differently depending on the degree of damage and severity of the disease. With equal success, you can count on a complete cure or absolutely zero result.

When choosing an irradiation method important role The location of the tumor plays a role, as it may be located near vital organs or blood vessels. Internal irradiation occurs when a radioactive substance is placed into the body through the digestive tract, bronchi, bladder or vagina. The substance can also be injected into blood vessels or through contact during surgery.

But external radiation comes through the skin. It can be general or focused on a specific area. The source of radiation may be radioactive chemical substances or special medical equipment. If external and internal irradiation is performed simultaneously, it is called combined radiotherapy. Based on the distance between the skin and the beam source, remote, close-focus and contact irradiation is distinguished.

Algorithm of actions

But how is radiation therapy done for oncology? Treatment begins with histological confirmation of the presence of a tumor. Already on the basis of this document, tissue affiliation, localization and clinical stage are established. The radiologist, based on these data, calculates the radiation dose and the number of sessions required for treatment. All calculations can now be done automatically, since there are appropriate computer programs. Available data also help determine whether radiation therapy should be given in combination with or without other modalities. If the treatment is combined, then irradiation can be carried out both before and after surgery. According to the standard, the duration of the course of radiation before surgery should be no more than three weeks. During this time, radiation therapy can significantly reduce the size of the tumor. In oncology, reviews of this method are very polar, since the effect remains unpredictable. It also happens that the body literally repels radiation or accepts it with healthy cells rather than diseased ones.

If radiation therapy is carried out after surgery, it can last from a month to two.

Side effects of the procedure

After starting treatment, a sick person may experience weakness, chronic fatigue. His appetite decreases and his mood worsens. Accordingly, he can lose a lot of weight. Changes can be observed in tests - the number of red blood cells, platelets and leukocytes in the blood decreases. In some cases, the site of contact with the beam may become swollen and inflamed. This can cause ulcers to form.

Until recently, irradiation was carried out without taking into account the fact that healthy cells could also fall into the action zone. However, science is moving forward and intraoperative radiation therapy has appeared in breast oncology. The essence of the technique is that the irradiation process can be started at the surgical stage, that is, after excision, the beam can be directed to the intervention site. Promptness in this matter allows us to minimize the likelihood of residual tumor, as it is neutralized.

With a breast tumor, a woman always has the risk that she will have to part with her breasts. This prospect is often even more frightening than fatal disease. And breast restoration through the intervention of plastic surgeons is too expensive for the average woman. Therefore, women turn to radiation therapy as a means of salvation, since it can allow them to limit themselves to excision of the tumor itself, rather than removing the gland completely. Places of possible germination will be treated with rays.

The effect of radiation therapy directly depends on the patient’s health, his mood, available side diseases and depth of penetration of radiological rays. Often the effects of radiation appear in those patients who have undergone a long course of treatment. Minor pain may occur for a long time- these are the affected ones muscle tissue remind you of yourself.

The main problem of women

According to statistics, radiation therapy in uterine oncology is the most common treatment method. This pathology occurs in older women. It must be said that the uterus is a multi-layered organ, and cancer affects the walls, spreading to other organs and tissues. IN last years Uterine cancer also occurs among young women, which doctors often explain early onset sexual activity and carelessness regarding contraception. If you “catch” the disease at an early stage, then it can be cured completely, but in late period achieve complete remission will not succeed, but following the recommendations of the oncologist, you can prolong a person’s life.

The basis of treatment for uterine cancer is surgical intervention, radiation therapy and chemotherapy. The bonus is hormonal treatment, special diet and immunotherapy. If the cancer is actively progressing, then excision is not the right method. Best results can be achieved through irradiation. The procedure is prohibited in case of anemia, radiation sickness, multiple metastases and other ailments.

Radiotherapeutic techniques may vary in the distance between the source and the affected area. Contact radiotherapy is the mildest, since it involves internal exposure: a catheter is inserted into the vagina. Healthy tissues are practically not affected. In this case, can the cancer suffered be harmless? After radiation therapy, after removal of the uterus and other unpleasant procedures, the woman is weak and vulnerable, so she absolutely needs to reconsider her lifestyle and diet.

The uterus is removed if the tumor has grown greatly and affected the entire organ. Alas, in this situation, the possibility of further procreation is called into question. But this is not the time to regret, since so radical measures will extend the life of a sick woman. Now you need to reduce intoxication, which is done by drinking plenty of water, taking plant food and vitamin complexes with the lion's share of antioxidants. Protein food should be introduced into the diet gradually, focusing on fish, chicken or rabbit meat. Bad habits need to be eliminated once and for all, and preventive visits to an oncologist made a rule.

It is worth including foods that have anti-cancer effects in your diet. These include potatoes, cabbage in all varieties, onions, herbs and various spices. You can focus on dishes made from cereals or whole grains. Soybeans, asparagus and peas are held in high esteem. Beans, beets, carrots and fresh fruits are also useful. It is still better to replace meat with fish and eat low-fat fermented milk products more often. But all alcoholic drinks, strong tea, smoked and salty foods, and marinades are prohibited. We'll have to say goodbye to chocolate, processed foods and fast food.