In addition to surgery and chemotherapy, radiotherapy is one of the pillars of cancer treatment. This energy-rich, ultra-hard x-ray photon beams to destroy the tumor cells. What are the side effects there are and how the therapy runs out.
A cancer diagnosis hits Affected suddenly and unexpectedly. In the fight against the disease, patients will see physical and mental strain, which raise many questions. Nowadays, radiation therapy alongside chemotherapy and surgery to one of the most important methods of treatment. Predominantly a so-called percutaneous radiation therapy, a radiation from the outside, is used, which acts in contrast to chemotherapy, locally, and not on the whole body.
How is radiotherapy treatment?
In a detailed interview with the patient, the treating radiation clarifies a therapist all the details regarding the disease, as well as the planned irradiation. Then it applies the body to be irradiated section to determine precisely. This is done by means of Computer or magnetic resonance tomography, the exact location and size of the tumor and the border to the surrounding healthy tissue places. On this basis, the so-called “target volume”, i.e. the area of the mm to be irradiated can be determined with high resolution.
Then, the medical physicist made a radiation plan. The number of irradiation sessions, and thus the dose will be determined by the specialist. For the treatment often individual positioning to be customized AIDS such as head masks, which help to position the patient each treatment session to the millimeter. This is for the exact application of a sound irradiation plan is essential. To Check the correct positioning of images in treatment position are held in many of the indications several times a week and sometimes even daily Inspection.
A special feature is the in recent years, increasing application of stereo-tactically-guided ablative irradiation. These are often meetings in only a few Irradiation (usually one to ten sessions) small tumors in the lung, liver and brain with high irradiation doses per day treated. The success rates are, in many cases, with which an Operation comparable to or even better (depending on tumor size, type and localization).
Especially for patients who are not suitable due to age or severe comorbidities for surgery, this type of irradiation is a useful and mostly equally promising treatment option. Also, this type of treatment can outpatient. Patients should be a section of a radiation therapist for advice.
About the author
Daniel Habermehl is the Medical Director and specialist for radiation therapy and radio Oncology of radprax, Wuppertal.
How long will the treatment take?
The therapeutic schedule varies from Patient to Patient. In most cases, the radiation therapy takes place on an outpatient basis, so that Affected appear, depending on the case of illness, usually for five consecutive days in the irradiation device. A session lasts, depending on the irradiation technique for a few minutes. The exact positioning of the patient and the irradiation unit takes up the vast majority of the time. Typically, radiation therapy occurs in 10 to 35 outpatient appointments.
What is the effect of the radiation in the body?
For the application of energy-rich, ultra-hard x-ray photon beams. Nowadays, there are also facilities for the treatment, with protons and heavy carbon ions. In these methods, the effect of irradiation is based on the energy transfer to the irradiated tissue in scattering processes. Water molecules are ionized, creating free radicals, which are highly toxic and Cell components react chemically. There is damage to the genetic material of the tumor cells can no longer reproduce this in the best case will be the result.
The radiation therapy side effects?
Each treatment carries a certain risk, which can lead to side effects or complaints. This, however, depends on the radiation dose, the treated part of the body, as well as the size of the irradiation volume. Due to the locally limited application possible side effects, such as, for example, mucus occur in most instances only to the corresponding regions of the body skin or on skin irritations. In some cases, Nausea, difficulty swallowing, indigestion and loss of appetite, or fatigue as side effects. For brain irradiation, it can to a – usually only temporary hair loss.
What are the preventive measure for breast cancer are there?
In particular, in the case of breast cancer, regular check-apply studies as the most important preventive measure. 20. The age of the woman physician samples, for example, once a year, the Breasts and armpits. In addition, a self-examination of vulnerable areas it is recommended once a month – this also applies to men. Your disease risk is significantly lower than in women, but still present.
Particularly at risk are women between 50 and 69 years. Health insurance companies pay every two years for a mammogram. In case of abnormalities, a supplementary examination is then performed, for example in the Form of a sonography, or ultrasound examination. The suspicion of malignant change remains in place, should be taken from a tissue sample, to be able to check this in the lab carefully, and then make a diagnosis.
Which therapies to recommend experts in cancer?
In addition to the removal of the tumor by surgery and radiation therapy, the system represents therapy, the third pillar in the treatment of cancer. The order In which the measures is determined by the individual patient’s situation. It is, for example, for the removal of breast tissue, nowadays, a variety of reconstruction procedures of the bra prosthesis on silicone implants to reconstruction using the body’s own tissue. In order to reduce the risk of metastasis, then, depending on the individual Situation, further irradiations and the use of drugs.
When is chemotherapy used?
Nowadays we speak not only of “chemotherapy”, but more and more of a “system therapy”, a treatment with substances which act throughout the body. Not all of these to the medicines correspond to a classical cytostatic or chemotherapy, which is administered via infusions, injections or tablets. This intervenes in the different phases of the cell division and prevents, for example, the transmission of cell information. Other chemotherapy drugs interrupt the normal cell division by integrating into the metabolic processes or the DNA of the tumor-destroying cells. Some of the activate the patient’s immune system to combat tumors.
Through the application of cytotoxic drugs combined often with each other, as many tumor reach cells as possible. During irradiation acts locally, in the case of chemotherapy, the active ingredients in various organs and may die to detect scattered secondary tumours, called metastases, and destroy. So it will be always used, if an effect is in the whole body. An exception is the brain, the only certain cytotoxic drugs – due to the so-called “blood brain barrier” – can penetrate.
However, some medications are known to attack healthy tissue. To do this, especially those body cells that divide fast, such as the cells of mucous membranes, hair follicles or cells of blood formation. As side effects, the decay in the rule with the end of chemotherapy without consequences, apply to the inflammations of the mucous membranes in the mouth and gastrointestinal tract, loss of hair, weakening of the immune system or increase bleeding tendency.
Newer therapies such as the so-called Checkpoint inhibitors, which have recently been approved for more indications, from the mechanism of action here is completely different than the previously described chemotherapy. Specifically the immune response against tumor-amplified cells and tumor cells for the body’s own immune cells “more visible”. A special feature of this treatment is that it works well together with radiation therapy is particularly good.
When is surgery possible?
If and when an intervention is appropriate, clarify the individual patient with the attending Physicians. Because an intervention always depends on the findings. For example, there are types of cancer such as breast or skin cancer, for which there is a high Chance of cure by removal of the tumor. The complete removal succeeds because the disease is still in an early stage, it is even possible that the cancer treatment is completed.
Certain tumors tend to be, however, more likely to return than others. On the basis of various investigations of the tumor tissue is estimated, therefore, the risk of relapse of an individual patient. Depending on how this assessment is true, is conducted in connection with a surgery, radiation and/or chemotherapy. In the case of some indications, high – dose stereotactic irradiation or combined radiation and chemotherapy can replace a surgery.
In the end, clarify the attending Physicians, for which patient which treatment option is out of the question, and weigh both advantages and disadvantages, taking into account the quality of life.