The Complete Beginner’s Guide to Radiotherapy

Radiation is a special type of energy carried by waves or particles. It can be produced by special devices or released by substances called radioactive. This energy is used in medicine for imaging purposes as well as to treat cancer and some other diseases. Here is everything you need to know about radiotherapy, the radiotherapy meaning, the relationship between radiotherapy and oncology, and options to receive radiation treatment abroad.

What is Radiotherapy?

As mentioned above, the energy carried by certain particles or waves is labeled as radiation. Special devices are needed to direct the radiation to the diseased organ. Therefore, the radiotherapy definition can be summed up simply as radiation used for medical reasons. In other words, the use of high-dose radiation energy for treatment is called radiotherapy or radiation therapy.

Which Diseases Can Be Cured with Radiotherapy?

Radiotherapy is applied in cancer types that can occur in almost any part of the body and approximately 50% of cancer patients. For some types of cancer, radiotherapy is the only treatment. Radiotherapy is a treatment method that can be applied alone or in combination with surgery and/or chemotherapy, in which a full recovery can be achieved in many patients. There are various cancer types that respond with high success rates, the most common ones being radiotherapy for prostate cancer and radiotherapy for lung cancer. The general usage of radiotherapy includes;

• In order to shrink the tumor before surgery,
• In order to clean the cancer cells that may have remained at the micro-level in the body after surgery,
• As the primary treatment for the disease alone,
• Without surgery, for immediate treatment with chemotherapy.

In addition, in some cases, where it is impossible to completely cure the disease, a radiotherapy procedure can be applied to reduce the patient’s complaints such as pain and bleeding. This type of treatment is called palliative therapy.

How Is Radiotherapy Performed?

Radiotherapy can be conducted in one of two ways: externally and internally. In some patients, these two forms can be applied in succession.

External Radiotherapy

In most patients, radiotherapy is applied externally. It is an application that is generally performed in treatment centers and outpatient clinics, and it is performed by directing the rays to the diseased tissue using radiotherapy devices. External treatments were carried out in 2D with devices called Cobalt-60 or linear accelerator until recent years. In two-dimensional treatments, normal tissue damage and radiotherapy side effects were more common, as wide safety margins were required to deliver sufficient doses to the target volume.However, thanks to the technological changes in radiotherapy devices in recent years, three-dimensional conformal radiotherapy, IMRT (Intensity-Modulated Radiotherapy), VMAT Radiotherapy, and Stereotactic Body Radiotherapy (linac-based, Gammaknife, Cyberknife) are the up-and-coming techniques that apply maximum dosage to the target volume, while it can be ensured that the normal tissue receives a minimum dose. Once the decision is made to administer radiation therapy, the doctor will also decide which device is more suitable for the patient.

Internal Radiotherapy

In internally applied radiation, the radioactive material or source is placed directly into the tumor or a body cavity with thin wire or tubes. Sometimes, it can be placed in the remaining space after surgery. Internal radiotherapy uses are mostly common in stubborn and advanced types of tumors that are hard to cure in an alternative option.

Stereotactic Radiotherapy

In radiation therapy, this is the treatment that provides an ablative (destructive) radiation dose to certain points and maximum protection of normal tissues. These treatments are often used most effectively in tumors of 3 cm or less. Its use in patients who cannot undergo surgery in the early stage of lung cancer is the most common application area. It can also be applied individually to metastatic disease areas. Treatment is often performed with 1-3 applications after special planning. It is a painless treatment method with minimal side effects.

What to Expected Before & During Radiotherapy?

Before starting the treatment, the patient takes off his clothes and puts on a gown. For this reason, it is recommended to come to therapy with clothes that can be changed easily.The radiotherapy technician uses previously marked lines on the patient’s skin to identify the treatment area. The patient should sit in a special chair or lie on the treatment table. Although each session requires 15 to 30 minutes in the treatment room, the delivery of the radiation dose takes place in 1 to 5 minutes. External radiotherapy is as painless as an X-ray.The patient does not need to hold their breath during the procedure, and only normal breathing is sufficient. During the sessions, the defined dose must be given most sensitively, the rays reach the right place in the body, the patient’s location has not deteriorated throughout the treatment, the same position is created in each treatment, and that the environment is immobilized in order to ensure the comfort of the patient in the best way. In this process called immobilization (fixation), accessories such as head and neck masks, vacuum mattresses, under-knee stabilizers or shoulder pullers can be used depending on the treated area.The radiotherapy technician leaves the room before the beam is delivered. The devices are controlled from a small area nearby. The patient can also watch through a monitor or window. Meanwhile, when the patient speaks, their voice can be heard through the loudspeaker, and the technician can be contacted. A noisy environment may occur when radiotherapy devices rotate around the treatment area at different angles due to their large structures. However, it is important to remember that the patients are operated on by the relevant technicians, and their operation is regularly checked.Radiation cannot be seen, heard, or felt in any way. However, if a situation occurs during the treatment session in which the patient will feel very bad or uncomfortable, the technician should be informed immediately. When necessary, the operation of the devices can be stopped immediately.

What Are the Side Effects of Radiotherapy?

External radiotherapy does not make the body radioactive. Therefore, there is no need to avoid contact with people receiving treatment. Furthermore, even during physical contact, no risk will negatively affect other people.The radiotherapy effects usually consist of complaints in the treated area. The doctor and nurse advise the patient on how to manage these side effects. The doctor or nurse should be informed about complaints such as cough, fever, sweating, or unusual pain during the treatment. Side effects usually disappear within a few weeks after the end of treatment and can be controlled with medications or diet. Side effects that may last longer can also be managed with appropriate treatments.The doctor monitors the effectiveness of the treatment. After the treatment, it is felt that pain, bleeding, and other similar complaints decrease, and other signs of improvement appear over time. The doctor may also order some blood tests while monitoring the treatment effects. It is normal for these numbers to be low during treatment.Many patients nowadays choose foreign countries in order to receive radiotherapy treatment. Turkey, Australia, Thailand, Germany, and Spain are the most forth-coming countries selected by millions each year to undergo cancer treatments such as GammaKnife, CyberKnife, IMRT, and VMAT. To learn more about radiation therapy options abroad, click here.