06 Mar, 2024
06 Mar, 2024
Radiotherapy, or radiation therapy or radiation treatment, is an important pillar of cancer treatment. It is a non-invasive and localized treatment approach that involves targeting the tumor, which could be present in any part of the body, with high-intensity radiation beams, which could be X-rays, gamma rays, electron beams, or proton beams.
These high-intensity radiation beams destroy cancer cells and stop them from dividing further and forming new cancer cells.
Radiation therapy may be administered alone or in combination with other treatments to improve the treatment response shown by the patient and the overall effectiveness of the treatment.
Now comes the important question - “Can radiotherapy cure cancer?”
Yes, in the earliest stages, some cancers can be treated with radiotherapy alone. However, this depends on a lot of other factors as well, and they include the type of cancer, the exact location and size of the tumor, the patient’s age, the patient’s overall health, and the patient’s preferences.
A genetic mutation is a sudden change in the DNA structure of a cell. Sometimes, these mutations can be beneficial; however, in some cases, these mutations can become detrimental, leading to various health conditions, including cancer. The key to controlling the growth of cancer cells is to destroy the DNA structure of these cells, and that is exactly what radiotherapy does.
High-energy waves, such as X-rays, induce breaks in the DNA structure, which leads to the death of cancer cells.
There are different goals for radiotherapy treatments, depending on the extent of the disease’s spread:
To cure or shrink the tumor: In some types of early-stage cancers, radiotherapy alone is used to treat the disease. In some cases of early-stage cancers, radiotherapy may be combined with surgery, wherein radiotherapy is administered first to shrink the tumor, which is later removed through surgery.
To kill the residual cells and reduce recurrence risk: Radiotherapy may be recommended after the surgery to kill the residual cells that were missed during surgery. This helps reduce the risk of the recurrence of various types of cancer.
To delay disease progression and prolong survival: advanced stages, when remission is not possible, radiotherapy may be administered to control cancer growth and prolong survival.
To relieve pain and improve the quality of life: terminal stages, when it is not possible to cure or control the disease, radiotherapy may be administered to alleviate pain and improve the quality of life.
Generally, radiation therapy success rate is excellent for early-stage cancers, and the rates gradually decline as the stage advances. Apart from the stage, multiple other factors also determine the success rate of radiotherapy, and they include the type of cancer, the exact location of the tumor, the size of the tumor, the patient’s age, the patient’s overall health condition, the treatment plan, the patient’s treatment response, and lastly, the patient’s preferences.
Radiation therapy and chemotherapy are different types of cancer treatments. Although both damage cancer cells and control cancer growth, the way they do it is completely different. The biggest difference between chemotherapy and radiotherapy is the way they target the cancer cells in the body. The table below lists the differences between chemotherapy and radiotherapy.
| Parameters | Radiation Therapy | Chemotherapy |
|---|---|---|
| Treatment type | Localized | Systemic (the entire body) |
| Method | It uses powerful, ionizing radiation beams to damage the cellular DNA of cancer cells and control their growth. | It uses potent anti-cancer drugs to target fast-growing cancer cells, damage their DNA structure, and control cancer growth. |
| Method | Tumor location | Throughout the body |
| Mode of Administration | External beam radiation therapy and internal beam radiation therapy | Topical, oral, intravenous, intramuscular, intrathecal, intrapleural, intraperitoneal, intravesical, and intraarterial |
| Duration | 1-8 weeks | 3-6 months |
| Pain | The pain could be localized to the treatment site, and it may feel like soreness or a burning sensation. | The pain could be neuropathic, and it feels like tingling or numbness. |
| Side Effects | In the case of radiation therapy, the side effects may be specific to the organ treated. | Side effects of chemotherapy include loss of appetite, metallic taste in the mouth, mouth sores, diarrhea, constipation, diarrhea, hair loss, fatigue, etc. |
The majority of early cancer cases require treatment with surgery either alone or along with other therapies, such as radiation therapy and chemotherapy. However, people do not know that despite surgical oncology being an important pillar of cancer treatment, many cancers do not require surgery and can be treated with radiation therapy alone or chemoradiotherapy. Some of these cancers include:
When the technology was not very developed, doctors performed the surgery and removed the vocal cords to manage this cancer type and prevent its progression. However, radiation therapy can help in avoiding surgery in stages I, II, and III of larynx cancer. Radiation therapy also prevents the loss of structure and function of the vocal cords. So, the patient does not have to lose their voice.
Radiation therapy has a 90-95% success rate in stage I, 85-90 % success rate in stage II, and 75-80% success rate in stage III. After radiation therapy, the patient is advised to visit the doctor for follow-up every three months. The oncologist may also suggest an endoscopy to monitor the effectiveness of treatment and if there is any recurrence of cancer. In some cases, the healthcare professional asks the patient for a full-body scan to rule out the spread of cancer.
Nasopharyngeal cancer affects the nasopharynx. It is present behind the nose and above the throat. The main treatment for nasopharyngeal cancer is radiation therapy along with chemotherapy. Surgery is quite difficult for patients with this cancer due to the location of the tumor.
Different techniques of radiation therapy are used in the management of nasopharyngeal cancers, and they include IMRT, IGRT, or proton therapy. For some recurrent cases, we can also use SBRT or brachytherapy. All stages of nasopharyngeal cancer can be treated with chemoradiation, with a high success rate.
Anal canal cancer comprises approximately 10% of the total cancers in the anorectal region. Radiation therapy for anal canal cancer is considered an organ-preserving treatment. It is because the conventional treatment for anal canal cancer comprises abdominoperineal resection (APR surgery). In this method, the surgeon removes the lower part of the colon, the anus, and the rectum. After the abdominoperineal resection, the doctor performs a colostomy. During this procedure, the surgeon brings the lower part of the colon outside the body through the abdominal skin. Colostomy may have a negative impact on the quality of life.
With advancements in radiation and chemotherapy, the anal canal tumor can be treated successfully, while sparing patients from permanent colostomies. In some cases, where primary tumors are < 4 cm, radiation alone may also have a success rate in managing the tumors of the anal canal. Chemoradiation is effective in managing all stages of anal canal cancer. The quality of life is significantly improved with no abdominoperineal resection or colostomy.
Lung cancer tops the list of causes of cancer deaths globally. Radiation therapy is used to manage stage I lung cancer using the technique of stereotactic body radiotherapy (SBRT). Administering radiation therapy in combination with chemotherapy (chemoradiation) helps manage stage II and III lung cancer with a high success rate. Further, it is not only effective in managing early-stage lung cancer but also delays the progression of advanced lung cancer.
Advanced radiotherapy techniques prevent damage to surrounding normal tissues, and patients can have a better quality of life. Further, stereotactic body radiation therapy and stereotactic ablative radiation therapy also effectively kill cancer cells when the tumor is small.
Radiation therapy is also effective in managing tonsil tumors. Treating tonsil tumors through surgery in adults is challenging and may have several complications. Radiation therapy is effective in treating early-stage tumors where the cancer cells have not spread beyond the tonsils. Further, the doctor may also combine chemotherapy with radiation therapy to improve the effectiveness of locally advanced tumors. It is because chemotherapy makes cancer cells more vulnerable to radiotherapy.
Radiation therapy is one of the commonly recommended treatment approaches for both early-stage and advanced-stage rectal cancers. It can be delivered in both high doses and low doses, depending on individual case parameters.
Radiotherapy for rectal cancer may be recommended to destroy the tumor, shrink the tumor, or kill the residual cancer cells after the surgery. Also, radiotherapy can be combined with chemotherapy to improve the overall effectiveness of the treatment. Both external beam radiotherapy and internal beam radiotherapy can be used for rectal cancer treatment. Rectal cancer treatment without surgery positively impacts the recovery speed and quality of life of patients.
Radiotherapy is one of the most effective approaches when the focus is to administer throat cancer treatment without surgery, and it is often the first line of treatment in the early stages. Radiotherapy for throat cancer may be recommended to destroy the tumor after the surgery to kill the remaining cancer cells, along with chemotherapy for a better treatment response or to relieve pain and discomfort, depending on the stage and other individual case parameters.
The treatment outcomes of throat cancer treatment through radiotherapy are excellent. It also positively impacts the quality of life as patients get to keep their voice even after the treatment, depending on the extent of the disease.
Most of the side effects of radiation therapy are temporary, and these side effects are limited to the area treated and are managed through medications. Before the session, the patient and the doctor will have a detailed discussion on the possible side effects of radiation therapy and measures to manage them.
Diarrhea and local irritation while passing stool and urine when treating anal cancer or other cancers of the pelvic region.
Mouth ulcers, difficulty swallowing, cough, skin irritation, etc., occur when radiation treatment is administered to the head and neck region.
Patients may experience fatigue and tiredness because of a lack of appetite.
Thinning of hair or hair loss occurs in the area that is treated with radiation therapy.
Radiation therapy not only treats cancer primarily but also reduces the chances of recurrences. Sometimes, doctors prefer radiation therapy either before (neoadjuvant) or after (adjuvant) the surgery. Before the surgery, it helps shrink the size of the tumor, while after surgery, it removes the cancer cells that were not eliminated during surgery. It has an essential role in preventing the recurrence of breast cancer and head and neck cancer.
Radiation therapy and surgery are the two important pillars of cancer treatment, and both have their pros and cons. For certain cancers, which can be treated with either surgery or radiotherapy, oncologists prefer radiation treatment, as it has certain advantages over surgery that significantly impact treatment outcomes and the quality of life among patients. The following are the different advantages of radiotherapy over surgery:
Unlike surgery, radiotherapy is non-invasive. Both external beam and internal beam radiation therapy do not require incisions. During external beam radiotherapy, the linac, or radiation source, emits radiation beams toward the target from a distance. During internal beam radiotherapy or brachytherapy, a radiation source is placed inside the body cavity without any incisions, either close to the tumor or inside the tumor, which emits radiation beams that damage cancer cells.
Since radiotherapy is non-invasive, there is no blood loss, pain, or hospitalization required. Radiotherapy can also be administered as an outpatient procedure, depending on the patient’s overall health condition.
Many years ago, we were not able to target tumors as we do today. Today, with precise treatment planning capabilities, including real-time imaging, dose and intensity modulation, precise patient positioning, AI automation, etc., specialists can precisely target the tumor, thereby preserving organ function and minimizing damage to nearby tissues.
One of the biggest drawbacks associated with cancer surgeries is the risk of surgical site infection, and various factors increase the risk of post-surgery infection. However, this is not the case with radiotherapy. In radiotherapy, there is no entry point for infection, as there are no incisions made. However, radiotherapy may still increase the risk of infection by hampering immune system function. That said, the overall risk of infection is generally lower in the case of radiotherapy than surgery.
The incisions made during surgery will take time to heal, and they may also cause pain and discomfort for patients. The recovery time among those who have undergone surgery may depend on various factors like the type of cancer, the type of surgery performed, and the patient’s overall health.
Since radiotherapy is non-invasive, there will be no wounds of any sort. Therefore, patients can have a relatively faster recovery when they undergo radiation therapy.
Prolonged hospitalization due to surgery can also negatively impact the quality of life among cancer patients. With outpatient radiotherapy, patients can complete their treatment and leave for home on the same day. This, along with other benefits discussed before, will positively impact the quality of life for those undergoing radiotherapy.
As the best cancer hospital in India, HCG has pioneering experience in cancer management. With a large team of globally trained radiation oncologists and state-of-the-art radiotherapy platforms stationed across the network, we aim to deliver the highest quality, personalized radiotherapy solutions for various types of cancer. At HCG, we have a dedicated department of central physics, and its core function is to chart out precise treatment plans for every cancer case and help patients visiting HCG receive the right treatment, the first time.
Radiation therapy is a mainstay treatment for early-stage cancers as well as advanced cancers. However, the patients must identify the early signs of cancer and consult a doctor nearby for an early diagnosis and a better cure. Radiation therapy has localized and temporary complications, which are easily manageable with medications. It helps preserve the functional status of the organs, unlike surgery.
The success rate of radiation therapy depends on multiple factors, such as the type of cancer, the stage of the disease, the size and shape of the tumor, the patient’s age and overall health, and the treatment response. Generally, the success rates of radiation therapy are excellent for early-stage cancers, and they begin to drop as the disease advances.
The duration of radiation therapy varies from one patient to another. There could be a shorter course of high-dose radiotherapy that may last for a week or a longer course of low-dose radiotherapy that may last for eight weeks, depending on the type of cancer, its stage, and other individual patient parameters.
The radiation treatment kills cancer cells by destroying their DNA structure, which is necessary for their multiplication and growth. High-energy beams of X-rays, gamma rays, electrons, and protons are used to destroy cancer cells.
Usually, if the radiation therapy is successful in eliminating the disease, the patient can live a long and healthy life, provided they adhere to the follow-up guidelines provided by their doctor and keep up with their follow-up appointments. That said, the survival rate of radiation therapy depends on factors like the type of cancer treated, its stage, its exact location, and lastly, the patient’s age and health status.
Most side effects associated with radiation treatment wear off within a few weeks to two months after the treatment. The severity of the side effects may vary from one patient to another, and in most cases, they are tolerable. The patient may get in touch with their expert team if the side effects are severe and need to be managed with appropriate medical intervention.
In some cases, stage 4 cancer patients can achieve remission, and radiotherapy may be administered as one of the treatments in such cases. However, stage 4 cancers often involve the spread of the disease to different parts of the body, and treatment goals, in those cases, primarily focus on delaying disease progression, prolonging survival, alleviating symptoms, and improving the quality of life. Accordingly, radiotherapy may be administered to achieve these goals as well.
Yes, it is possible to live a normal life after radiotherapy. The field of radiation oncology has advanced significantly in recent years, and specialists can target the tumors present throughout the body with enhanced precision. This precision in tumor targeting translates to multiple patient benefits, such as faster recovery, fewer treatment-related complications, and a better quality of life.
Patients often wonder if chemotherapy can cure cancer when it is administered along with radiation therapy. The answer is that it depends on the type of cancer treated and its stage, along with the patient’s overall health condition. Chemoradiotherapy is often associated with excellent success rates and is considered one of the most effective treatment options for various types of cancer.
