Radiotherapy is a type of treatment using ionizing radiation. In fact, we are familiar with radiation, that is, the transmission of energy in the air. Many vehicles such as mobile phones, television antennas, satellite positioning systems (GPS) and radios are working on the principle of transmitting energy in the air. We call the rays we use for medical treatment as "radiotherapy ”or“ radiation therapy “. The rays that we use for radiotherapy are ionizing, that is, they have the power to cause damage to DNA, the human genetic material. Radiotherapy can cause damage to both the tumor and normal tissues of the human body. Tumor cells cannot get rid of the damage caused by radiotherapy, but normal tissues can repair this damage. In this way, radiation has been used successfully for medical treatment since the 1890s when it was first found.
Most of us were examined with computed tomography or direct x-ray graphy. The input and output of low energy X-rays from our body cannot be felt by us. The higher energy rays used mostly in radiation therapy also cannot be perceived by human beings. For this reason, patients treated in our radiation therapy devices feel mostly nothing during radiotherapy.
Radiation applied during radiation therapy is often performed by external irradiation devices (external radiotherapy), where the patients lying without motion and the radiation source turning around the patient. In the meantime, the rays applied in and out of your body at the speed of light. It does not have any accumulating properties in the body and it causes no radiation dose to your relatives. In brachytherapy, which is another form of radiation therapy, we use applicators that allow the delivery of radioactive sources into the cavity organs or tissues of the patient, such as the uterus. After these devices are placed in the patient, the radioactive source goes to the area to be irradiated and irradiation is given. Then the radioactive source comes out of the applicator. Then the applicator is removed and the patient is sent to home. Since there is no radiation accumulation in the patient after brachytherapy applications, no irradiation again occurs to your relatives.
Our patients can apply for radiation therapy at various stages. Sometimes it may be necessary to complete missing tests before starting treatment. Before starting radiotherapy, the Radiation Oncology Specialist tells the patient why radiotherapy is needed. Most radiotherapy treatments will involve an entire organ or a certain area, sometimes similar to surgical procedures, and sometimes the areas of the lymph nodes in which the organ's lymph fluid is drained. Therefore, it may be necessary to make different preparations according to the region to be irradiated. As an example, we recommend preventive oral-dental care before radiotherapy to patients with head and neck cancer. In patients preparing for lower abdominal irradiation, adjustments can be made regarding the fullness or emptiness of the bladder and rectum. Since blood counts will be important during radiotherapy, blood counts can be requested before starting the treatment.
We often start radiotherapy planning with treatment planning computed tomography. Your radiation oncologist, who decides on the areas to be irradiated, makes the necessary drawings on computed tomography. Arrangement of the areas required for irradiation of the determined targets and how to irradiate them are decided together with the medical radiophysics specialists. The total treatment time, daily radiation dose and the number of fractions will be determined by the radiation oncologist. The medical history of the patient, the status of the disease in the body, the details of the pathology report and other concomitant diseases of the patient are important determinants for the total dose.
Yes there is. Although radiotherapy is not felt during the treatment device, it may cause side effects that may be encountered during and after radiotherapy depending on the regions where it is applied.
2-Redness / darkening of the skin and sometimes open wound: If the irradiated area is skin (skin cancer or cancers that have reached the skin) or close to the skin (breast cancer, head and neck cancers, soft tissue cancers, some stomach cancers), the redness of the skin, darkening, peeling and sometimes open wounds may occur. Your doctor may recommend the use of certain skin gels, especially to avoid open wounds. If an open wound has developed, this usually heals rapidly after completion of radiotherapy. Darkening of the irradiated area usually improves within months following radiotherapy.
3-Difficult to swallow: Mucosa cells that cover our esophagus are made up of very dividing cells just like the cells in our mouths. Therefore, irradiation involving the esophagus (lung cancer, esophagus cancer, stomach cancer, head and neck cancers) may cause difficulty in swallowing. Complaints usually resolve with dietary recommendations and cessation of radiotherapy.
4-Diarrhea: Radiation involving the abdomen (rectum, stomach, pancreas, endometrium, cervical cancers) may cause diarrhea because the cells covering the small intestine mucosa are sensitive to radiotherapy. Some medications usually relieve symptoms with adherence to nutritional recommendations and discontinuation of radiotherapy.
5-Decrease in blood counts: Reduction in blood counts may occur during radiotherapy. For this reason, your physician may require a certain frequency of blood count. Sometimes you may need blood tranfusion.
6-Nausea and vomiting: Nausea and vomiting may occasionally occur after radiotherapy. In particular, irradiation of the brain, head and neck, upper abdomen may cause nausea and vomiting. It can often be controlled by the use of a number of anti-nausea drugs.
2-Dry mouth: Especially during head and neck irradiation of the salivary glands within the irraidated area, various degrees of dry mouth may occur. The use of artificial saliva or the use of certain medications may be recommended.
3-Growth retardation: Growth retardation can be seen especially after irradiation of infants and children who have not completed their development. The reason is the irradiation of the bones in the skeletal system and the hormone-producing glands in the body (i.e. pituitary, tyroid, adrenal, hypothalamus). Following the irradiation of infants and children, it may be recommended to follow the growth development of the patients and to make hormonal supplements if necessary.
4-Hormonal deficiencies: Deficiency in the production of various hormones may occur as a result of irradiation of hormone-producing glands or brain. Hypothyroidism and diabetes are the examples. If necessary, hormonal supplementation should be appropriate.
5-Skin-under-skin hardness: Especially near the skin or skin area radiation may cause hardness. Mostly it is not a serious problem.
6-New cancer development: Radiation may cause new cancer especially after 10 or more years. These are mostly within/near the radiation fields. Healthy life style (i.e. weight control, not to use alcohol and tobacco) is also important not to see those new cancer. These cancers are also treated appropriately.
7-Hair loss: Hair loss, especially after irradiation of the brain and head and neck region can be seen. The regrowth of the hair may vary with the dose of radiotherapy, chemotherapy and personal features (i.e. hair capacity).
8-Fertility and reproductive system problems: In women, especially after lower abdominal irradiation, ovarian and uterine function deficiencies are normal. This may affect normal menstruation and fertility. It will be useful to talk to your doctor before treatment regarding the place to be irradiated. If you have any expectation about fertility, it may be helpful to talk to your doctor before treatment, such as ovum freezing and embryo storage. Again, in men after abdominal irradiation, decreased sperm count or no living sperm may occur. Although this does not often lead to erection problems, it may affect reproductive function. Consult your physician about sperm freezing or embryo storage if you have a partner before treatment.
Radiotherapy applications are performed under the supervision and control of Radiation Oncology Specialist. During radiotherapy you should follow your doctor's recommendations and go to your controls properly. It is helpful to inform your physician during radiation therapy, especially if you have new complaints (fever, swallowing difficulties, etc.) and before using any medication
During radiotherapy, the issue of nutrition may vary according to the irradiated area. For example, in the irradiations involving the head and neck and esophagus, a diet consisting of soft, non-burning foods is recommended, whereas in the irradiations containing the lower abdomen, a diarrhea-free diet is preferred. Some cancers, such as breast cancer, are sensitive to hormones, so your doctor may recommend that you do not gain weight. It is helpful to ask your physician about nutritional considerations during your own irradiation.
Your doctor will give you information about sexual intercourse during your radiotherapy. For female patients, sexual intercourse will not be appropriate in lower abdominal irradiation as in gynecological cancers. Since the quality of sperm may be affected in abdominal irradiation in male patients, it is generally not recommended to have children in this period and 2 months after the end of radiotherapy. If lower abdominal irradiation is performed in a male cancer patient, this may result in azoospermia (absence of viable sperm in the semen) after radiotherapy. Although this often does not affect erection, it is useful to inform such patients about sperm freezing before starting radiotherapy if they intend to have children later. Lower abdominal irradiation of female patients to become pregnant after the period of special preparation is not possible without special preparations. In these cases, you should get information from your physician about egg storage and embryo freezing if you have a partner.
Although social life may not be affected as much as chemotherapy during radiotherapy, it is helpful to discuss with your doctor what kind of social life you will have. Sharing some information about your illness with your family and relatives who you may find appropriate, may help you to get over your radiotherapy and other treatments.
Three-dimensional treatments based on sectional anatomy are the basis of today's modern radiotherapy systems. Three-dimensional radiotherapy systems using IMRT and IGRT systems are strengthened by 4-dimensional systems that allow the machines to follow physiological movements such as respiration.
Stereotactic radiotherapy is a special type of radiotherapy that can protect normal tissues as much as possible while ensuring that the rays sent from different planes increase to high doses that will cause maximum damage to the tumor. Stereotactic RT systems, produced in the 1960s, are used to treat primary and secondary brain tumors. In the first stereotactic radiotherapy applications, the comfort problem caused by the screws placed on the skull of the patient and the necessity of the treatments to be applied in a single session led to the need to search for alternative technologies. In the 1990s, robotic radiotherapy systems and then the above-mentioned features have accelerated the use of high-tech linear accelerators in stereotactic radiotherapy.
Another modern use of three-dimensional treatments, three-dimensional brachytherapy is carried out by bringing the radioactive sources closer to the irradiated areas of our patients. The regions to be irradiated have cavities (gynecological cancers, lung cancers) in some of our patients, while others have tissues (prostate cancer, soft tissue cancers). During this process, a number of applicators are placed in or near the regions to be irradiated, and then radioactive source is sent into these applicators. This treatment, which has been performed with two-dimensional systems for years, has now become modern 3D system with using the patient's three-dimensional cross-sectional anatomy.
2-Treatment of brain metastases of appropriate number and size.
3-For the purpose of operation cavity irradiation in operated brain metastases
4-In the treatment of metastases that have previously undergone all irradiation of the brain, but which are newly developing or growing within the brain.
5- In the treatment of metastases in liver, adrenal glands, lungs and bones as an adjunct to systemic treatments in patients with few metastases in the body.
6-Treatment of spinal metastases of appropriate number and size.
7. In the treatment of lung metastases of appropriate number and size, whose source is elsewhere in the body but has metastasized to the lung.
8-Treatment of appropriate pancreatic tumors
You could look at NCCN nutrition guidelines. With treatment completed, you no doubt want to put cancer behind you and resume a more normal life. Now is the time to take charge of your health, focus on wellness, and swear off unhealthy habits, such as fast foods and a sedentary lifestyle. Research shows that the best formula for staving off another bout of cancer is proper nutrition combined with weight control and exercise. ...