Radiation oncology is one of the three main pillars of cancer treatment. These are, respectively, the branches of Cancer Surgery, Radiation Therapy (Radiotherapy, formerly known as radiation therapy), and Medical Oncology.
What diseases does radiation oncology treat?
In the field of radiation oncology, all types of cancer are treated; 50-70% of all cancer patients are treated in a radiation oncology clinic at some point in their lives.
- Breast Cancer
- Prostate Cancer
- Lung Cancer
- Brain Tumors
- Bladder Tumors
- Skin Cancer
- Laryngeal Cancer
- Uterine, Cervical Cancer
- Rectal Cancer
- Lymphoma
- Pancreatic Cancer
- Bone Metastases
- Brain Metastases
- Liver Metastases
- Lymph Node Metastases
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How does radiotherapy work?
It works by interacting high-energy ionizing radiation beams or accelerated particles with cancerous tissues. Gamma or X-ray beams are generally used. These rays cause breaks in the DNA of cancerous tissue, either killing the cancerous cell or neutralizing it by stopping its multiplication.
DNA damage in normal tissues can be repaired much more effectively than in cancerous tissue. Furthermore, because the radiation beams are highly concentrated in cancerous tissue using cutting-edge technology, side effects in normal tissues have been reduced to very low levels.
How is the decision for radiotherapy made?
Decisions regarding radiotherapy (radiation therapy) are generally made by tumor boards comprising physicians from all relevant specialties.
What are the purposes of radiotherapy?
Curative treatments aim to completely eliminate cancer.
Palliative care includes treatments aimed at relieving pain, preventing bone fractures, and stopping bleeding.
What are the options for radiotherapy (radiation therapy)?
Remote Treatments (Teletherapy)
This is performed with linear accelerators that can provide image-guided intensity-modulated treatment. The number of treatment sessions is between 1 and 40, the treatment time is 10 minutes-30 minutes. It may vary between .
Patients remain motionless in a specific position under the machine. The machines move around the patient, delivering the required concentrated dose while maximally protecting cancer-free tissue.
Internal Treatments (Brachytherapy)
It is a treatment that involves close contact. The radiation source is placed directly into the tumor.
Our Current Radiotherapy Devices
The equipment available at the Radiation Oncology Department of Medipol Mega University Hospital is as follows:
Varian TrueBeam
The Varian TrueBeam system, with its rapid treatment capability, opens new doors for the treatment of lung, liver, head and neck, and prostate cancers.
What is the Varian TrueBeam system?
Varian Medical Systems is an advanced radiotherapy device. This device is designed to deliver radiation only to the tumor with very high pinpoint accuracy and precision. By combining advanced imaging capabilities with tumor movement tracking, it enables treatment with pinpoint accuracy. With its rapid treatment capability, it opens new doors for the treatment of lung, liver, head and neck, and prostate cancers.
Halcyon
Halcyon is a radiotherapy device that assists in radiation treatment processes thanks to its advanced features.
Halcyon, a next-generation technology, shortens treatment times, allowing more people to receive treatment in a single day. The device also delivers dose-intensity controlled radiotherapy by constantly moving.
CyberKnife M6
CyberKnife M6 can treat tumors located anywhere in the body, including the lungs, prostate, liver, pancreas, brain, and spinal cord.
What is the CyberKnife M6?
CyberKnife robotic radiosurgery system is a treatment option used to destroy cancerous or non-cancerous cells anywhere in the body without the need for surgery. This treatment promises a new life for the patient by delivering high radiation doses to the tumor with very high precision.
Brachytherapy (VariSourceiX)
All medical devices selected for diagnosis, treatment, patient care, and patient safety consist of leading brands with internationally recognized achievements.
Brachytherapy is a system that treats cancerous tissues with a radioactive source that is briefly placed inside the tumor.
GammaKnife (Perfexion)
The only target oriented, non-surgical treatment in brain diseases Gamma Knife is considered the "gold standard" of stereotactic radiosurgery.
Gamma Knife radiosurgery
Gamma Knife is one of the most advanced techniques used in the treatments of diseases that affect the brain and it is considered as the "gold standard" of stereotactic radiosurgery. Gamma Knife is a treatment system that enables the destruction of diseased brain tissue with determined coordinates using gamma rays. With Gamma Knife, both benign brain tumors (meningiomas, pituitary adenomas, acoustic neuromas) and malignant brain tumors (brain metastases, glial tumors) can be treated. In addition to brain tumors, Gamma Knife is also used in vascular brain diseases (arteriovenous malformations) and functional brain diseases (trigeminal neuralgia, parkinsonism, epilepsy).
IntraBeam (ZEISS)
IntraBeam is a device that enables radiation irradiation to be delivered to the tumor area during a surgical procedure. This device is used for a treatment method called intraoperative radiotherapy (performed in the operating room during surgery). The procedure involves delivering focused radiation to the tumor area during the same operation, immediately after the tumor has been surgically removed. This approach aims to treat the tumor bed by directly targeting it, offering a faster treatment option compared to traditional external radiotherapy.
What procedures are performed before radiotherapy (radiation therapy)?
First, the radiation oncologist informs the patient about which area the radiation will be applied to, and at what frequency and dose. The doctor also informs the patient about the possible early and late side effects of the radiation. After obtaining the patient's consent, the necessary CT scan is performed to facilitate planning.
After preliminary preparations based on the area being treated, contrast-enhanced and non-contrast CT scans, known as simulations, are obtained by assigning specific positions and using necessary fixation systems.
During CT simulations of breast and lung cancer, breath-holding techniques significantly reduce doses to the heart, coronary arteries, and healthy lungs.
In prostate and cervical cancers, keeping the bladder full is one of the methods used to minimize bowel and bladder doses, and thus potential side effects. After this stage, the treating physician compares the planning CT scan with other available images (PET/CT, magnetic resonance imaging, angiography, etc.) to identify the tumor, areas of potential spread, and critical organs. Then, medical physicists step in to create the most optimal plans.
What are the side effects of radiotherapy?
Side effects after radiotherapy can vary depending on the area treated, the radiation dose, the duration of treatment, and the patient's overall health.
Early effects (first three months);
- Weakness, loss of appetite, nausea, impaired taste and smell.
- Difficulty swallowing, sore throat, diarrhea, abdominal pain, hoarseness, cough, decreased saliva production, inflammation in the mucous membranes, excessive secretions, and phlegm.
- Radiation pneumonia
- Decrease in blood cells
- Skin redness, wet and dry peeling, edema.
- Hair and beard loss
Late effects (approximately 6 months after completion of radiotherapy);
- Breast tissue hardening, retraction, breast and arm edema
- Painful breast inflammation
- Non-microbial lung inflammation, lung tissue damage.
- Rib fracture
- Chronic endocarditis, myocardial infarction, ischemic heart disease, congestive heart failure (especially after left breast radiotherapy)
- Prominent capillaries in the skin
- Rarely, brachial nerve damage, radiation-induced bone damage.
- Rectal bleeding, urinary incontinence, decreased bladder capacity.
- Reduced saliva production, tooth decay.
- Secondary tumor development
- Spinal cord damage, decreased hearing and vision.
Frequently Asked Questions About Radiation Oncology
What is the minimum and maximum number of radiotherapy sessions?
Stereotactic radiosurgery procedures, such as CyberKnife or Gamma Knife, used to treat small brain metastases, may be completed in a single session, while conventional prostate treatments can take up to 40 sessions.
Generally, head and neck cancers require 28-35 sessions, brain tumors 27-30 sessions, and lung tumors 30-33 sessions. Treatment is given 5 days a week, with Saturdays and Sundays being a break to allow healthy tissues to repair themselves. In addition, there are accelerated sessions that are conducted 6 days a week, with 6-hour intervals between morning and evening sessions.
How long does a radiotherapy session last?
This procedure, performed by a radiation oncology specialist and their team, takes approximately 10-30 minutes. Treatment duration depends on the technique used in the procedure. This period may be longer on the first day of treatment.
Will I harm my family members after radiotherapy?
In radiotherapy, the radiation dose received is eliminated from the body before the patient leaves the treatment room. Absolutely no harm will come to the household. A grandfather undergoing treatment for prostate cancer can hold his grandchild, and a mother can hold her child, after each treatment session.
Can I drive after radiotherapy?
The decision regarding driving after radiotherapy rests with the treating physician.
Does radiotherapy affect social life?
No, it won't affect it. Because the radiation received is not the type of radiation that accumulates in the body, circulates, is scattered, or transmitted to another person. Therefore, it is possible to resume normal life as usual after a radiotherapy session.
Does radiotherapy cause pain?
The patient does not feel any pain during the radiotherapy session.
Does radiotherapy cause hair and beard loss?
If the hair and beard area is included in the radiotherapy field, temporary and permanent hair loss may occur, depending on the total dose, fractional dose, and patient-related factors.
Is the duration of radiotherapy the same for every patient?
The duration of radiotherapy is not the same for every patient. Many factors determine the duration of a patient's treatment. This matter should be discussed with the doctor who will be treating the patient.
Can dental treatment be performed during radiotherapy?
A radiation oncologist will recommend consulting with a dentist before undergoing any treatments involving the head and neck region. If there are teeth to be extracted or filled, these procedures must be completed at least 2-3 weeks before the treatment.
Tooth extractions and fillings are not performed during treatment involving the head and neck region. After head and neck radiotherapy is completed, approval from a radiation oncologist is required for continued treatment. It is recommended that all treatments, including implant treatment, be completed within 6 months to 2 years after radiotherapy, as this is considered the most appropriate treatment time.
