Radiotherapy

Radiotherapy is a localized cancer treatment that is often administered in combination with chemotherapy. High doses of radiation are delivered to the cancerous area with the aim of destroying cancer cells, shrinking tumors, or, in early-stage disease, completely eliminating the cancer.

What is Radiotherapy?

Radiotherapy (radiation therapy) is a treatment method that uses high doses of radiation to kill cancer cells or shrink malignant tumors locally. Radiation damages the DNA of cells, preventing cancer cells from dividing and ultimately causing their death over time.

While radiation is commonly used in low doses for imaging techniques such as X-rays, radiotherapy involves high-dose radiation. It can be administered alone or in combination with chemotherapy, immunotherapy, cancer surgery, or hormone therapy.

Radiotherapy can be delivered either internally or externally:

Internal Radiotherapy (Brachytherapy):
Also known as internal radiotherapy, brachytherapy involves placing a special device directly in or near the cancerous area, allowing more focused and targeted radiation.

Radioisotope Therapy:
This method involves administering radioactive substances (isotopes) orally, intravenously, or via injection to treat certain cancers or thyroid diseases. The isotopes accumulate in the targeted tissue, emit radiation from within, and destroy cancer cells. This is considered a type of internal radiotherapy.

External Radiotherapy:
External radiotherapy delivers high-dose radiation from outside the body to the cancerous area. This is the method most commonly associated with the term “radiotherapy.”

The duration and number of radiotherapy sessions depend on the stage of the disease, the patient’s overall health, and the location of the cancer. Radiotherapy is generally painless, though side effects may vary depending on the treated area and radiation dose.

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What is Radiotherapy Used For?

Radiotherapy is used to kill cancer cells, prevent their division and growth, and shrink tumors. It can be applied alone or in combination with chemotherapy, immunotherapy, or surgery, which can help prolong survival or even completely eliminate the cancer. In advanced-stage cancers, radiotherapy may also be used to relieve symptoms.

Radiotherapy can be used to treat various types of cancer, including breast cancer, lung cancer, prostate cancer, gynecological cancers, head and neck cancers, brain tumors, and lymphoma.

How is Radiotherapy Performed?

Radiotherapy is delivered using a device called a linear accelerator, which produces high-energy radiation targeted specifically at cancerous tissues. Radiation oncologists and dosimetry teams identify target volumes and organs at risk, and adjust the radiation dose distribution. Each session is called a “fraction”, and the total number of sessions depends on the type and stage of cancer.

The radiotherapy procedure is as follows:

• The patient is positioned in the linear accelerator.
• The machine delivers high-energy radiation to the predetermined area.
• The device does not touch the patient.
• Each session typically lasts 5 to 15 minutes.
• The patient does not feel pain or heat during the treatment.

Is Preparation Needed Before Radiotherapy?

Before radiotherapy, simulation and planning steps are carried out. Patients generally do not need any special preparation, but the radiotherapy team determines the treatment position, dose distribution, and organs to be protected.

Before treatment, patients should:

• Avoid tobacco and alcohol
• Pay attention to nutrition
• Stay well-hydrated
• Manage fatigue

If radiation is targeted to the mouth or throat area, a dental evaluation and oral care plan may be needed. For pelvic radiotherapy, special preparation may be required to manage bladder fullness and bowel movements.

Who Receives Radiotherapy?

Radiotherapy is generally administered to most patients diagnosed with cancer. The dose intensity, number of sessions, and duration vary depending on the cancer stage, the patient’s overall health, and the location of the tumor.

What Are the Purposes of Radiotherapy?

Radiotherapy can be administered for curative, adjuvant, neoadjuvant, or palliative purposes:

• Curative Radiotherapy:

Aims to completely eliminate the disease. It is generally preferred for early-stage cancers and can be applied alone or in combination with chemotherapy.

• Adjuvant Radiotherapy:

Delivered after surgery to destroy any microscopic cancer cells that may remain following tumor removal or tissue clearance.

• Neoadjuvant Radiotherapy:

Administered before cancer surgery to shrink the tumor, facilitate the surgical procedure, or increase the likelihood of a successful outcome.

• Palliative Radiotherapy:

Not intended to cure the cancer, but to relieve symptoms experienced by the patient. It aims to reduce issues such as pain, bleeding, and shortness of breath.

Side Effects of Radiotherapy

The side effects of radiotherapy depend on the treated area, size of the region, radiation dose, fractionation schedule, and any concurrent treatments. Side effects vary by region:

• Head and Neck: May cause dry mouth, headaches, taste changes, and difficulty swallowing.
• Chest: Can cause skin irritation, allergic reactions, or dryness.
• Abdomen and Pelvis: May lead to nausea, diarrhea, vomiting, or bladder irritation.
• Skin Cancer: Typically results in mild redness and dryness.

Frequently Asked Questions About Radiotherapy

What is the difference between Radiotherapy and Chemotherapy?

Radiotherapy (radiation therapy) is a local treatment that delivers high-dose radiation to the cancerous area to kill cancer cells, usually from outside the body.

Chemotherapy is a systemic treatment that uses drugs administered orally or intravenously to target cancer cells throughout the body.

Which is “harder,” Radiotherapy or Chemotherapy?

The intensity depends on cancer stage, patient health, treatment area, dosage, and combined therapies. Radiotherapy typically causes localized side effects, while chemotherapy causes systemic side effects.

Does Radiotherapy Cure Cancer?

Radiotherapy can cure certain localized cancers, shrink tumors, slow cancer growth, or relieve symptoms depending on the case.

Can You Be Near Someone Receiving Radiotherapy?

Yes, patients receiving external radiotherapy are not radioactive after treatment. However, internal radiotherapy (brachytherapy or radioisotope therapy) may require limited contact, as advised by the physician.

At What Stage is Radiotherapy Given?

Early-stage: Curative treatment

Advanced-stage: Palliative treatment for symptom relief

Before surgery (Neoadjuvant): Shrink tumor or cancerous area

After surgery (Adjuvant): Reduce risk of recurrence or eliminate residual microscopic cancer cells

Does Radiotherapy Hurt?

Radiotherapy is painless. Radiation beams are invisible and the machine does not touch the skin.

How Long Does a Radiotherapy Session Last?

Sessions usually last 5 to 30 minutes, depending on positioning, imaging, and treatment verification. Duration may vary based on overall health, cancer stage, and treatment area.

Does Radiotherapy Cause Hair Loss?

Hair loss occurs only in the treated area. For example, high-dose radiation to the head and neck may cause hair, eyebrow, or beard loss. Radiation to other body areas does not affect hair.

How Should a Person Receiving Radiotherapy Eat?

Patients should follow a balanced, healthy diet, including protein, vitamins, antioxidants, and healthy fats, stay well-hydrated, and avoid fried, salty, or processed foods, as well as alcohol and tobacco.

How Long is Recovery After Radiotherapy?

Side effects typically appear during the first weeks of treatment and gradually improve within weeks after completion. Common effects like fatigue usually decrease over the first few months. Recovery duration depends on overall health, cancer stage and location, and combination with other treatments.