Cancer Treatment -
Taking Pride in the Advances in Radiation Therapy
"The Best News
About Radiation Therapy" Book
radiation therapy so stigmatized? After all, it is a very useful
treatment and its benefits far outweigh its risks. How can a modality
that cures cancer and spares people from mutilating cancer surgery, such
as the removal of the voice box, a mastectomy, and the amputation of
limbs, be so fearsome?
Unfortunately, people are
misinformed. Also, most people’s perceptions of radiation therapy are
colored by unfortunate anecdotes, which people have not put into their
proper perspective. After all, one hears about bad outcomes when people
travel in motor vehicles. Yet, people do not fear the potential dangers
of driving or being a passenger they way dread the thought of radiation
therapy. Furthermore, society does not make the distinction between
cleanly prescribed medical radiation and nuclear accidents like
In addition, most people are unaware
of advances that revolutionized radiation therapy in the new millennium.
After all, radiation therapy in 2005 is a world apart from what it was
more than 100 years ago, when Madame Curie discovered that x-rays shrank
radiation treatments were delivered with radioactive materials, called
isotopes, such as radium, which were placed on, in, or along side of
tumors. People subsequently sustained burns and other devastating
Moreover, the earliest radiotherapy
machines did not have energy high enough to penetrate to the area of
interest, also known as the target, such as the prostate gland.
Instead, the radiation unintentionally deposited a substantial dose on
the skin, resulting in burns. Also, these machines were stationary, and
could not rotate around the area that needed to be treated.
Today, such equipment has been
supplanted by sophisticated, computer driven, high energy linear
accelerators, which can treat a target from multiple angles, thus
spreading out the radiation dose instead of concentrating it on only one
area. This is one measure that protects normal tissue.
In the early days, there were no
treatment planning computers to perform dosimetry, the precise
measurement of the radiation dose in the target and the normal tissues
through which the radiation beam passed.
Also, there were no data to show
that by prescribing radiation therapy in a protracted manner over
several weeks, the normal tissues recovered from the insult of
radiation, while tumor cells died and were naturally eliminated by the
Today, radiation oncologists know
how much radiation therapy each organ can tolerate before it incurs
injury. Hence, radiation therapy can be safely prescribed to treat the
target properly, yet spare the healthy, surrounding organs.
When the radiation oncologist cannot
avoid treating the skin, such as when the chest wall is irradiated after
a mastectomy to prevent a recurrence on the chest wall, a prophylactic
treatment break is given to prevent or reduce the severity of a burn.
Also, such a problem is temporary, and with proper care, patients get
Through the evolution of radiation
therapy, radiation oncologists have learned that shaping the treatment
field to conform to the shape of the target limits the amount of normal
tissue exposed to radiation. This means that the treatment field, which
is normally a square or a rectangle, can be shaped with lead blocking
devices to match the shape of or target. Modern techniques use CAT
scans and 3-D treatment planning computers for this purpose.
More sophisticated imaging tools,
such as high resolution CAT scans, MRI scans, and PET scans, further
enable radiation oncologists to confine radiation therapy to the target.
For example, CAT scan and conformal blocking techniques for breast
cancer allows the treatment team to spare virtually all the heart when
the left breast or chest wall is treated.
Taking these tools to the next
level, targeted radiation therapy techniques have evolved. These ensure
the radiation hits the target precisely, which is especially important
for organs that shift, such as a lung tumor with respiration and the
prostate with bladder and rectal emptying and re-filling. Such
innovative technology eliminates any uncertainties in defining and
treating the target, thus enabling the use of much smaller treatment
fields and higher doses, which potentially translates into more cures.
Fortunately, contemporary radiation therapy is generally a kind and
gentle treatment that is highly effective at controlling the symptoms of
cancer and at curing the disease, with few or no side effects.
Dr. Kornmehl is a
board certified radiation oncologist and author of the critically
acclaimed consumer health book, "The Best News About Radiation Therapy"
(M, Evans, 2004). Her website is
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