Radiation therapy, also known as radiation therapy, is a local treatment method that uses ionizing radiation to kill cancer cells. Ionizing radiation especially kills rapidly growing tumor cells or prevents them from dividing and multiplying. The main goal of radiotherapy is to destroy tumor cells while preserving surrounding normal tissues. This method, which is also called targeted therapy today, is applied using special devices. Radiotherapy can be applied in two ways: externally or internally. External radiotherapy; It is the most commonly used form of treatment. Nowadays, radiotherapy plans are prepared individually, by defining the target volume and risky organs with the help of the patient's imaging on the planning tomographies taken before the treatment. These plans are prepared by health physicists on planning computers in line with the doctor's request. Radiation beams are directed to the patient's area to be irradiated by computer-controlled devices, the device does not come into contact with the patient and does not feel any pain during the treatment. The irradiation time is short, but the patient's doctor decides the dose and how many days of irradiation will be given. During the radiotherapy program, the patient can go to and from outpatient treatment.
Three quarters of all cancer patients may need radiotherapy at any stage of treatment. While radiotherapy is a curative (primary) treatment option in the treatment of some tumors, it can be applied to some tumors to shrink the tumor before the operation or to prevent the tumor from recurring in that area after the operation. Different radiotherapy options are decided by taking into account the pathological type, stage, location of the tumor, the patient's age, general condition, symptoms and physical examination.
Frequently Asked Questions
1.Is pain felt during radiotherapy?
During radiotherapy? No pain or suffering is felt. Many of us have had a CT scan before. In radiation therapy, like tomography, the rays coming out of the device cannot be seen with the naked eye and cannot be felt entering or exiting the body.
2. While receiving radiation therapy, the rays coming out of the device cannot be felt. Will I damage the moments?
During radiotherapy treatment, the beam is directed to the target organ in the patient's body and leaves the body, without any accumulation. For this reason, it is not possible for the person receiving treatment to harm or infect people around him (family members, children, pregnant women, etc.).
3.How long does radiation treatment last?
The duration of radiation treatment depends on the histological type of the tumor, its location, the size of the area to be irradiated, etc. It is determined by the radiation oncologist depending on many factors. Radiation therapy is a form of treatment that is conventionally applied every day of the week. The time the person stays in the device during the beam may vary between 5-20 minutes depending on the type of treatment. In conventional radiotherapy applications, the irradiation time (20-39 fractions) varies between 4-7 weeks. In some cases, your doctor may apply shorter schedules according to the suitability of the tumor and the patient. When techniques such as SRS/SBRT are used, short fraction (1-8) treatments are generally applied every other day or intermittently.
4.Are there any side effects of radiotherapy?
Although nothing is felt during irradiation. Depending on the area irradiated, surrounding tissues may be affected later in the treatment. Depending on the irradiated area, side effects such as mouth sores, redness/darkening of the skin, diarrhea, difficulty swallowing, nausea-vomiting, and decrease in blood count may occur. With new treatment techniques and devices, side effects are generally less common.
5. Will my hair fall out during radiation treatment?
Side effects of radiation therapy only affect the tissues around the irradiated area. Hair loss is not expected in people who have brain tumors and radiotherapy to areas other than the head and neck area.
6. Does radiation therapy affect sexual functions and fertility?
In particular, lower abdominal irradiation in women may affect ovarian and uterine functions. It can prevent menstruation and pregnancy. For this reason, you can meet with your doctor before the radiation and evaluate methods such as egg freezing and embryo storage. Sexual intercourse is not recommended during lower abdominal irradiation for gynecological cancers. In men, there may be a decrease in sperm count or erection problems during pelvic area irradiation. Therefore the ray You can discuss sperm freezing with your doctor before treatment. Since sperm quality will decrease during radiation treatment, it is not recommended to have children during this period.
RADIOSURGERY APPLICATIONS
Stereotactic Radiosurgery (SRS):
Surgery performed with special devices and techniques using high doses of ionizing radiation is called radiosurgery. The tumor tissue is coordinated in three dimensions and is aimed to be completely destroyed in a single session. Application of treatment with IGRT (imaging-guided radiotherapy) increases the selectivity of tumor tissue and reduces normal tissue damage. It is especially used in the treatment of small volume brain tumors. Radiosurgery of body tissues other than the brain is called stereotactic body radiotherapy (SBRT). It can be used in the primary treatment of tumors such as lung and prostate or in the treatment of metastatic lesions. SRS or SBRT can generally be applied in small tumors.
Stereotactic Radiotherapy (SRT):
The application of stereotactic radiosurgery in lower radiation doses and in multiple sessions (usually 3-8 sessions) is called stereotactic radiotherapy. .
LUNG CANCER RADIOTHERAPY
Lung cancer is the most frequently diagnosed and one of the leading causes of cancer-related deaths. Smoking is the main risk factor. Lung cancer; It is divided into two groups: NSCLC (non-small cell lung cancer) and SCLC (small cell lung cancer). 80-85% of newly diagnosed patients are diagnosed with NSCLC and 15-20% with SCLC cancer. With early diagnosis, the chance of treatment of the disease increases. Patients may have complaints such as cough, sputum, shortness of breath, hemoptysis (blood in the sputum), weight loss, weakness, fatigue, hoarseness, difficulty swallowing, and chest pain.
Radiotherapy in NSCLC (non-small cell lung cancer) Radiotherapy can be applied as curative treatment by adding chemotherapy to radiotherapy. Another area of use is pre-surgical It can be applied as preoperative radiotherapy in the preoperative period to shrink the tumor and facilitate surgical resection, or as postoperative radiotherapy in the postoperative period to reduce the possibility of recurrence after surgery. Especially in tumors below 4 centimeters, SBRT (stereotactic body radiotherapy) is the primary treatment method that provides local control equivalent to surgery.
Radiotherapy in SCLC (Small Cell Lung Cancer)
The most effective method in determining the location of radiotherapy in SCLC. The important factor is the spread of the disease in the body, that is, its stage. If the tumor is only in the lung tissue, chemotherapy can be added to radiotherapy to destroy the tumor tissue. At the same time, prophylactic radiotherapy is required in these patients to reduce the spread of the tumor to the brain. If the tumor has spread (metastasized) to another organ or tissue of the body other than the lung tissue, palliative radiotherapy options are on the agenda to reduce the patients' complaints. Palliative treatment can be applied to the brain and another part of the body (bone, spinal cord, adrenal gland, etc.) most commonly at risk of spread. In this patient group, in recent years, it has also been recommended to apply radiotherapy to the lungs if a good response is obtained after chemotherapy.
PROSTATE CANCER RADIOTHERAPY
Prostate cancer is the most common type of cancer in men. . It ranks second in cancer-related deaths. It is an organ located under the bladder (urinary bladder) that produces various secretions for reproduction. The most important risk factors for prostate cancer are age and family history. It is usually seen in people over the age of 65, so prostate cancer screening with PSA measurement is recommended for men over the age of 50. While patients may have no symptoms in the initial phase; In advanced stages, when the tumor puts pressure on the urinary tract, complaints such as difficulty urinating, frequent urination, burning sensation, bleeding and pain during urination may be observed. In prostate cancer, treatment options such as primary (curative) radiotherapy, postoperative (postoperative) radiotherapy and palliative radiotherapy come to the fore, taking into account the stage of the tumor, PSA level, spread of the tumor to other tissues in the body, the age and general condition of the patient. knows. In cases of localized disease limited only to the prostate and/or the surrounding lymphatic area, curative treatment can be provided with hormonotherapy combined with radiotherapy as a method equivalent to surgery. Palliative (for complaints such as pain) or radiotherapy to reduce the tumor burden can be applied to patients who have spread to distant organs (metastatic).
RADIOTHERAPY IN BONE AND SOFT TISSUE TUMORS
In Our Body Tumors arising from bone, joint, cartilage, muscle, vascular, nerve and fatty tissue are called tumors. The general nomenclature of this group of tumors is sarcoma. They can appear with swelling, redness, mass, pain or bone fracture anywhere in the body. Although tumors are generally seen in children and young adults, they can be seen in all age groups. Factors affecting the treatment decision for sarcomas are: type of sarcoma, location, histological grade, proliferation rate and other factors depending on the patient. Although surgery is the primary treatment for many types of sarcoma, radiotherapy is also a treatment option that can be used to prevent tumor recurrence after surgery or to shrink the tumor before surgery and to remove the tumor surgically. Palliative radiotherapy can be applied to prevent pain, bleeding, bone fractures or nerve compression in tumors that have spread throughout the body (metastasized). Additionally, in some cases, SBRT can be applied to lung metastases.
RADIOTHERAPY IN BREAST CANCER
Breast cancer is the most common type of cancer among women and the most common cause of death after lung cancer. One in every 8 women has a chance of developing breast cancer in her lifetime. For this reason, every woman after the age of 20 should perform a manual breast examination in the first week after menstruation; Between the ages of 40 and 69, it is recommended to have a mammogram every year. Risk factors: female gender, postmenopausal age between 50 and 70, family history of cancer, early menstrual onset, late menopause, long-term hormone therapy, smoking, obesity, never having given birth, and never breastfeeding. Symptoms: palpable hardness or mass in the breast, nipple retraction, asymmetry compared to the opposite breast, skin redness or crusting, pain, pink-red nipple discharge, palpable lump in the armpit.
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