Radiotherapy

Definition

In radiotherapy, radiation oncologists use special type of radiation beams to remove cancer cells from the body. These beams cause damage to rapidly dividing cells in the body, such as cancer cells. Like chemotherapy, doctors prescribe radiotherapy in cycles to reduce damage to healthy tissues and minimize side effects.

Different equipment such as Gammaknife, Cyberknife, Truebeam or LinAc systems all use radiation beams to cancer cells. In the past, oncologists used radioactive materials such as Cobalt-60 to generate radiotherapy beams. With the discovery of Linear Accelerators, these older systems became obsolete. Linear Accelerators do not have radioactive materials but instead use particle physics to generate radiation beams.

Radiotherapy planning

Planning and delivering radiation therapy requires a team effort between radiation oncologists, radiotherapy dosimetrists and technicians. Depending on the cancer type, the oncologist first prescribes a treatment plan. Number of cycles can vary and are personalized for each patient. Most people receive treatment five times a week. Doctors may also refer to each treatment session as a ‘fraction’.

After the oncologist lays out the plan, radiotherapy technicians acquire images of the body with CT or MRI scans. Specially trained physicists, also called dosimetry specialists, calculate the radiation dose to be delivered to the tumor. Only after these preparations actual treatment can begin.

What to expect during a radiotherapy session?

When you arrive for the radiotherapy session, technicians help you fit in a comfortable position within the radiotherapy machine. They sometimes put temporary casts to immobilize certain body parts to achieve better precision.

Each session usually lasts up to 30 minutes. The linear accelerators might rotate around the body and make sounds during treatment. Radiotherapy requires you to stay still as much as possible. Technicians might ask you to hold your breath occasionally.

Common side effects of Radiotherapy

Side effects depend on the body part to be treated. If the treatment is given for a head and neck cancer, mouth dryness (xerostomia), taste changes, and difficulty swallowing are common side effects. When other body parts are treated, skin problems such as rashes and dryness, shortness of breath, nausea and diarrhea can be expected. Usually, these side effects are temporary, and symptoms get better after the treatment is over. Some changes to skin and digestive system can persist after the treatment.

There are other rare side effects of radiation treatment, such as bone marrow suppression or tumors caused by the treatment itself. Oncologists carefully check for symptom of these serious side effects and may stop the treatment if they are suspicious. Treatment is recommenced after the side effects are resolved.

Treatments are available to alleviate the effects of radiotherapy on healthy tissues and oncologists prescribe these as necessary.

Costs of Radiotherapy

Costs depend on the number of radiotherapy sessions and technology used for the delivery of the radiation beams. Typically, one session of radiotherapy with a linear accelerator device costs around $100. For example, a complete radiotherapy treatment for cancer requiring 30 cycles of radiotherapy costs $3000. These costs include all the preparation steps, such as image acquisition, consultation with the oncologists and prescription of any drugs.