Radiotherapy in Cancer Care- Killing the myths & looking at New Horizons

Radiation therapy, like cancer itself, has a bit of social stigma attached to it. It is referred to by the lay public by various gory terms such as sikaai, bijli ki sikai, bijli ka jhatka, jalana and so on. Some patients consider it akin to physiotherapy and heat therapy. These misnomers and misconceptions have further augmented the fears and apprehensions of cancer patients. Even general practitioners have some erroneous beliefs about this treatment modality. Given that nearly 60% of all cancer patients would require this modality of treatment, it is time we give up many of these misconceptions.

Radiotherapy means the treatment of cancer by special x rays (or in some cases gamma rays). These rays are special because, unlike ordinary x rays, these rays have much higher energy and much higher precision for accurate treatment delivery. Traditionally radiation area used to be empirically marked on the patient's body by the treating doctor. With the advent of diagnostic x ray-based imaging, treatment area (or fields) started being marked based on bony landmarks. In the early 1970s, the CT scanner arrived and very soon radiation oncologists started using CT based methods for radiotherapy planning (also known as simulation). With this arrived 3-dimensional conformal radiotherapy (3D CRT, intensity-modulated radiotherapy (IMRT) and image-guided radiotherapy (IGRT). Using these, the oncologists could draw the tumour area and the normal structures slice by slice in the planning system computers, enabling a much higher degree of efficiency in treatment.

Oncologists soon realized that some sites are more mobile during respiration and their planning requires information regarding their motion (such as lung tumour and some liver tumors). This lead to the development of techniques called 4 D (4 dimensional, the fourth dimension being time). Such advanced modalities enable further accuracy in radiotherapy treatment, enabling the radiation oncologist to spare critical normal structures adjacent to tumor region.

While a multitude of modern equipment and technology is available, it needs to be executed by a radiation oncologist well versed and experienced in these techniques. This is an important point, often ignored by patients. Many patients land up asking for a particular technology, not appreciating that every technology use needs an expert hand as well.

Patients have other misconceptions about radiation which need to be cleared. The following facts are therefore being presented. External radiation therapy by x rays (or gamma rays) does not make one radioactive. The patients undergoing treatment can have contact with friends, children and others. It is a completely painless procedure. Unless the patients are having other ailments, they usually tolerate the treatment quite well and are able to lead an active life during the treatment course and beyond. Also, radiotherapy is a local treatment (just like surgery is a local treatment) and does not have much impact on sites away from the target area. However, as in the case of other diseases, no two patients are the same and their tolerance even to the same treatment can be different.

To summarize, radiation therapy is an efficient tool in the management of cancer. For a modern-day cancer centre, a radiation therapy unit is an absolute must. High-level evidence coupled with modern radiotherapy technology has led to the emergence of a new horizon in radiation therapy in Delhi. 

Manipal Hospital Dwarka is the best cancer treatment hospital in Delhi having experts experienced in treating any kind of cancer. For radiotherapy in Delhi consult the best cancer hospital near you.

Dr. Anusheel Munshi

HOD - Radiation, Oncology Sciences

Manipal Hospitals, Dwarka

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