Early stage cancers can usually be treated with a single modality of treatment whereas advanced cancers need a multi-modality approach. Radiotherapy is a form of local treatment like surgery whereas chemotherapy is a systemic treatment, i.e., has effect on the whole body.
Dr Mahadev senior consultant, radiation oncologist from Apollo Hospitals explains that Radiotherapy is the use of ionizing radiation to treat cancers and some non-cancerous pathology as well.
It is broadly divided into external radiotherapy, where the source of radiation is at a distance from the body and brachytherapy where the source of radiation is placed close to the tumor. Brachytherapy is a highly precise form of radiotherapy but can be used only for small and accessible tumors.
Hence early oral cancers, prostate cancer, cervix cancer can be cured with brachytherapy alone. The main advantage of brachytherapy over external radiotherapy is the very short treatment duration (3-5 days) unlike external radiotherapy where curative treatment normally takes 7-8 weeks. All locally advanced tumors require external radiotherapy.
The main aim of radiotherapy is to deliver a high dose of radiation to the tumor while avoiding radiation to the surrounding normal structures. External radiotherapy has evolved from the cobalt era to highly sophisticated Linear accelerators to deliver Intensity modulated radiotherapy (IMRT), image guided radiotherapy (IGRT), rapid arc, stereotactic radiosurgery (SRS) and Stereotactic body radiotherapy (SBRT). Cyberknife robotic radiosurgery system is high precision radiotherapy to deliver SRS&SBRT.
The main advantage of cyberknife is the submillimetre accuracy and very short treatment duration. It is an outpatient treatment and does not require any anesthesia, he added Dr. Mahadev that all those technologies are found from Apollo hospitals.
So, early lung and prostate cancers can be treated in 3 to 5 days, which normally take 7-8 weeks with conventional radiotherapy. Cyberknife is also very useful in treating tumors, which are inoperable because of their critical location in brain or spinal cord.
It is used to treat meningiomas, acoustic schwanommas, chordomas, pituitary tumors, arteriovenous malformations (AVM), and metastasis in brain, lung and liver,
Dr Mahadev stated one of the most sophisticated ways to deliver radiotherapy is the Protons. The main advantage of Protons over conventional linear accelerators is delivery of highly precise radiotherapy with practically no radiotherapy dose beyond the tumor. This leads to better outcomes with minimal complications.
As there is no dose beyond the tumor, it is very useful in treating pediatric tumors where we are worried about the late side effects of radiation. Proton beam radiotherapy is revolutionizing cancer care. Cancers of head and neck, lung and prostate are commonly treated with Proton beam therapy.
Some of the cancers, which are treated with surgery, can be effectively treated with radiotherapy too. Early oral, esophageal, lung and prostate cancers can be cured with radiotherapy alone.
The main advantage over surgery in this scenario is the feasibility of organ preservation. The patient can have a functional organ so that he/she has a better quality of life. Most of the locally advanced cancers may require a combination of surgery, radiotherapy and chemotherapy for cure and can be obtain from our Apollo hospitals.
We have moved away from an era of extensive surgeries to organ preservation with the help of better radiotherapy technology and newer chemotherapy drugs. For example, Breast cancer is the leading cancer in females worldwide. Previously, the entire breast had to be removed.
However, now most of the patients can be offered breast conservation, which involves only minimal surgery. An intact breast is a tremendous psychological boost for the patient and leads to better quality of life. Head and neck, esophageal, ano-rectal cancers are the other sites where organ preservation plays an important role.
Radiotherapy is integral to surgery and chemotherapy in the fight against cancer. Rapid advances in technology and computerization have allowed delivery of high precision radiotherapy with minimal side effects.
SOURCE: www.appolohospitals.com
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