Radiotherapy

Radiotherapy, also known as radiation therapy, is executed by damaging cellular DNA directly or indirectly through high doses of radiation designed to kill cancer cells or to shrink tumors. It has proven highly effective, serving as part of the treatment plan for about 40% of cancer cures (NHS Radiotherapy). Moreover, radiotherapy, especially hybrid radiotherapy techniques, may reduce the chance of cancer recurrence or relapse, and toxicity to organs—namely, the lungs and heart—particularly, for breast cancer (Zhang, Zeng, Peng, Yu, Zhang, & Wu, 2023). However, some types of tumors are resistant to radiotherapy due to innate resistance or acquired resistance, developing after treatment. Cancer stem cells are though to be the driver of radiation resistance, and tumor heterogeneity (differences in tumors of the same type (Fisher, Pusztai, & Swanton, 2013) across patients on account of spatial heterogeneity, uneven distribution of tumor cell subset; temporal heterogeneity, time change of cancer cell molecular composition; or nuclear pleamorphism, intra-tumor heterogeneity that is particularly considered in breast-cancer grading) (Liang et al, 2021).

Benefits
  • Can cure cancers in patients (either alone or alongside other treatments)
  • Effectively relieves symptoms or prolongs survival in advanced cancers
  • Has proven effective across almost all forms of cancer
  • Commonly used toward curing cancers globally
  • Reported to improve quality of life according to patients
Side Effects
Radiotherapy can cause side effects that vary on the site of treatment. However, most side effects are brief, mild, and treatable, usually subsiding within a few weeks after treatment. Nevertheless, some side effects can develop months or years late effects. Late effects depend on the site of treatment and the level or radiation, or does, used. Potential side effects are:
  • Early effects: fatigue, skin changes, hair loss, mouth irritation, nausea and vomiting
  • Late effects: fibrosis (over-development of fibrous connective tissue as a restorative response to injury or damage), atrophy, necrosis (death of cells in body tisssues) and vascular damage in tissues with slow turnover such as in the brain, kidney, liver, and muscles
  • Skin: increased sun sensitivity, altered skin texture, permanent hair loss, red spidery marks (for those of lighter complexions) and lymphoedema (chronic condition that causes swelling the soft tissues due to accumulation of protein-rich fluid)
  • Fertility: inability to become pregnant or father a child if the ovaries or testicles were in the treatment area
Other possible side effects include memory or concentration problems, headaches, and blurry vision. 

Risks 
  • Bladder issues (being able to hold less urine, especially after receiving treatment in the abdominal area)
  • Inconsistent bowel movements (especially after treatment in the pelvic area)
  • Increased breathlessness or respiratory conditions
  • Narrowing of the oesophagus (food pipe)
Please consult with your medical provider before beginning any treatment regimen.

Works Consulted

Fisher, R., Pusztai, L., & Swanton, C. (2013). Cancer heterogeneity: Implications for targeted therapeutics. British Journal of Cancer, 108(3), 479-485. doi: 10.1038/bjc.2012.581

Liang, Z., Jiang, M., Wang, H., Sun, H., Zhu, J., Zhao, W., Fang, Q., Yu, J., Chen, P., Wu, S., Zhang, Z., & He, Y. (2021). A narrative review of tumor heterogeneity and challenges to tumor drug therapy. Annals of Translational Medicine, 9(16), 1351. doi: 10.21037/atm-21-1948

National Cancer Institute. (2022). Radiation therapy side effects. https://www.cancer.gov/about-cancer/treatment/types/radiation-therapy/side-effects

Radiation Oncology—The Royal Australian and New Zealand College of Radiologists. (2020). Benefits and effectiveness. https://www.targetingcancer.com.au/about-radiation-oncology/benefits-and-effectiveness/

Zhang, Q., Zeng, Y., Peng, Y., Yu, H., Zhang, S., & Wu, S. (2023). Critical evaluation of secondary cancer risk after breast radiation therapy with hybrid radiotherapy techniques. Breast Cancer: Targets and Therapy, 15(2023), 25-38. https://doi.org/10.2147/BCTT.S383369
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