Radiation Therapy in India

What is Radiation Therapy?

Radiation is one of the most crucial treatments for cancer. This therapy uses high-energy radio waves such as gamma rays, electron beams, or protons; to destroy cancerous cells and prevent them from growing.

Usually, normal cells divide to form new cells, whereas cancerous cells grow and divide faster to form solid tumors.

It is here that the radiation comes into use. The function of radiation therapy is to shrink and break the DNA inside the cancer cells.

Due to this, the cancerous cells stop growing and dividing and eventually leads to its death.

Malignant conditions such as the treatment of liver cancer, bone cancer, breast cancer, brain cancer, stomach cancer, skin cancer, etc., are a few of many where radiation therapy is proven effective.

Also, Benign Conditions where tumor growth is not cancerous such as Goitre, spurs, several painful and inflammatory diseases of the joints like bursitis and tendonitis, blood diseases, skin diseases, harmless brain tumors, can be treated.
 

Radiation therapy is sometimes the only treatment provided, but it is often given alongside other cancer treatments such as chemotherapy and surgery.
 

While chemotherapy exposes the whole body to cancer-fighting drugs, radiation therapy is normally a localized treatment.
 

Generally, it is used to treat a specific part of the body where the cancer cells are located.

Sometimes harm may come to the nearby normal tissues. Still, due to technological advancement, it is now possible to minimize harm to those tissues.
 

But if they are harmed, most recover and go back to working the way they should.

When is Radiation Therapy used?

1. Primary Mode of Treatment: In some cancers, radiation therapy might be effective independently as the first and the only mode of treatment.

 2. Before Surgery: If the tumor is too big to be removed easily through surgery, radiation therapy is administered to shrink the size of the tumor so it can be easily removed. Further, this makes cancer less likely to return.

3. During surgery: In this case, the tumor area is exposed during surgery, and the radiation therapy is applied directly to the tumor bed. This technique is also called Intraoperative radiation therapy.

Generally, this is used when it is difficult to remove cancer during surgery or when there is a risk of microscopic amounts of cancer remaining.

Intraoperative radiation therapy also helps doctors protect the normal tissues from radiation.

4. After Surgery: If the surgery fails to properly remove all the cancerous tissues or observed that the cancer is still present in adjacent organs or lymph nodes, it becomes essential to treat them as a chance of relapse or metastasis.

In such cases, radiation therapy is administered to destroy any remnant cancer and prevent it from returning.

5. In Conjunction with Chemotherapy: During cancer treatment, there might satisfy multiple treatments to ease cancer symptoms.

For this, radiation therapy might be used alongside chemotherapy.

Some chemo drugs called radiosensitizers help radiotherapy work better by making cancerous cells more sensitive to radiation.

Generally, in such cases, chemotherapy is given before the radiation therapy.

This can also make the side effects of chemotherapy and radiation therapy treatments somewhat worse.

6. Palliative Treatment: Radiation therapy is also used to control cancer symptoms or prevent symptoms from occurring.

This type of treatment aims not to cure cancer but to relieve its symptoms and improve patient's quality of lifeient.

So, the doses of radiation are lower and can be used without any major side effects.

Usually, palliative radiation will be given alongside surgery, chemotherapy, or hormone therapy which may be more beneficial.

7. In Non-cancerous Diseases: Radiation therapy can be used in benign or non-cancerous conditions independently as a treatment method or medicinal or surgical treatment.

Why Avail India for Radiation Therapy?

Cancer Treatment in India is one of the recognized and best care facilitators across the world.

International patients can receive low-cost cancer treatment in India with high-quality therapies and cutting-edge technologies.

International patients from countries like Bangladesh, Pakistan, Africa, Middle East, Afghanistan, Sri Lanka, etc., come to India for radiation therapy.

India has many multi-specialty hospitals for medical tourism that offer beneficial outcomes for various cancer treatments, including radiation therapy.

The cost of radiation therapy in India is extremely reasonable as compared to other developed nations.

Most international patients prefer undergoing low-cost radiation therapy in India as it helps them save thousands of dollars.

Cancer Hospitals in India charge only one-third of the total cost, which other countries like the United States usually charge.

Some best hospitals in India are known for their consistency in delivering high-class medical care and services.

In addition, the majority of Indian doctors follow international protocols to ensure patient’s good health.

Also, you will find some of the best oncologists in India.

Therefore, you can count on such unmatched services and avail radiation therapy in India.

Types of Radiation Therapy

1. Internal Radiation Therapy

Internal Radiation Therapy allows the radiation oncologist to provide a higher dose of radiation in a smaller area.
 

It uses radiation sources that are usually sealed in a small holder called an implant.

There are many implants, such as pellets, ribbons, tubes, seeds, wires, capsules, balloons, or needles.
 

Moreover, it doesn’t really matter which type of implant the doctor uses, and it is safely placed in your body, close to or inside the tumor.
 

Due to internal radiation therapy, a very less number of normal tissues are harmed.
 

A. Brachytherapy

Brachytherapy, also known as Internal Beam Therapy, is a procedure in which the radioactive sources are left in place or near the tumor permanently or temporarily, depending upon your Cancer.
 

There are two main forms of Brachytherapy – Intracavitary and Interstitial.

With Intracavitary treatment, the radioactive sources are placed where the tumor is located, such as the vagina, cervix, or windpipe. 

With the Interstitial treatment, the radioactive sources are directly put into the tissues, such as in the prostate.

The radiation from the Brachytherapy kills the cancer cells by inflicting overwhelming damage to the DNA.

Soon the tumor shrinks as the cells stop dividing and die.

Brachytherapy treats many cancers like,

1. Breast
2. Oesophagus
3. Bile Duct underneath the Liver
4. Uterus
5. Cervix
6. Vagina
7. Prostate
8. Rectum
9. Skin
10. Head and Neck
11. Lungs

Brachytherapy can also be used along with External Beam Radio Therapy (EBRT) and other cancer treatments.

Basically, there are two types of Brachytherapy:

1. HDR (High Dose Rate)
2. LDR (Low Dose Rate)

a. HDR (High Dose Rate)

HDR Brachytherapy is a powerful way of delivering radiation therapy internally by inserting a tube called a Catheter directly targeting the tumor.
 

The radioactive sources pass through this tube and destroy the cancer cells.

With the help of best doctors for Breast cancers, skin cancers, cervical cancers, and prostate cancers can all be treated with this procedure.
 

HDR Brachytherapy can be used as a standalone treatment or after the tumor is removed surgically to eliminate other remaining cancerous cells.

In this process, the radiation dose deposits faster. The doctor and his team of radiation technicians will monitor you from a separate room.

Usually, HDR Brachytherapy is given in multiple doses, either once or twice daily or once or twice weekly.

You may go home after the treatment with few restrictions.

Benefits of HDR Brachytherapy :

✔ Precise radiation therapy delivered internally.

✔ Used alone or applied after surgery to prevent recurrence of cancer.

✔ Suitable treatment

✔ Usually pain-free

✔ Minimizes the risk of short and long-term side effects.

b. LDR (Low Dose Rate)

In LDR brachytherapy, the radioactive sources/seeds, which are rice grain size, are positioned inside or immediately next to the tumor for several days. Still, they might also be left in position permanently.

These seeds emit radiation resulting in shrinking the tumor.

LDR Brachytherapy is usually used to treat prostate cancer and brain tumor.

In prostate cancer, the urologist in India, with the help of the radiation oncologist, performs this implant by placing the radioactive seeds in the prostate tissue.

In case of a brain tumor, the neurosurgeon in India, along with the radiation oncologist, will place the radioactive sources in position after removing the tumor.

During this process, nearly 50 to more than 100 radioactive seeds may be placed in a single session using 20 to 50 needles.

Generally, in LDR Brachytherapy, the patient will have to stay in the hospital for a day or two so that the radiation delivery device stays in place and he can receive continuous radiation.

Benefits of LDR Brachytherapy:

✔ The radioactive seeds can be positioned next to the tumor with a high degree of accuracy.
 

✔ Each seed affects a small area, so very little radiation reaches the nearby organs.

✔ As the recovery time is fast, the patient can return to work within a few days.
 

B. Radiation Iodine Therapy/ Radioiodine

Radioactive Iodine Therapy is an internal radiation therapy used to treat Thyroid cancer.

In this treatment, iodine 131 (Radioiodine), which is a radioactive substance, is used.

Before the treatment, you might be asked to eat a low iodine diet. Also, your doctor may advise you to change your thyroid medicines or other medicines for a while.

Furthermore, you undergo a scan before the treatment. This helps the doctor to have a clear picture of your thyroid.

During the treatment, you will be kept in an isolated room where you might have to stay for a few days.

Next, you will be given radioiodine as a drink or capsule. You won’t be able to eat or drink for a couple of hours so that your body absorbs the radioiodine.

Further, your body will absorb the radioiodine, and this iodine will be picked up by the cancer cells. The radiation then destroys the cancer cells.

This is also a type of targeted therapy as the treatment straight-a-way affects cancer and has minimal effect on healthy cells in the body.

2. External Beam Radiation Therapy (EBRT)

External Beam Radiation Therapy is a type of radiation therapy that aims at a beam of radiation from outside the body towards the cancerous cells present inside the body.

It is a treatment that uses doses of radiation to destroy cancerous cells and shrink the tumor.

EBRT comes from a machine that targets radiation directly at your cancer.

It is a local treatment that treats a specific part of your body.

How EBRT works?

• EBRT uses a special X-ray machine that delivers high-energy rays to tumours.
• The machine shapes radiation beams to the outline of the tumours and allows accurate radiation delivery from any angle as the machine moves around the patient during the treatment.
• All these treatments can be designed in such a way that they destroy cancer cells, sparing the surrounding/nearby tissues and organs. Also, patients don’t feel anything during the treatment.

How long does it take?

• EBRT is usually conducted daily over a period of 6 to 8 weeks.
• Most people are treated once a day for five days each week.
• EBRT treatment occurs from Monday to Friday, Saturday and Sunday being the rest days for the patient.
• Moreover, patients might receive two treatments in the course of a single day, depending upon the cancer stage and condition of the patient.
• Each treatment takes a few minutes and is provided as an outpatient procedure.
• The patient is allowed to go home after the Radiation Therapy.

Types of Machines used in EBRT

1) ARTISTE

The ARTISTE from Siemens is a high-precision radiation therapy machine.

It is ideally suitable for IGRT, as it improves the targeting of the radiation beam and reduces risk to the tissue nearby.

The ARTISTE machine integrates imaging along with treatment delivery to provide fast and accurate radiation.

The machine is equipped with the world’s most advanced megavoltage 3D imaging system, which guides patient positioning in complex cases.

Further, ARTISTE also provides a precisely shaped 3D radiation dose for IMRT (Intensity Modulated Radiation Therapy).

2) TomoTherapy

TomoTherapy is a form of IMRT (Intensity Modulated Radiation Therapy) in which the radiation is transmitted slice by slice.

TomoTherapy is an advanced technology that continuously delivers powerful and precise radiation beams to treat incurable tumors effectively.

There is an inbuilt CT scan that helps in confirming the size and position of the tumour before the treatment.

TomoTherapy has a unique 4D kV imaging feature that provides 4D images of the tumours that are moving.

Due to this precision, radiologists can target the tumours without harming the healthy tissues.

3) TrueBeam Stx

TrueBeam STx is a radiation therapy machine that treats cancer with speed and accuracy by delivering radiation to the tumour and not harming the nearby healthy tissues.

This machine is amongst the latest radiation machine in India.

This is a versatile and powerful machine that allows radiation oncologists to treat complex and organ specific cancers in India throughout the body.

The TrueBeam STx machine treats the patient in a much lesser time period compared to other radiation machines.

Here, the patient lies down, and within 15 minutes, the machine gives radiation while moving 360 degrees around the patient.

The radiation beam precisely targets only the tumour sparing the healthy tissue.

Within 15-20 minutes, the patient is good to go back home and needs no hospitalization.

Moreover, this machine can be used to deliver many other forms of radiotherapy, such as:

• IMRT (Intensity Modulated Radiation Therapy)
• IGRT (Image- Guided Radiation Therapy)
• SRS (Stereotactic Radio Surgery)
• SBRT (Stereotactic Body Radiation Therapy)

Radiation is a very complex topic, and you surely must be wondering about the techniques used in it.

So for your benefit, we have briefly discussed all the different Types of Techniques below:

A. IGRT (Intensity-Guided Radiation Therapy)

Basically, Image-Guided Radiation Therapy (IGRT) uses imaging while providing radiation therapy to improve the precision and accuracy of treatment delivery.

Before IGRT treatment, the patient undergoes simulation wherein CT scan, Ultrasound, and X-rays are taken just before the radiation treatment daily.

The information from the CT scan is then transmitted to a computer where the doctors compare the previous images with the present one.

This helps the doctor compare the images to see if any adjustment is needed in treatment without harming healthy tissues.

IGRT is mostly suitable for Prostate cancer, Lung cancer, Gynaecological cancer, and Urinary bladder cancer.

The main objective of IGRT is to achieve accurate targeting of tumours.

B. IMRT (Intensity Modulated Radiation Therapy)

Intensity Modulated Radiation Therapy or IMRT allows the radiation beam to be shaped exactly to fit the tumour.

It is a specialized form of 3D-CRT.

During IMRT, the radiation beams can be broken into “beamlets,” and the intensity of each beamlet can be managed individually.

Usually, Prostate cancer, Head and Neck Cancer, and Central Nervous System cancers are treated with IMRT.

Firstly, the patient needs to go through few scans like CT scan, PET scan, and MRI scan, which are used to scan the area of the body which needs to be treated. 

Next, all the information from these scans is directly fed into the radiotherapy planning computer.

Using the scan images, the team plans the treatment carefully.

The radiation oncologist uses advanced computerized dose calculations to find the dose strength pattern that matches the tumor's shape best.

Lastly, the doctor will ask the patient to lie down on a radiotherapy couch.

The radiographers take few x-rays to ensure that you are in the right position.

Later, the patient will be left alone in the room so that the doctors don’t get exposed to the radiation.

While going through the procedure, the patient can’t feel the radiations, and it won’t hurt.

Moreover, it takes 15 to 30 minutes or maybe more than that, depending upon the stage and site of the tumour.

Machines like LINAC or TomoTherapy usually give IMRT.

TomoTherapy has a CT scanner combined with IMRT.

C. IORT (Intra-Operative Radiation Therapy)

IORT or Intra-Operative Radiation Therapy is an advanced technique wherein a concentrated dose of radiation is delivered to the cancerous tumour during surgery.

It allows direct radiation to target the tumour while sparing normal nearby tissues.

IORT is mainly used to treat cancers that are difficult to get rid of during surgery.

Compared to conventional radiotherapy, IORT allows higher effective doses of radiotherapy.

With this treatment, you can avoid the removal of the organ and only remove the cancerous growth.

Usually, to ensure that all cancer cells are destroyed, and chances of recurrence are minimized, the patient will have to go through 25 to 30 sessions of radiation therapy for over 5 to 6 weeks.

There are about three types of IORT:

1. Electron IORT: Electron IORT has the advantage of controlling the depth of the radiation penetration by providing a very uniform dose to the tumour.

It takes only 1 to 3 minutes to deliver the prescribed radiation dose.

Few hospitals have built a shielded operation room where a conventional linear accelerator is installed to deliver electron IORT radiation.

This eliminates the patient’s transportation from the operation room to the radiation room.

The doctor can simultaneously deliver electron IORT radiation treatment while performing surgery.

Mobetron is used to deliver electron IORT radiation.

But as it is costly, only a few hospitals such as cancer hospitals in Mumbai can use this approach.

2. HDR-IORT: This technique was developed to combine the advantages of high dose rate brachytherapy and IORT for treating some complex cancers.

However, it costs lower than the electron IORT.

Many cancer hospitals in Banglore have HDR system that can be transported to the operation room when HDR-IORT is needed.

However, it does require a shielded operation room to deliver HDR-IORT.

During this procedure, the penetration is limited, typically either ½ cm to 1 cm depth.

It sometimes requires extensive surgery because of the limited penetration of the radiation.

HDR-IORT takes around 40 minutes or longer, resulting in longer operation room duration, more anesthesia, and greater blood loss than electron IORT.

This treatment is mainly used to treat colorectal cancer, head and neck cancer, and gynecological cancers.

3. Low Energy IORT: This type of IORT uses low-energy x-rays to deliver intraoperative radiation with a high dose, precisely to the tumour or directly to the tumour bed after the incision.

Low energy x-rays have relatively high biological effectiveness due to the higher ionization density of radiation in tissue than megavolt X-rays.

Moreover, due to the steep dose, the tissue of concern is irradiated to reduce damage to the other tissue.

This is a special characteristic of low-energy radiation.

Low energy IORT can be used majorly to treat breast cancer.

Immediately after tumour incision, the tumour bed can be delivered IORT with low-distance X-rays by a single dose.

D. 3D-CRT (3 Dimensional Conformal Radiation Therapy)

3D – CRT or 3 Dimensional Conformal Radiation Therapy is majorly used to deliver a conformal dose of radiation to the tumours, sparing the nearby healthy tissues.

The radiation oncologist prefers using 3D-CRT as it provides patient-specific 3D images used in the treatment planning process.

This is what distinguishes 3D-CRT from conventional radiotherapy.

Generally, tumours don’t have a regular shape and size.

3D-CRT uses specialized computers and imaging techniques such as CT, MRI, and PET scans which show the accurate shape and size of the tumor and the surrounding organs.

Depending upon the shape and size, the radiation oncologist can then precisely and accurately tailor the radiation beams to the tumour.

E. VMAT (Volumetric Modulated Arc Therapy)

VMAT is considered a next-generation arc therapy.

With newly established standards for radiation therapy, it reduces the treatment delivery time to few minutes.

Usually, during IMRT treatment, the machine rotates several times around the patient, or it repeatedly starts and stops to treat the tumour.

However, VMAT can deliver the radiation dose in an arc shape to the entire tumour by rotating 360-degree, typically in less than two minutes.

So, VMAT is considered an advanced form of IMRT treatment.

Also, it reduces patient motion and ensures better comfort.

This technique is eight times faster than IMRT.

Benefits of VMAT:

✔ Personalized, safe, high-quality radiation therapy.

✔ Higher tumour control

✔ Reduced treatment time to prevent inconvenience.

✔ Minimized side effects and complications.

F. SRS (Stereotactic Radio Surgery)

Stereotactic Radio Surgery (SRS) is a technique that involves the delivery of a high dose of radiation, precisely focused on the tumour in the brain.

SRS is a non-surgical procedure with no involvement of an actual surgery; it is called radiosurgery due to its precision.

The Gamma Knife, a highly specialized machine used for SRS, gives out tightly focused gamma rays to the tumour by sparing the sensitive nearby organs and tissues.

It is a standard machine for SRS, with unparallel capabilities and supreme normal tissue protection compared to other techniques for brain radiosurgery.

Radiosurgery is often used for:

• Small brain metastasis
• Benign brain tumours

G. SBRT (Stereotactic Body Radiation Therapy)

Stereotactic Body Radiation Therapy (SBRT) is a similar treatment procedure to the SRS.

Just the difference is SRS treats tumours of the central nervous system, and SBRT treats tumours outside the central nervous system.

SBRT gives radiation from many angles around the body. The beams meet exactly at the tumour.

This means the tumour receives a high dose of radiation, and the organs or tissues near it receive a much lower dose.

This minimizes the risk of side effects.

SBRT treatment can also treat areas that have already been treated with radiotherapy.

For example, if someone has earlier received radiotherapy in the pelvis region, they might not get radiotherapy in that area again.

But because SBRT is an exact treatment, it can often mean that the treatment is possible in the same region.

This treatment involves a single high-dose radiation treatment or a few fractionated radiation treatments (usually up to 5 treatments).

SBRT is mainly used to treat patients with Lung, Spinal, and Paraspinal tumours.

The radiographers will set you up in the right position on the radiation couch.

Once you are in the right position, the doctor and radiographers will leave you alone in the room to not be exposed to radiation.

However, you need not worry as the radiographers can speak to you through the intercom and they can even see you and hear you the whole time from the other room from where they are monitoring you.

It is essential to lie still throughout the treatment, which will take 15 minutes to 2 hours.

It might take even longer than this. You may receive the treatment in one go or into short breaks, depending upon your condition.

You won’t feel anything during the treatment as the machine doesn’t touch you.

The machine will beep from time to time.

Once the treatment is over, the radiographers will come in and help you get down from the radiation couch comfortably.

SBRT with CyberKnife

The CyberKnife is a radiotherapy machine that also treats the patient with SBRT.

The machine has a robotic arm that moves around the treatment couch and provides doses of radiation from different angles.

The machine takes X-rays every 10-20 seconds.

Further, the robotic arm corrects its position with the help of these images.

Due to this, the radiographers can target the radiation beams accurately at the tumour, even if the tumour is moving while you breathe.

This treatment might take 30 minutes to 4 hours, depending upon the type of cancer and the position of the tumour.

A special thing about CyberKnife is that it can treat multiple tumours at the same time.

Moreover, it can be beneficial to treat areas of cancer metastasis.

You might undergo the treatment in one go, or it may be broken into short breaks.

H. Total Body Irradiation (TBI)

Radiation therapy given to the whole body is known as Total Body Irradiation or TBI.

You might be given TBI alongside high-dose chemotherapy drugs for a stem cell or bone marrow transplant.

TBI is usually given to the patients with:

• Lymphoma
• Leukemia
• Myeloma

TBI given along with chemotherapy helps kill off leukemia, lymphoma, and myeloma cells in the bone marrow.

While performing a bone marrow transplant process, the doctor gives TBI to the patients using donor stem cells.

TBI suppresses the immune system, which helps to prevent the rejection of the donor stem cells.

Further, the treatment is planned and executed by the radiographers.

Usually, TBI is given twice a day for 3 or 4 days.

Or else just 1 or 2 radiotherapy treatment is given depending upon the patient’s condition.

There are two types of TBI:

1. TBI Treatment Lying Down

In the lying down session of TBI, the radiographers measure the thickness of different parts of the body and place small radiation monitors known as diodes on your body.

They might even use gel bags or padding materials between the knee and over your neck and chest.

This is to ensure that you receive an even dose of radiation throughout your body.

During the planning session, you receive a minimal dose of radiotherapy from a radiotherapy machine.

The couch near the radiotherapy machine moves so that one-half of your body can receive radiation.

Then the couch turns so the other part of the body can also get radiation treatment.

2. TBI Treatment Standing Up

During a Standing up TBI treatment, the radiographer will make you stand in a specially designed frame.

First, you stand facing the radiotherapy machine, and later, you turn around so that your back faces the machine and receive the treatment.

I. Proton Beam Therapy

Proton therapy is also known as proton beam therapy.

It is a type of radiation therapy that uses protons instead of X-rays to treat cancer.

A proton is a highly charged particle used to kill cancer cells at high energy.

Doctors may recommend proton therapy alone or combined with chemotherapy, surgery, x-ray radiation, or Immunotherapy.

Just like x-ray radiation, proton therapy is a type of external-beam radiation therapy. It painlessly and precisely delivers radiation to the tumour through the skin from a machine outside the body without harming any other organ or nearby tissue.

What can you expect?
 

People usually receive proton therapy in an outpatient block.

The number of sessions completely depends on the type and stage of the cancer.

Generally, the doctor uses large doses of radiation for a fewer number of treatments. 

However, sometimes they might also deliver 1 to 5 proton beam therapy.

Planning of treatment

Proton therapy demands a lot of planning. Before the treatment, you will have to undergo few scans like CT, PET, or MRI.

During these scans, you will be in the same position as during the treatment.

The doctor will make you lie on the radiation couch and figure out your position.

To limit your movement, a device will be fitted, which helps you stay still.

The type of device depends on the location/site of the tumour in your body.

It will assist the doctor in figuring out the exact places where the radiation therapy is to be given, whether on your body or the device.

This helps the doctor in ensuring your position during each proton therapy.

The radiographers will use the radiation treatment scans to mark the tumor site and where the normal tissues are to avoid that area.

This process is similar to the planning of radiation treatment through x-rays.

Receiving treatment

Patients eligible for proton therapy are taken to a special treatment room.

For every treatment, one of the radiographers will place you into the device.

For some patients suffering from tumours in the head and neck, such as the eye, they will be positioned in a chair instead of a table.

Before the treatment proceeds further, the team takes x-rays or CT scan pictures to position the patient in the same position for every treatment.

This preparation is done so that the proton beams hit the tumour and not the healthy tissues near the tumour.

Some proton therapy treatment rooms have a machine called a gantry.

It rotates around the patient to give out radiation to the tumour from the best angles.

The machine contains a nozzle from where the protons are emitted towards the tumour.

Protons travel through the machine, and the magnets direct them to the tumour.

Once the patient is positioned properly, the team will leave the room and go to the delivery control room.

From that room, the team will control the delivery of proton treatment.

They will see you and hear you, and talk to you through the video placed inside the treatment room.

Treatment Time

• Usually, a proton radiation treatment lasts up to 15 to 30 minutes, right from when you enter the room.
• Also, it depends on the location of the tumour and the number of treatments.
• Moreover, it will also depend on how easily the team locates the tumour with x-rays and scans.
• Other factors which affect the time of treatment are, such as waiting for one patient’s treatment to be finished.
• Most proton centres have only one machine.
• Even if there are two proton machines, the protons are magnetically steered from one room to another.
• There are times when both the rooms are ready to deliver the treatment at the same time. But it is not possible, and one of the patients will have to wait till the other patient’s treatment is delivered.

Cancer treated with Proton Therapy.

• Proton therapy mainly treats tumours that have not metastasized and are near important parts of the body.
• For example, cancers near the brain and the spinal cord.
• The drawback of proton therapy is that it does not treat all types of cancers.
• Further, the cost of radiation therapy in India for this type of treatment is quite high.

Few cancers which are treated by Proton Therapy:

1. Central nervous system cancers
2. Eye cancer
3. Head and Neck cancer
4. Lung cancer
5. Liver cancer
6. Prostate cancer
7. Spinal and Pelvic sarcomas
8. Non-cancerous brain tumours.

What are the Risks and Side Effects associated with Radiotherapy?

• As we know, every treatment associated with cancer has its own set of side effects. In Radiotherapy, high doses of radiation beams kill the cancerous cells in and around the tumour.
• The side effects of radiotherapy emerge as they damage the healthy tissues around the treatment area.
• As Radiotherapy has advanced by leaps and bounds in the last 20 years, the severity of side effects has reduced a lot. However, the severity of the side effects also differs from patient to patient.
• Some patients experienced more side effects, and on the other hand, some patients experienced few or none of the side effects.
• Your radiation oncologist will weigh the benefits of any treatment option against the side effects and determine what is best for you.
• It is important to make sure that you inform your radiation oncologist about any side effects you are experiencing, be it minor or major.
• This is because they will help you cope with it and make things easier for you by adjusting the doses of radiation.
• Some of the Side Effects of Radiotherapy are Anemia, Depression, Fatigue, Hair Loss, Skin Problems, etc.

FAQs

• Is Radiotherapy a primary or a secondary option treatment for cancer?

Radiotherapy is neither a primary nor a secondary option treatment. All the treatment options are available for cancer treatment like – chemotherapy, immunotherapy, targeted therapy, surgery, radiation therapy and so on are used by international guidelines. Most of the types of cancer have a preset series of treatments according to those guidelines. These guidelines even dictate the order of the treatment and the choices of treatment options available to them.

• What are the benefits of this therapy?

The benefits of Radiotherapy are as follows:

In case of breast, bowel, prostate, bladder, lung, cervix, skin, and head & neck cancers, radiation therapy is highly effective in reducing the risk of recurrence post-surgery or aids to help the execution of the surgery.

The cancers mentioned in the 1st point have both surgery and radiation therapy for treatment options. In Surgery, the organ affected by cancer is either partially or completely removed, which hampers its functionality. Sometimes Radiotherapy and Chemotherapy are used to eliminate the cancer cells, thereby saving the functionality of the organs.

You won’t lose hair from your head as you do in chemotherapy. However, you only lose hair at the site of irradiation and nowhere else.

• Do you lose weight when undergoing radiation therapy?

The effects of radiation and chemotherapy often result in a loss of appetite. They can also cause adverse effects including nausea, vomiting, and mouth sores, which can make it difficult to eat properly, resulting in weight and muscle loss.

• After radiation therapy, what is the next step?

Following the completion of your radiation therapy, you will visit with your radiation oncologist for a follow-up appointment. Following that, you could do the following steps: If necessary, meeting with other care teams for extra therapy. For supportive care, I met with the cancer survival team.

• When it comes to radiation therapy, what is the success rate?

Patients who are in the early stages of cancer may benefit from either brachytherapy or external beam radiation. With either technique, success rates of about 90% or greater can be attained.