Radiation therapy is one of the main methods of cancer treatment, as it uses ionizing radiation to destroy cancer cells. This treatment is applied to more than 60% of cancer patients at some stage of their overall treatment. The fact that it is so widely used makes it one of the most important pillars in the fight against the disease.

“Despite the apparent complexity of the procedure, understanding how radiation therapy works can help patients feel safer and more informed when making their treatment decisions,” said Dr. Skarlos Pantelis Radiation Therapist, Oncologist, Director of the 2nd Radiation Oncology Clinic at the Metropolitan Hospital & Doctor of the Aristotle University of Thessaloniki, who then explains the mode of operation, types, benefits and side effects of radiation therapy:

How radiation therapy works

Radiation therapy is based on the use of X-rays produced by special medical machines, such as linear accelerators. These rays are precisely directed to the tumors to destroy the cancer cells. The process is done by causing damage to the DNA of cancer cells, which leads to cell death. This specialized cell destruction allows radiation therapy to be highly effective in targeting cancer cells, without causing serious damage to adjacent healthy tissue.

Healthy cells have the ability to repair radiation damage much better than cancer cells, which enhances the success of the treatment. In addition, radiation therapy is one of the few tools that can be applied even to difficult parts of the body, offering targeted action.

Types of radiation therapy

Radiation therapy is used in a variety of ways, depending on the diagnosis and the needs of the patient. In most cases, it is aimed at treating cancer, but its applications vary:

• Radical radiation therapy: The aim is to completely eliminate the cancer in its early stages.
• Preoperative radiation therapy: Used before surgery to reduce the size of the tumor, making it easier to remove.
• Post-operative radiation therapy: Aims to destroy any remaining cancer cells after surgery to reduce the chances of recurrence.
• Palliative radiation therapy: In cases of advanced cancer, the treatment helps reduce pain and other symptoms, improving the patient’s quality of life.

Depending on the stage and type of cancer, radiation therapy may be combined with other treatments, such as chemotherapy or immunotherapy, to maximize treatment results.

The advantages of radiation therapy

Radiation therapy has many advantages that make it particularly effective and necessary in the treatment of cancer. One of its main benefits is that it can often replace the need for surgery. Especially in cases where surgery is dangerous or impossible because of where the tumor is, radiation therapy offers an alternative that can be just as effective.

Another important advantage is its targeted action. Radiation therapy is highly precise, meaning that the radiation is focused exclusively on the cancerous area, leaving as much of the healthy tissue intact as possible. This significantly reduces the risk of complications and side effects.

Side effects of radiation therapy

Radiation therapy is generally a painless procedure, but it is accompanied by side effects, which are divided into two categories: acute, which occur during treatment and subside after its completion, and late, which can occur weeks or months after the end of treatment.

The most common acute side effects include:

• Fatigue: Many patients report an intense feeling of fatigue during and after treatment, which can last for a few weeks.
• Skin irritation: In the areas receiving radiation, the skin may experience redness, dryness or itching.
• Swallowing problems: In cases of radiation to the neck or chest, swallowing difficulties may occur.
In more advanced cases or when treatment involves larger areas, more serious side effects may occur, such as:
• Hair loss: Occurs when radiation therapy is applied to the head area.
• Gastrointestinal disturbances: Occur in cases of radiation in the abdominal area.

However, it is worth noting that most side effects are manageable and temporary. Also important is the fact that patients undergoing external beam radiotherapy do not emit radiation after treatment, which means they do not pose a risk to those around them, allowing them to maintain their social lives without restrictions.

Preparation and duration of treatment

The process of radiation therapy begins with the selection of the right doctor and center. The radiation oncologist performs a detailed assessment of the patient’s condition before proceeding with treatment planning. This usually involves a CT scan, which is used to pinpoint the area that will receive radiation.

Sessions last only a few minutes but patient preparation and positioning may require a total of approximately 30 minutes daily. The duration of treatment depends on the type and stage of the cancer and can range from 3 to 7 weeks.

What is the future of radiation therapy in the treatment of cancer?

“The future of radiation therapy in the treatment of cancer is oriented towards more personalized and targeted approaches, taking advantage of new technologies and discoveries in cancer biology. Some of the trends and developments shaping the future of radiation therapy in cancer are as follows:

1. Personalized treatment: With the improvement of molecular oncology and a deeper understanding of tumor biology, radiation therapy is tailored to the individual needs of each patient. Using information from biomarkers, doctors can adjust radiation doses and identify patients who may need less or no radiation therapy.
2. High Precision Radiation Therapy (IMRT and DIBH): Even greater improvement of techniques and introduction of the fourth dimension, i.e. time, in our treatments (adaptive radiotherapy).
3. Subfractionation of radiation therapy: Subfractionation of radiotherapy is the administration of higher doses of radiation in fewer sessions. This technique has become more widespread and can provide effective treatment in a short time, reducing overall costs and hospital visits for patients with breast, larynx, rectal and prostate cancer.
4. Use of artificial intelligence (AI): Artificial intelligence and machine learning algorithms are expected to help analyze big data from patients and optimize treatment plans. AI can better identify patients who will respond best to radiation therapy and tailor treatments based on individual prognosis.
5. Combination therapies: The combined use of radiation therapy with immunotherapy or targeted drugs can enhance the effectiveness of treatment. Combining these treatments can increase the response of cancer cells to radiation, improving the overall outcome.

This means that treatment can be adjusted in real time, maximizing effectiveness and minimizing side effects. The Radiotherapeutic Oncology Clinic of the Metropolitan Hospital, an exemplary, integrated radiation therapy unit with the possibility of applying all modern techniques, comparable to the most advanced foreign centers, has been supporting this effort for over 15 years, to offer the full range of state-of-the-art treatments to oncologists patients”, concludes Mr. Skarlos.