Radiotherapy

Radiotherapy, also called radiation
therapy, is the treatment of cancer and other diseases with ionizing radiation.
Ionizing radiation, deposits energy, that injures or destroys cells in
the area being treated (the "target tissue") by damaging their genetic
material, making it impossible for these cells to continue to grow. Although
radiation damages both cancer cells and normal cells, the latter are able
to repair themselves and function properly. Radiotherapy may be used to
treat localized solid tumors, such as cancers of the skin, tongue, larynx,
brain, breast, or uterine cervix. It can also be used to treat leukemia
and lymphoma (cancers of the blood forming cells and lymphatic system,
respectively).

One type of radiation therapy
commonly used, involves photons, "packets" of energy. X rays were the first
form of photon radiation, to be used to treat cancer. Depending on the
amount of energy they possess, the rays can be used to destroy cancer cells
on the surface of or deeper in the body. The higher the energy of the x-ray
beam, the deeper the x-rays can go into the target tissue. Linear accelerators
and betatrons, are machines that produce x-rays of increasingly greater
energy. The use of machines to focus radiation, (such as x-rays) on a cancer
site, is called, external beam radiotherapy.

Gamma rays are another form
of photons used in radiotherapy. Gamma rays are produced spontaneously
as certain elements (such as radium, uranium, and cobalt 60) release radiation
as they decompose, or decay. Each element decays at a specific rate and
gives off energy in the form of gamma rays and other particles. X rays
and gamma rays have the same effect on cancer cells.
Another technique for delivering
radiation to cancer cells is to place radioactive implants directly in
a tumor or body cavity. This is called internal radiotherapy. (Brachytherapy,
interstitial irradiation, and intracavitary irradiation are types of internal
radiotherapy.) In this treatment, the radiation dose is concentrated in
a small area, and the patient stays in the hospital for a few days. Internal
radiotherapy is frequently used for cancers of the tongue, uterus, and
cervix.
Several new approaches to radiation
therapy, are being evaluated to determine their effectiveness in treating
cancer. One such technique, is intraoperative irradiation, in which a large
dose of external radiation is directed at the tumor and surrounding tissue,
during surgery.
Another investigational approach
is particle beam radiation therapy. This type of therapy, differs from
photon radiotherap,y in that it involves the use of fast moving subatomic
particles to treat localized cancers. A very sophisticated machine, is
needed to produce and accelerate the particles required for this procedure.
Some particles, (neutrons, pions, and heavy ions) deposit more energy along
the path they take through tissue, than do x-rays or gamma rays, thus causing
more damage to the cells they hit. This type of radiation is often referred
to as, high linear energy transfer (high LET) radiation.
Scientists also are looking
for ways to increase the effectiveness of radiation therapy. Two types
of investigational drugs are being studied for their effect on cells undergoing
radiation. Radiosensitizers make the tumor cells more likely to be damaged,
and radio protectors protect normal tissues from the effects of radiation.
Hypothermia, the use of heat, is also being studied for its effectiveness
in sensitizing tissue to radiation.
Other recent radiotherapy research
has focused on the use of radiolabeled antibodies to deliver doses of radiation
directly to the cancer site (radioimmunotherapy). Antibodies are highly
specific proteins that are made by the body in response to the presence
of antigens (substances recognized as foreign by the immune system). Some
tumor cells contain specific antigens that trigger the production of tumor
specific antibodies. Large quantities of these antibodies can be made in
the laboratory and attached to radioactive substances (a process known
as radiolabeling). Once injected into the body, the antibodies actively
seek out the cancer cells, which are destroyed by the cell killing (cytotoxic)
action of the radiation. This approach can minimize the risk of radiation
damage to healthy cells. The success of this technique will depend upon
both the identification of appropriate radioactive substances, and determination
of the safe and effective dose of radiation that can be delivered in this
way.

Radiation therapy may be used
alone, or in combination with chemotherap or surgery. Like all forms of
cancer treatment, radiation therapy can have side effects. Possible side
effects of treatment with radiation, include temporary or permanent loss
of hair in the area being treated, skin irritation, temporary change in
skin color in the treated area, and tiredness. Other side effects are largely
dependent on the area of the body that is treated.
These web sites may be useful:
             
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