Radiation based therapies
Radiation therapy is a cancer treatment that uses high or concentrated doses of radiation to kill cancer cells and shrink tumors.
At certain doses, radiation therapy kills cancer cells or slows their growth by damaging their DNA. Cancer cells whose DNA is damaged beyond repair stop dividing or die. When the damaged cells die, they are broken down and removed by the body.
However, radiation therapy does not kill cancer cells right away. It can take several treatments over several days, weeks or even months before DNA is damaged enough for cancer cells to die. Then, cancer cells may keep on dying for weeks or months after radiation therapy ends.
Radiation therapy may be classed as external beam or internal treatment and the type of treatment you may be offered will depend on the type, site, size and position of the tumour(s) to be treated. Your medical team will also need to assess your current health, the risk/benefit of treatment – and what other treatments you may have already had or may need to have in the future. For example – if you have already had external beam radiotherapy to a specific site of the body, you may not be able to have further therapy to that same area, because of the risk of doing more harm than good.
External Beam Radiation Therapy
(You may see this abbreviated to EBRT or DXT)
External beam radiation therapy comes from a machine that aims radiation at your cancer. The machine does not touch you, but can move around you, sending radiation to a specific part of your body from many directions.
External beam radiation therapy is a local treatment, which means it treats a specific part of your body. For example, if you have cancer in your lung, EBRT will target your lung tumour and not to your whole body.
Radiotherapy may be given after surgery to kill any cancer cells that might remain at the margins of or original site of your tumour.
EBRT may also be used as a palliative (non-curative) treatment for painful bone secondaries – if isolated in specific spots, rather than disseminated (spread throughout the skeleton).
Internal Radiation Therapies
Internal radiation therapy is a treatment in which a source of radiation is put inside your body. The radiation source can be solid or liquid.
Internal radiation therapy with a solid source is called brachytherapy. In this type of treatment, seeds, ribbons, or capsules that contain a radiation source are placed in your body, in or near the tumor. Like external beam radiation therapy, brachytherapy is a local treatment and treats only a specific part of your body. It may be used to treat cancers of the prostate gland or female reproductive system.
Internal radiation therapy with a liquid source is called systemic therapy. Systemic means that the treatment travels in the blood to tissues throughout your body, seeking out and killing cancer cells. You receive systemic radiation therapy by swallowing, through a vein via an IV line, or through an injection.
As mentioned in Interventional Radiology.
Radioligand Therapy – also known as PRRT
PRRT (Peptide Receptor Radionuclide Therapy) delivers radiation to specifically targeted cancer cells, with a minimal effect on healthy cells.
A radioligand is made of two parts: a ligand, which can find cancer cells that have a particular surface molecule – in Neuroendocrine Cancer – we use Octreotide as it has a particular affinity for certain Neuroendocrine Cancer cells, and a radioisotope, which emits therapeutic radiation to kill these cells. The radioligand can target cells anywhere in the body.
PRRT (Peptide Receptor Radionuclide Therapy)
Neuroendocrine Cancer Treatments work in a variety of ways – and whilst we wish it wasn’t the case, side-effects can occur – not will occur – but can occur.
Many of these, if they happen, can be mild and manageable – others may cause an alteration or adjustment in treatment, such as reduced dose or interval – occasionally a treatment may have to stop – either temporarily ( a ‘treatment break’) or permanently, because the side-effect is more severe.
You may also be given treatments in a different order to what was first planned or how you may see them given in others – remember – your treatment plan will be personalised to you.
But it is only possible to deal with changes and side-effects, if you are able to talk them through with your specialist nurse or team.
If you notice a change, or don’t feel well, during or after a treatment – it may be tempting to ignore it or not mention it or wait a few weeks to see if things improve. You may be worried that if you do highlight any changes, your treatment may be stopped. However, the sooner your team knows what is happening, the sooner they can help you to deal with any changes – which will not always mean stopping treatment.
Changes or new symptoms may not always be caused by your treatment – Neuroendocrine Cancer itself can cause alterations in health – and other unrelated health issues can also occur. So, it can be helpful to know what to expect from treatment, what to look out for – and, importantly, when and who to contact if changes occur.
Further information about Radioligand Therapy, in general, can be found here.