“Prostate cancer is an age-related cancer, meaning it mainly affects people over the age of 40. Radiotherapy plays an important role in its treatment as well as other pelvic cancers,” explains Dr. Surendran J – Senior Consultant Radiation Oncology (at dr. Kamakshi Memorial Hospitals) while discussing the efficacy of their latest linear accelerator in treating pelvic tumors.
Q: What are the main cancers that occur in the pelvic area and can be effectively treated with radiotherapy?
Ans: This includes tumors in the prostate (in men) or cervix (in women), rectum, and urinary bladder. These cancers usually affect people over the age of 40. In the past, prostate cancer was more common in western countries, but today we see more cases here.
Q: Is radiotherapy the first line of treatment for all pelvic cancers?
Ans: It is the definitive choice when it comes to prostate and cervical cancer. In most cases of prostate cancer, the disease progresses extremely slowly and the person shows virtually no symptoms for an extended period of time. When it comes to cervical cancer, the pre-invasive stage can last up to 8 years, which is why there are strategic screening tests to detect the cancer. In the invasive stage (except during stage 4), with radiotherapy as the main treatment method, it is very curable. There is a high chance of a complete cure for both cancers. This makes it necessary to increase (increase) the dose to eliminate the cancer cells and achieve a healing result facilitated by brachytherapy (internal radiation).
Q: Is radiotherapy of use in the treatment of tumors in the bladder and rectum?
Answer: Yes. In the case of rectal or bladder cancer, radiation is used to shrink the tumor and surgery is used to remove it or part of the affected organ. Usually, if the tumor is in the upper part of the rectum, only that part is surgically removed and the upper and lower parts are fixed together. However, if the cancer is in the middle or lower part of the rectum and closer to the anal canal, this method is not possible. Previously, after the part with the tumor was surgically removed, a colostomy was performed through which an opening for the colon or colon was made through the abdomen. However, the current trend is sphincter-sparing procedures to avoid colostomy. Radiation helps shrink the tumor and make surgery possible.
Q: What is image-guided radiation therapy?
Ans: Radiation therapy begins with treatment planning that first involves a CT scan of the tumor and the affected organ, along with the critical organs near the tumor. This allows us to determine the magnitude of the dose to be administered and how much of the organ should be exposed. Before the planned treatment is performed on the patient, it is verified against a simulated spatio-temporal localization on the planning system and treatment room to ensure that our plan is correct. Once we have established the dose and area of exposure, this captured image and information will be shared with the linear accelerator. At the time of treatment, the linear accelerator also performs a CT scan on the targeted area. This acquired image is then compared with the recorded image. If both match, the treatment is performed. However, in the case of the prostate or uterus, their position depends on how full the other two organs are, as they are close to the rectum and bladder. A full bladder pushes the prostate back. When the bladder is almost empty, the prostate will sit more forward. This is why the recorded image and the acquired image must be compared and matched before the radiotherapy session begins to ensure that the dose is correctly targeted. This is image-guided radiation therapy (IGRT).
Q: What is adaptive radiation therapy?
Ans: During irradiation after administration of a satisfactory dose, tumors may regress in size and volume. In such a situation, targeting the same region as previously decided will mean that more normal cells are affected. Once the tumor size decreases, the target area can be reduced and the dose increased. This is Adaptive Radiotherapy (ART). IGRT and ART make it possible to perform stereotactic body radiotherapy (SBRT), a specialized radiation delivery technique to deliver ablative tumoricidal radiation doses with definitive accuracy and minimizing exposure of normal adjacent tissues to the dose.
Q: And is the linear accelerator in the Dr. Kamakshi Memorial Hospitals equipped to perform procedures on adults and children?
Ans: The linear accelerator at dr. Kamakshi Memorial Hospitals is one of the best radiotherapy equipment available for the treatment of cancer and can be adapted for use in adults and children. It can be used to treat all body sites, using advanced techniques such as Image Guided Radiation Therapy (IGRT), Adaptive Radiation Therapy (ART), Volumetric Modulated Arc Therapy (VMAT), Stereotactic Radiation Therapy (SRT) and Stereotactic Body Radiation Therapy (SBRT) .
dr. Surendran out dr. Kamakshi Memorial Hospitals is the Senior Consultant in Radiation Oncology with 25 years of experience in cancer treatment and care. Next week we will discuss the impact of the pandemic situation on cancer diagnosis and treatment. Click the link below to view other frequently asked questions from Dr. Surendran to watch:
Lung and liver cancer
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