New tools lead to lower radiation therapy side effects

Radiation therapy side effects such as radiation dermatitis or organ toxicity have been common complaints of patients with cancer after receiving radiation therapy treatments. However, recent improvements have led to less side effects while improving or having no impact on outcomes.

Dr. David Lee, radiation oncologist with Cancer Care & Research at Marshfield Clinic Health System tells his patients to not believe the horror stories they read on the internet.

“Radiation therapy has changed a lot in the last 10 years – yes, even 10 years ago we were using techniques that would be considered out of date today,” Dr. Lee said. “Most patients are pleasantly surprised that the side effects are not as bad as what they heard about.”

Below are advancements that have reduced radiation therapy side effects.

Implants

One example of an implant is a product called SpaceOAR, which reduces tissue damage to the rectum during prostate cancer radiation therapy treatments.

SpaceOAR is actually a gel that your doctor places between the rectum and prostate. This creates a space about the size of a centimeter and also reduces the amount of radiation exposure on the rectum.

“Bladder toxicity, diarrhea, rectal incontinence or late-chance rectal bleeding are common side effects for patients undergoing radiation therapy for their prostate cancer,” Dr. Lee said. “In most cases, SpaceOAR reduces or eliminates these side effects.”

The water-based gel lasts for three months in the body and does not have any side effects.

It is also common practice to implant markers inside of an organ. These markers allow the radiation oncologist to find the organ with greater accuracy and increase effectiveness when providing radiation therapy.

Advancements in technology

The linear accelerators used today have improved significantly over those in use 10-20 years ago.

“We’ve been upgrading our radiation equipment to our most modern machines with the latest platform in radiation therapy treatments,” Dr. Lee said. “This includes improvements in imaging quality, freedom of setup and accuracy.”

Improving image quality and accuracy ensures the radiation is targeted to the cancer cells and not the normal cells.

A fairly new technology called stereotactic body radiation therapy, or SBRT, has reduced the amount of radiation on normal cells. SBRT uses many separate beams of radiation that meet at one point in the tumor to make a supercharged dose of radiation. This kills the cancer cells at that location in your body while reducing the radiation’s impact on the normal cells.

As additional research is being done on cancer, researchers are finding that some cancers can be treated with less radiation.

“One of the things we have identified is HPV-associated head and neck cancers actually respond better than we used to think,” Dr. Lee said. “We are finding we might actually be able to reduce radiation doses for those types of cancers, which would reduce side effects.”

Moisturizers

Radiation therapy works by damaging the DNA in a cell. For tumor cells, the DNA cannot repair itself so the cancer cells die. However, the other cells around the cancer are able to repair itself. This is why radiation therapy is one of the primary treatment options for cancer.

Skin cells are the most common normal cells to become damaged during radiation therapy. Radiation dermatitis is where your skin gets dry and flaky, similar to a sun burn. Typically you can treat this with a moisturizer and pain reliever.

In some cases, deeper skin layers can peel and the area actually becomes moist. Doctors call this moist desquamation, which they typically treat with a prescription cream and a loose dressing.

For more information about radiation therapy, talk to your doctor.