Radiotheraphy

When performing radiation therapy or radiotherapy, tumours are treated with ionising radiation. During this treatment energy, calculated by a physicist, targets and destroys the tumour or possible secondary tumours (metastases). Because of the rapid development of imaging and computer efficiency, radiation therapy can now be administered in an accurately targeted way. This allows us to treat the tumour area with higher doses of radiation while the surrounding tissue is protected. In this way, larger tumours can be destroyed whilst reducing side effects.

When performing radiation therapy or radiotherapy, tumours are treated with ionising radiation. During this treatment energy, calculated by a physicist, targets and destroys the tumour or possible secondary tumours (metastases). Because of the rapid development of imaging and computer efficiency, radiation therapy can now be administered in an accurately targeted way. This allows the medical team to treat the tumour area with higher doses of radiation while the surrounding tissue is protected. In this way, larger tumours can be destroyed whilst reducing side effects. 

Nowadays, it is also possible to further optimise the dose distribution with "intensity modulated radiotherapy" or IMRT which enables the medical team to irradiate around healthy organs and to expose the tumour region to even more radiation. For this kind of radiation therapy precise accuracy is of great importance. The patient’s position is meticulously adjusted and permanently controlled, to ensure that even respiratory movements can be compensated for. This form of treatment is called “image guided radiotherapy" or IGRT.

Treatment Pathway

Individual Treatment 

Behind every disease there is a person with his or her own personal and individual medical history. It is precisely for this reason that we provide individualised treatment for our patients. The following is a summary of the procedure: Initial Consultation Once the attending doctor has registered the patient for radiotherapy, they will receive an appointment for an initial consultation (either by mail or telephone). It is advisable to bring a family member, partner or friend to the initial consultation, where possible.

Assessing the Present Situation

In order to provide the correct treatment, the radio-oncologist must first assess the current situation. For this purpose, additional examinations may also be required before commencing the radiotherapy treatment. It is important to know whether the patient suffers from other illnesses which may influence the radiotherapy. The examining doctor will discuss all the details with the patient and explain any additional procedures that might be necessary. The examining doctor should also be informed of any medication currently being taken by the patient, as well as any other treatment the patient is undergoing.

Determining the Treatment Course

During the initial consultation, the doctor will explain the planned course of treatment and answer any questions. The patient will once again be asked questions about their illness and will be examined by the doctor, if necessary. This part of the process is essential, because a description or referral letter issued by the patient’s doctor to the radiotherapy department can never replace a personal discussion and examination. It is also possible that the disease may have changed fundamentally since the last examination was performed.

 

Side Effects

The doctor will also discuss the possible side effects of the therapy. He will try to explain the entire treatment process. He will also give the patient information on any further examinations, check-ups or treatments after the radiotherapy.

Possible Side Effects

All types of therapy have their side effects, and this to radiotherapy. However, as a result of more precise radiation techniques and better supportive measures, these have been significantly reduced in recent years.

Skin Reactions

A skin reaction may occur depending on the type of radiotherapy (location, volume, single dose and total dose). With radiotherapy targeting a tumour in the mouth or throat region, or with breast cancer treatment, the skin is relatively severely affected. After two to three weeks of treatment, patients may experience a skin reaction similar to sunburn. Patients experiencing such symptoms should contact the nursing staff who will coordinate further treatment with the doctor. Household remedies should not be used without prior consultation with the doctor. Many common skincare lotions and creams contain traces of heavy metals. The use of such creams causes the radiation to be scattered into the surface of the skin and leads to even higher skin exposure.

Reactions of the Mucous Membranes

With radiotherapy of the throat and thorax areas (e.g. for lung or oesophageal cancer), parts of the mucous membranes of the mouth, throat and oesophagus are often treated simultaneously. These membranes develop an inflammation which may begin to manifest itself in the second or third week of radiotherapy. Any inflammation causes redness, swelling and particularly pain, which mainly affect the patient while eating. In case such symptoms occur, the patient should notify the nursing staff. The nursing staff will coordinate further treatment and care, for example the prescription of a painkiller, with the doctor.

Diarrheoa and "Radiation Hangover"

With radiotherapy in the stomach and abdomen areas, side effects often include diarrhoea. Treatment of the rectum often causes increased urge to defecate (however, without the actual defecation). Such symptoms are also caused by inflammation in the treated intestinal area as a result of the radiotherapy. Occasionally, patients who receive radiation targeting the intestinal area may feel slightly nauseous an hour or two after treatment. This frequently occurs at the start of a radiotherapy course during the first sessions and is also known as “radiation hangover”. Such symptoms mostly disappear after one to two weeks of treatment and can be easily treated with medication. Such symptoms should also be discussed with the specialised nursing staff.

Individual Reactions are Difficult to Predict

In general, the severity of the side effects varies from individual to individual and depends on the volume and type of radiotherapy. Each person reacts slightly differently to the treatments and unfortunately it is impossible to predict which side effects might actually occur.