David Clump, MD, is a radiation oncologist at UPMC Presbyterian and UPMC Shadyside who specializes in treating head and neck cancers. As part of the interdisciplinary team at UPMC Hillman Cancer Center — composed of surgical oncologists, medical oncologists, radiation oncologists, pathologists, palliative care providers, social workers, and dietitians — Dr. Clump’s goal is to improve outcomes for his cancer patients.
Here, Dr. Clump answers some of the most common questions about radiation oncology.
How is radiation oncology different from getting an x-ray?
Radiation oncology is actually a way to treat cancer, not just to diagnose it, says Dr. Clump. “We use radiation to treat and control tumors,” he says. “In many instances, we can shrink the tumor, and in some instances, we can eliminate it.”
Can radiation therapy be used on its own?
Like so many aspects of cancer treatment, that depends. Radiation can be used alone or combined with chemotherapy. Doctors may use radiation as well as chemotherapy before or after surgery. It also can be used instead of surgery.
How effective is radiation therapy?
Radiation therapy is considered safe, but its effectiveness depends on the type and stage of the cancer and the overall treatment plan.
“In terms of radiation therapy and its effectiveness, we consider the patient’s goal,” says Dr. Clump. In the vast majority of cases, radiation oncology will at least produce a response, which is the minimum expectation. It may shrink a tumor, it may destroy the tumor completely, or relieve pain associated with a tumor.
How long does radiation therapy last?
It varies from patient to patient. For someone who receives radiation instead of surgery, the treatment may take six or seven weeks. (Treatments are given daily, Monday through Friday, which means roughly 30 to 35 total sessions.)
A patient who has pain related to a tumor may find relief in as little as one treatment.
How does radiation work?
It’s all about damaging the DNA in the cancer cells.
“Radiation works by multiple processes,” explains Dr. Clump. But typically, the treatment is delivered by a machine called a linear accelerator. The radiation oncologist used this machine to target the tumor within the patient’s body and deliver radiation that destroys the DNA within the tumor’s cells. The cancer cells eventually die.
Radiation can give you cancer, so how does radiation oncology treat cancer?
It’s true that radiation exposure is something we try to avoid, says Dr. Clump. “However, when an individual develops a malignant tumor, that tumor becomes the biggest threat to the patient’s quality of life and to their ultimate survival.” Radiation therapy may be curative (to shrink the tumor) or palliative (to relieve symptoms associated with the tumor).
Does radiation oncology hurt?
The short answer is no. “You do not feel anything during the actual course of the treatment,” explains Dr. Clump. And the treatments themselves are short — about five to 10 minutes. But there can be side effects.
What are the side effects?
Side effects can include sores near the treatment site, hair loss, nausea, changes in bowel movements, and pain during urination.
“It all depends upon what area of the body we are treating,” says Dr. Clump. “Radiation is going to affect the tissue being treated and any normal tissue that could potentially be in that path.”
If you are being treated for stomach cancer, for example, that could mean nausea. If you are being treated for brain cancer, there may be hair loss since the radiation passes through the skull.
How do you make sure that only the cancer itself is getting radiation?
“Our field has evolved over the past 100 years, and we’ve fine-tuned the technology so we can treat tumors deep within the body while avoiding the normal tissues that surround the cancer,” says Dr. Clump. Radiation oncologists use image-guided radiation therapy to pinpoint the tumor’s location. This offers the most effective cancer treatment with the fewest side effects.
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International Journal of Medical Sciences, "Cancer and Radiation Therapy: Current Advances and Future Directions," published online 2012 Feb 27. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3298009/
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