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Benefits & Effectiveness PT2

One of the reasons that radiation therapy is so cost-effective is that it is usually given as out-patient treatment- people can come in for short visits and often continue their normal activities. Although radiation therapy centres are expensive to set up, a typical treatment machine (linear accelerator) can treat more than 30 patients each day for up to 10 years.

For many common cancers, such as breast cancer, bowel cancer, uterine cancer, skin cancers and prostate cancer, radiation therapy is highly effective in reducing the risk of cancer recurrence if delivered either before or after surgery. In some cancers (for example (prostate, head and neck, bladder, lung, cervix and skin cancers), radiation therapy, with or without drug therapy, can be used as the main curative treatment and in this way avoids the risks of surgery and the removal of organs.

For some cancers that are too advanced to be cured, radiation therapy is very effective for pain and other problems caused by cancer, such as bleeding from the lung or bladder. For example, pain in the bones from the spread of cancer can be improved significantly or be completely removed in around 75% of patients.

New technological advances in radiation therapy have made life better for cancer patients in recent years by making treatments even quicker, more accurate and effective. Ongoing investment in new technology is vital, so Australians and New Zealanders (as in all countries) can keep benefiting from high quality, world-class radiation therapy.

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Benefits & Effectiveness

Radiation therapy (also called radiotherapy) is a highly effective cancer treatment with wide-ranging uses. Radiation therapy leads to cancer cure in many patients (either alone or with other treatments) and relieves symptoms or prolongs survival in more advanced cancers. There are proven roles for nearly all cancer types.

Radiation therapy is a highly targeted treatment accurately controlling the cancer wherever it might be in the body. This allows the cancer cells to be killed or reduced in number whilst protecting the majority of other organs and tissues in the body.

Radiation therapy contributes to 40% of all cancer cures world-wide as well as improving the quality of life for many others. Despite this great benefit, the total cost of radiation therapy to the Commonwealth government is less than 9 cents in every dollar spent on all cancer diagnosis and treatment. Each year of life saved in Australia by radiation therapy costs us less than one saved using other cancer treatments. In other words, radiation therapy is a very cost-effective cancer treatment.

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Sex and fertility issues for women

In women, there's a risk that radiotherapy could cause:

loss of interest in sex (loss of libido) – this tends to gradually improve after treatment stops

stiffening and narrowing of the vagina – your care team may suggest using vaginal dilators (devices you insert into your vagina) to prevent this; having sex regularly may also help

vaginal dryness – lubricants, vaginal moisturisers and medicated creams can help with this

the menopause – this can cause symptoms such as hot flushes and night sweats, but treatment with hormone replacement therapy (HRT) can help

infertility – if there's a risk this could happen, it may be possible to store some of your eggs before treatment

Cancer Research UK has more information about women's sex life and fertility after radiotherapy.

Sex and fertility issues for men

In men, there's a risk that radiotherapy could cause:

loss of interest in sex (loss of libido) – this tends to gradually improve after treatment stops

difficulty getting an erection (erectile dysfunction) – this tends to improve with time and there are several erectile dysfunction treatments available

pain when ejaculating – this should pass a few weeks after the treatment ends

infertility – if there's a risk this could happen, it may be possible to store a sample of your sperm before treatment

Cancer Research UK has more information about men's sex life and fertility after radiotherapy.

Emotional issues

Having radiotherapy can be a frustrating, stressful and traumatic experience. It's natural to feel anxious and to wonder if your treatment will be successful.

Stress and anxiety can also increase your risk of depression.

Speak to your care team if you're struggling to cope emotionally. They can offer support and discuss possible treatment strategies.

Joining a cancer support group may also help. Talking to other people in a similar situation can often reduce feelings of isolation and stress.

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Diarrhoea

Diarrhoea is a common side effect of radiotherapy to the tummy or pelvic area.

It usually starts a few days after treatment begins and may get a bit worse as treatment continues.

Tell your care team if you get diarrhoea. Medicine is available to help relieve it.

Diarrhoea should disappear within a few weeks of treatment finishing. Tell your doctor if your symptoms have not improved after a few weeks, or if you notice blood in your poo.

Stiff joints and muscles

Radiotherapy can sometimes make your joints and muscles in the area being treated feel stiff, swollen and uncomfortable.

Exercising and stretching regularly can help to prevent stiffness.

Tell your care team if joint or muscle stiffness a problem. They may refer you to a physiotherapist, who can recommend exercises for you to try.

Sex and fertility issues

Radiotherapy can have an effect on your sex life and fertility, especially if your lower tummy, pelvic area or groin is treated.

Ask your care team if there's a chance it could affect you.

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Sore mouth

Radiotherapy to your head or neck can make the lining of your mouth sore and irritated. This is known as mucositis.

Symptoms tend to happen within a couple of weeks of treatment starting and can include:

the inside of your mouth feeling sore – as if you have burned it by eating very hot food or drink

mouth ulcers, which can become infected

discomfort when eating, drinking and/or talking

a dry mouth

reduced sense of taste

bad breath

Tell your care team if you have any of these problems. They may recommend painkillers or a special mouthwash that can help. Avoiding spicy, salty or sharp foods can also help.

Mucositis usually gets better a few weeks after treatment finishes, although sometimes a dry mouth can be a long-term problem.

Loss of appetite

Feeling sick and tired during radiotherapy can make you lose your appetite, which could lead to weight loss. You may also find that your sense of taste changes, which can also affect appetite.

But it's important to try to eat healthily and maintain your weight during treatment. Tell your care team if you do not feel you're eating enough.

They may give you tips, such as eating frequent small meals instead of 3 large meals, or refer you to a dietitian.

Discomfort when swallowing

Radiotherapy to your chest, head, neck or oesophagus (gullet or food pipe) can make swallowing uncomfortable.

Tell your care team if this affects you, as you may need to make some changes to your diet, such as eating soft or liquid foods.

You may also be prescribed medicine to reduce the discomfort and in a few cases you may need a temporary feeding tube.

Read more about treatments for swallowing problems.

Swallowing problems usually improve after treatment stops.

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Radiotherapy can cause side effects, although many of these can be treated or prevented and most will go away after the treatment stops.

It's difficult to predict what side effects you'll get and in some cases you may only develop side effects months, or even years, after you start treatment.

Side effects vary from person to person and depend on things such as the part of your body being treated and the type of radiotherapy you have. Ask your care team about the side effects you might get.

Sore skin

In some people, radiotherapy can make your skin sore, change colour (it might become red, lighter or darker than your normal skin tone), or dry and itchy. Sometimes it can blister and peel.

This tends to start 1 to 2 weeks after treatment begins.

Tell your care team if you notice any soreness or changes to your skin.

To care for your skin during radiotherapy you should:

wash your skin every day with your usual soap

pat your skin dry instead of rubbing it

apply your usual moisturiser every day, or start using a moisturiser

use your usual deodorant, unless it irritates your skin

avoid shaving the area if possible and do not use laser, wax, or hair-removal creams

avoid using heat or cold packs on the area

try wearing loose-fitting clothes made from natural fibres such as cotton or silk, and avoid tight bands, ties or straps on the sore area

use a high-factor sunscreen (SPF 50 or above) to protect your skin from the sun and continue to use it for at least a year after treatment ends

check with your care team if you should stop swimming – chlorine in the water can sometimes make your skin worse when you're having radiotherapy

stop using any products on your skin if your skin breaks

Skin problems usually settle within 2 to 4 weeks of treatment finishing, but sometimes your skin might stay slightly darker or lighter than it was before.

Tiredness

Many people having radiotherapy feel tired (fatigued) a lot of the time or become tired very easily from doing everyday activities.

This usually starts during treatment and can continue for several weeks or months after treatment finishes.

It can help to:

get plenty of rest

avoid doing tasks or activities that you do not feel up to

do light exercise, such as going for short walks, if you're able to – this can boost your energy level, but be careful not to push yourself too hard

ask your friends and family for help with everyday tasks

If you're working, you may want to ask your employer for time off or to let you work part-time until your treatment has finished.

Read more tips to help fight tiredness.

Contact your care team if you suddenly feel very tired and out of breath. This can be a sign of a lack of red blood cells (anaemia), which may need to be treated.

Hair loss

Hair loss is a common side effect of radiotherapy. But unlike hair loss during chemotherapy, it only causes hair loss in the area being treated.

Ask your care team to show you exactly where your hair is likely to fall out.

Your hair will usually start to fall out 2 to 3 weeks after treatment starts.

It should start to grow back a few weeks after treatment finishes, although sometimes it may be a slightly different texture or colour than it was before.

Occasionally, hair loss can be permanent if you have a high dose of radiotherapy. Ask your doctor if this is a risk before starting treatment.

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Do not take Chemotherapy if you have lung problems or other underlying conditions.

Chemotherapy may also damage cells in the heart, lungs, kidneys, bladder, and nervous system.

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After Therapy:

Eat healthy & stay hydrated. Helps the Immune system and healing

Exercise regularly

Get enough rest

Stress reduction techniques

Practice good hygiene

Follow up appointments with health care provider

Don’t s:

Rub, scrub, scratch sensitive areas

Avoid putting very hot or cold things like hot pads or ice packs

Avoid raw or undercooked eat raw or undercooked food

Overexert yourself

Interact with infectious people

Drink alcohol

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How much radiation therapy costs

Radiation therapy can be expensive. It uses complex machines and involves the services of many health care providers. The exact cost of your radiation therapy depends on the cost of health care where you live, what type of radiation therapy you get, and how many treatments you need.

Talk with your health insurance company about what services it will pay for. Most insurance plans pay for radiation therapy. To learn more, talk with the business office at the clinic or hospital where you go for treatment.

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Types of cancer that are treated with radiation therapy

External beam radiation therapy is used to treat many types of cancer.

Brachytherapy is most often used to treat cancers of the head and neck, breast, cervix, prostate, and eye.

A systemic radiation therapy called radioactive iodine, or I-131, is most often used to treat certain types of thyroid cancer.

Another type of systemic radiation therapy, called targeted radionuclide therapy, is used to treat some patients who have advanced prostate cancer or gastroenteropancreatic neuroendocrine tumor (GEP-NET). This type of treatment may also be referred to as molecular radiotherapy.

How radiation is used with other cancer treatments

For some people, radiation may be the only treatment you need. But, most often, you will have radiation therapy with other cancer treatments, such as surgery, chemotherapy, and immunotherapy. Radiation therapy may be given before, during, or after these other treatments to improve the chances that treatment will work. The timing of when radiation therapy is given depends on the type of cancer being treated and whether the goal of radiation therapy is to treat the cancer or ease symptoms.

When radiation is combined with surgery, it can be given:

Before surgery, to shrink the size of the cancer so it can be removed by surgery and be less likely to return.

During surgery, so that it goes straight to the cancer without passing through the skin. Radiation therapy used this way is called intraoperative radiation. With this technique, doctors can more easily protect nearby normal tissues from radiation.

After surgery to kill any cancer cells that remain.

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Radiation Therapy to Treat Cancer

Radiation therapy kills cancer cells or slows their growth by damaging their DNA.

Credit: National Cancer Institute

Radiation therapy (also called radiotherapy) is a cancer treatment that uses high doses of radiation to kill cancer cells and shrink tumors. At low doses, radiation is used in x-rays to see inside your body, as with x-rays of your teeth or broken bones.

How radiation therapy works against cancer

At high 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.

Radiation therapy does not kill cancer cells right away. It takes days or weeks of treatment before DNA is damaged enough for cancer cells to die. Then, cancer cells keep dying for weeks or months after radiation therapy ends.

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Chemotherapy side effects

Hair loss

Diarrhea

Fatigue

Nauseous and vomiting

Skin changes

Urinary and bladder problems

It takes 6 months or more to recover

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Cancer is a disease in which some of the body’s cells grow uncontrollably and spread to other parts of the body.

Cancer can start almost anywhere in the human body, which is made up of trillions of cells. Normally, human cells grow and multiply (through a process called celldivision) to form new cells as the body needs them. When cells grow old or become damaged, they die, and new cells take their place.

Sometimes this orderly process breaks down, and abnormal or damaged cells grow and multiply when they shouldn’t. These cells may form tumors, which are lumps of tissue. Tumors can be cancerous or not cancerous (benign).

Cancerous tumors spread into, or invade, nearby tissues and can travel to distant places in the body to form new tumors (a process called metastasis). Cancerous tumors may also be called malignanttumors. Many cancers form solid tumors, but cancers of the blood, such as leukemias, generally do not.

Benign tumors do not spread into, or invade, nearby tissues. When removed, benign tumors usually don’t grow back, whereas cancerous tumors sometimes do. Benign tumors can sometimes be quite large, however. Some can cause serious symptoms or be life threatening, such as benign tumors in the brain.

https://www.cancer.gov/about-cancer/understanding/what-is-cancer#:~:text=Cancer%20is%20caused%20by%20certain,tightly%20packed%20DNA%20called%20chromosomes.&text=Cancer%20is%20a%20genetic%20disease,how%20they%20grow%20and%20divide.

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The Definition of Cancer

Cancer is a disease in which some of the body's cells grow uncontrollably and spread to other parts of the body.

Cancer can start almost anywhere in the human body, which is made up of trillions of cells. Normally, human cells grow and multiply (through a process called cell division) to form new cells as the body needs them. When cells grow old or become damaged, they die, and new cells take their place.

Sometimes this orderly process breaks down, and abnormal or damaged cells grow and multiply when they shouldn't. These cells may form tumors, which are lumps of tissue. Tumors can be cancerous or not cancerous ( benign).

Cancerous tumors spread into, or invade, nearby tissues and can travel to distant places in the body to form new tumors (a process called metastasis). Cancerous tumors may also be called malignant tumors. Many cancers form solid tumors, but cancers of the blood, such as leukemias, generally do not.

Benign tumors do not spread into, or invade, nearby tissues. When removed, benign tumors usually don't grow back, whereas cancerous tumors sometimes do. Benign tumors can sometimes be quite large, however. Some can cause serious symptoms or be life threatening, such as benign tumors in the brain.

Differences between Cancer Cells and Normal Cells

Cancer cells differ from normal cells in many ways. For instance, cancer cells:

grow in the absence of signals telling them to grow. Normal cells only grow when they receive such signals.

ignore signals that normally tell cells to stop dividing or to die (a process known as programmed cell death, or apoptosis).

invade into nearby areas and spread to other areas of the body. Normal cells stop growing when they encounter other cells, and most normal cells do not move around the body.

tell blood vessels to grow toward tumors. These blood vessels supply tumors with oxygen and nutrients and remove waste products from tumors.

hide from the immune system. The immune system normally eliminates damaged or abnormal cells.

trick the immune system into helping cancer cells stay alive and grow. For instance, some cancer cells convince immune cells to protect the tumor instead of attacking it.

accumulate multiple changes in their chromosomes, such as duplications and deletions of chromosome parts. Some cancer cells have double the normal number of chromosomes.

rely on different kinds of nutrients than normal cells. In addition, some cancer cells make energy from nutrients in a different way than most normal cells. This lets cancer cells grow more quickly.

Many times, cancer cells rely so heavily on these abnormal behaviors that they can't survive without them. Researchers have taken advantage of this fact, developing therapies that target the abnormal features of cancer cells. For example, some cancer therapies prevent blood vessels from growing toward tumors, essentially starving the tumor of needed nutrients.

How Does Cancer Develop?

Cancer is a genetic disease-that is, it is caused by changes to genes that control the way our cells function, especially how they grow and divide.

Genetic changes that cause cancer can happen because:

of errors that occur as cells divide.

of damage to DNA caused by harmful substances in the environment, such as the chemicals in tobacco smoke and ultraviolet rays from the sun. (Our Cancer Causes and Prevention section has more information.)

they were inherited from our parents.

The body normally eliminates cells with damaged DNA before they turn cancerous. But the body's ability to do so goes down as we age. This is part of the reason why there is a higher risk of cancer later in life.

Each person's cancer has a unique combination of genetic changes. As the cancer continues to grow, additional changes will occur. Even within the same tumor, different cells may have different genetic changes.

When Cancer Spreads

A cancer that has spread from the place where it first formed to another place in the body is called metastatic cancer. The process by which cancer cells spread to other parts of the body is called metastasis.

Metastatic cancer has the same name and the same type of cancer cells as the original, or primary, cancer. For example, breast cancer that forms a metastatic tumor in the lung is metastatic breast cancer, not lung cancer.

Under a microscope, metastatic cancer cells generally look the same as cells of the original cancer. Moreover, metastatic cancer cells and cells of the original cancer usually have some molecular features in common, such as the presence of specific chromosome changes.

In some cases, treatment may help prolong the lives of people with metastatic cancer. In other cases, the primary goal of treatment for metastatic cancer is to control the growth of the cancer or to relieve symptoms it is causing. Metastatic tumors can cause severe damage to how the body functions, and most people who die of cancer die of metastatic disease.

Types of Cancer

There are more than 100 types of cancer. Types of cancer are usually named for the organs or tissues where the cancers form. For example, lung cancer starts in the lung, and brain cancer starts in the brain. Cancers also may be described by the type of cell that formed them, such as an epithelial cell or a squamous cell.

You can search NCI's website for information on specific types of cancer based on the cancer's location in the body or by using our A to Z List of Cancers. We also have information on childhood cancers and cancers in adolescents and young adults.

Here are some categories of cancers that begin in specific types of cells:

Carcinoma

Carcinomas are the most common type of cancer. They are formed by epithelial cells, which are the cells that cover the inside and outside surfaces of the body. There are many types of epithelial cells, which often have a column-like shape when viewed under a microscope.

Carcinomas that begin in different epithelial cell types have specific names:

Adenocarcinoma is a cancer that forms in epithelial cells that produce fluids or mucus. Tissues with this type of epithelial cell are sometimes called glandular tissues. Most cancers of the breast, colon, and prostate are adenocarcinomas.

Basal cell carcinoma is a cancer that begins in the lower or basal (base) layer of the epidermis, which is a person's outer layer of skin.

Squamous cell carcinoma is a cancer that forms in squamous cells, which are epithelial cells that lie just beneath the outer surface of the skin. Squamous cells also line many other organs, including the stomach, intestines, lungs, bladder, and kidneys. Squamous cells look flat, like fish scales, when viewed under a microscope. Squamous cell carcinomas are sometimes called epidermoid carcinomas.

Transitional cell carcinoma is a cancer that forms in a type of epithelial tissue called transitional epithelium, or urothelium. This tissue, which is made up of many layers of epithelial cells that can get bigger and smaller, is found in the linings of the bladder, ureters, and part of the kidneys (renal pelvis), and a few other organs. Some cancers of the bladder, ureters, and kidneys are transitional cell carcinomas.

Sarcoma

Sarcomas are cancers that form in bone and soft tissues, including muscle, fat, blood vessels, lymph vessels, and fibrous tissue (such as tendons and ligaments).

Osteosarcoma is the most common cancer of bone. The most common types of soft tissue sarcoma are leiomyosarcoma, Kaposi sarcoma, malignant fibrous histiocytoma, liposarcoma, and dermatofibrosarcoma protuberans.

Our page on soft tissue sarcoma has more information.

Leukemia

Cancers that begin in the blood-forming tissue of the bone marrow are called leukemias. These cancers do not form solid tumors. Instead, large numbers of abnormal white blood cells (leukemia cells and leukemic blast cells) build up in the blood and bone marrow, crowding out normal blood cells. The low level of normal blood cells can make it harder for the body to get oxygen to its tissues, control bleeding, or fight infections.

There are four common types of leukemia, which are grouped based on how quickly the disease gets worse (acute or chronic) and on the type of blood cell the cancer starts in (lymphoblastic or myeloid). Acute forms of leukemia grow quickly and chronic forms grow more slowly.

Our page on leukemia has more information.

Lymphoma

Lymphoma is cancer that begins in lymphocytes (T cells or B cells). These are disease-fighting white blood cells that are part of the immune system. In lymphoma, abnormal lymphocytes build up in lymph nodes and lymph vessels, as well as in other organs of the body.

There are two main types of lymphoma:

Hodgkin lymphoma - People with this disease have abnormal lymphocytes that are called Reed-Sternberg cells. These cells usually form from B cells.

Non-Hodgkin lymphoma - This is a large group of cancers that start in lymphocytes. The cancers can grow quickly or slowly and can form from B cells or T cells.

Our page on lymphoma has more information.

Multiple Myeloma

Multiple myeloma is cancer that begins in plasma cells, another type of immune cell. The abnormal plasma cells, called myeloma cells, build up in the bone marrow and form tumors in bones all through the body. Multiple myeloma is also called plasma cell myeloma and Kahler disease.

Our page on multiple myeloma and other plasma cell neoplasms has more information.

Melanoma

Melanoma is cancer that begins in cells that become melanocytes, which are specialized cells that make melanin (the pigment that gives skin its color). Most melanomas form on the skin, but melanomas can also form in other pigmented tissues, such as the eye.

Our pages on skin cancer and intraocular melanoma have more information.

Brain and Spinal Cord Tumors

There are different types of brain and spinal cord tumors. These tumors are named based on the type of cell in which they formed and where the tumor first formed in the central nervous system. For example, an astrocytic tumor begins in star-shaped brain cells called astrocytes, which help keep nerve cells healthy. Brain tumors can be benign (not cancer) or malignant (cancer).

Our page on brain and spinal cord tumors has more information.

Other Types of Tumors

Germ Cell Tumors

Germ cell tumors are a type of tumor that begins in the cells that give rise to sperm or eggs. These tumors can occur almost anywhere in the body and can be either benign or malignant.

Our page of cancers by body location/system includes a list of germ cell tumors with links to more information.

Neuroendocrine Tumors

Neuroendocrine tumors form from cells that release hormones into the blood in response to a signal from the nervous system. These tumors, which may make higher-than-normal amounts of hormones, can cause many different symptoms. Neuroendocrine tumors may be benign or malignant.

Our definition of neuroendocrine tumors has more information.

Carcinoid Tumors

Carcinoid tumors are a type of neuroendocrine tumor. They are slow-growing tumors that are usually found in the gastrointestinal system (most often in the rectum and small intestine). Carcinoid tumors may spread to the liver or other sites in the body, and they may secrete substances such as serotonin or prostaglandins, causing carcinoid syndrome.

Our page on gastrointestinal neuroendocrine tumors has more information.

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Explanations about what cancer is, how cancer cells differ from normal cells, and genetic changes that cause cancer to grow and spread.

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Cancer is a disease caused when cells divide uncontrollably and spread into surrounding tissues. Cancer is caused by changes to DNA. Most cancer-causing DNA changes occur in sections of DNA called genes. These changes are also called genetic changes.

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what forms cancer?

Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal bleeding, prolonged cough, unexplained weight loss, and a change in bowel movements. While these symptoms may indicate cancer, they can also have other causes. Over 100 types of cancers affect humans.