How to Determine the Place of Radiation Therapy in the Treatment of Cancer?

Unfortunately, so far, in many medical centres they do not always agree and exercise all stages of complex treatments on time. Regarding how to determine the place of radiation therapy in the general treatment plan, LISOD's clinical oncologist and head of the department of radiotherapy Dr. Zvi Bernstein says:

"Radiation therapy may be the only method of treatment or a part of the combined treatment when chemotherapy is given as well. Irradiation may be performed prior to surgery (e.g., as in tumours of the rectum) in order to destroy microscopic tumour spread, lower disease stage, or perform after the surgery - it depends on the type of cancer. Oncologists need to know this. It is for the development of treatment strategies that a multi-disciplinary tumour board exists. Before treating any patient, a plan is made where the place of each method must be defined."

In some types of cancer, such as cervical cancer and squamous head and neck cancer, radiotherapy plays a crucial role, as it is directed to the patient's recovery.

Today, radiation therapy is brining many opportunities and they continue to grow. "There is no type of tumours where the use of radiation therapy would have been studied. Today, there is a study of usage of radiosurgery for brain tumours, prostate cancer, and with lung tumours. New types of external beam radiotherapy can displace brachytherapy (contact radiotherapy), and replace surgery", emphasizes Zvi Bernstein.

For each patient, and in each case, the location, the dose, and the goal of radiation therapy should be determined by specialist oncologists in accordance with international protocols of treatment. However, in Ukraine, often controversial questions on radiotherapy arise in the treatment of breast cancer. "The place of irradiation in this case depends on the amount and type of surgery. If the whole gland is completely removed, and there is no involvement of the lymph nodes, it is possible to avoid irradiation. There are guidelines developed by the American Association of Oncology regarding in which cases, the radiation therapy is indicated. The only thing that is not shown, and that is still done in Ukraine is the prophylactic irradiation of zones of lymphatic collectors", Dr. Bernstein says.

To develop the right treatment plan and place of radiotherapy, it is important to find out the prevalence of all cancer processes for diagnostics. This makes it possible to determine at what stage of the treatment radiation should be applied, and to calculate the most efficient doses for each patient.