Radiotherapy for Cancer

Radiotherapy (also known as radiation therapy, radiation oncology or deep x-ray therapy) is an excellent way to cure cancer, and has been around for over one hundred years. There are many types of radiotherapy, including external beam radiotherapy (which uses photons or x-rays, electrons, protons etc), brachytherapy (which uses rods, seeds, molds, applicators) and radioisotopes (which are injected, such as Strontium or radio-iodine).

Radiotherapy is usually a very safe and effective treatment, with the ability to cure cancer as well as to eradicate troubling cancer sypmtoms.

An example of the curative ability of radiotherapy can be seen here, where a 104 year old patient was treated with external beam radiotherapy and had a very large cancer completely cured with very few side-effects. This patient and the patient's family kindly agreed to have the images made available as an educational resource.

Large Cancer in a 101 yo independent patient, involving face and bone. Cancer caused pain, odour, ooze and difficulty eating.

Prof Shakespeare delivered a 2 week course of radiotherapy. The above photo was taken 6 weeks after radiation: the cancer is gone. The area where the cancer was is healing by forming new skin and scar tissue. The patient has no pain, odour, or ooze, and can eat normally.

The best way to give radiotherapy for most patients is by using external beam radiation (EBRT), delivered by linear accelerators (or "linacs") using 3D conformal radiation. Prof Shakespeare believes 3D conformal radiation should be the standard of care for most patients, and that patients should ask whether their tumour will be treated with CT-simulated 3D conformal radiotherapy. For many patients such as those with prostate, head and neck, and brain cancers, intensity modulated radiotherapy (IMRT) is usually the best option available, although is often not offered. Many patients (eg prostate, lung, head and neck and brain cancers) would also benefit from MRI-CT fusion or PET-planning as part of radiotherapy planning. Again, these should be offered to patients. Finally, many patients would benefit from daily imaging before each radiotherapy treatment to ensure the tumour is being treated (rather than accidentally treating other areas instead). If imaging using electronic portal imaging (EPIs), port films, cone beam or image-guided radiotherapy (IGRT) is only once a week, this is probably not the best way to give radiotherapy. Finally, a small minority of tumours such as very selected cases of cervix cancer, endometrial cancer and prostate cancer, may be suitable for brachytherapy treatment.

For more educational information, please visit the breast cancer and prostate cancer pages.

The same Cancer 6 months after  radiotherapy: the cancer is cured. The area where the cancer used to be has now fully healed. The patient's life has returned to normal.