The cases in which the first choice are increasing. The possibility of using X-rays becomes a precious resource if, for reasons of age or particular conditions, surgery and certain drugs are excluded because they are too risky
An official survey by the Italian Association of Radiotherapy and Clinical Oncology (Airo), which surveyed the work carried out in 104 Italian centers during 2020, revealed that, with radiation alone, over 15 thousand were treated for radical purposes. cancer patients. The research focused in particular on head and neck, prostate, cervix and lung cancers, for which there is already extensive experience in this regard.
That the radiotherapy is sufficient to completely eliminate a neoplasm not a new thing, but still little known – he points out Marcello Mignogna, director of Oncological Radiotherapy at the San Luca Hospital in Lucca -. As international guidelines indicate, radiation treatment can play a crucial role for each area of the body and for each tumor, both solid and haematological. One of its peculiarities is the width of the age range to which it can be prescribed: from children up to over eighty. Over the years, surgery and certain drugs are excluded because they are too risky for the patient.
Effective against many different types of cancer
Definitely the prostate cancer in first place among the neoplasms that can be cured and cured only with a radiation treatment, which is proposed as an alternative, with fewer side effects, to radical prostatectomy surgery when the disease in the initial stage, small and localized, especially in men after the age of 70. The same happens for the non-small cell lung cancers, always in the early stages, in which stereotaxic radiotherapy can have a curative role and equivalent to the operation that would be too destructive – continues Mignogna -. And again: in head and neck tumors, for example nasopharynx and larynx, or for the rarer ones affecting the anus, radiation is the first choice to eradicate the neoplasm without using a scalpel, thus preserving the function of the affected organ as much as possible. Those are then added to the list cases that are inoperable for various reasons and blood cancers, in particular lymphomas, where radiotherapy is often combined with drugs to eliminate any residual cancer cells.
Fewer visits to the hospital
The Airo survey shows that in Italy the use of innovative and advanced techniques and technologies, such as modulated intensity (IMRT), used in almost all neoplasms affecting the head and neck area and the prostate, is increasingly predominant. Especially in prostate cancer, then, it is also spreading therehypofractionation, that is, fewer sessions with a higher dose of radiation, which reduces hospital visits with the same results in terms of efficacy. If for many patients radiotherapy constitutes a valid alternative to surgery, for still others it represents the only possibility of cure – he says Cinzia Iotti, director of Oncological Radiotherapy at the AUSL-IRCCS of Reggio Emilia and president of Airo -. a discipline in continuous evolution: its use, alone or combined with other therapies, including new immunotherapeutic drugs, is gaining ever wider sectors, even in the metastatic patient to whom in the past only purely palliative treatments were administered and who today can instead count on much more ambitious therapeutic approaches, aimed at improving his life expectancy. Without forgetting that radiation is also exploited against relapses
or to clean up the area surrounding the operated area with the aim of destroying any residual cancerous cells and thus reducing the risk of the neoplasm recurring. A strategy widely used, for example, in women with breast cancer after surgery.
Side effects
What are the most frequent side effects? Modern radiotherapy manages to be much less toxic than in the past – he replies Vittorio Donato, Head of the Department of Oncology and Specialized Medicine and Director of the Radiotherapy Division at San Camillo-Forlanini in Rome -. In general, the side effects are nowadays linked only to the radiation field. For example, there may be difficulty swallowing with burning if the chest is irradiated, or diarrhea if the rays are directed to the intestine or skin irritation, as frequently occurs in the breast area. THE however, disorders are generally transient and can be controlled with adequate supportive care. Finally, remember that the patient does not become radioactive and can be in contact with family and friends without restrictions: the radiations exert their action on the irradiated tissues mainly during the delivery of the rays, concludes Donato.
The example of prostate cancer
With 36 thousand new diagnoses every year, prostate cancer is the most frequent cancer among Italian males from the age of 50. It is also the neoplasm on which the greatest amount of data has been collected on the decisive role of radiation to aim for definitive recovery with the least possible side effects. The scientific literature shows that, in terms of survival, the results of the radiation treatment are completely comparable to those of surgerybut the impact in terms of the patient’s quality of life appears to be in favor of radiation points out Riccardo Valdagni, Director of the Prostate Program at the National Cancer Institute of Milan and professor of Radiotherapy at the University of Milan. Many international researches have proven this by now: with radiotherapy, especially during the treatment period, irritation of the urinary and intestinal tract and transient diarrhea can occur, but urinary incontinence is almost absent and the risk of erectile dysfunction more frequent with surgery . Since the cure rates of the tumor are the same, It is important that the choice between the two therapies is made taking into consideration the possible undesirable consequences. It is therefore the men who, weighing the pros and cons of each option, decide what is best for them, concludes Valdagni.
March 17, 2022 (change March 18, 2022 | 17:54)
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