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PicoMed Radiation Elimination!
Approved by the Cancer.Net Editorial Board, 08/2020

Radiation therapy is the use of high-energy x-rays or other particles to destroy 
cancer cells. A doctor who specializes in giving radiation therapy to treat cancer
 is called a radiation oncologist. A radiation therapy regimen, or schedule, 
 usually consists of a specific number of treatments given over a set period.
What are the goals of radiation therapy?

Radiation oncologists use radiation therapy to destroy cancer cells and slow 
tumor growth while limiting the harm to nearby healthy tissue.

Sometimes, doctors recommend radiation therapy as the first cancer treatment.
 Other times, people receive radiation therapy after surgery or therapies 
 using medication, like chemotherapy. This is called adjuvant therapy. It 
 targets cancer cells remaining after the initial treatment.

When it is not possible to destroy all the cancer, doctors may use radiation
 therapy to shrink tumors and relieve symptoms. This is called palliative 
 radiation therapy. Palliative radiation therapy may reduce pressure, pain,
  and other symptoms. The goal is to improve a personís quality of life.

More than half of people with cancer receive some type of radiation therapy. 
For some cancers, radiation therapy alone is an effective treatment. Other 
types of cancer respond best to combination treatments, which is using more
 than 1 treatment for a patient's treatment plan. For instance, this may 
 include radiation therapy plus surgery, chemotherapy, or immunotherapy.
What is external-beam radiation therapy?

External-beam radiation therapy is the most common type of radiation therapy.
 It delivers radiation from a machine outside the body. It can treat large 
 areas of the body, if needed.

A machine called a linear accelerator, or linac, creates the radiation beam 
for x-ray or photon radiation therapy. Special computer software adjusts the 
beamís size and shape. This helps target the tumor while avoiding healthy
 tissue near the cancer cells.

Most treatments are given every weekday for several weeks. Form-fitting 
supports or plastic mesh masks are used for radiation therapy to the head,
 neck, or brain to help people stay still during treatment.

The types of external-beam radiation therapy are:

Three-dimensional conformal radiation therapy (3D-CRT). Detailed 3-dimensional
 pictures of the cancer are created, typically from computed tomography (CT)
  or magnetic resonance imaging (MRI) scans. This allows the treatment team 
  to aim the radiation therapy more precisely. It often means that they can 
  safely use higher doses of radiation therapy while reducing damage to 
  healthy tissue. This lowers the risk of side effects. For instance, dry 
  mouthis common after radiation therapy for head and neck cancer. But 
  3D-CRT can limit the damage to the salivary glands that causes dry mouth.

Intensity modulated radiation therapy (IMRT). This is a more complex form of 
radiation. With IMRT, the intensity of the radiation is varied within each 
field unlike conventional 3D-CRT, which uses the same intensity throughout 
each beam. IMRT targets the tumor and avoids healthy tissue better than 
conventional 3D-CRT.

Proton beam therapy. This treatment uses protons rather than x-rays. 
A proton is a positively charged particle. At high energy, protons 
can destroy cancer cells. The protons go to the targeted tumor and 
deposit the specific dose of radiation therapy. Unlike with x-ray 
beams, there is very little radiation dose beyond the tumor. This 
limits damage to nearby healthy tissue. Currently, doctors use 
proton therapy to treat certain types of cancer. This therapy is 
relatively new and requires special equipment. Therefore, it is 
not available at every medical center. Learn more about proton 

Image-guided radiation therapy (IGRT). This refers to the practice 
of using daily images of each treatment field to confirm patient 
positioning and make sure the target is in the field. These daily 
images are compared to the images used to plan treatment. IGRT 
allows your doctor to make each treatment field smaller. This 
allows better targeting of the tumor and helps reduce damage 
to healthy tissue.

Stereotactic radiation therapy (SRT). This treatment delivers 
a large, precise radiation therapy dose to a small tumor area. 
The patient must remain very still. Head frames or individual 
body molds help limit movement. SRT is often given as a single 
treatment or in fewer than 10 treatments. Some patients may 
need more than one course of SRT.
What is internal radiation therapy?

Internal radiation therapy is also called brachytherapy. This
 type of radiation therapy is when radioactive material is 
 placed into the cancer or surrounding tissue. Implants may 
 be permanent or temporary and may require a hospital stay.

Types of internal radiation therapy include:

Permanent implants. These are tiny steel seeds that contain 
radioactive material. The capsules are about the size of a 
grain of rice. They deliver most of the radiation therapy 
around the implant area. But some radiation may exit the 
patientís body. This requires safety measures to protect 
others from radiation exposure. Over time, the implants 
lose radioactivity. And the inactive seeds remain in the

Temporary internal radiation therapy. This is when radiation
 therapy is given in one of these ways:


    Tubes, called catheters, that carry fluid in or out of
     the body

    Special applicators

The radiation stays in the body for anywhere from a few 
minutes to a few days. Most people receive radiation therapy 
for just a few minutes. Sometimes, people receive internal 
radiation therapy for more time. If so, they stay in a private
 room to limit other people's exposure to the radiation.
What are other radiation therapy options?

Intraoperative radiation therapy (IORT). This treatment delivers
 radiation therapy to the tumor during surgery using either 
 external-beam or internal radiation therapy. IORT allows 
 surgeons to move away healthy tissue in advance. This 
 treatment is useful when vital organs are close to the tumor.

Systemic radiation therapy. Patients swallow or receive an 
injection of radioactive material that targets cancer cells. 
The radioactive material leaves the body through saliva, sweat, 
and urine. These fluids are radioactive and people in close 
contact with the patient should take the safety measures 
recommended by the health care team. An example of this is 
radioactive iodine therapy (RAI; I-131) for thyroid cancer.

Radioimmunotherapy. This is a type of systemic therapy. It 
uses monoclonal antibodies, which are proteins that are 
attracted to very specific markers on the outside of cancer 
cells, to deliver radiation directly to the tumors. Because
the treatment uses these special antibodies, there is less 
effect on surrounding normal tissue. An example is ibritumomab
 (Zevalin), which is used in the treatment of some lymphomas.

Radiosensitizers and radioprotectors. Researchers are studying 
radiosensitizers. These are substances that help radiation therapy
 better destroy tumors. Radioprotectors are substances that protect
  healthy tissues near the treatment area. Examples of radiosensitizers
   include fluorouracil (5-FU, Adrucil) and cisplatin (Platinol). 
   Amifostine (Ethyol) is an example of a radioprotector.
Is radiation therapy safe for patients and their families?

Doctors have safely and effectively used radiation therapy to treat 
cancer for more than 100 years.

Having radiation therapy slightly increases the risk of developing a
 second cancer. But for many people, radiation therapy eliminates the
  existing cancer. This benefit is greater than the small risk that 
  the treatment could cause a new cancer in the future.

During external-beam radiation therapy, the patient does not become 
radioactive. And the radiation remains in the treatment room.

However, internal radiation therapy causes the patient to give off 
radiation. As a result, visitors should follow these safety measures:

    Do not visit the patient if you are pregnant or younger than 18.

    Stay at least 6 feet from the patientís bed.

    Limit your stay to 30 minutes or less each day.

Permanent implants remain radioactive after the patient leaves the
 hospital. Because of this, for 2 months, the patient should not 
 have close or more than 5 minutes of contact with children or 
 pregnant women.

Similarly, people who have had systemic radiation therapy should
 use safety precautions. For the first few days after treatment, 
 take these safety measures:

    Wash your hands thoroughly after using the toilet.

    Use separate utensils and towels.

    Drink plenty of fluids to flush the remaining radioactive 
    material from the body.

    Avoid sexual contact.

    Try to avoid contact with infants, children, and pregnant women

Questions to ask the health care team

    What type of radiation therapy is recommended for me? Why?

    What is the goal of having radiation therapy? Is it to 
    eliminate the cancer, help me feel better, or both?

    How long will it take to have this treatment? How often 
    will I have it?

    Will I need to get a mesh mask or support made before my 
    treatment begins?

    Where will I receive radiation therapy?

    What side effects can I expect during radiation therapy? 

    What can be done to relieve side effects I experience?

    Will special precautions be needed to protect my family 
    and others from radiation therapy I receive?

    Will I receive other cancer treatments in addition to 
    radiation therapy?

    When will we know if this treatment was successful? How?

Related Resources

What to Expect When Having Radiation Therapy

Side Effects of Radiation Therapy

Making Decisions About Cancer Treatment
More Information

National Cancer Institute (NCI): Brachytherapy to Treat Cancer

NCI: External Beam Radiation Therapy for Cancer

RadiologyInfo.org: Introduction to Cancer Therapy (Radiation 

RTAnswers.org: How Does Radiation Therapy Work

ASCO answers; Radiation TherapyDownload ASCO's free Radiation 
Therapy fact sheet. This 1-page printable PDF gives an introduction 
to radiation therapy, including an overview of the different types 
of radiation, what to expect during treatment, possible side effects, 
terms to know, and questions to ask the health care team. Order 
printed copies of this fact sheet from the ASCO Store.
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