Oncological surgical procedures, thanks to the implementation of the latest global medical technology advances, are becoming safer for the patient and possible to carry out, with the intention of a cure, even in the most advanced proliferative processes. Radiation treatment devices (radiotherapy) are being developed with an eye to ever-improving working precision, enabling targeted treatment, focused on the tumour lesion, with minimal strain on critical organs in the vicinity. The addition to oncology treatment of drugs from other groups, also new and successively modified and improved on the basis of previous experience with patients, makes it possible to more fully prevent the side-effects of oncology treatment, which is a burden.
Radiotherapy - side effects
Radiation is not a safe therapy - it can also damage healthy cells in the immediate vicinity of a cancerous tumour. As long as the patient is in good general condition, without immune deficiencies, in a well-nourished state, normal, healthy cells can regenerate much faster and therefore - in most cases - no permanent radiation damage occurs.
The spectrum of side effects from radiotherapy depends on the type and dose of radiation, the body area treated and the individual sensitivity of the patient to this type of treatment. Some patients get through a few weeks of irradiation very gently, while others experience very distressing side effects, sometimes imposing the need for urgent hospitalisation. Early (acute) complications, which occur already during or shortly after radiotherapy, are usually of short duration and reversible. They are most often limited to local soft tissue and shell reactions that resolve without scarring with regeneration of the epidermis and dermis. Occasionally, painful swelling of the irradiated area (especially in areas after lymphadenectomy - removal of lymph nodes) and other organ-specific complications occur. Late (chronic) complications can occur several to several months after irradiation and sometimes lead to chronic organ failure (e.g. lung or kidney fibrosis, heart failure, bone necrosis, non-healing ulcers). With appropriate protection, following the recommendations of the attending physicians and nurses experienced in working with oncology patients, these complications can be avoided in the vast majority or greatly reduced to a degree that does not impede active function and does not reduce the patient's quality of life.
Nuclear medicine
In oncology, the achievements of nuclear medicine are used in diagnostics - e.g. the detection of so-called 'sentinel' nodes to assess the progression of the cancer - the presence of cancer metastases to regional lymph nodes (e.g. Technetium Tc43 - breast cancer, malignant melanoma). Radioactive isotopes (e.g. strontium Sr89, samarium Sm153, phosphorus P32) are used to treat disseminated metastases of solid tumours to bone. The most widely used isotope is strontium - as a calcium analogue, it selectively accumulates in osteolytic foci in the bone, emitting radiation that locally destroys tumour cells with minimal damage to surrounding healthy tissue.
The main indication for the use of the radioactive isotope strontium is multiple, clinically symptomatic, painful bone metastases, which cannot be - due to their extent - irradiated by external sources (teletherapy). Metastatic lesions in the osteoskeletal system, especially when located in long bones (femur, tibia, upper limb and shoulder bones), significantly weaken their internal structure. They predispose to pathological fractures, which are very difficult to treat. In such a case, especially with multiple tumours, isotopic treatment is indicated even with minor pain. This provides an opportunity for pain prevention and bone strengthening at the site of metastases.
photo: panthermedia
The therapeutic- analgesic effect subsides after a maximum of 12 months (average 4-10). Sometimes, paradoxically, there is a transient increase in pain intensity before the full desired analgesic effect occurs. The most common use of this type of procedure is for metastases of breast cancer and prostate cancer to the bone. Isotope treatment can be used simultaneously with irradiation from an external source (teletherapy).
