Radiotherapy is one of the fundamental methods used in the treatment of cancer in particular. Also known as radiation therapy, this approach aims to control, reduce, or completely destroy cancerous cells. It can be used on its own or in combination with surgery, chemotherapy, immunotherapy, or targeted therapies. The decision regarding its use, the dose, and the number of sessions depends on numerous factors such as the type of tumour, its location, its stage, the patient's general condition, and the treatments already received.
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Radiotherapy does not serve solely to eliminate the tumour. In some cases, it is used before surgery in order to reduce the size of the tumour, after the operation to destroy any remaining cancerous cells, or at advanced stages to relieve symptoms such as pain, bleeding, organ compression, or breathing difficulties. It therefore represents an essential approach at once curative, preventive, and palliative within the comprehensive management of cancer.
How Does Radiotherapy Work in Cancer Treatment?
Radiotherapy works by damaging the DNA of cancerous cells. Given that these cells divide rapidly and in an uncontrolled manner, they are generally less able to repair the damage caused by radiation than healthy cells. The rays delivered to the targeted area disrupt the ability of the cancerous cells to multiply. Unable to divide, they eventually die or the tumour begins to shrink gradually. This effect is often progressive and may become apparent over the course of the sessions rather than immediately after the start of treatment.
One of the most important aspects of radiotherapy is its localised nature. It targets a precise area of the body where the tumour or at-risk tissues are situated, rather than the body as a whole. Modern techniques allow an effective dose to be delivered directly to the tumour whilst preserving the surrounding healthy tissues as far as possible. Before treatment, meticulous planning is carried out with the aid of medical imaging in order to define the contours of the tumour precisely and to protect sensitive organs. Depending on the case, radiotherapy may be used as the primary treatment or as a complement to improve the effectiveness of other therapeutic approaches.
In Which Types of Cancer Is Radiotherapy Favoured?
Radiotherapy is used in many types of cancer, including breast cancer, prostate cancer, lung cancer, brain tumours, cancers of the head and neck, cervical cancer, uterine cancer, rectal cancer, lymphoma, skin cancers, and certain paediatric cancers. For example, in breast cancer, it is frequently administered after surgery in order to reduce the risk of local recurrence. In prostate cancer, it can serve as an alternative to surgery or be used as a complement following a procedure. In cancers of the head and neck, it is often incorporated into the treatment in combination with chemotherapy or used on its own depending on the clinical situation.
The choice of radiotherapy depends on the type of cancer and the therapeutic objectives. In some cases, the aim is a complete cure, whilst in others, it serves to reduce the size of the tumour before an operation or to control the disease. In rectal cancer, for example, it may be administered before surgery to improve the operative outcomes. In lung cancer, it can be used on its own or in combination with other treatments, depending on the stage of the disease. For brain tumours, it helps to control the progression of the disease or to treat metastases. It also plays an important role in relieving symptoms, particularly in cases of bone metastases, by reducing pain or limiting complications arising from the compression of vital structures.
Can Radiotherapy Be Applied to All Patients?
Although radiotherapy is an effective method in many cases, it is not systematically suitable for every patient. The treatment decision is based on a comprehensive assessment that includes the patient's age, their general health, the type and stage of the tumour, its extent within the body, and the sensitivity of neighbouring organs to radiation. Factors such as previous radiotherapy to the same area, certain medical conditions, pregnancy, or the patient's inability to maintain a stable position during sessions can all influence the therapeutic strategy. This is why each indication is determined on a personalised basis by a specialist in radiation oncology.
In some cases, radiotherapy constitutes the primary treatment, whilst in others, it is used to complement surgery or medication. It may also be indicated with a palliative objective, in order to improve the patient's quality of life. For example, in advanced cancers, it can be used to relieve pain associated with bone metastases, to reduce neurological symptoms caused by brain metastases, or to lessen the effects of tumour compression. In every case, the decision rests on a precise analysis of the balance between the expected benefits and the potential side effects, in order to offer the patient the strategy best suited to their situation.