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From Japan, further disturbing information is coming to our country about the increase in the level of radioactive radiation in nuclear power plants that were damaged in the earthquake. On the occasion of various discussions on the possible adverse effects of increased radiation on health, the question about the safety of cancer treatment with radiotherapy has returned. Can the rays emitted by the irradiation devices be harmful to the patient?
Electromagnetic radiation is our daily bread. We don’t even realize how much of it is around us. Explosions from nuclear power plants in Japan are only a fraction of the radiation that reaches us. We are influenced by cosmic rays, radiation from the ground and, above all, from buildings, where we deal with a large amount of radon, radioactive gas from building materials. It lives in inexhaustible rooms and is an important – though not the only – source of radiation that affects us in natural conditions.
In the case of radiotherapy treatment, the values of radiation received by patients are of course incomparably higher. However, firstly, we irradiate a limited area of the body, and secondly, for therapeutic purposes, to save the patient’s life. Of course, radiation has side effects, but luckily in many cases they are reversible. Thus, therapeutic irradiation brings greater gains than losses.
What are the most common side effects of radiation therapy? What complications should a patient undergo irradiation deal with?
It depends on the area that is irradiated. The most common complications relate to the skin, which turns red as a result of irradiation, and in extreme cases it may lead to the so-called wet exfoliation. Another side effect of radiation therapy is hair loss in the irradiated area. Depending on the radiation dose, this effect may be permanent or transient. In the case of irradiation of the head and neck area, erosions of the mucous membranes of the mouth and throat appear very often. They are painful, make it difficult for patients to swallow, limit the quantity and quality of food consumed. These are the so-called early reactions, appearing within 90 days of starting radiotherapy. They are almost always reversible, and yet they are the ones that worry the sick the most, because they give unpleasant symptoms and manifest themselves in a stormy way.
What might the effects of ionizing radiation be?
We radiotherapists are most concerned about late reactions, which appear months to years after the end of irradiation and are usually tricky with no initially significant symptoms. These are organ complications such as brain necrosis, radiation pneumonia or narrowing of the coronary arteries, the intensity of which, unfortunately, increases with time (exactly the opposite is true for early reactions, which decrease with time). We do everything to reduce the incidence of late reactions by planning treatment and setting precise radiation doses.
Can it happen that despite careful treatment planning, the patient receives too much radiation? How often do irradiation equipment failures occur?
These are exceptional situations. Recently, we dealt with such a case a few years ago in Białystok, where patients with breast cancer were burned as a result of irradiation. Radiotherapy equipment failures are similar to plane crashes that sometimes happen. However, 99,9 percent. planes land safely, and if a mishap occurs, it is immediately broadcasted. It’s similar with radiation therapy. In the vast majority of cases, everything goes according to plan. Radiation accidents are really marginal.
With dr. n. med. Maciej Pysz, head of the Radiotherapy Department of the Beskid Oncology Center in Bielsko-Biała, interviewed by Mariola Marklowska-Dzierżak
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