A cancer treatment choice shrouded in mystery

PAIN, death, hopelessness, incurable, are usually the words that ring a bell in one’s mind when the word cancer is mentioned.

Cancer is a grossly misunderstood disease, many of us have the ill-advised notion that it is a death sentence, it is not. There have been major improvements in the diagnosis and treatment of cancer.

Today I take this opportunity to enlighten readers about radiotherapy which is a treatment modality widely used in the treatment of cancer not only in Zimbabwe but across the globe.

The World Health Organisation statistics shows that 50% of all patients who are diagnosed with cancer require radiotherapy at some stage of their disease progression.

It is estimated that treatment by radiation is directly responsible for at least 40% of those surviving beyond five years and by year 2020, 70% of the world’s need for radiotherapy will be in the developing world.

Radiotherapy is the use of high energy X-rays termed as ionising radiation in the treatment of malignant disease (cancer).

Radiotherapy only or in combination with other treatment modalities like surgery, chemotherapy as well as hormone therapy plays a pivotal role in the eradication of cancer.

It has a useful role as a treatment modality to destroy microscopic disease left after surgery, before surgery to shrink the size of tumour making surgery more viable, in advanced disease to relieve pain and discomfort, alone for disease localised on one site and as a preventative measure to prevent certain cancers spreading to certain regions of the body.

Having all the important roles listed above, it is still a form of treatment condemned and not favoured by a majority of individuals.

There has been many myths and misconceptions regarding this form of modality and this has been shown by cancer patients presenting late with advanced disease for treatment as most patients would have first denied radiotherapy a chance in their treatment modalities citing many absurd and unbelievable reasons.

Some people think that radiotherapy is a slow killer and the words that are used to describe this process in vernacular leaves many people in fear.

In vernacular when we want to refer to radiotherapy we say “kupisa gomarara” or “ukutshisa imvukuzane”.

The term “kupisa” or “kutshisa” does not literally mean getting burnt, it is a word that means the same as delivering ionising radiation to tumour cells. The process is not a painful one as many people would think and expect. As an individual you cannot see the ionising radiation, remember we are talking of X-rays that travel at the speed of light.

With radiotherapy you just see the effect of it; effect of pain decreasing, bleeding stopping, size of tumour decreasing, ability to swallow when you came unable to swallow, relief of breathing in patients who came with breathing difficulties or the radiation side effects.

Radiotherapy just like any other treatment modality used in the treatment of different ailments, has potential side effects.

The reason for this is because with radiotherapy we are using high doses of ionising radiation to destroy cancerous cells, but at the same time radiation can affect normal healthy cells and tissues near the treatment area, hence the side effects.

The advantage we have for normal tissues is that after being affected by radiation, normal tissue is able to repair itself, hence the issue of fractionation that is used in radiotherapy.

With fractionation, the radiation dose needed to destroy the cancerous cells is not given all at once but rather in fractions or phases of days to weeks giving break two times weekly to allow normal structures time to repair themselves.

The radiation side effects arise from the area of the body where the tumour is located. For example, people do not usually lose their hair from having radiation therapy.

This is only true if the radiation is aimed at a part of the body that grows hair such as the scalp.

Therefore, the general side effects include fatigue as well as certain skin problems like dryness, itching, change in skin colour and peeling.

These issues usually stop a few weeks after treatment has finished, so there is no need to worry if a patient experiences this.

The reason why oncologists (doctors specialised in treatment of cancer) refer patients for radiotherapy is not for radiation therapists to inflict harm on them but for them to destroy cancerous cells causing pain and discomfort while interfering with day to day lives.

Radiotherapy will remain an important and cost-effective modality in the treatment of cancer, therefore, more needs to be done to educate people about cancer and radiotherapy because with early presentation, radiotherapy proves very efficient in the treatment of cancer.

Let’s keep fighting cancer amid COVID-19 pandemic.