Radiation Therapy's Role in Glioma Treatment
- For some glioma patients, radiation can play a key role in keeping cancer under control. Patients with low-grade gliomas may not need to undergo radiation. However, it’s often recommended for those with grade 3 or 4 gliomas.
- Radiation therapy utilizes high-powered X-rays to target and destroy glioma cells that may have been inaccessible during surgery.
- The painless treatment is typically delivered over multiple sessions, usually five days a week for several weeks.
- Side effects can include fatigue, hair loss, skin changes, headaches, nausea or appetite changes, and cognitive effects.
“Radiation therapy is where we can target radiation to kill the cancer cells selectively — for that, we need to be really precise,” Dr. Preshant Vempati, a radiation oncologist at UH Seidman Cancer Center in Cleveland, Ohio, tells SurvivorNet.
Read More Whether you need radiation or not will depend on the type of glioma you have. Low-grade gliomas, such as grade 1 and grade 2 gliomas, may never require radiation. However, high-grade gliomas, such as grade 3 and grade 4 gliomas, often need radiation therapy either upfront or soon after surgery. Your medical team will assess your individual case to determine whether radiation therapy is the best course of action for your treatment.
How Does Radiation Therapy Work?
Radiation therapy utilizes high-powered X-rays to target and destroy glioma cells that may have been inaccessible during surgery. Clinical trials have demonstrated that radiation therapy can slow tumor progression and improve outcomes for patients with high-grade gliomas.By focusing on specific areas, radiation therapy aims to maximize tumor cell destruction while minimizing damage to surrounding healthy tissue.
“The brain is a very important organ. It has lots of important structures and there’s some areas we want to protect and there are some areas we want to treat,” Dr. Vempati explains.
What is the Preparation Process?
- The Simulation Scan: Before starting treatment, you will undergo a simulation scan, which typically involves a CT scan of your brain. During this process, an immobilization device is used to keep you still during treatment. This device is usually a moldable plastic mask that resembles a net, allowing you to see and breathe through it comfortably. The purpose of this step is to ensure precision in targeting the treatment area.
- Contouring: After your simulation scan, your doctor will use the images obtained, along with MRI scans of your brain, to outline the exact area that requires treatment. This process, known as contouring, helps the medical team define the radiation target while avoiding critical structures such as your eyes, lenses, and brainstem. By carefully mapping out the treatment area, your doctor ensures that the radiation dose is delivered as effectively and safely as possible.
- Planning: A specialized expert called a dosimetrist will then take the information from your scans and work alongside your doctor to create a detailed radiation plan. The dosimetrist is highly trained in radiation delivery methods and will design a customized plan that optimizes treatment effectiveness while minimizing side effects.
- Quality Assurance: Once your doctor has approved the radiation plan, it is sent to a radiation physicist for verification. The physicist ensures that the treatment plan can be safely and accurately delivered to you. This critical step guarantees that the radiation dose is appropriate and that the technology used is functioning optimally.
- Verification: Before your first treatment session, you will return to the clinic for a verification step. A radiation therapist, a professional trained to administer radiation therapy, will take X-rays to confirm that your positioning matches the setup from your simulation scan. This ensures that the radiation is delivered precisely as planned.
There are several different ways to deliver radiation therapy, depending on the specifics of your glioma and your overall treatment plan. The two most common methods include:
- External Beam Radiation Therapy (EBRT): This is the most commonly used type of radiation therapy. A machine called a linear accelerator (LINAC) delivers high-energy X-rays to your tumor from outside the body. The treatment is painless and typically lasts a few minutes per session. A technique called Volumetric Modulated Arc Therapy (VMAT) is typically used which allows you to be treated faster and with more precision than older techniques. You may notice the machine rotating around you in a continuous movement during your treatment.
- Proton Therapy: A newer form of radiation therapy, proton therapy uses proton beams instead of X-rays to target tumors. This method allows for more precise radiation delivery and can reduce damage to surrounding healthy tissues, potentially leading to fewer side effects.
Your doctor will discuss the best radiation delivery method for your case based on your tumor’s characteristics and your overall health.
Radiation Therapy: What to Expect
Radiation therapy is typically delivered over multiple sessions, usually five days a week for several weeks. Each session lasts about 15 to 30 minutes, and you can go home immediately afterward. The treatment itself is painless, and many patients do not feel anything while the machine is delivering radiation.
While radiation therapy is designed to be as targeted as possible, some side effects may still occur. These can vary from person to person and may include:
- Fatigue: Many patients report feeling tired during and after treatment. Resting and maintaining a balanced diet can help manage this symptom.
- Hair Loss: Radiation to the head may cause hair loss in the treated area. In most cases, hair grows back after treatment, although the texture and color may change.
- Skin Changes: The skin in the treatment area may become red, dry, or itchy. Using gentle skincare products and avoiding sun exposure can help.
- Headaches: Some patients experience mild to moderate headaches, which can often be managed with medication.
- Nausea and Appetite Changes: Depending on the radiation location, some patients may feel nauseated or lose their appetite. Eating small, frequent meals and staying hydrated can help manage these symptoms.
- Cognitive Effects: Some patients notice changes in memory, concentration, or processing speed. Your doctor may provide recommendations to help with cognitive function if needed.
It’s important to communicate any side effects you experience to your medical team, as they can provide supportive care and adjust treatment if necessary.
What Happens After Treatment?
Once you have completed your radiation therapy sessions, your doctor will schedule follow-up appointments to monitor your progress.
Recovery and follow-up might include:
- Regular MRI Scans: Your doctor will schedule periodic MRI scans to assess how well the radiation has worked and to check for any signs of tumor progression.
- Managing Side Effects: Some side effects may persist for weeks or months after treatment. Your care team will provide guidance on managing lingering symptoms.
- Rehabilitation Support: If you experience changes in cognitive function or physical abilities, rehabilitation services such as physical therapy, occupational therapy, or speech therapy may be recommended.
- Emotional Well-being: The journey through radiation therapy can be emotionally challenging. Support groups, counseling, and connecting with others who have undergone similar experiences can be helpful.
- Long-Term Outlook: The effects of radiation therapy continue even after treatment has ended, as the body works to eliminate the affected tumor cells. While some patients see improvement in their condition, others may require additional treatments such as chemotherapy or targeted therapies. Your medical team will tailor your follow-up care based on your individual needs.
Questions to Ask Your Doctor
- Is it necessary for me to undergo radiation therapy?
- How should I prepare for this treatment?
- Is there anything I can do to minimize side effects?
- How will I be monitored after radiation?
