My father is undergoing chemotherapy for his non-small cell lung cancer. He seems to be fighting the side effects. He said the joint pain, fatigue, and diarrhea is killing him. Radiotherapy will be next for him. Would he be okay going for radiation therapy while the chemo side effects are such a big issue for him?
Treatment of lung cancer depends on the stage and type of histology. It used to be systemic chemotherapy being the mainstay of treatment for advance and metastatic small cell lung cancer. But now there is the era of individualised genomic medicine where if certain mutational target are found, the patient can also be candidates for undergoing targeted treatment and immunotherapy. In general, without knowing more details of your father’s specific case, radiation is also very useful treatment modality for lung cancer. Radiation are Xrays, which are also targeted locally and specifically to an area. The side effects are usually well tolerated and more so then chemotherapy which is a systemic treatment. Most patients with advanced lung cancers will find that radiotherapy is well tolerated and your doctor can specifically advise about expected side effects, but side effects are likely to be acceptable.
My brother’s melanoma came back after surgery. His doctor advised radiotherapy. Is this effective to permanently destroy the cancer cell?
Melanoma is an incredibly locally recurrent and aggressive tumor. Early disease can be treated with radiotherapy and can be moderately effective especially a high enough dose can be given. There are some new effective immunotherapy options available for melanoma also
It’s not possible to know definitely without more details of your treatment, but usually radiotherapy is only given once to site and if you had been given to the breast or chest wall in the past, its unlikely to have a second treatment there. So, it is likely that the radiation is going to be for palliative reasons and in this case radiotherapy will treat the bones and the lungs metastasis for pain control.
I am having a skin rash that seems to be a side effect from my previous radiotherapy. Would the rash get severe if I continue the therapy before having it looked at? Have you experienced this rash in your patients?
Each person’s reaction to radiation is different. There are some persons who are more sensitive and may exhibit as skin redness or as a rash. Sometimes these rash are related to previous systemic chemotherapy in a recall reaction. There is a possibility that the rash will get worse before it gets better. Radiotherapy skin reactions are graded from 1 to 4 from mild redness, to more moderate redness with open wounds to ulcerations with infections. The doctor looking after you for radiotherapy will evaluate you weekly and be able to advise. These rash are common occurrences for patients receiving radiotherapy for the reasons above.
Is it normal for radiotherapy to cause more frequent urination? I am currently undergoing radiotherapy for prostate cancer. There are also times I cannot control my urine stream. Would this condition go away once I finish my radiotherapy?
If the radiotherapy is applied to the pelvis for prostate, rectal or gynaecology cancers, then frequent urination is one of the expected side effects, up to 10 to 15% but is mostly mild, but there are times when it could be more severe and leading to bladder irritation and even bladder infection. There are many reasons why one cannot completely control ones urine stream, there are tumor factors, factors relate to the patient as well as related to the treatment. Speak to your doctor to explain your specific problem. There are medications that maybe suitable if its related to bladder muscle instability or if there is an underlying urine tract infection that needs to be treated. There is a reasonable expectation that the bladder irritation related to the treatment will go away once the radiotherapy treatment ends.
My grandfather is fighting a metastatic brain tumor. He is 79 years old. Is radiotherapy still safe for a man his age? Is there any new development in the field that will bring about the most effective outcome with less side effects?
Radiotherapy is one of the modalities for treating metastatic brain tumor. Your doctor will be able to assess if your grandfather will be suitably treated based on tumor and patient factors. But in general, radiation therapy is well tolerated and suitable even when a patient is elderly and has a poor performance status. There are new drugs and genetic sequencing that can individualised the treatment for the specific tumor but they require a biopsy to get a sample of the tumor for testing. Your doctor can advise if its feasible and if there are any new protocol trials available to your grandfather.
I am currently in the midst of receiving radiotherapy for my cancer and my wife is pregnant. Is it safe for her to be around me?
The majority of radiation given is given daily via a linear accelerator, the radiation stops once the machines stops. And patients are not actively radioactive, there are able to be near small children, pregnant women or even pass through Xray detectors in airports because of this fact. It is completely safe to be near your pregnant wife, to go about your daily activities including sharing foods.
My father has stage 3 non-small cell lung cancer. His doctor said he is not fit for surgery due to his heart condition. He is now undergoing radiotherapy. Is it safe for his enlarged heart valve? And is it effective to do radiotherapy without surgery?
Stage 3 lung cancer is usually not an operable condition and radiation therapy is a standard treatment technique with or without chemotherapy. The doctor administering and planning the radiotherapy can selectively avoid the heart and can be made safe even for people with enlarged hearts by limiting the dose. As above, the condition is not suitable for surgery and radiotherapy is the standard treatment.
Chemotherapy has made my father lose a lot of weight. His doctor has suggested he postpone his radiation therapy. But we are worried his disease will progress and worsen. What’s your advice in this position? How far will weight loss pose as a problem for someone who is about to undergo radiation therapy?
Without knowing further details on what stage and type of cancer it is. Usually we defer radiotherapy to allow the patient to build up strength to start. Because it would be deleterious to start and then have to interrupt the radiotherapy treatment, the doctor can make a risk benefit judgement, not deferring the radiation too late but allow time to prepare the patient for the next course. Usually a weight loss of more than 10% from normal baseline weight shows a worser prognosis. A course of nutritional therapy and advise of a dietician on cancer nutrition may help.
Hi Dr Chin. What do you think of brachytherapy? Is it still the best form of radiotherapy for cervical cancer? How about the side effects? Are there any less harmful but reliable options?
Brachytherapy by using radioactive seeds are an effective integral part of treating cervical cancer, usually with some form external beam radiation given over daily. The advantage of brachytherapy is being able to deliver high doses to the tumor around the cervical and have a sharp dose fall off to limit dose and side effects to the surrounding small intestines and bladder. The other options for early stage cervical cancer is an operation, but more advance stage cervical cancer is radiotherapy with or without chemotherapy.