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When a person is diagnosed with cancer, there is very naturally an emotional response, that includes a flurry of thoughts, questions, fears, and unknowns, that are critical to address as a component of the consultation with the oncologist, not to mention the support and expertise offered by other specialists and the family physician involved in their care. That care is commonly referred to as part of their “Cancer Journey”. Many components of the “Cancer Journey” are standard of care; they are treatment options one would receive at all cancer centres. Cancer treatment covers a broad spectrum of therapies including: surgery, chemotherapy, radiotherapy and newer approaches called targeted therapies and immunotherapy.
Click here for more information about the different treatment options for cancer.
Over the past 80 years, radiation therapy, has been well established as a common treatment for many cancers with a strong evidence-base for its effectiveness. In approximately 50% of all patients with cancer, radiation therapy is used during the course of their treatment.1 It is an important tool in our arsenal in the fight against cancer.
Radiation therapy may be recommended with the goal of curing a cancer, slowing or stopping a cancer’s growth, preventing cancer from returning, or alleviating symptoms as part of palliative care.2 It can be used as the primary (only) treatment, before, during, or after a surgery, together with other treatments like chemotherapy or immunotherapy.2,3 Radiation therapy utilizes high-energy rays, or sometimes particles, like protons, to kill cancer cells.4,3 Like all cells in our body, cancer cells need to grow and divide. DNA in cancer cells is crucial to this process. During radiation therapy, cancer cells are exposed to high levels of radiation.2 This radiation damages the cancer cells’ DNA repeatedly, to the point where they cannot repair themselves.5 When cancer cells experience enough DNA damage from the radiation, they will stop dividing and growing, causing them to die.2,5
Click here for more information about how radiation therapy works.
Why do side effects of radiation therapy occur?
Radiation therapy is an important part of cancer treatment, but it does often come with side effects. Common side effects include fatigue, skin problems and hair loss.6 These commonly described effects of radiation therapy are due to the ability of the radiation to not only kill cancer cells, but to injure normal body cells or kill normal surrounding cells in the body. Often times, normal cells are able to recover from the damage caused by radiation within a few months of stopping treatment.5,7
Click here for more information about the side effects of radiation therapy.
Clinical research can have an important role in an individual patient’s “Cancer Journey”. The field of radiation medicine has seen huge advances over the past 20 years, and those advances continue to progress faster in more recent years. This is based on a number of factors including:
• Improved medical care to manage cancer-related symptoms and treatment-related effects.
• New-generation computers that allow for complex radiation treatment plans
• Better understanding of tumor biology and other areas of biomedical research
• Common usage of combined treatments, such as surgery, chemotherapy, and radiation to improve outcomes.
Despite these advances, we have only scratched the surface of understanding cancer. However, those achievements in basic research and clinical medicine have transformed the radiation treatment of cancer in many ways, and provided improved quality of life for many cancer patients.
Is clinical research in radiation therapy happening in Windsor-Essex?
There is a lot of exciting research happening in Windsor-Essex in the field of radiation therapy. Radiation oncologists are an especially important part of research into radiation therapy. Through the expertise of radiation oncologists, much of the research seeks to help the patient achieve the benefits of treatment, while reducing the risk of side effects. To achieve this goal, radiation oncologists apply knowledge of clinical medicine, radiation physics and biology. The term “quality of life” describes the goal of achieving an effective treatment, while minimizing side effects; the ultimate goal of clinical research of any kind.
Current cancer research, within our hospital and academic community, is wide ranging, and includes epidemiologic, basic molecular and cell biology, informatics, and clinical trials of newer therapies. It also involves conducting retrospective reviews on populations of patients treated across many types of cancer to study outcomes of response, toxicities and treatment. In addition, evolving research in the technology of radiation treatment planning is being actively pursued, which will help standard radiation treatment plans, and improve efficiencies so that more patients have faster access to starting radiation. Participation in large clinical trials groups as well as drug company sponsored research is also common practice.
“Automated Organ Segmentation With Deep Learning Algorithm: A Pilot Study of Artificial Intelligence in the Radiation Treatment Planning Process for Esophageal Cancer” is an example of a research project that is related to radiation therapy. This project is being conducted by researchers from the University of Windsor working in collaboration with those at Windsor Regional Hospital’s Cancer Program, including Dr. Ming Pan, Dr. Arash Ahmadi, and John Agapito. The goal of this project is to develop an AI computer that is capable of automatically contouring organs and structures when using CT scans to plan radiation therapy. To learn more about this project, please see the further reading section.
Further Reading
Radiation Therapy Information Pamphlet Project by Alexi Jankulovski
WE-SPARK Health Institute – Cancer Resources
Canadian Cancer Society – Radiation Therapy
National Cancer Institute – Radiation Therapy
Automated Organ Segmentation With Deep Learning Algorithm: A Pilot Study of Artificial Intelligence in the Radiation Treatment Planning Process for Esophageal Cancer
Meet The Expert
Dr. Ken Schneider attended medical school at McMaster University (Hamilton, ON) in 1987. He served as the Chief of Oncology at Windsor Regional Hospital from 2002 until January 2018. He continues his role as a Clinical Lead of the Radiation Oncology Program. His reasearch focuses on clinical trials for optimizing treatment of head and neck cancer, breast cancer, gynecologic cancers, and tumours of the brain. Dr. Schneider is also the Windsor Regional Cancer Center's Co-Representative for the National Cancer Institute of Canada (NCIC), a clinical trails institute.
References
*This article was written with the support of Eddie Grimmett, WCRG Ignite Student 2021.
