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What Is Radiation Therapy?

Radiation therapy, or radiotherapy, is a type of cancer treatment in which specialists kill cancerous
cells in the body by exposing them to ionizing radiation, such as X-rays, gamma rays, high-energy
electrons or heavy particles. It is one of the most widely used cancer treatments, with around half of
all patients requiring radiotherapy at some point during the course of the disease.

How does radiation therapy work against cancer?

Cancer is a condition in which cells in a specific part of the body begin to grow and reproduce
uncontrollably, forming tumours which affect surrounding tissues and organs and sometimes spread
to other parts of the body through the bloodstream or lymphatic system.

Radiotherapy involves using carefully selected doses of ionizing radiation to damage the DNA of
cancer cells. The DNA controls how they divide. Radiation causes the tumour to shrink and, in some
cases, die. Radiation therapy has been used since the 1890s to treat almost all types of cancer. It is
applied alone or in combination with other treatments, such as chemotherapy or surgery, to cure
cancers or control symptoms of the disease.

Types of radiation therapy

Depending on the type and location of cancer, radiation oncologists use two types of radiation
therapy, alone or in combination: external, also known as teletherapy, and internal, or brachytherapy.

The selected treatment needs a team of qualified experts, consisting of a radiation oncologist, medical
physicist and radiation therapy technologist, who use radiation to destroy the tumour while
minimizing harm to healthy cells.
Teletherapy
The most common type of radiation therapy is teletherapy, whereby radiation is delivered to the
tumour area in the form of a high-energy beam. This radiation is emitted from a machine located at a
distance from the body, such as a cobalt unit or a linear accelerator.

During the therapy, the patient lies motionless on a table while the machine moves around the body,
directing precise doses of radiation at the tumour from several angles. The beam size and shape are
carefully adjusted to deliver the dose to the tumour while sparing the normal tissues.
Brachytherapy
With brachytherapy, a small encapsulated radioactive source is placed inside the body, enabling a
high dose of radiation to be delivered directly to the tumour with only minimal impact on the
surrounding tissues.

The source can be placed either temporarily or permanently. For temporary application, a capsule
containing caesium, iridium or cobalt sources is inserted through a needle or a special applicator.
Depending on the dose delivered by the source, the capsule can remain in the body for several
minutes to several days. For permanent application, an implant – one example of which is iodine-125
and is usually about the size of a rice grain – is inserted into the body and targets the tumour with
radiation, before losing its radioactivity over time.

Brachytherapy is often used to treat prostate, breast, skin and some head and neck cancers. (Graphic: A.
Vargas/IAEA)

How effective is radiotherapy?

Radiotherapy is a highly effective and well-established treatment that millions of patients undergo
every year for brain, breast, head and neck, cervical, prostate, skin and other cancers. The effects of
the therapy can be seen over time, rather than immediately, and it can take days, weeks or months
after the end of the treatment to see the impact of the radiotherapy on the tumour.

Some of the latest advances in radiotherapy, including 3-D conformal radiotherapy, intensity-
modulated radiotherapy and image-guided radiotherapy, help define the target area with high
accuracy and effectively deliver precise doses of radiation, causing only minimal damage to healthy
cells, tissues and organs.
What are the side effects of radiation therapy?
Side effects depend on the amount of radiation used in radiotherapy and the part of the body that
has been irradiated. Patients may experience short- and long-term side effects or no side effects at all.
Is radiotherapy safe?
Teletherapy, conducted with specially designed equipment by a team of highly qualified healthcare
professionals, is safe. While patients may experience side effects, others, including doctors or family
members near the patient during treatment, are not at any risk of radiation.

Teletherapy does not make patients radioactive. The hazards associated with brachytherapy are
also minimal. When the radioactive source is put inside temporarily, the patient remains in the
hospital, under special conditions to prevent the staff and public from being exposed to radiation.
Once the source has been removed, there is no residual radiation in place.

A permanent implant is placed in such a way that the radiation is absorbed by the tumour. To make
sure that the radiation levels are sufficiently low, doctors carry out a special check before they release
the patient from the hospital.
What is the role of medical imaging in radiotherapy?
Medical imaging plays a crucial role in cancer patient management and is requisite for the planning,
delivery and evaluation of radiotherapy treatment. The integration of advanced imaging techniques in
radiotherapy has revolutionised cancer care and improved patient outcomes. In this context, the role
of medical imaging includes:

Evaluation of disease location and spread

Determining whether the cancer is at an early stage or has spread to other parts of the body is done
through medical imaging. Image-guided procedures such as biopsies are minimally invasive and are
necessary for accurate tissue diagnosis.

Medical imaging modalities, such as computed tomography (CT), ultrasound, magnetic resonance
imaging (MRI) and positron emission tomography (PET), are essential for accurate cancer diagnosis
and staging. These techniques help identify the location, size and extent of the tumour, as well as its
relationship to adjacent structures and the presence of metastases.

Treatment planning

Imaging is used for treatment planning: from medication and radiotherapy to surgery or, in certain
cases, palliation. During radiotherapy planning, medical imaging generates three-dimensional images
of the tumour, allowing for better radiation therapy targeting of the tumour while minimising damage
to healthy tissues.

Image-Guided Radiotherapy (IGRT) incorporates real-time medical imaging into the radiotherapy
process to ensure accurate and consistent delivery of radiation doses.

What is Radiation Therapy? | IAEA

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How to Control Insect Pests Using Radiation

Insect pests spread diseases. Mosquitoes, for example, are responsible for the spread of malaria,
which affected 247 million people in 2021 alone and caused over 600 000 deaths. Parasitic insect
pests, such as parasitic flies, can threaten whole ecosystems, putting at risk long-term conservation of
animals and biodiversity. Other insect pests, such as fruit flies, moths, tsetse flies and screwworms
destroy crops and livestock, threatening farmers’ livelihoods, harming international trade and
undermining global food security. According to official estimates, pests destroyed up to 40 per cent of
global crops and caused $220 billion in losses in 2021.

The use of radiation can help in the regulation or management of pests — known as pest control —
effectively preventing insect-related risks to human and animal health, the ecosystems and food
security (including crop and livestock production). Methods using radiation for pest control include
the sterile insect technique (SIT), inherited sterility and biological control.

What is the Sterile Insect Technique (SIT)?

The sterile insect technique is a method that uses ionizing radiation to sterilize large numbers of
insects reared in a laboratory, which are then released over infested areas to mate with the wild pest
population. As these sterilized insects are incapable of producing any offspring, the insect population
declines over time.

Although both sterile males and females can be released in the cases of many insect species, for
most, releasing only the males as part of SIT is more cost-effective. There are few key reasons for this.
Firstly, sterile males are much more effective at hindering the reproduction of wild populations,
because they actively search for wild females to mate with and can mate with multiple females.
Therefore, releasing males only, speeds up the induction of sterility since the sterile males mate with
the wild females only, without being distracted by the sterile females. Moreover, in the unlikely event
of a fault in the sterilization process, this removes the risk of introducing fertile females into the
environment. Secondly, In the case of insect species for which only males are released, the costs of
packing and releasing the sterile insects are cut by half when compared against releasing both males
and females. Thirdly, it is a lot safer, since in some cases, releasing female insects can have a negative
impact — for instance, only the female mosquitoes bite humans in search for blood as a source of
protein, and can spread deadly diseases.

The SIT is one of the safest and most eco-friendly insect birth control methods available, which
ensures environmental protection through a reduced use of insecticides. In addition, since sterile
insects cannot self-replicate, this creates a long-term solution for the pest problem without running
the risk of introducing non-native species into the ecosystem.

Since the 1950s, SIT has been successfully used in the global control of some insects affecting the
health of people and livestock, such as the new world screwworm, the tsetse fly and disease
transmitting mosquitoes, as well as in the control of insect pests that destroy crops and affect trade,
such as the fruit flies and moths.
Insect pests and radiation: SIT, inherited sterility, biological control (iaea.org)

https://youtu.be/yV7WLrlzbLk