Introduction
Challenge to raise quality of life of cancer patients
Radiation therapy is a method of treating cancer using high-energy radiation, and is one of the three major cancer treatment methods along with surgery and chemotherapy. In department of Radiation Oncology, radiation is focused on damaging tumor cells and minimize effects to surrounding normal tissues. We are treating patients in a number of sophisticated ways. Gachon University Gil Medical Center introduced Novalis Tx linear accelerator for the first time in Asia to enhance clinical capabilities and is currently operating 3 state-of-the-art linear accelerators.
Radiation therapy is largely divided into external irradiation and brachytherapy. Externally irradiated radiation is generated by radiation from a machine outside the body and irradiated to the body. There are treatment techniques such as electron beam therapy, three-dimensional stereoscopic radiation therapy, intensity-controlled radiation therapy, image-guided radiation therapy, and stereotactic radiosurgery. Proximity irradiation radiotherapy is a method of irradiating high doses of radiation to local areas by placing radioactive isotopes close to the tumor itself, and is mainly used for the treatment of gynecological tumors.
Radiation therapy can be divided into radical treatment and conventional treatment depending on its purpose. Radical radiation therapy includes treatment for early stage lung cancer, head and neck cancer, prostate cancer without chemotherapy agent. The other treatment is the radiacal method combined with surgery or chemotherapy agent for breast cancer, locally advanced lung cancer, brain cancer or rectal cancer. Conventional radiotherapy is aimed at maintaining the quality of life through fracture prevention, pain control, and managing dyspnea even when radical treatment is difficult. Although this radiotherapy is mainly targeted for malignant tumors (cancer), it is also applied to the treatment of some benign tumors, such as keloids or thyroid ophthalmopathy.
External radiation therapy takes about 10 to 20 minutes per treatment, and it is a comfortable treatment that does not cause any pain or physical discomfort during treatment.
Modern cancer treatment is not a single treatment under each department, but it requires multidisciplinary cooperation, such as surgery, radiation therapy, chemotherapy, radiology, nuclear medicine, and diagnostic medicine. Gachon University Gil Medical Center offers customized treatments that are optimized for patients through the best multi-disciplinary care system together with IBM Watson Onology.
Area
Breast Cancer
Breast cancer is the second most common cancer among women in Korea. In 2013, breast cancer accounts for 15.4% of all female cancers. Radiation therapy to the breast after breast preservation surgery is an essential treatment for reducing the local recurrence rate. Even after some mastectomy, radiation therapy may be done if the tumor is large or there is large lymph node metastasis.
Breast radiotherapy is scheduled 5 times a week, and treatment takes about 6 weeks. Each treatment session takes about 10 minutes. There are no hot or painful feeling during treatment. However, as treatment progresses, radiation dermatitis may occur at the treatment site in some patients, but most symptoms are not severe and they will disappear in 2 weeks.
Department of Radiation Oncology leads research activities regarding special techniques such as end-inhalation radiation therapy, abdominal gastric radiation therapy or intensity-controlled radiation therapy to minimize long-term side effects after treatment, and continue to publish in international journals. We are making efforts to maximize the quality of life of patients by applying them to actual patient cases.
Theoretically, in cancer cases of the liver / biliary tract / pancreas, radiotherapy is not a standard treatment. However, in most cases, treatment is usually started in advanced stages, and radiotherapy is performed for various purposes, such as post-operative adjuvant therapy or symptom improvement considering general condition and stage.
Liver cancer refers to cancer that occurs in liver cells, and treatment methods include hepatectomy, liver transplantation, radiofrequency ablation or hepatic arterial chemoembolization. Recently, with the innovative development of radiotherapy technology, radiotherapy for liver cancer is actively being progressed. Radiation therapy using stereotactic excision radiotherapy (SABR) is becoming an effective alternative if previous treatment was ineffective or the lesion occurred within limited boundary.
In the case of pancreatic cancer and biliary tract cancer (biliary duct cancer), surgery is performed depending on its stage. Radiation therapy is used as adjuvant therapy postoperatively or to improve symptoms in biliary obstruction and pain.
Esophageal cancer and stomach cancer
In terms of mortality rate, esophageal cancer is ranked at no.8 in Korea. It occurs mainly after the 50s and has the highest incidence rate in the late 60s. Risk factors include smoking, drinking, hot tea and it is more common in those who enjoy alcohol and tobacco. Radical treatment for esophageal cancer is surgery. If you are at advanced stage of cancer or have condition that surgery is not possible - such as old age -, radiation therapy and chemotherapy are considered as well.
Esophageal radiation therapy is planned 5 times a week for about 5 weeks. It takes about 15 minutes for each treatment, and there is no hot or painful symptom during treatment. Hospitalization is not required for radiation therapy, and inpatient treatment is done only when it overlaps with inpatient chemotherapy. As radiation treatment progresses, damage to the esophageal mucosa due to radiation will begin, and symptoms of esophageal discomfort and difficulty swallowing may occur. In this case, we will help you minimize your pain by active pain control and nutrition management.
In South Korea and East Asian countries, surgical techniques for gastric cancer have been developed and extensive surgical procedures have been performed. So radiation therapy is rarely performed in gastric cancer. However, in case of lymphoma occurred in the stomach, radiation therapy is the main treatment method.
Heterogeneous skin cancer
Skin cancer is a general term for malignant tumors from the skin, and is largely divided into malignant melanoma and non-melanoma skin cancer. Most skin cancers other than melanoma occur locally and metastasis to other organs are not common. On the other hand, malignant melanoma can be treated by surgery if found early; otherwise, metastasis occurs with late diagnosis and this is life-threatening.
In case of skin cancer, surgery is not possible or radiation therapy is ordered depending on the pathological results after surgery.
Radiation therapy for other internal organs minimizes skin dose to alleviate radiation dermatitis, but skin radiation therapy increases the radiation dose to the skin itself, so there is a high probability of pain due to radiation dermatitis from the middle course of treatment.
Therefore, prevention creams and active pain management are being implemented.
Rectal and colon cancer
Large intestine is the digestive system that is located between the small intestine and the anus. Colorectal cancer is divided into colon cancer and rectal cancer depending on its location, and the treatment method is also different. Particularly, in the case of rectal cancer, the role of radiation therapy is significant. It used to be performed as adjuvant purpose only after surgery. Nowdays, radiation therapy is used to not only prevent recurrence but also to increase the possibility of preserving the anus by reducing the cancer size before proceeding to surgery. At this time, in order to increase the effectiveness of radiation therapy, chemotherapy is used in combination during the radiation therapy period. After treatment is completed, regular checkup is performed for the diagnosis and treatment of cancer recurrence or side effects that may occur after treatment.
Gynecological cancer
Cervical cancer, endometrial cancer, and ovarian cancer that occur in the genitals of women are called gynecological cancer. Among these, radiation therapy plays an important role in cervical cancer and endometrial cancer. Cervical cancer is a malignant tumor that occurs in the cervix where the uterus and vagina are connected. In early stage, surgery or radiation therapy is performed. From the biopsy result, if there is a tumor on the resected surface or high risk factor of recurrence - such as lymph node invasion or invasion to surrounding tissues - is found, additional radiotherapy and chemotherapy should be performed. For stage 2 to early 4, radical treatment is chosen in combination with radiation therapy and chemotherapy. In case of endometrial cancer that occurs in endometrium of the uterine body, the primary treatment method is surgery, and it is determined whether radiotherapy and chemotherapy are performed according to pathological results. Radiation treatment methods include external radiation treatment that irradiates radiation from the outside of the body, and internal radiation (intra-radiation) treatment that closely irradiates radioactive isotopes to the uterine cavity and vaginal cavity. The treatment method is determined according to the degree of disease progression. After treatment is completed, regular checkup is performed for the diagnosis and treatment of cancer recurrence or side effects that may occur after treatment.
Sarcoma
Sarcoma is a malignant tumor that occurs on non-epithelial cells such as muscle, connective tissue, blood vessels, and bone. It accounts for less than about 1% of all cancers, and soft tissue sarcoma, bone, and cartilage that occur largely in muscles, fats, nerves, and blood vessels. It can be classified as osteosarcoma from the back. Among these, soft tissue sarcoma is the most common symptom of asymptomatic mass. It is common in the lower extremities, especially the lower extremities, and it can also occur in other organs and trunks in the abdominal cavity. The treatment of soft tissue sarcoma is surgery, radiation therapy, and chemotherapy, and the treatment method is determined according to the type and progression of sarcoma. In general, some soft tissue sarcoma with a large tumor size as surgery are the primary treatment, and surgery may be performed after reducing the tumor size with radiotherapy. After treatment is completed, regular treatment is provided for the diagnosis and treatment of cancer recurrence and side effects that may occur after treatment.
Metastatic and other cancers
Regardless of the type of cancer, we provide conventional treatment aimed at improving the survival and quality of life even if it is difficult to take radiacal approache due to cancer progression. Radiation therapy is used to control neurological symptoms caused by brain metastasis. In particular, if the pain is severe due to bone metastasis, pain can be significantly reduced through radiation therapy. Radiation therapy does not require any other intervention, and there is no pain or feeling during treatment, so patients can be comfortably treated through conventional treatment regardless of disease stage or condition.