ASK ANY GROUP OF AVERAGE AMERICANS to define the role of radiation oncology in medicine, and their response will likely be some version of: “It’s a specialty that uses beams of radiation to treat cancerous tumors.” Indeed, radiation oncology is a cornerstone of modern cancer treatment. However, the role of this ever-evolving field goes far beyond the targeting of malignancies.
According to Wainright Jaggernauth, MD, of The Toledo Clinic Cancer Centers, radiation oncologists in the United States are discovering—or, more accurately, rediscovering— that radiation can be an effective tool in treating a host of benign conditions in addition to malignancies.
Dr. Jaggernauth notes that the use of radiation to treat non-malignancies was relatively common practice in the U.S. from the 1940s through the 1980s but fell out of favor due to concerns about overutilization and other factors. He adds, “Other countries continued using radiation therapy for both cancerous and benign conditions. In fact, in some European countries, about 50 percent of radiation treatment is performed on non-malignant conditions, such as osteoarthritis, bursitis, contractures, plantar fasciitis, and bulging eyes from thyroid disease. In the U.S., we’re now starting to readdress these treatment options and some sites are beginning to develop protocols to implement them.”
To illustrate how radiation can be beneficial in treating a non-cancerous condition, Dr. Jaggernauth gives the example of a patient with severe osteoarthritis of the knee. “This patient would likely be sent for surgery, but that isn’t going to eliminate the process that caused the damage in the first place. In this case, radiation therapy can be used to reduce pain and inflammation, bringing the patient relief,” he says. Radiation can also bring welcome relief to patients with arthritis who are determined to be poor candidates for surgery, for example individuals with uncontrolled diabetes.
Another good example Dr. Jaggernauth provides is the use of radiation to treat a condition called Dupuytren’s contracture. He explains, “This is a disease of the hand in which tendons that connect to the fingers become fibrotic and pull on the fingers, causing them to start curving inward toward the palm. Radiation treatment won’t actually cure the fibrosis, but if done at the right time in the disease process, it can prevent it from getting worse, potentially delaying surgery for months if not years.”
Of course, radiation therapy— whether utilized individually or in combination with surgery, chemotherapy, or other leading-edge treatments (e.g. immunotherapy or hormone therapy)—continues to be a mainstay treatment for malignancies, leveraging advanced technology and techniques to destroy cancerous cells or reduce tumors while minimizing damage to surrounding healthy tissues. That last objective— minimizing damage to surrounding tissues—is perhaps the radiation oncologist’s greatest challenge when targeting a malignancy. As Dr. Jaggernauth explains, “We can cure all cancers if we can hit them with an unlimited amount of radiation, but that would destroy the entire site being treated. So, our objective is to deliver the highest possible dose of radiation to the tumor while limiting damage to surrounding critical structures. For example, when treating lung cancer, we must consider that the heart is close by and can only tolerate a certain amount of radiation. Similarly, if a tumor is located near the spinal cord, treating the tumor while minimizing the risk of paralysis is always a challenge.”
In the past, the need to protect nearby healthy tissue and organs meant radiation oncologists had to leave a relatively wide margin around targeted tumors. Today, thanks to powerful advances in stabilizing imaging technology that can compensate for factors such as patient movement during breathing, oncologists can very precisely visualize the location of the tumor and surrounding critical structures. Using this cutting-edge technology, they can work with much tighter margins and deliver a very focused, effective dose of radiation while still sparing nearby healthy organs and tissues, Dr. Jaggernauth notes.
This is just one example of how advances in delivery and imaging technology are improving the precision and accuracy of radiation therapy and helping to lower the risk of side effects. Many other exciting innovations have emerged or are currently in the pipeline that will continue to enhance safety and patient outcomes—and not just when treating malignancies.
The Toledo Clinic Cancer Centers, located at 1200 Medical Center Parkway in Maumee and 4126 N. Holland Sylvania Road, Suite 105 in Toledo, also provides imaging, laboratory, chemotherapy, specialized pharmacy, and IV services. The cancer center consists of 12 physicians, now including a Rheumatologist, as well as 11 advanced practice providers. The cancer center also has satellite centers in Napoleon, Bowling Green, Wauseon, Bellevue, Oregon, and Monroe.
For more information, please call The Toledo Clinic Cancer Centers at 419-479-5605. ✲
