Radiation sickness of the cervix. What is radiation therapy? Indications for appointment

Cervical cancer is a malignant neoplasm that develops in the cervical area of a woman. This disease in last years very progressing, according to statistics, the disease ranks first in reducing the number of years of life, and second in frequency of occurrence after breast cancer. It is known that it can shorten a woman's life by 25-30 years. This is enough high rate, which makes you think about how to be much more attentive to your health. It is known that this disease appears against the background of precancerous pathologies, so it can be easily predicted and even prevented. For this, it is necessary to systematically visit a gynecologist, at least twice a year.

Scientists say that the disease can be provoked various factors, the main ones include: entry into early sexual activity (14-16 years), frequent change sexual partners, the presence of the papilloma virus and herpes, taking hormonal oral contraceptives, smoking and so on. Concerning symptomatic manifestations cancer, then they are very long on early stages may be missing.

Often a woman or girl learns about an existing pathology only at a gynecologist's appointment, and it is good if this is only the initial stage of the development of a cancerous process, which is well treatable and in 90% of cases leads to a complete recovery.

So, to the main clinical manifestations diseases include:

foamy discharge from the vagina with an admixture of blood between menstruation, the discharge before and after menstruation is especially intensified;
discharge occurs during or after intercourse, the process may be accompanied by pain;
at a later date, the above symptoms may be joined pain syndrome, which is localized in the abdomen and sacrum;
in advanced cases begin to appear pathological changes in the work of the kidneys and intestines.

Treatment of the disease with radiation exposure

Radiation therapy for cervical cancer involves exposure to atypical cells of very high doses x-rays that have a devastating effect on them and lead to death.

This type of treatment for CMM cancer pathology can be of two types, namely: external and internal. As a rule, the doctor selects any one type for treatment, but often these days, specialists have begun to combine these two types. If we talk about the duration of RT treatment, then it can vary from 5 to 8 weeks, everything will depend on the patient and the stage of the disease. Often this method of treating cervical cancer is used in the initial stages, but its effectiveness has also been proven in the fight against tumors. large sizes that have gone beyond the cervix.

radiation exposure with cancerous pathology of the cervix, it is also used after surgery, during which the malignant tumor and there is a risk of relapse. AT this case radiation would be combined with chemotherapy, which would only double the effectiveness of the treatment.

I would like to talk separately about the consequences after the radiotherapy with cervical cancer. It is known that this irradiation has an extremely negative effect on the ovaries and for women of reproductive age this may indicate complete cessation their performance, that is, practically it leads to infertility. In addition, all this contributes to the development of early menopause, as a rule, it occurs two, sometimes three months after the start of therapy. If the patient still wants to be able to give birth to a baby, then she must definitely discuss all these nuances with the doctor. Today there are special means and procedures to stop the menopause process and increase the duration of reproductive function.

Recovery period

Recovery after radiation therapy for cervical cancer is very important point for female patients. The body of a woman after undergoing a course of RT is very weakened and it needs time to recover. To do this, you need to breathe as often as possible. fresh air, do not refuse walks, or at least ventilate the ward as often as possible. Proper nutrition is of great importance, for a start, doctors recommend eating food without great content lactose and fiber, gradually introduce rice, potatoes, cheese into the diet. In addition, experts advise giving up milk, smoked meats, fried foods, and caffeine for the duration of rehabilitation.

Being enough serious illness, cervical cancer (CC) is considered one of the most difficult to treat. For its treatment, various ways and options for relief, which are determined by the stages of the development of the disease, the presence of metastases. One popular method is radiation therapy.

The concept of cervical cancer: features of the structure of the uterus, typology of cervical cancer

Cervical cancer (CC) is considered a disease that is formed under the influence of a malignant tumor. Pathology can be observed both in the uterus and in the cervical canal.

The cervix is not a separate body. Considered the part of the uterus that carries out protective function from negative flora from the outside. The structure is divided into two departments:

Supravaginal - is large in size. Not visualized at the time of examination by a gynecologist;
Vaginal - tightly located to the vagina. Possesses characteristic features: pallor and pink color, smooth surface, homogeneous epithelium over the entire plane.

There are two types of epithelium in the cervix - flat multilayer and cylindrical (single layer).

Typology of cervical cancer

The symptoms that should be the reason for examining a woman are listed in the picture:

Given the diversity of cancer types, there are several forms of cervical cancer. Some of them are considered rare. According to the existing criteria, there are:

taking into account the tissue that forms a pathological tumor - squamous and glandular forms of cervical cancer. Squamous cell carcinoma occurs in about 92% of cases.
according to the degree of invasion - pre-invasive (zero stage), micro-invasive (stage 1A), invasive (stages 1B-4).
taking into account the level of cell differentiation, they distinguish between highly differentiated, moderately differentiated and low differentiated cervical cancer.

As far as high differentiated tumors, then they are treatable, do not form metastases.

Stages of cervical cancer

The likely outcomes of cervical cancer are related to the stage at which the diagnosis was made. The stages of cancer indicate the severity of the disease.

There are 4 stages:

The first stage means damage to the cervix.
The second stage is different in that the tumor penetrates the uterus. Distinguish the degree depending on whether the affected serous membranes or not
At the third stage, the spread of metastases begins along the wall of the vagina and pelvis.
The last, fourth stage, involves the formation of metastases in parts remote from the cervix. On it, the tumor can reach the intestines and bladder.

Detailed information about the stages of cervical cancer is presented in the picture:

The essence of radiation therapy in the treatment of cervical cancer

The first symptoms and signs of cervical cancer are found in women aged 30-55 years. They do not have any features and are diagnosed after appropriate manipulations (taking a biopsy of the affected area to determine whether the formation is benign or not).

In this regard, the radiation procedure is most effective in the early stages of the development of the disease (no further than the third). In more difficult situations This method is combined with radiotherapy.

The essence of the method lies in the fact that a radioactive beam is directed at a cell affected by cancer and breaks its center, and therefore its further development and functioning is impossible. They lose the ability to divide. Wherein healthy cells not harmed by radiation.

Watch the report from the oncology congress on the tactics of cervical cancer treatment and the results of radiation therapy:

Types of radio exposure and methods for their implementation

Oncologists who refer a patient for treatment of cervical cancer with radiation therapy can use the following methods:

gamma therapy,
X-ray therapy.

Depending on the location and implementation of activities on the part of the radiation apparatus in relation to the patient, there are:

intracavitary irradiation,
Impact on cancer cells remotely,
contact method,
Interstitial radiotherapy.

In addition, a distinction is made between external and internal therapy. With an external method of exposure to radiation, the area that has the tumor is exposed. A linear catalyst is used for the effect. Duration of implementation similar treatment determined by the severity of the disease. Not side effects and pain in the patient.

At the core internal way lies the impact on the cervix and surrounding areas. The necessary dose of radiation is injected with a special tool and placed in the focus of the disease. If the patient's uterus is removed, then the procedure is performed without the use of anesthetics. Otherwise, before the introduction of the applicator, anesthesia is administered to eliminate pain.

The essence of internal irradiation is shown in the picture:

When treating a patient with radiotherapy, CT is initially prescribed. Based on the images, the doctor, taking into account the size and structure of the formation, selects a treatment regimen, a measure of radiation. All this is done in order to most accurately affect the cancer-affected areas.

The process is carried out by a special computer that controls the activity of the inserted applicator, adjusts the inclination of the radio beams to the tumor. The duration of one session is from 5 to 10 minutes. The patient needs to lie still for the result to be achieved as quickly as possible. If a procedure is missed in the treatment regimen, two such operations are scheduled on the same day, but with an interval of about eight hours.

Indications for implementation and contraindications

Radiotherapy is effective in several cases, namely:

With the development of cervical cancer in early dates(before the procedure to remove the organ);
In the event of the appearance of metastases, it is possible to use if they are distributed to neighboring organs and tissues;
In a situation where the cancer is considered inoperable, but the first improvements are observed after the use of chemotherapy;
In the case of prophylaxis in the event of a possible recurrence of the disease.

As the main contraindications for which it is impossible to carry out similar procedure, allocate:

The presence of a feverish condition in a woman;
Decreased levels of white blood cells and platelets in the blood;
anemia;
Radiation sickness;
Diabetes of any type;
Diseases of the cardiovascular system;
In a situation where the disease is at the last stage;
Other personal reasons.

How to prepare for the procedure?

At the initial stage, oncologists, together with the physicists of the organization in which the therapy is carried out, calculate the individual radiation dose. A special marking is made on the patient's skin, which helps to determine the direction of the laser beam.

A few days before the session, the patient is prescribed the use of iodine-containing medicines. In the presence of diaper rash, it is necessary to inform the attending physician.

During the entire course of treatment, as well as a few weeks before it begins, you should be guided by the recommendations of the oncologist, in order to ensure the effectiveness of the procedures:

Drink enough liquid;
Eating with principles proper nutrition;
There is a ban on alcohol and smoking;
When choosing clothes, preference should be given to those made from high-quality and natural materials. Should not tightly fit a place exposed to rays;
The irradiated area cannot be treated with cosmetics;
Also, you can not heat or excessively cool the tumor.

After a session of radiation therapy, it is necessary to restore strength by eating food that is high in calories and sugar.

Side effects from therapy

Due to the increased effect of radiation on cancerous malignant formations, this method of treatment has negative impact on the patient's well-being. It can manifest itself in the form of a decrease in appetite, a disorder gastrointestinal tract(diarrhea, constipation), nausea and vomiting appear, there may be allergic reactions, as well as frequent urges to urination.

Recovery period after procedures

Tips for recovery after radiation therapy will be shown in the form of a picture:

Recovery after radiation therapy is considered one of the longest. In order to reduce the negative consequences, to avoid remission, a number of conditions must be followed:

Completely give up bad habits;
Take daily walks in nature;
Reduce the consumption of tea and coffee drinks;
Incorporate into daily routines physical activity(gymnastics, swimming, light running).

After radiation therapy, it is necessary to adhere to the basics of proper nutrition. It means to exclude bakery products, products containing sugar, starch, as well as fried, fatty and smoked goods. You should introduce more fruits and vegetables into the diet, thereby reducing the number of meat dishes.

Consequences of radiotherapy for cervical cancer

Complications may occur after cervical irradiation procedures are completed. They are connected, first of all, with the way radiation affects the affected areas, as well as with the dosage of radiation. At the end of the sessions, bleeding from the vagina is observed, which should not be accompanied by pain. Otherwise, you need to seek help from a specialist.

One of side effects state can be distinguished chronic fatigue. It can be eliminated in the case of the normalization of rest time and the conduct of certain physical activities. The walls of the intestines may also become thinner and more fragile, and therefore spotting will be present in the urine.

When using this therapy, the menstrual cycle stops.

Based on the results of the procedures, a favorable outcome can be guaranteed, depending on the degree of damage to the uterus by cancer cells. If a woman is in the first stage of the disease, then the probability of a good outcome is equal to almost 98%. In the case of the second stage - 75% positive result. At the third stage, approximately more than 65% of cancer patients survive. Due to the fact that surgical intervention prohibited in the fourth stage of the development of the disease, then this radiation therapy can prolong the life of 10% of those who seek treatment.

Methods for treating such a dangerous pathology as cervical cancer (rcm) differ different options based on the severity of the diagnosed disease. Radiation therapy for cervical cancer is a commonly used treatment technique aimed at suppressing vigorous activity tumor cells and their subsequent destruction. However, during irradiation, healthy tissues of the body can also be damaged, therefore, a scheme for such therapy is drawn up for each patient individually, its doses are clearly calculated taking into account the severity of tissue damage, the prevalence of the process and overall indicators woman's health.

Radiation therapy for cervical cancer involves a method of exerting a local effect on pathological foci using x-rays.

They are formed in the form of beams of elementary particles generated by a special device in the form of a medical accelerator. Ionizing radiation can block the processes of division and spread of tumor cells. Radiotherapy does not destroy the tissues of pathologically altered foci, but affects their cellular level, modifying the DNA structure.

Malignant cells in the course of such therapy lose the ability to actively divide. Modification of atypical cells and influence on molecular bonds slows down the progression of the tumor process, while minimally affecting healthy cells. Irradiation for cervical cancer is carried out by systematically changing the direction of beams of rays, allowing them to be concentrated strictly on pathological foci.

Oncologists note the effectiveness beam method at I and II stages of the disease as self therapy. It is used as an adjunct to surgery. Chemotherapy for uterine cancer is connected to radiotherapy to combat the metastatic process. The combination of a course of radiation and chemotherapy for cancer makes it possible to eliminate foci that are inaccessible to surgery.

To perform a course of radiation therapy (RT), X-rays and gamma radiation are used. The impact is carried out:

irradiation when an intracavitary scheme is used;
remotely to areas of affected tissues;
by contact;
in an interstitial way.

Distinguish between external and internal LT.

In the list of indications for the implementation of the course of LT consider:

diagnosed malignant formation in the area of the uterine neck (oncology in stages I and II, before hysterectomy);
detection of tumor metastases in adjacent tissues of organs and in the region of regional lymph nodes;
one of the inoperable forms of the disease, when radiotherapy is considered as a palliative method that contributes to a temporary improvement in the patient's condition;
countering possible relapse illness.

Among the contraindications note:

serious abnormalities in blood counts ( low white blood cells and platelets)

elevated temperature;

cardiovascular and renal failure;

diabetes;

signs of radiation sickness;

other contraindications of an individual nature.

Preparatory stage

The course of radiotherapy is preceded by a preparatory stage. The patient is undergoing computed tomography in order to clearly represent the size, structural structure, contours of the tumor, and prevalence based on the obtained images. oncological process. This allows the radiologist to determine the direction of the rays in order to maximize the impact on pathological foci without touching healthy tissue. Competent calculation therapeutic doses irradiation allows you to increase the effectiveness of the course of radiotherapy.

Approximately one week before the start of the RT course, a woman is recommended to:

eat high-calorie foods and a sufficient amount of fluids;
do not smoke or take alcohol;
do not sunbathe;
wear underwear made from predominantly cotton fabrics, abandoning synthetics;
do not expose the intended area of irradiation to overheating, cooling, friction;
on the eve of radiotherapy sessions, do not use cosmetics (creams, deodorants, aromatic powders).

Method of external irradiation

According to computed tomography, the boundary contours of the impacts are indicated. Radiation therapy for uterine cancer by external (external) radiation refers to effective ways at terminal stage cancer and can significantly alleviate the condition of the patient. The course is held in stationary conditions within 4-8 weeks.

A comprehensive examination using CT allows you to accurately identify the localization malignancy. On the skin of the pelvic region, marking areas (marking) are applied to optimize the direction of the rays. Computer control allows you to place and rotate the patient's body, as well as monitor the installation of protective screens.

Radiotherapy does not cause pain. For maximum effectiveness of the session, it is necessary to maintain immobility during its execution. The session lasts from 3 to 5 minutes and is carried out daily. In rare situations, it is allowed to perform 2 sessions with an interval of about 8 hours, if the next daily session was missed, but the attending specialist decides how appropriate this is.

Method of internal irradiation

Often performed some time after external irradiation. With the help of medical applicator tubes inserted into the cervix after preliminary anesthesia, radiation directly affects the pathological foci. The insertion site of the applicators is plugged to prevent their displacement. The position of the applicators is controlled by a computer device. If they are in the correct position, the apparatus for generating directional radiation is turned on. The elimination of discomfort from the stay of the applicators in the vagina is eliminated by taking analgesics, therefore, after the session, the woman, as a rule, takes the drugs prescribed by the doctor. This treatment option is suitable for patients who have preserved the uterus.

In the case of a previously performed hysterectomy (after surgery for the removal of the uterus), a larger applicator can be inserted without anesthesia. Internal LT is performed during one long session or several consecutive short sessions (10-15 minutes each) in 2-3 days. The applicator tube is temporarily removed until the next session. In some cases, it is rational to use a catheter to facilitate the excretion of urine.

The nature of the treatment depending on the radiation doses

Treatment of cervical cancer is carried out by therapy:

high-dose;
low-dose (pulse).

Which of these types is more appropriate to use, the radiologist decides together with the attending oncologist and surgeon.

With low-dose treatment, one session is performed, which can last about 12 hours or longer. It implies strict bed rest. The patient is placed separately from other patients, during this period she cannot be visited. A catheter is placed in the bladder cavity, which, together with applicator tubes located inside the vagina and uterine cavity, causes pain Therefore, the patient is required to take painkillers. The technique of radioactive irradiation is carried out with low doses in a continuous mode.

With pulsed exposure, irradiation is carried out at the rate of a total low dose, but it is performed with a certain frequency, and not in a continuous mode. In this case, the extraction of applicators is delayed until the end of the course.

High-dose type of therapy refers to common methods. A woman receives an individually selected high dose of radiation during a short session (up to 10-15 minutes). After the end of each session, the applicators-tubes are removed. The course of therapy includes several sessions carried out with a time interval. The number of sessions and the duration of the time interval between them is determined by the doctor.

Efficiency of LT

Application radiation techniques different types allows you to achieve:

decrease pain in the small pelvis;
eliminate the remnants of tumor cell formations;
minimize the risk of developing a metastatic process;
the chances of a complete recovery in oncopathology of cervical cancer, if it is detected at the first stage of the disease.

Radiation therapy used for cervical cancer is characterized by positive feedback from oncologists. It has a high level of effectiveness in relation to stage I of the disease. When the malignant tumor is removed, surgery is complemented by a radiation technique. For II and Stage III diseases, it is considered as the only therapeutic alternative. In the fight against disease terminal form, courses of RT are possible as palliative treatment to provide relief to the patient.

Ray therapy is included in many treatment regimens the fight against malignant tumors in the cervical region of the uterus and in situations where the oncological process is characterized by spread beyond the uterine borders and tumors in other parts of the small pelvis that cannot be eliminated surgically. Chemotherapy for cervical cancer is often combined with RT methods, if noted high level threats of recurrent processes. Recurrence of cervical cancer is possible with insufficient volumes surgical intervention, incorrectly calculated doses of rays, or when the chemotherapeutic effect was limited. In order to avoid the re-growth of a malignant formation, it is necessary to be observed by a gynecologist with a regular sequence and take tests, at least 1 time per quarter.

List of possible consequences of RT

The consequences of radiation therapy, observed in cervical cancer, affect many functions of the woman's body, as well as the consequences of chemotherapy. Given their number and level of intensity, the following side effects are noted:

Disorders of the stool with the appearance of diarrhea. The patient is advised to drink a sufficient amount of liquids, in order to avoid the development of dehydration.
Nausea against the background of loss of appetite, the appearance of vomiting, sometimes ending in vomiting. If reception ordinary food becomes a provocateur of nausea attacks, a woman is recommended to temporarily use special high-calorie cocktails until full recovery appetite and disappearance of vomiting.
Fatigue, feeling constant weakness. After a course of radiation therapy, the patient should have a good rest, and also avoid any physical exertion.

The appearance of hyperemia, redness, rash in the area exposed to external irradiation. Due to inflammation skin experts do not advise using hygiene products that contribute to their additional irritation.
The occurrence of narrowing in the vaginal cavity due to the action of applicators and tissue damage. This creates difficulties in carrying out gynecological examination and the introduction of applicator tubes in subsequent courses of RT. To maintain the normal size of the vagina, a woman is recommended to use special tubes called dilators. They minimize the risk of microdamage to the vaginal mucosa. Sometimes the use of hormonal ointments is also advised.
Increased urination, burning sensation in urethra. These phenomena occur as a reaction to the use of a catheter and eventually disappear.

One of frequent complications is the occurrence of bloody and blood secretions different intensity from the vaginal cavity. Short-term light bleeding is not dangerous, but if it continues for more than 10 days, you should contact your doctor.

The degree of manifestation of side effects can vary, from moderate to intense, so you need to try to get plenty of rest, eat well and emotionally tune in to recovery.

Among the long-term complications of radiation techniques that appear after more than one month after radiotherapy courses, there may be disturbances in urination and emptying. Radiation can cause thinning of the vasculature and capillaries in the tissues of the bladder and intestines, which impairs their blood supply. When such problems arise, you need to contact specialists. Puffiness from the tissues of the external genitalia and lower extremities sometimes occurs with lymphostasis, provoked by the negative effect of the rays on the adjacent groups of lymph nodes.

Recovery period rules

Recovery after radiation therapy for cervical cancer is individual for everyone. Recovery time, on average, takes several weeks. For it to be successful, you must adhere to the following rules:

regularly walk in the fresh air;
avoid cigarettes and alcohol;
follow a diet, with the rejection of muffins, hard-to-digest dishes, smoked, spicy, marinades, saturating the diet with vegetables, fruits and sour-milk products;
do exercises with moderate physical activity.

After the operation and the subsequent combination of radiation and chemotherapy courses, recovery will take more than one month.

Diagnosis of cervical cancer requires integrated approach to therapeutic tactics. Radiation exposure is priority, because it allows to stop the process of mutation in cells at the earliest stages of its occurrence.

Radiation therapy for cervical cancer involves exposure to special rays that contribute to the destruction of atypical elements, followed by cessation of the growth of the focus. As a rule, healthy tissues are practically not damaged.

Description of the technique

A malignant focus in the cervix is one of the most frequently detected oncological diseases in the female half of the population. Up to half of all detected cases are running forms, so medical tactics includes not only chemotherapy, but also radiation exposure.

A similar technique can be the main way to get rid of a malignant focus, if it was detected at stages 1-2. To describe the process in brief, the essence is that beams of directed radiation, having met an atypical cell, contribute to the destruction of its very foundation. As a result, it is not able to fulfill its functional purpose. Elements without mutation are stronger, able to endure the effects of radiation particles. Mutated structures are weakened, and therefore lose the ability to reproduce and die.

The main types of therapy

To date, radiation therapy for cervical cancer is used in several ways:

According to the type of radiation used:
radiotherapy;
gamma therapy.
By placing the device relative to the patient:
contact option;
intracavitary therapy;
remote influence;
interstitial treatment.

The choice of the method of optimal irradiation for cervical cancer directly depends on the stage of the identified tumor focus, its size, and the presence of metastases in distant organs. Therefore, the same principle determines whether radiation therapy will independent methodology or it must be combined with other areas of treatment.

How procedures are carried out

A specialist in making a decision - a cancerous focus has been identified, and it needs to be treated, focuses on the structure of the tumor, whether it is malignant, size, age category sick.

The fact that radioactive rays pose a direct threat to tissues not affected by atypia is also taken into account. Such therapy is necessarily carried out in several stages - with breaks of several weeks between procedures. As needed, separate procedures are applied to influence certain areas.

Preliminary setup of the equipment is a mandatory step. A careful selection of the correct direction of the beams is carried out, for an accurate hit on the tumor focus. After taking a series of images, the information is displayed on the screen, and the specialist identifies the localization of the carcinoma, its boundaries, and calculates the load of radiation therapy.

Then the device system itself will manage the process of placing and subsequent rotation of the patient, the emitter itself, and also adjusts the position of the protective devices. If the contours of the neoplasm were clearly marked on the images, then laser ray will highlight the point of direct impact on the body of the irradiated person.

It is somewhat more difficult if the malignant lesion has moved to neighboring tissues and organs. However, modern equipment makes it easier for specialists - tomographs allow you to get a three-dimensional image of the tumor, followed by the abandonment of the radiation exposure program.

The duration of each session is no more than 1-5 minutes. The procedures are absolutely painless - the patient does not experience any discomfort. Negative consequences, the inevitable companions of this treatment method, thanks to modern equipment, can be minimized.

Benefits of Radiation Therapy

Against the background of purposeful exposure of mutated cells directly to the focus of mutated cells, under the influence of high doses of radiation, they are no longer able to divide, and the tumor stops growing. Healthy structures at the same time receive minimal damage and are quickly restored.

Oncologists necessarily take into account many facts on preparatory stage to a similar method of treating cervical cancer - after all, every woman has her own characteristics of the body. Of great importance is the structure of the tumor, and its size, and localization, and the presence of metastases in other organs.

Benefits of Radiation Therapy:

ionizing rays practically do not affect healthy cells;
high efficiency in the fight against cancer;
rays have accessibility even to the most difficultly located neoplasms;
a significant reduction in the risk of recurrence of pathology;
the general health of patients is not too oppressed;
the technique is more loyal in comparison with the effect of chemotherapy drugs.

However, radiation therapy has its drawbacks and consequences. Therefore, it is so important to go through a comprehensive diagnostic examination recommended by a specialist at the stage of preparation and preparation of a treatment plan.

External exposure

Held in outpatient settings- The cycle of procedures lasts about 5-6 weeks. After a preliminary comprehensive examination and compilation of a three-dimensional image of the tumor focus, markers are placed on the patient's skin, allowing further directing the equipment to the desired area of the body.

As a rule, sessions are held 5 times a week, with intervals of two days off. The duration of one procedure may vary and does not exceed a few minutes.

The woman does not feel discomfort or intense pain impulses. Patients are only required to be absolutely still. If the session was missed due to a series objective reasons, then the attending physician may decide to conduct two in one day, with an interval of 7-8 hours.

At the time of irradiation, the woman is alone in a specially equipped room, but the course of the procedure is necessarily controlled by a specialist. After the end of the session, the patient is not radioactive at all and may well communicate with other people.

Method of internal irradiation

The essence of the technique lies in the antitumor effect of rays on the cervical region, or in the immediate vicinity of the uterine neoplasm. Procedures can be carried out not only in stationary, but also on an outpatient basis.

To achieve the desired therapeutic effect, tubes-applicators are inserted into the cervix or the uterus itself - if no surgery has been performed. Of these, irradiation is carried out.

If it is necessary to place the applicator in the uterus itself, manipulations are carried out under general anesthesia. Subsequently, the woman is introduced various medicines for anesthesia.

If there is no need to place the applicator in this way, then there is no need for anesthesia. In order to prevent displacement of the already placed intraorgan applicator, a tampon is additionally inserted into the vagina.

Before the very beginning of the irradiation session, a control CT scan is necessarily performed to ensure that the applicators are located correctly. The duration of each session is selected by the specialist individually - one long or a series of short ones.

There are several types of such radiation therapy - high-dose, low-dose, as well as pulsed. Which option to resort to, only a specialist decides - based on the structure of the neoplasm, the age of the patient, as well as the initial state of her health.
Possible side effects

Unfortunately, specialists and patients themselves, along with undoubted benefit from radiation therapy, side effects are also observed. This is due to the high radioactivity of the rays.

Temporary Disorders:

diarrhea - to prevent dehydration, it is recommended to take a sufficient amount of fluid;
moderate bleeding from the vagina - no longer than 5-7 ducks;
urge for nausea, loss of appetite - in order to avoid weight loss, experts recommend drinking high-calorie drinks;
some narrowing of the vagina, making it difficult to further gynecological examination;
previously uncharacteristic fatigue, severe weakness - the way out is to increase the time to rest after each irradiation procedure.

These side effects pass quickly. More serious consequences of radiation therapy requiring medical procedures include violations in bladder and lymphoedema. With the right treatment tactics, they can be minimized.

Radiation therapy exposes cancer cells to high doses of X-rays, causing them to be destroyed, with relatively little harm done to healthy cells in the body.

Radiation therapy for cancer of the cervix is divided into external and internal. Often there is a combination of these two types. The duration of radiation therapy varies from 5 to 8 weeks.

Radiation therapy is often used to treat initial stages RShM. Radiation therapy is also included in the usual treatment plan for large tumors located in the cervix, or in those clinical cases when the cancer has spread beyond the cervix and cannot be completely cured surgically. Radiation therapy may also be used after surgery if the risk of recurrence is high. In such cases, radiation therapy is combined with chemotherapy (chemoradiotherapy).

Radiation therapy, which is given during treatment for cervical cancer, affects the ovaries. For women of reproductive age, this is expressed in the cessation of the functioning of the ovaries, namely, the cessation of ovulation and the production of the hormones progesterone and estrogen. It actually means infertility. Also, this will eventually lead to early menopause usually about three months after the start of treatment. It is necessary to discuss all these issues with the attending physicians before starting treatment. They will report all necessary information about procedures and medications to help manage menopausal symptoms and possibly preserve fertility.

For some women, doctors suggest performing an operation before radiation therapy - repositioning the ovaries from the area of radiation therapy higher into the abdominal cavity. This reduction is usually done at the same time as initial stages surgical treatment. if surgeons have reason to believe the need for further radiation therapy. It is also possible to perform this operation endoscopically.

Alas, in some cases to prevent early attack menopause fails.

External Beam Therapy

External beam radiation therapy is usually given to outpatients as a cycle of short sessions in an inpatient radiotherapy department. X-rays are sent directly to the cancerous area by a special apparatus called a linear catalyst.

Treatment planning

Planning is a very important part of the upcoming treatment, which is why it can be carried out in several visits. Proper planning is a guarantee that the treatment will be as effective as possible.

During the first visit to the radiotherapy department, the patient undergoes CT scan, thanks to which the doctor receives a three-dimensional image of the area of \u200b\u200bthe upcoming treatment. The data is used to determine the exact boundaries of the intervention.

Once the treatment area has been determined, small markers are placed on the patient's skin to help the radiologist verify that the patient is positioned correctly. The markers are permanent, but they are tiny dots and are almost invisible. The patient may experience some discomfort at the time of applying the markers, but they are necessary.

Start of treatment

As a rule, irradiation is performed from Monday to Friday, with a break on weekends. In the event that the patient accidentally missed the daily procedure, two sessions can be performed on the same day with an interval of 6-8 hours.

The duration of the sessions directly depends on the type of cancer and the size. malignant neoplasm, the entire course, as a rule, takes 5-6 weeks. Before starting the procedure, the radiologist will check that the patient has taken the correct position on the couch. During the procedure, the patient is alone in the room, but the doctor can observe her through a special glass. The session lasts several minutes.

The procedure is painless, however, in the process of irradiation, you should remain completely immobile. Radiotherapy does not make the patient radioactive - contacts with other people (including children) are absolutely safe.

Internal radiation therapy

In this case, the cervix and adjacent areas are directly exposed to radiation. As a rule, the course of such treatment is prescribed after external radiation therapy. The course can be conducted both on an inpatient and outpatient basis.

To irradiate these organs, a radiation source is placed in specially designed hollow tubes - applicators - which are placed as close as possible to the cancer.

If the patient has not undergone a hysterectomy, intrauterine radiation therapy will be performed. In this case, the doctor places the applicators in the vagina and passes them through the cervix into the uterus. In some situations, it is advisable to place additional applicators near the cervix. The applicators are placed surgically, the patient is under anesthesia. In order to prevent possible displacement of the applicators, a cotton pad or gauze swab. To reduce the discomfort from finding the applicators in the uterus, it is required permanent reception painkillers.

If the patient has undergone a hysterectomy, a large applicator will be placed in the vagina - anesthesia is not required in this case.

X-ray or computed tomography is used to control the position of the applicators. Once the correct placement of the applicators has been confirmed, the source is placed in them and treatment begins.

This type of radiation therapy can be carried out as a method of one long exposure, or in the form of several short sessions - the specific choice depends on the situation and the systems used.

High dose treatment

The most common type of internal radiation therapy. The patient receives large dose radiation exposure for several minutes. Typically, a session takes 10-15 minutes. This course of therapy includes a small amount of sessions repeated at intervals of several days.

As a rule, the applicators are removed between sessions, however, in some cases it is advisable to remove the devices only after the final session. If it's about outpatient treatment, the applicators are removed before the patient leaves home.

A catheter may be placed in the patient's bladder to facilitate the drainage of urine.

Low dose treatment

As a rule, it includes one session lasting 12-24 hours, but in some cases, exposure may take several days. The patient should follow bed rest, which ensures that the correct position of the applicators is maintained. A catheter is placed in the bladder, which, in combination with applicators, causes quite serious discomfort - to minimize it, the patient regularly receives strong painkillers.

The patient is kept in a single room, which is necessary to protect other patients from exposure. Visits are strictly limited. The removal of the applicators is performed under general anesthesia.

Pulse treatment

In this case, the applicators remain in place for the same amount of time as for low-dose treatment, but the patient receives radiation exposure periodically, not continuously.

Side effects

As a rule, immediately after the end of treatment, the patient has a slight vaginal bleeding or discharge. If the problem persists for several weeks or begins to cause serious discomfort, you should consult a doctor.

Radiation therapy in the area pelvic cavity may cause side effects such as diarrhea, fatigue and burning sensation when urinating. In some patients, these side effects are mild, while in others they are much more severe.

Diarrhea

Diarrhea is one of the most common side effects that occur as a result of radiation therapy. In the presence of this complication Drink plenty of fluids to prevent dehydration.

Nausea

Lack of appetite, nausea and vomiting are also common. For these symptoms, high-calorie meal replacement drinks may be prescribed.

inflamed skin

The skin in the treatment area may become inflamed. Soaps, creams and deodorants can irritate the skin and should not be used during treatment. The choice of cosmetics should be agreed with the doctor.

Fatigue

Chronic fatigue is one of the main complications of radiation therapy. the best way dealing with this problem is to rest as much as possible.

Narrowing of the vagina

This complication can make it difficult to inspect the treatment area and place the applicators. Doctors may prescribe the use of vaginal dilators, which are plastic tubes that are placed in the vagina and maintain its diameter. This greatly facilitates the treatment. At correct use vaginal dilator, the likelihood of damage to the vagina is minimal.

Also, hormonal creams can help solve this problem.

Return to sexual activity

As a rule, women return to sexual activity a few weeks after therapy. Many patients are wary of having sex after cancer treatment, however, it is completely safe: cancer is not sexually transmitted, and sexual contact does not affect the likelihood of a relapse. Also regular sex life Helps prevent narrowing of the vagina.

Smoking

Smoking exacerbates the side effects of radiation therapy, so it is recommended to stop smoking.

Long Term Consequences

Radiation therapy in the pelvic region can in some cases cause long-term side effects ( long-term consequences), but this is extremely rare. These complications include:

Bladder and bowel dysfunction

In some patients, radiation therapy may blood vessels in the intestines and bladder are more fragile, leading to blood in the stool or urine. Such effects may appear months or years after treatment, at the first detection of them, you should consult a doctor.

AT rare cases radiation therapy causes narrowing of the intestines and intestinal obstruction, which can cause vomiting, constipation, and abdominal pain. To treat this problem, the patient will most likely have to be hospitalized.

Complications associated with the vagina

Radiation therapy can cause vaginal bleeding or chronic narrowing of the vagina. The gynecologist deals with the treatment of such problems.

Swelling of the legs, pelvis, or genitals

Radiation therapy can affect the lymph nodes located in the pelvic region, which leads to the occurrence of lymphostasis. This complication is most likely to occur in combined treatment: surgery and radiotherapy.