Radiation and chemotherapy used together

Radiation may help how well chemotherapy (chemo) works. And chemo may help the effects of radiation. Experts are working to find the best use of chemo and radiation.

Intraoperative irradiation

This means radiation is used during surgery. This can be done to treat some types of cancer. It may be radiation from a device outside the body. This is called external beam radiation therapy. Or it may be other types of radiation. The benefit of this method is that less tissue is exposed to radiation. The target area can be directly looked at. A more effective dose of radiation may be used. Radiation used in surgery can also improve cancer treatment in some cases when used with chemo.

Stereotactic irradiation (radiosurgery)

This is the use of a single high dose of radiation to do surgery. The radiation is sent into the diseased tissue with very narrow beams. One type is called linear acceleration. Another type is called the Gamma Knife®. With these types of surgery, you may spend less time in the hospital afterwards. It also lowers the costs for treating some kinds of brain cancer and other conditions.

Particle radiation therapy

This therapy uses higher-energy particles of radiation to treat cancer. The types of particles used include neutrons, protons, ions, and antiprotons. Proton therapy is the most common type of therapy. Fast neutron therapy may be used to treat some tumors that come back or can’t have surgery. There are only a few places in the U.S. that have this treatment. Antiproton therapy is the newest type under study. It may be used for radiosurgery. Internal hadron therapy is another type of particle radiation therapy. One example of this is boron neutron-capture therapy. A boron compound is given to the person by injection. The boron builds up in the tumor or cancer tissue. A reaction occurs in the tumor when a beam of neutrons is sent into the tumor. This kills the cancer cells. The benefit of this method is that it can be used to treat widespread cancer.

3-D conformal radiation therapy

Before the use of CT scans, it was hard to target cancer cells for radiation therapy. CT gives a 2-D means of finding the area to be treated. But CT and MRI can be used to provide a 3-D view that shows all the borders of the cancer growth. This allows for more precise treatment planning.

Intensity-modulated radiation therapy (IMRT)

This is like 3-D conformal radiation therapy. IMRT uses single radiation beams that have different kinds of intensity in them. This reduces the amount of radiation to normal tissues around the area being treated.

Radioimmunotherapy

This uses antibodies tagged with a cancer-killing substance. These tagged antibodies find tumor cells and bind with them. This brings the cancer medicine directly to the tumor tissue. The tagged antibodies may be given directly into an artery or under the skin. Or they may be put into a body area, such as the uterus. This method may be used to treat cancer that has spread but can't be seen. This helps stop the spread of the cancer.

Your treatment choices

Talk with the radiologist or radiation oncologist. They should have a high level of skill and extra training to do these procedures. Ask if the provider is certified. This means they have a special type of approval. They may be certified by a professional group. Or it may be done by a national board. Before agreeing to treatment, ask the provider these questions:

• What is the treatment for?

• Why do I need this treatment?

• How many times have you done this treatment?  

• Are there better options?

• What are the possible complications?

• Which hospital or facility is best prepared to do this procedure?

• Are there side effects?

• Will this treatment interfere with medicines I am taking?

• When will I get the results?

• How much will it cost?

Answers to these questions will help you make an informed choice about your treatment.