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Oncologists to answer cancer questions

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People ask Dr. Jennifer Fischbach what they can do for the nausea they believe radiation will bring. They've confused it with chemotherapy.

"Many people in the community do not understand the differences between modalities for treatment for cancer. We have patients who come in who misunderstand what chemotherapy is, what radiation is, who may have heard about side effects of one and attribute it to the other.

"They think everyone loses hair, with either radiation or chemotherapy. Well, not everyone loses hair with chemo; it depends on the particular drugs used. They have misconceptions about radiation therapy and unacceptable side effects, like it always makes you sick."

They are unclear about what radiation is — it's precisely targeted x-ray — or how it's delivered. They have ideas, often wrong, about how long treatment takes.

The questions are very familiar to Fischbach, a radiation oncologist with LDS Hospital who, along with medical oncologist Dr. Ross Morgan will field questions about cancer detection, prevention and treatment during the Deseret News/Intermountain Health Hotline, which runs from 10 a.m. to noon Saturday.

It's increasingly common to see combination cancer therapy that involves both radiation and chemotherapy, especially for tumors.

Radiation therapy, unlike implanted isotopes, is not radioactive after treatment, though short-term side effects may occur, depending on what the target is. When the abdomen is treated, for instance, other organs in the area may be affected. The bladder may be irritated or the patient may experience diarrhea. Treatment for a brain tumor may cause hair loss. Someone being treated for neck cancer or head cancer may get a very bad sore throat. But the person receiving radiation for bladder cancer doesn't lose hair, and the one with a brain tumor doesn't get diarrhea from the treatment.

Most, but not all side effects are fairly short-lived. But there may be longer-term effects, depending on how high the radiation dose is and what's being treated. Long-term treatment of the pelvis, for instance, may create bowel obstruction. And there are more acute side effects.

Most people with blood-based malignancies won't be treated with radiation. Chemotherapy is more likely.

Radiation is common for breast, lung, prostate, rectal and other "organ" cancers.

The purpose is to cure the cancer or relieve a particular symptom, sometimes even when the disease is expected to be incurable. Radiation can relieve pain, bleeding or obstruction, in some cases. Radiation treatment may last from two weeks to eight weeks, with the shorter treatments more palliative than curative.

The cancer is not the limiting factor, according to Fischbach; the normal tissue is.

"How much can you give a certain area? You can't go beyond normal tissue tolerance."

Radiation itself is painless, though side effects may not be, she said.


E-MAIL: lois@desnews.com