Posted by: ayrshirehealth | June 18, 2014

Educating Ayrshire by @craigb_blahblah

Educating Ayrshire: ‘A whistle-stop tour in to the world of radiotherapy’

What is a therapeutic radiographer? A therapy radiographer? A radiotherapist? A radiation therapist? Well, they really are all the same thing. We are radiographers, but not diagnostics. We are allied health professionals that are qualified in the localisation, and treatment of cancers using ionising radiation. It all sounds very complicated but our diagnostic colleagues image patients to achieve a diagnosis and the two professions really are extremely different. The one similarity being that they both use radiation. If you’ve ever heard of someone going to hospital for radiotherapy – we will be the people they see.

BeatsonBackground – My name is Craig Blackwood, an almost 4th year Radiotherapy & Oncology student at Glasgow Caledonian University.  I have known for some time that my purpose was to work in cancer care, after losing my gran to metastatic colorectal cancer when I was 16. This fuelled my passion and I knew my personal experience would only bring positive qualities to me as a health professional. At school I always had an avid interest in human anatomy – so radiotherapy seems a sensible pathway to go down. What I didn’t realise is quite how “physics-y” my course would be.  Since the start, my clinical time has had me placed in the radiotherapy department at The Beatson West of Scotland Cancer Centre in Glasgow.

Firstly…What is radiotherapy and how does it work?

Radiotherapy is the use of high energy rays (usually x-rays or electrons) to treat cancers. Now we can get all technical and get in to the radiobiology of how it does this, or I can say simply, that it damages the DNA in cancer cells, as well as healthy tissues in the path of the beam. It is delivered using a machine called a linear accelerator, shown below. These cost about £2.5 million each; and they put me in charge of driving it!Linear Accelerator

Radiotherapy plays a vital role in the management of cancers, normally in combination with chemotherapy and/or surgery. 40% of people who are effectively cured from their cancers, receive radiotherapy at some point in their treatment pathway. It can be given externally, or internally. External beam radiotherapy is the most common, and is just like having a long x-ray. Internal radiotherapy or brachytherapy however, involves the placement of a radioactive source close to an actual tumour, to deliver a local dose. An example of it’s use is in men with a low grade prostate cancer, where radioactive seeds are implanted in to the prostate to give a dose. These sources decay and become less radioactive with time, and are left in permanently.

Radiotherapy takes place in specialised departments within hospitals or stand-alone centres in the big cities – unfortunately we don’t have facilities in every hospital. Radiotherapy is delivered in daily appointments referred to as fractions (#s). This allows the total dose to be delivered over a safe period of time.

The 24 hours between appointments allows the healthy cells that have been irradiated time to recover – unlike the cancer cells that are already genetically ‘faulty’ – so we can ‘kick them when they’re low,’ day after day, so to speak.

Radiotherapy can be given ‘radically’ – with the aim of cure or for ‘palliation’ – the management of symptoms. It can be used to treat benign tumours (e.g pituitary adenomas) but the work is mainly in malignancy management. It can be given neo-adjuvantly – in other words, before the primary treatment; such as being used to debulk a tumour prior to surgical excision. Furthermore, it can be used adjuvantly – following the primary treatment, to act as ‘an insurance policy’ for any missed cells, reducing risk of recurrence. It plays a vital role in the management of malignant spinal cord compression, and can often give patients considerable bone pain relief near the end of their life.

 The future of radiotherapy

In recent years, this long-time cancer treatment has undergone significant revolutions. I won’t bore you with the technicalities, but if you’re interested you can google the following terms and see what they all do: IMRT, IGRT, VMAT, SABR and SRS. These advances really are amazing, and allow greater precision, less surrounding tissue damage, and better long term results for the patients. The machinery has advanced, and new machines designed, such as the Cyberknife radiosurgery system, below.

CyberknifeSpecific chemotherapy drugs have also been developed and can be administered alongside radiotherapy treatment to act as ‘radiosensitisers.’ ChemotherapyThese drugs make the cancer cells more vulnerable to radiation, and again, getting technical – they hold the cancer cells in their most radiosensitive stage of the cell cycle – enabling a greater cell kill.

Greater care in recent years has been taken to help minimise the long term side effects associated with radiotherapy. Along with radiotherapy, the therapy radiographer’s role is also expanding. We now have specialist site-specific radiographers e.g specialist breast or colorectal radiographers and even specialist research radiographers. My hope is that this role continues to expand, perhaps even out of the hospital setting and in to the community, allowing us to support patients in their own homes. We may also be able to prescribe medications to help manage short and long-term side effects and provide information and support to patients throughout and after their treatment. The recent statistics regarding cancer incidence, with 1 in 3 of us expected to have a cancer diagnosis at one point in our lives, reveal the importance of cancer treatment and advances in the field.

Other Services

screen-capture-8Alongside university and placement, I also help run a Macmillan Cancer Support and Information drop-in centre. Across the last few years, Irene Wilson and Shoana Connell have been responsible for forming these throughout Ayrshire. We offer information, support and sign-posting to other organisations – all over a good cuppa. MacM FB pageWe can be found on Facebook – ‘Macmillan Cancer Care Information & Support Service – Ayrshire & Arran’ or on Twitter at @macayrshire.

I feel honoured to work in cancer care. We get to know patients well, and see them every day for up to 7 weeks of treatment. This is the part of the job I enjoy. I enjoy getting to know them, their stories, and supporting them and their families in such a vulnerable situation. The disease is horribly clever and non-discriminatory, meaning you meet such a vast range of people from all walks of life. In my working day, I’m either giving patients more quality time left with their family, or effectively saving their life – nothing is better than that. Patients are often extremely appreciative of our work, and I’m excited about what I can bring to patients in the future within cancer services in the west of Scotland and indeed the world. I will continue to reassure patients that they’re in fact not ‘radioactive,’ and they can hold their grandkids without giving them a dose!Craig

This week’s blog was by @craigb_blahblah (Craig Blackwood) who is a Radiotherapy & Oncology Student at Glasgow Caledonian University/NHS Greater Glasgow & Clyde | Volunteer with Macmillan Information and Support Service, Ayrshire & Arran

Further information

Further information on radiotherapy can be seen in a recent article in the Telegraph – http://www.telegraph.co.uk/sponsored/health/scientific-breakthroughs/10523959/cancer-treatment-radiotherapy.html

Or

on Youtube, one of the videos includes and excellently informative video aimed at children who require, or have a relative undergoing radiotherapy. https://www.youtube.com/watch?v=8pBjobqdtrc

Craig can be contacted by email me on cblack200@caledonian.ac.uk , on twitter (@craigb_blahblah) or via LinkedIn.

 

 

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Responses

  1. […] Educating Ayrshire: ‘A whistle-stop tour in to the world of radiotherapy’ by Craig Blackwood on the Ayrshire Health blog […]

  2. Craig, really encouraging to see such enthusiasm about and care for people in your blog. All too often people think of doctors and nurses when they think abou healthcare, but as you so ably reminded us- the whole patient’s journey needs to be supported by caring compassionate people. Your gran would have been proud of you. Well done.

    • Hi Fiona,

      Thanks for your kind words – especially about my wee gran. Lots of lovely emails and Facebook/twitter messages today aswell. I agree, for the professions to work together throughout the whole process; each performing and overlapping on the other’s role allows for a seamless pathway. And a happy and appreciative patient. I know my purpose is to care for people, in which profession I’m not quite decided – but definitely in the field of oncology and palliative care. And the people doing the caring make all the difference.

  3. […] radiotherapist Craig helps to treat people with cancer, a career path taken in memory of his gran. Educating Ayrshire: ‘A whistle-stop tour in to the world of radiotherapy’. Ross Wigham made the jump from localgov comms into health comms and it’s proving to be a […]

  4. […] Educating Ayrshire by student radiographer Craig Blackwood (@craigb_blahblah) was posted on Ayrshirehealth. Craig explains the role of a radiographer, as well as introducing the reader to some of the equipment he uses. […]


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