What is Radiation Therapy?

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Transcript

Tessa Lackey: [00:00:00] Whether you've been diagnosed with cancer or are curious about cancer treatment, radiation therapy can be a scary topic that 70 percent of patients with a cancer diagnosis will have when they meet with a radiation oncology specialist. Welcome to Prescribed Listening. I'm your host Tessa Lackey today we have Dr.

Mershia Hadziahmetovic with us to discuss what radiation therapy is, what patients can expect from treatment, and what is it used for from cancer treatment to other treatments in lower doses like for osteoarthritis. So here's our discussion with Dr. Hadzi. Thank you Dr. Hadzi for joining us again today.

So just to get a introduction to you, tell us about you and what you do for UToledo Health.

Dr. Mersiha Hadziahmetovic: Sure. Thank you so much, Tessa. My name is Mersiha Hadziahmetovic, I'm better known as Dr. Hadzi in the hospital and in the community. I'm a radiation oncologist, and that is an area of medicine, specifically oncology, that uses radiotherapy, uh, for medicinal and therapeutic purposes, uh, primarily in patients with cancer, but also in patients with certain benign conditions.

Tessa Lackey: [00:01:00] Okay. And then just to give us a brief overview of what we're going to talk about today, what is radiation therapy?

Dr. Mersiha Hadziahmetovic: Sure. That's a great question. So I'll preface by saying, you know, a lot of people have kind of visceral reaction to the very term radiation. It it's scary and it makes people nervous, but, uh, radiation is really just high energy x rays and using x ray energy to, for example, disrupt the DNA in the cancer cell.

And that's how we. kill the cancer or tumor, a malignant tumor from inside out, so to speak. We all learned in high school about electromagnetic radiation and or electromagnetic spectrum and radiation is kind of on the far end of that spectrum with x rays and gamma rays. Radiation has actually one of the longest track records and established records of safety and efficacy in all of medicine.

X rays were discovered in 1895, so since 1895 to this day. All day, every day in every [00:02:00] hospital in the world, radiation is used either in the diagnostic radiology, which is diagnostic radiation, versus radiation therapy, which is the therapeutic arm of our field. And that's what I do.

Tessa Lackey: So radiation isn't something, it's been something that's been studied for a long time.

Dr. Mersiha Hadziahmetovic: Absolutely. Absolutely. And we discovered it in, you know, at the end of 19th century and most of 20th century was figuring out how do we use this kind of amazing, uh, you know, some people call it God's gift to humanity. How do we. Harness this great property of radiation that is very effective at killing cancer, but how to we do it safety that it does not harm the patient. The 20th century was all about establishing that.

So focusing on cancer, with the understanding that everyone's body is different and will react differently, If you or a loved one have received a cancer diagnosis, what symptoms can people expect when receiving radiation therapy?

Sure. 70 percent of patients with a cancer [00:03:00] diagnosis will at some point meet with a radiation oncologist. I always say cancer care or oncology is a team sport. So you have a team of people, a team of doctors, team of nurses, uh, helping take care of you. Radiation or radiotherapy is sometimes. It's offered as frontline therapy, meaning like the first therapy against your cancer that you will get part of that will be radiation or down the line, maybe after surgery or in a palliative setting, for example.

But the side effects largely depend on the body side that is being treated, the size of the tumor, the dose we're taking the tumor to, and most importantly, the adjacent structures that are next to the tumor. So, for example, If you, if you have lung cancer and it's close to the middle of your chest and it's close to your swallowing tube, for example, your esophagus, then in order to cover the tumor beautifully with the radiation dose, there will be some stray dose.

It's immediately adjacent to whatever is touching the [00:04:00] tumor. For example, your esophagus. So you might have some painful or uncomfortable swallowing for, you know, two, three weeks and we would have to give you some pain medicines and maybe arrange some IV fluid hydration so as. to make sure you don't get dehydrated.

But side effects really vary from person to person depending on what type of tumor they have, how large is it, what's it next to, what dose we're taking it to, and how many treatments we're giving it.

Tessa Lackey: So symptoms depend on where the tumor is and then from there it it would just depend on it would be discomfort and Again, depending on the person.

Dr. Mersiha Hadziahmetovic: Depending on the person, and I always tell patients and their family members, you know, be very cautious to get an impression about radiotherapy from some random person who's had radiation. For example, a patient with tongue cancer will have very different side effects than a woman with breast cancer, will have very different side effects than a man with prostate cancer, very different side effects than somebody say, a bony [00:05:00] metastasis.

The vast majority of patients are actually very pleasantly surprised how underwhelming the whole process is. External beam radiation, which is We do, it's completely non invasive, there's no needles, there's no anesthesia, there's no bodily pain. It's a process that takes just a couple of minutes for the daily treatments and the patient just sort of plays statue while they're in position, receives their invisible treatment of x ray energy, And goes on about with their day.

And that is, but you sort of almost have to like go through it to believe it. So I hear it all the time from patients that, wow, it goes by so quickly. And wow, it's not nearly as bad as I imagined it in my head.

Tessa Lackey: So what determines someone having the therapy option for radiation therapy or what determines someone getting radiation therapy?

Dr. Mersiha Hadziahmetovic: Sure, sure.

Yeah. So we call those indications. What is the indication for radiation therapy in patients? Any given case. So these indications are well established [00:06:00] through published data. Well, obviously, we all have at least Five to six years of training beyond medical school and also something called NCCN guidelines.

We know that if you have a diagnosis X, stage Y, that standard of care is you need radiation and you need this dose. this many treatments over this period of time. And a lot of times in tandem, either with chemotherapy or after surgery or before surgery to make surgery easier for the surgeon down the line, all of that depends on your diagnosis and stage.

So the body part, you know, where is the primary tumor and what stage are we at? Um, so about, like I mentioned earlier, 70 percent of patients, So 10 people with a cancer diagnosis will be recommended to receive radiation therapy at some point. During their cancer treatment. Sometimes it's up front, sometimes it's midway, sometimes it's, [00:07:00] um, after all of the other options have been exhausted.

And then there are the different so called intents of treatment. There's the so called curative intent. Radiation therapy plays a role in the curative intent of, for example, primary brain tumors, head and neck cancers like tongue cancer, tonsil cancer, voice box cancer, breast cancer, lung cancer, esophagus cancer.

Some gastrointestinal cancers, anal cancer, rectal cancer. And then there's palliative intent where you're sort of, I, I like to say bandaid in the form of radiation, in the form of x rays, for example, painful bony metastases, if cancer is gnawing at your bone and it hurts and you can't walk, we can make that feel better with some x rays.

You don't have to then, you know, take strong opioid medications around the clock, for example. Or if somebody is coughing up blood radiation, palliative radiation can help stop that. If somebody is bleeding. Non stop radiation is great at stopping bleeding. So this is more common in, for example, [00:08:00] women with gynecological cancers, like cervical cancer, that will not stop bleeding.

And then we just deliver a treatment or two, usually within first few treatments that the bleeding stops. And then, okay, patient is stable. So the intent of therapy matters and the diagnosis and stage. And these, this is in our textbooks, in the guidelines. And we just sort of know this.

Tessa Lackey: It really just comes down to if I'm understanding correctly with intent of treatment, how big your tumors are, how, and then how,

Dr. Mersiha Hadziahmetovic: how widespread,

you know, so there's, we have a staging system called TNM.

So we look at is the tumor. in the body part it started. For example, breast cancer. Is it, say, an olive sized tumor? Is it a walnut sized tumor? Is it a mandarin orange sized tumor? Is it a tumor that's busted through the skin? Is it a tumor that has spread to the lymph nodes? Well, what lymph nodes? Is it lymph nodes in the underarm?

Is it lymph nodes in the neck? That all influences staging. And then depending on the stage, we know what's going on. [00:09:00] Through evidence based medicine, for example, the best way to treat stage 2, stage 3 breast cancer in 2024 is XYZ. And a lot of times radiation fits into that XYZ somehow.

Tessa Lackey: Okay, okay. And then one other question I wanted to ask you was When I think of radiation therapy, I think of I'm going to lose my hair as a symptom.

Now, we discussed how with radiation therapy, there, there's, it's minimal symptoms. And again, this all depends on the person and your own diagnosis. Um, what would you say to people that are worried about getting radiation therapy and what they should do? Are worried about that potential option.

Dr. Mersiha Hadziahmetovic: Oh,

sure. So the vast majority of patients do not lose their hair unless we're treating The patient's entire brain whole brain radiation then look at the scalp and the hair follicles do get irradiated Or say a very large primary brain tumor after surgery, obviously the surgeon already has done shaved the partially scalp, then even though we're doing partial brain irradiation, there can be some permanent patchy hair loss.

[00:10:00] In women, if they have long hair, they can sort of adjust their hairstyle and cover the bald spot. And then there's also, you know, wonderful other options, wigs and certain head coverings that can help patients sort of, you know, Embrace their new self increasingly women are just sort of not trying to cover up these scars You know, this is sort of their so called battle scars.

This is part of their identity. They don't want to cover it up They actually want to tell the world I went through this

This is part of me now.

Tessa Lackey: Yeah. You shouldn't have to cover it up, especially if you don't want to, and if you're comfortable with it, then, then you can,

but yeah.

Dr. Mersiha Hadziahmetovic: So yes, there are a lot of, you know, creative options nowadays.

So there are people who, who tattoo their scalps, do some artistic tattoo around the same mastectomy scar. There are swimsuit makers who now make up. Post mastectomy swimsuit where actually the scar is exposed.

Tessa Lackey: Oh, that's cool.

Dr. Mersiha Hadziahmetovic: Where people are just like, this is me. This is the new me and I'm here for her.[00:11:00]

Yeah. Why hide her?

Tessa Lackey: Well, and then for anyone who is interested in covering that up, we do have Renee's Survivor Shop.

Dr. Mersiha Hadziahmetovic: Yes, Renee's Survivor Shop is a wonderful resource for all of these options for breast prostheses, for wigs, for bonnets, for hair coverings, turbans, bandanas. That's the place to go.

Tessa Lackey: Okay. Is there any.

Any do's or don'ts, I guess we're going through treatment. Is there anything that people can do with their diet or anything that they need to worry about with exercise or with being around other people? Anything like that?

Dr. Mersiha Hadziahmetovic: Sure. No, that's a great question. So patients who receive external beam radiotherapy are not radioactive at all.

So they absolutely can be around other people, including small children and pregnant women. There is another form of radiotherapy called brachytherapy or treatments with radioisotopes that's. sort of what we call internal radiation. With that modality, yes, technically you are radioactive for maybe a day or two, uh, and there are some radiation safety precautions, but the [00:12:00] vast majority of patients get just external beam radiotherapy and they're not radioactive.

Tessa Lackey: So this specific form of therapy, you can't get any superpowers.

Dr. Mersiha Hadziahmetovic: No, no, you will not glow in the dark. I mean, some patients do feel like it actually energizes them. There is a concept called hormesis where you're exposed to like low dose radiation. And some scientists believe that it actually gives a little oomph or a little pep in, in your step to like your cells.

And they, Like work better than they otherwise would. Some people believe in that. But typically it's well tolerated. As far as do's and don'ts. A do is always kind of focus on what you can control. Your nutrition. If a patient is smoking, we would definitely advise at least cutting down. But ideally smoking cessation.

The efficacy of radiation really depends on having a well oxygenated tumor. We want the blood vessels to. To not be constricted, for example, when a person smokes, that can cause what's called vasoconstriction or constriction of the blood [00:13:00] vessels. And in theory, maybe cannot take as much oxygen to the tumor.

The more oxygen there is in tumor, the more sensitive it is to radiation controlling quality of your sleep, nutrition, hydration, status, physical activity, uh, one common side effect of radiation is. Mild to moderate fatigue. What that means is with mild fatigue, you can kind of go on about your day uninterrupted.

You don't really need to change anything, but you may go to bed earlier than usual or take it easy on the weekends. With moderate, you're actually struggling to get through your day. But study after study has demonstrated that patients who are physically active, even if it's just doing 10 15 minutes of chair yoga or tai chi or a walk around your neighborhood, those patients actually Hardly ever experienced fatigue.

So physical activity or active rest is a great way to have a much better experience through your radiotherapy course. Another daunt that is more theoretical is to stop taking vitamins, [00:14:00] specifically antioxidants in a pill form. A vitamin, for example, vitamins A, C, and E are all antioxidants. And when you take a vitamin supplement, you're You're sort of getting like the 10, 000 percent of the daily recommended value of that vitamin.

The reason why this is important is because the way radiation actually works on a cellular level, it creates oxidants. So these oxidants are these little, uh, called reactive oxygen species. They're little molecules. They sort of keep hitting the DNA in the cancer cell. Like you want oxidants. The oxidants are the ones.

Assaulting the DNA in the cancer cell, and you don't want to neutralize them by taking 10, 000 percent of the daily recommended value of say vitamin C or vitamin A or vitamin E. I tell patients, you know, by all means eat your fruits and vegetables, eat your salads, but like you're eating a normal amount of, you know, if you're eating an orange or some strawberries or having a lemonade or drinking some cranberry juice, you're getting maybe 50 to 100 percent of the [00:15:00] daily recommended value, not, not like the equivalent of eating three bags of oranges.

So that's, you know, another thing that we hone in on. We scrutinize your medication and supplement list, because we really don't want to blunt our ax, so to speak, against your cancer. We want to give it the best shot to do what we want it to do, i. e. kill as much of that cancer as possible.

Tessa Lackey: So essentially, if I'm understanding right, because you want more oxygen.

in your system for the radiation therapy, these vitamins could potentially hinder some of

that.

Dr. Mersiha Hadziahmetovic: Uh, not oxygen, oxidants, oxidants. Yeah. So there's antioxidants and oxidants. So this has been kind of oversimplified in the media where like oxidants are bad and we have to neutralize them, but actually oxidants are, you know, in our bodies, it's Sort of a balancing act.

We need oxidants. Like when we have a bacterial infection or a viral infection or cancerous cells in our body, it is those oxidants that actually attack these pathogens or cancer cells. Like [00:16:00] you want them there. Disease process happens when there's like, Too much of either one. So just, you know, temporarily for a few weeks, we don't want to blunt our ax.

In theory, you know, this is what we're taught during our training. We tell our patients, you know, don't take these certain vitamins, certain ones, which are not antioxidants. You're okay to take, but vitamins A, C, and E ideally should not be taken in a Pill form while you're getting your radiation and maybe for a few weeks after the radiation ends, and then you can safely resume that.

Tessa Lackey: And this

is one of the reasons why it's important to have an accurate list of medications as you're getting ready to start treatment.

Dr. Mersiha Hadziahmetovic: Absolutely

accurate and updated.

Tessa Lackey: Talking about nutrition as well and having a healthy nutrition. Is there anything specific that people should be including extra in?

Like, should people be eating extra oranges or making sure they're eating more beets or whatever? Anything specific?

Dr. Mersiha Hadziahmetovic: So, uh, just wholesome foods, ideally minimally processed to non processed foods, packaged as Mother Nature intended, um, high protein, you know, cancer treatment [00:17:00] can a lot of times be physically exhausting, patients become more sedentary as they're sort of nursing their side effects, and whenever we're sedentary, we lose muscle mass.

And we need to have the building blocks for muscles, which are the protein, you know, in our diet and also physical activity. So you sort of have the initiative to get up and exercise, even if it's just five, 10 minutes at a time. It doesn't matter as long as you're up and moving and having adequate protein in your diet.

Tessa Lackey: Okay. So to wrap up nutrition as much as possible, what mother nature intended, how it, how it's packaged. It doesn't matter. There isn't any, any magic orange that's going to make your radiation therapy better or worse. Reducing smoking, and that's, I'm assuming, vaping, cigarettes, cigars, any form of smoking.

Absolutely. Okay. And then talk to your doctor about your vitamins. That way, you're getting what you need and you can go back to what you need to do.

Dr. Mersiha Hadziahmetovic: Yes, this, the, the vitamin point is more of a nuance for the radiation team, not so much other [00:18:00] physicians. So that is something that hear, um, from other physicians, but a radiation physician will always hone in on those.

Tessa Lackey: Anything specific for men or women during radiation therapy that they need to consider for their own treatment? gender.

Dr. Mersiha Hadziahmetovic: When we're treating pelvic malignancies in people of childbearing age and women of childbearing age and men who, for example, are thinking of fathering a child, we do advise against getting pregnant or fathering a child for 12 to 18 months after treatment just because of some genetic mutations that could occur.

Tessa Lackey: Okay, and is there anything that these groups of people that may be considering conceiving?

Dr. Mersiha Hadziahmetovic: There are so called oncofertility specialists. And we have some in town. So there nowadays, reproductive medicine is really, you know, phenomenally advanced and can help our younger patients offload some of those anxieties.

Because unfortunately, the incidence of serious cancers is [00:19:00] rising in young Americans. And this is becoming an issue we have to think about in our kind of current batch of patients that we're increasingly seeing.

Tessa Lackey: How can loved ones, family, friends, Be supportive of someone who's going through radiation therapy.

Dr. Mersiha Hadziahmetovic: Oh, sure. In many ways. So a lot of patients actually do really well through radiation therapy. Patients who've had surgery, followed by chemotherapy, followed by radiation. For example, women with breast cancer or certain flavors of breast cancer have to have all three. A lot of times we'll hear from patients, Oh, wow, this is a walk in the park compared to, say, chemotherapy.

Other times radiation can be very toxic. For example, in head and neck cancer, patients with tongue cancer, tonsil cancer, voice box cancer, quote unquote throat cancer. Those patients really have a hard time. There are many ways to help patients that there's the emotional support where friends and loved ones can create a safe space for the patient to be vulnerable.

Sometimes people just want. To [00:20:00] talk to somebody about all the conflicting feelings they're experiencing. They're not necessarily asking for a solution. They just want you to lend an ear. I would recommend that you try to keep a positive outlook without, you know, sugarcoating or infantilizing the patient, sugarcoating the situation or infantilizing the patient, but providing reassurance, you know, reminding the patient they're not alone and going through this cancer journey, you're there to support them and support, you know, the little, the little victories.

And also physical support, you know, running chores. Like I mentioned earlier, cancer treatment can be very physically exhausting. So just helping with running errands, cooking, cleaning, helping arrange transportation, sometimes patients are just. to beat to drive themselves to their appointment and then they have to wait in the waiting room, then they have to be triaged, then they have to drive back.

And if they feel crummy, you know, that's really hard as opposed to somebody just saying, listen, I'll pick you up. I'll go with you. I'll take notes. I'll make sure you don't miss any important [00:21:00] information. You can take a nap on the way home. Some patients drive. One and a half, two hours, one way to see us.

The fact that they don't have to drive is, you know, it's a huge relief. These are some practical ways to help somebody can just offer to do it. As opposed to saying, let me know if I can help. Sometimes you just say, Hey, I'll do this for you. When's your next appointment?

Tessa Lackey: Yeah. Cause anytime someone says.

You know, let me know what I can do to help. No one's going to come out and say, Hey, will you drive two hours to my appointment for me?

Dr. Mersiha Hadziahmetovic: You can say, Hey, I'm going to come over for two hours. I'm going to vacuum. I'm going to do your laundry. I'm going to meal prep your meals when you're feeling really crummy.

So, you know, all of that helps conserve energy and is really much appreciated. There are people who have nobody. They have nobody to help them and it's very difficult to, to see those patients. I feel like they always have a much harder time through treatment because of that crutch is not there.

Tessa Lackey: Yeah. So for the people that can be there, it's, it's great that you can be there.

Dr. Mersiha Hadziahmetovic: Absolutely. So that's, that's one way. [00:22:00] Another way is to. to maybe look up resources and additional information online. For example, clinical trials or finding a support group, especially if they have rare malignancy that be on a state or a national level, there's a support group that meets remotely that can be really helpful to find like a tribe of people.

people who've gone through the same thing. Uh, that's something practical that can also be done, but, but, you know, just being considerate, compassionate, consistent is the best way to, to help somebody in this situation.

Tessa Lackey: Yeah. I love that. I love that way to wrap it up. I think that says it all. So on a cancer side of things, is there anything else you can think of that we can talk about in terms of radiation therapy that would help someone after they've received the, you're getting radiation therapy...

Dr. Mersiha Hadziahmetovic: Sure, you know, ask your physician about online resources.

There are some really fantastic YouTube channels, websites that are reputable, that will not lead you astray. We, if you're really thirsty for additional information, we would [00:23:00] be more than happy to guide you in the right direction. I would advise against. You know, just Googling stuff because it can take you down a rabbit hole to a non reputable site and can confuse you even more.

You know, your, your typical cancer specialist has gone to school for 25, 26 years. They know what they're doing, right? And they've learned a lot in, in that quarter of a century. So let us shepherd you through this. We're on your team and we want what's best for you.

Tessa Lackey: Plus they know your body. And if that resource is going to apply to you specifically with your own treatment, your own type of cancer.

Dr. Mersiha Hadziahmetovic: Exactly.

Tessa Lackey: So we had talked about how radiation therapy can be used for other conditions and other treatments other than just for cancer. What are some of those treatments?

Dr. Mersiha Hadziahmetovic: Absolutely.

So there's been a resurgence of utilizing so called low dose radiation therapy. Low dose radiation therapy, by definition, is using doses that are like 1 20th to 1 30th.

30th of the doses we use for cancer. There's a strong body of work dating decades where [00:24:00] radiation is very good at relieving bothersome pain from, for example, osteoarthritis. 50 million Americans. Suffer from morbidity of having osteoarthritis in their knees, in their hips, in their shoulder joints, elbows, hands, wrists.

The treatment again, non invasive, usually just maybe six treatments, very low dose. Works 70 percent of the time, very well to improve pain at rest and decrease the need To pop pain pills. This is a problem, especially for older Americans. By the time somebody's 75, 80, 85, they're probably, chances are, on a bunch of other medications.

And so called polypharmacy, being on so many different medications, that also a lot of times have side effects that can harm their mental health. cognitive status that can maybe do some harm to their kidneys or liver, either other vital organs. So radiation being non invasive with such low doses, completely pretty much [00:25:00] without side effects and with a 70 percent probability that it will relieve pain and decrease the need for strong pain.

Medicine is sort of a win win situation. So we actually just started doing this at University of Toledo Medical Center. We are building a program for radiation medicine for benign conditions. Other conditions that we treat that are not cancer, certain skin conditions that run in families, a much lower dose than is used for cancer treatment, works beautifully.

And in Germany, actually, they treat hundreds of thousands of joints every year with low dose radiation. They also treat certain conditions of the palm and soles of the feet, kind of the claw hand, before it becomes a claw hand. That is very effective in kind of slowing. that disease process down. So if patients have awareness, if their family doctors have awareness of this treatment modality, hopefully they will actually never develop a claw hand.

People are studying radiation for [00:26:00] psoriasis, eczema, again, low dose radiation. So it's very exciting to see our field also going this direction where we can harness the amazing power of x rays and do good for humanity.

Tessa Lackey: Are we seeing patients for this? Right now at UToledo Health?

Dr. Mersiha Hadziahmetovic: Yes.

Yes. We are treating patients with certain skin conditions and osteoarthritis that has failed to respond to other therapies.

But patients cannot, for example, have surgery, knee replacement, for example, or don't want to have surgery just yet. So that's low dose radiation therapy is one way to sort of prevent that. Kick the can on surgery down the road a little bit further.

Tessa Lackey: It sounds like you can kick the can also on medications you're taking.

Is that right?

Dr. Mersiha Hadziahmetovic: Absolutely. Absolutely.

I've treated some patients in their mid to late eighties, early nineties, my physician colleagues who are geriatricians. So that is the patient population. They see these physicians are very hesitant to give a patient who's 85, 90 years old, a [00:27:00] strong pain medication.

Like. oxycodone or a morphine because it can really impair their cognition, increase the risk of falls. I mean, if you fall and fracture a hip, statistics on that are not good. It lands you in a nursing home, makes you dependent on others. Geriatrics colleagues are very excited about the results they've been seeing in the patients we've treated because we've been able to It doesn't force their hand to give these possibly kind of double edged sword medications to the patients.

Tessa Lackey: So if someone let's say they're on a bunch of medications and they're listening to this and they're like I would like to I'm interested. I would like to try this. How can they try this?

Dr. Mersiha Hadziahmetovic: Oh sure They can always reach out to our department and schedule an appointment sort of as a self referral And we can then get in touch with their family physician Or they can go through their family physician and, you know, mention this podcast and the family physician is always welcome to call us and I'll be more than happy to speak with them.

You know, we're not just there for patients with cancer. We're there for [00:28:00] patients who don't have cancer as well.

Tessa Lackey: Very interesting. Very interesting. Okay, well, Dr. Hadzi is there anything else you'd want to add for people listening to this? Who are learning about radiation therapy.

Dr. Mersiha Hadziahmetovic: Oh, I just wanted to thank you for the opportunity to, I guess, debunk some of the myths, um, and, um, hopefully people learn.

Tessa Lackey: Yeah, of course. I know I learned something about this. I didn't know you could use radiation therapy for anything else. And then. It's not as scary as it, it seems to.

Dr. Mersiha Hadziahmetovic: Yes, it is the word radiation because of Chernobyl, because of Fukushima, all the nuclear disasters, you know, we've seen our world news. It is very scary, but we've known for a very long time that radiation is truly amazing at killing cancer.

And actually we could kill any cancer with radiation. Probably we're just limited by what dose we can deliver to it. We're limited. Many times by what is next to the tumor, next to the target. So if you have a target right next to, say, the spine and the spinal cord, well, the spinal cord is [00:29:00] limiting how much dose you can deliver.

So the adjacent structures are the limiting factor. Otherwise, I think no tumor is radiation resistant.

Tessa Lackey: Awesome. Well, Dr. Hadzi, for joining us today and for this insightful information about radiation therapy.

Thank you Dr. Hadzi for joining us and thank you for listening. If you would like to schedule an appointment to discuss radiation therapy at UToledo Health, you can call the Eleanor N.

Dana Cancer Center at 419 383 6644. And if you like this episode, don't forget to hit subscribe before you go so you can hear more from our UToledo experts like Dr. Hadzi and listen to past episodes like what happens once you've been diagnosed with cancer and what happens after you're cancer free.