There is no skin reaction to radiation. Basalioma after radiation therapy: consequences and prevention of complications

Doctor of Medical Sciences, Professor Afanasyev Maxim Stanislavovich, oncologist, surgeon, expert in photodynamic therapy of basal cell carcinoma.

Basalioma, or basal cell skin cancer, is a complex disease. Medicine offers many treatment methods, but all of them are traumatic, fraught with the formation of serious cosmetic defects, the development of long-term complications, and none of them eliminates relapses in the future.

Even Hollywood stars, who have access to the most high-tech and expensive treatments, have to undergo treatment for basal cell skin cancer for years. The most famous example is Hugh Jackman. The actor has been fighting the disease since 2013 to save his nose. And so far he has succeeded. But against the backdrop of his sixth relapse, Jackman has a serious risk of losing it.

Unfortunately, they do not guarantee getting rid of basal cell carcinoma forever.

And if even Hugh Jackman, who has access to the most modern medical care, cannot get rid of the problem, then a logical question arises: is this disease treatable? Is it possible to cure basal cell carcinoma?

Is it necessary to remove basal cell carcinoma?, if she doesn't bother?

Many people treat basal cell carcinoma treatment too leniently. Because this form of cancer grows slowly and almost never metastasizes, doctors rarely insist on treatment and usually do not warn about the consequences of failure.

And if for elderly patients such tactics can be considered justified with a stretch, then for young people - and over the past 10 years basal cell carcinoma has become very “younger” - it does not stand up to criticism.

With this approach, the patient does not take his seemingly insignificant disease seriously and decides not to do anything about it. Very often, treatment is limited to the use of so-called “green stuff”.

But I believe that Hugh Jackman is right in his persistent desire to get rid of basal cell carcinoma. And not only because of an aesthetic defect.

Treatment is necessary. Basalioma is a tumor that, although slowly, is constantly growing. It never goes away on its own. Sooner or later, it overcomes the skin, grows into muscles and nerves, penetrates cartilage and irreversibly disrupts the functioning of organs. If basal cell carcinoma is located on the face, it literally destroys it. Basalioma in the area of ​​the eye or nose, growing, can lead to their loss. Over time, basalioma of the head can destroy the skull and grow to the brain.

Need I say that these processes are also extremely painful?

In this stage basal cell carcinoma It is practically impossible to treat, because along with basal cell carcinoma it will be necessary to remove part of the organ or the entire organ.

You need to know the enemy by sight

Before continuing our conversation, I must tell you about one type of basal cell carcinoma that cannot be recognized at the diagnostic stage.

In approximately 6% of cases, treatment of basal cell carcinoma does not have any effect - removal of the basal cell carcinoma ends in relapse, and it reappears in the same place. And after the next removal, the whole process repeats... This form of basal cell carcinoma is called persistently recurrent basal cell carcinoma.

Unfortunately, modern medicine does not have a single effective means of combating stubbornly recurrent basal cell carcinoma. The mechanism why it returns has not yet been figured out.

However, even for such a head start on basal cell carcinoma, the founder of PDT in Russia, Professor Evgeniy Fillipovich Stranadko, recommends using exclusively photodynamic therapy as the method of choice. Indeed, in case of manifestation of persistently recurrent basal cell carcinoma, it is necessary to repeated treatment, the cosmetic effect of which will depend entirely on the method of its removal chosen at an early stage.

We must understand that any surgical treatment is always a “minus tissue” treatment, a mutilating treatment. Only PDT allows effective treatment without removing healthy tissue and obtaining an aesthetic result even against the background of persistently recurrent basal cell carcinoma.

Surgery for basal cell carcinoma

Surgical removal of basal cell carcinoma usually performed with a laser, scalpel or radio wave scalpel with the obligatory capture of 5 mm of healthy tissue. Surgical techniques also include the cryodestruction method - removal of basal cell carcinoma with nitrogen, and the Mohs method.

I strongly advise you not to agree to remove basal cell carcinoma with a scalpel - this method usually leaves behind a rough scar.

On early stages removal of basal cell carcinoma surgically gives a good effect. Therefore, it makes sense to remove very small and accessible formations up to 2-3 millimeters surgically. I myself prefer this method: the procedure is simple, quick and does not require special rehabilitation.

Disadvantages of the surgical method:

• High percentage of basal cell carcinoma recurrence after excision. Advanced basal cell carcinomas, which have managed to grow beyond the skin, recur especially often.

You should not trust information that surgery to remove basal cell carcinoma has a low recurrence rate. This figure is relevant only for small entities. When basaliomas larger than 2-3 mm are removed, usually more than half of them recur.

• Difficulty and impossibility re-treatment due to severe tissue loss.

Recurrence of basal cell carcinoma requires repeated surgery. But after the second or third relapse, surgery is usually impossible: imagine what happens to the area in which, with each removal of the basal cell carcinoma, an additional 6 mm of healthy tissue is removed.

• Relapse after surgery occurs in the scar area. This area is almost impossible to treat with PDT. Therefore, in case of relapse of basal cell carcinoma after surgical treatment you will have practically no alternative method left - only repeated surgery or irradiation.
• If the tumor is located on the wings of the nose, on the auricle or in the corners of the lips, if multiple basal cell carcinoma is to be treated, then the surgical method literally turns into a mutilating operation. In these areas, every millimeter of tissue is important, but often, along with the tumor, it may be necessary to remove up to half of the nose or ear, and the lack of tissue cannot be compensated for by plastic surgery methods.
• A contraindication to surgery is the location of the basal cell carcinoma in close proximity to the eye - there is a high risk of its loss.

Laser removal of basal cell carcinoma: features of the method and its disadvantages

Laser treatment of basal cell carcinoma is a surgical operation.

Laser removal of basal cell carcinoma has one significant drawback. The fact is that the laser beam does not cut the tissue, but evaporates it, layer by layer. After the laser, only a charred crust remains from the tumor. Thus, “cauterization” with a laser does not make it possible to send the removed tumor for histological examination. Only histology allows one to assess the completeness of basal cell carcinoma removal and exclude a more serious form of cancer, which in rare cases is hidden or adjacent to basal cell carcinoma.

This method also has one more drawback. Laser treatment of basal cell carcinoma thermally damages tissue, and such a wound heals with the formation of a scar.

Removal of basal cell carcinoma using Surgitron: features of the method and its disadvantages

Radio wave removal of basal cell carcinoma, or electrocoagulation, or treatment with electric knife,

- another surgical method. In this case, a tip with a thin wire is used to remove the formation. When an electric current of a certain frequency is passed through a wire, it acquires the properties of a scalpel.

Most often, treatment of basal cell carcinoma with radio waves is performed using medical equipment from the American company Surgitron, which gave the method its second name.

This method is good because after its use, tissue remains for biopsy - the pathologist will be able to assess the completeness of basal cell carcinoma removal and exclude more aggressive form cancer. The disadvantage of electrocoagulation is the same as that of all surgical techniques - a high rate of relapse for all tumors exceeding 2 mm.

You also need to be mentally prepared for the fact that excision of skin basal cell carcinoma using radio waves leaves behind a scar.

Cryodestruction of basalioma: features of the method and its disadvantages

Cryodestruction, or cryotherapy, is the cauterization of basal cell carcinoma with liquid nitrogen.

The method is cheap and quite widespread. However, you shouldn’t count on a miracle. Removing basal cell carcinoma by cryodestruction has a very serious drawback: the depth of exposure of liquid nitrogen to tissue cannot be controlled. That is, after treating basal cell carcinoma with nitrogen, there is a risk of both leaving lesions in the skin and, conversely, affecting too large areas of healthy tissue. In the latter case, after cauterization of basal cell carcinoma, there is a high probability of developing an extensive scar.

Treatment of basal cell carcinoma with cryodestruction has another drawback. Since the method does not make it possible to assess whether the tumor has been completely removed or not, basal cell carcinoma after cryodestruction may well resume its growth and eventually require repeated removal.

Mohs method: features of the method and its disadvantages

This is a high-tech and expensive treatment method that requires special equipment, special training of the surgeon and the presence of the clinic’s own pathology laboratory. It is designed to achieve high aesthetic results in the treatment of tumors on the face, neck, legs and arms, and genitals.

This is probably the method used to treat Hugh Jackman.

The Mohs operation can be compared (very loosely, of course) to using a slicer: tissue is removed in thin layers, layer by layer, and immediately sent to the laboratory. The procedure is repeated until tumor cells are no longer detectable in the section.

Since the entire operation is carried out under the supervision of a pathologist, there is no need to remove the basal cell carcinoma “involving” 6 mm of healthy tissue.

The operation is highly aesthetic, and if there is a lack of skin in the operated area, it is replaced with implants.

Irradiation of basal cell carcinoma: features of the method and consequences after irradiation of basal cell carcinoma

Radiation, or radiation, treatment methods are used only if there are contraindications to alternative methods. This is the method of choice for complexly located (for example, on the face), deep or too large tumors up to 5 cm that cannot be treated surgically. They are also prescribed to elderly patients with contraindications to surgical treatment.

Since the use of the method is always accompanied by complications, it is used mainly for elderly people over 65 years of age.

Irradiation of skin basalioma is carried out:

• using close-focus X-ray therapy,
• using gamma rays,
• using beta rays (electrons).

The use of a particular method is not always determined by rationality. Close-focus X-ray therapy is presented in every oncology clinic, so most often patients are referred to it. Electronic installations are expensive and complex, so literally only a few clinics are equipped with them.

Let's look at how radiation therapy works on basalioma.

It is believed that treatment of basal cell carcinoma with radiation therapy negatively affects the DNA of tumor cells. Ionizing radiation makes their further division impossible, basal cell carcinoma after radiation therapy stops growing and collapses over time.

There is often information that radiation treatment of basal cell carcinoma does not have any serious consequences. Unfortunately, this is not true. Irradiation of skin basalioma causes a lot of complications, which impossible to avoid. Therefore, treating basal cell carcinoma with radiation is often comparable to shooting sparrows with a cannon, since the side effects of such treatment often exceed the severity of the disease itself.

This is what a radiation ulcer looks like

If at the beginning of treatment the skin in the training area only turns red and itches, then by the third week of therapy a non-healing bright red ulcer develops. It is very easily infected and has extremely bad smell, and with great difficulty it is delayed only 1.5 months after the end of treatment.

2. A radiation ulcer always heals with the formation of a scar. This creates not only a defect in facial expressions, but also makes it very difficult to treat basal cell carcinoma in case of relapse.

3. It is impossible to predict in advance how radioactive particles will act. On the one hand, therapeutic radiation is aimed at rapidly dividing cells, and this is the main property malignant neoplasms: radiation damages basal cell carcinoma cells and makes them nonviable.

But on the other hand, radiation exposure itself has high mutagenic properties. Healthy tissue is also exposed to radiation, and the DNA of healthy cells is damaged.

Thus, an initially safe basal cell carcinoma is highly likely to “degenerate” into metastatic forms of cancer – for example, squamous cell skin cancer.

The risk of developing this complication persists for the rest of your life after basal cell carcinoma irradiation. It is for this reason that radiation treatment is not given to patients under 50 years of age. Due to the high risks of complications, radiation treatment is not used for recurrent basal cell carcinoma.

4. If basal cell carcinoma occurs on the head, irradiation leads to hair loss in the affected area, which grows brittle and dull after treatment.

5. The risk of complications increases in proportion to the depth of penetration of basal cell carcinoma and the intensity of irradiation.

6. When treating tumors located near the eyes, cataracts may occur.

7. Treatment of basal cell carcinoma with irradiation leads to changes in the functioning of the sebaceous and sweat glands in the area of ​​radiation exposure.

8. Anatomically difficult areas are not treated with any of the methods of radiation therapy.

9. With radiation treatment of basal cell carcinomas on the face, the risk of relapse is higher than on other areas of the skin.

This is what a device for close-focus X-ray therapy looks like.

Since the depth of exposure to this radiation ranges from a few millimeters to 7–8 cm, the dosage and number of sessions are calculated individually.

Close-focus X-ray therapy is effective only in the initial stages of basal cell carcinoma and is used only on accessible areas of the skin. For example, the corner of the nose is considered difficult to treat.

This method also has its drawback. X-ray radiation is well absorbed dense fabrics- for example, bones. Therefore, when basal cell carcinoma is located close to the bone - in the area of ​​the ears and on the head - electron radiation therapy is recommended.

Electronic therapy for basal cell carcinoma: features of the method and its disadvantages

Beta rays are called electrons. Accordingly, beta ray treatment is called electron therapy.

Compared to X-rays, electron radiation is considered more gentle, selective and highly targeted. Electrons are absorbed by tissues equally and regardless of their density. Unlike X-rays, whose energy is lost with increasing depth, uh The energy of the electron beam increases to a peak at a certain depth and then drops sharply.

All this means that with the correct dose calculation, radiation minimally injures healthy tissue around the tumor. Electronic therapy also allows irradiation of large areas of skin for multiple basal cell carcinomas.

But electronic therapy treatment also has limitations. On the one hand, this is the high cost of equipment. On the other hand, the technique is indicated in advanced stages - the size of the basal cell carcinoma should be no less than 4 cm2, since the device is quite labor-intensive to set up and does not allow focusing the flow onto a smaller area.

Electron irradiation is also not used to treat basal cell carcinoma in the eye area: modern radiology does not effectively protect the organ of vision.

The main disadvantage of all existing treatment methods is high risk relapses. As a result, you have to cut or irradiate again and again. Moreover, each stage of treatment is accompanied by significant loss of healthy tissue and scarring.

The need for deep tissue excision is a critical moment in the treatment of basal cell carcinomas on the face - especially on the nose, ears and corners of the lips, when each recurrence of basal cell carcinoma is accompanied by irreversible loss of a significant part of the organ.

Relapsebasal cell carcinomasin the rumen - perhaps the most terrible consequence treatment of basal cell carcinoma using classical methods

You need to understand that almost everything existing methods treatments lead to the formation of a scar, which is a dense connective tissue, poorly penetrated by vessels and poorly supplied with blood. In this case, relapse of basal cell carcinoma occurs in the area of ​​its original localization - that is, always in the scar area.

Unfortunately, in this case, PDT loses its effectiveness - the microcirculation of the rumen does not allow the photosensitizer to accumulate in sufficient concentration. Accordingly, recurrence of basal cell carcinoma in the scar is poorly susceptible to any alternative methods treatment other than surgery.

So, having performed an operation to remove basal cell carcinoma just once, you become a hostage to the surgical method.

How to treat basaliomato cure. Treatment of basal cell carcinoma using PDT

PDT – effective technique relapse-free treatment of basal cell carcinoma in one procedure.

Extensive personal experience in treating basal cell carcinoma using PDT allows me to confidently say that:

• PDT in 96% of cases forever eliminates basal cell carcinoma in one procedure,
• Photodynamic treatment of basal cell carcinoma shows the highest efficiency among all existing techniques. The method targets cancer cells and fully eliminates them. The risk of recurrence of even large basal cell carcinoma after correct and fully performed PDT is several times lower than from other treatment methods and is only a few percent.
• Only the photodynamic method of treating basal cell carcinoma provides the highest aesthetic result: either no scar remains or it is almost invisible.
• The method is suitable for the most complex basal cell carcinomas in the nose and eyelids.
• PDT shows very good results in the treatment of large basal cell carcinomas.
• It has almost no side effects, since healthy cells are not harmed during PDT.

What is the essence of the technique

Photodynamic removal of skin basalioma begins with a dropper - a photosensitizer drug is injected into the patient’s blood, which increases the photosensitivity of tissues. The photosensitizer has the special property of being retained only in old, atypical, damaged and cancer cells.

2-3 hours after injection, the tissues are irradiated with a laser according to a special scheme. The photosensitizer is activated by light and enters into a complex photochemical reaction, which results in the release of toxic compounds and reactive oxygen species that destroy cancer cells.

The duration of the procedure depends on the size and number of tumors and takes from 20 minutes to 2.5 hours.

It is this targeted effect on cancer cells that ensures complete tumor removal and an excellent aesthetic result after the procedure.

Is it that simple?

Of course, the PDT procedure is not at all as simple as it might seem at first glance. To obtain a guaranteed result, it requires very high-quality equipment, the highest craftsmanship, jewelry precision and strictly individual developed treatment plan.

For every patient I I am developing my own treatment protocol, which depends on age, medical history, size and location of the tumor, and concomitant diseases.

I make sure to diagnose and differentiate the tumor:

• visual examination with dermatoscopy;
• collection of material for cytological evaluation;
• taking a fingerprint-smear in the case of an ulcerated form;
• taking a biopsy for tumors larger than 5 cm2.

This procedure allows you to accurately diagnose basal cell skin cancer and exclude the more aggressive squamous cell cancer.

Before the procedure, I carefully calculate the dosage of the photosensitizer, as well as the intensity and time laser exposure. I carefully control the power of laser radiation during the procedure.

Compliance with the PDT protocol and an individual approach allows me to achieve good treatment results of 96% the first time.

By the way, not all specialists trained in PDT are able to trigger the necessary photochemical reaction and achieve a cure.

The photograph shows hyperthermia - a tissue burn that should not occur after a correctly performed PDT procedure. From the reaction of the tissues, I understand that no photochemical reaction occurred in this case, even if before the procedure the patient was injected with a photosensitizer and a laser was used. The treatment result shown in the photograph does not give the right to call it PDT. Therefore, after completion of treatment, the patient will not receive the benefits of the technique that I spoke about above.

The photochemical reaction may be accompanied by whitening of the tissue in the affected area, as shown in the photograph.

On days 14-20, a crust forms, under which epithelization occurs.

Rehabilitation

After the procedure, cyanosis appears at the site of treatment, which becomes covered with a black crust on days 14-20.

If the patient is in postoperative period Over the course of 4–6 weeks, the patient carefully complies with the doctor’s requirements; after the PDT procedure, a small and almost invisible scar remains on the skin. If a small basal cell carcinoma is removed, the tumor often disappears without a trace after PDT.

Why is the PDT method poorly represented in Europe and the USA?

Thank you

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!

Contraindications for radiation therapy

Despite the effectiveness radiotherapy ( radiation therapy) in the treatment of tumor diseases, there are a number of contraindications that limit the use of this technique.

Radiotherapy is contraindicated:

• In case of dysfunction of vital organs. During radiation therapy, the body will be exposed to a certain dose of radiation, which can negatively affect the functions of various organs and systems. If the patient already has severe diseases of the cardiovascular, respiratory, nervous, hormonal or other body systems, radiotherapy may aggravate his condition and lead to the development of complications.

• With severe exhaustion of the body. Even with highly precise radiation therapy, a certain dose of radiation reaches and damages healthy cells. To recover from such damage, cells need energy. If the patient’s body is exhausted ( for example, due to damage to internal organs by tumor metastases), radiotherapy may cause more harm than good.
• For anemia. Anemia is a pathological condition characterized by a decrease in the concentration of red blood cells ( red blood cells). When exposed to ionizing radiation, red blood cells can also be destroyed, which will lead to the progression of anemia and may cause complications.
• If radiotherapy has already been performed recently. In this case, we are not talking about repeated courses of radiation treatment for the same tumor, but about the treatment of a different tumor. In other words, if a patient has been diagnosed with cancer of any organ, and radiotherapy was prescribed for its treatment, if another cancer is detected in another organ, radiotherapy cannot be used for at least 6 months after the end of the previous course of treatment. This is explained by the fact that in this case the total radiation exposure to the body will be too high, which can lead to the development of serious complications.
• In the presence of radioresistant tumors. If the first courses of radiation therapy did not give absolutely no positive effect ( that is, the tumor did not decrease in size or even continued to grow), further irradiation of the body is inappropriate.
• If complications develop during treatment. If during a course of radiotherapy the patient experiences complications that pose an immediate danger to his life ( for example bleeding), treatment should be discontinued.
• If there are system inflammatory diseases (for example, systemic lupus erythematosus). The essence of these diseases is increased activity cells immune system against one’s own tissues, which leads to the development of chronic inflammatory processes in them. Exposure of such tissues to ionizing radiation increases the risk of complications, the most dangerous of which may be the formation of a new malignant tumor.
• If the patient refuses treatment. According to current legislation, no radiation procedure can be performed until the patient gives written consent.

Compatibility of radiation therapy and alcohol

During radiation therapy, it is recommended to refrain from drinking alcohol, as this can negatively affect the general condition of the patient.

There is a popular belief that ethanol ( ethyl alcohol, which is the active component of all alcoholic beverages) is able to protect the body from the damaging effects of ionizing radiation, and therefore it should be used during radiotherapy. Indeed, a number of studies have found that the introduction of high doses of ethanol into the body increases tissue resistance to radiation by approximately 13%. This is due to the fact that ethyl alcohol disrupts the flow of oxygen into the cell, which is accompanied by a slowdown in the processes of cell division. And the slower a cell divides, the higher its resistance to radiation.

At the same time, it is important to note that in addition to minor positive effects, ethanol also has a number of negative effects. For example, an increase in its concentration in the blood leads to the destruction of many vitamins, which themselves were radioprotectors ( that is, they protected healthy cells from the damaging effects of ionizing radiation). Moreover, many studies have shown that chronic consumption of alcohol in large quantities also increases the risk of developing malignant neoplasms ( in particular tumors of the respiratory system and gastrointestinal tract ). Considering the above, it follows that drinking alcoholic beverages during radiation therapy causes more harm to the body than good.

Is it possible to smoke during radiation therapy?

Smoking is strictly prohibited during radiation therapy. The fact is that tobacco smoke contains many toxic substances ( ethers, alcohols, resins and so on). Many of them have a carcinogenic effect, that is, upon contact with the cells of the human body, they contribute to the occurrence of mutations, the outcome of which can be the development of a malignant tumor. It has been scientifically proven that smokers have a significantly increased risk of developing lung cancer, pancreatic cancer, esophageal cancer and bladder cancer.

Considering the above, it follows that patients undergoing radiation therapy for cancer of any organ are strictly prohibited not only from smoking, but also from being near smoking people, since carcinogens inhaled can reduce the effectiveness of the treatment and contribute to the development of the tumor.

Is it possible to perform radiation therapy during pregnancy?

Radiation therapy during pregnancy can cause intrauterine damage to the fetus. The fact is that the effect of ionizing radiation on any tissue depends on the speed at which cell division occurs in this tissue. The faster the cells divide, the more pronounced the damaging effects of radiation will be. During intrauterine development, maximum intensive growth absolutely all tissues and organs of the human body, which is due to the high rate of cell division in them. Consequently, even when exposed to relatively low doses of radiation, the tissues of a growing fetus can be damaged, which will lead to disruption of the structure and functions of internal organs. The outcome depends on the stage of pregnancy at which radiation therapy was performed.

During the first trimester of pregnancy, the laying and formation of all internal organs and tissues occurs. If at this stage the developing fetus is irradiated, this will lead to the appearance of pronounced anomalies, which are often incompatible with further existence. This triggers a natural “protective” mechanism, which leads to the cessation of fetal activity and spontaneous abortion ( I'll have a miscarriage).

During the second trimester of pregnancy, most internal organs are already formed, so intrauterine fetal death after irradiation is not always observed. At the same time, ionizing radiation can provoke developmental anomalies of various internal organs ( brain, bones, liver, heart, genitourinary system and so on). Such a child may die immediately after birth if the resulting anomalies turn out to be incompatible with life outside the womb.

If exposure occurs during the third trimester of pregnancy, the baby may be born with certain developmental abnormalities that may persist throughout life.

Considering the above, it follows that it is not recommended to perform radiation therapy during pregnancy. If a patient is diagnosed with cancer early stages pregnancy ( up to 24 weeks) and radiotherapy is required, the woman is offered an abortion ( abortion) for medical reasons, after which treatment is prescribed. If cancer is detected at a later stage, further tactics are determined depending on the type and rate of tumor development, as well as the wishes of the mother. Most often, such women undergo surgical removal tumors ( if possible - for example, for skin cancer). If the treatment does not give positive results, you can induce labor or perform a delivery operation at an earlier date ( after 30 – 32 weeks of pregnancy), and then begin radiation therapy.

Is it possible to sunbathe after radiation therapy?

Sunbathing in the sun or in a solarium is not recommended for at least six months after completing a course of radiotherapy, as this can lead to the development of a number of complications. The fact is that when exposed to solar radiation, many mutations occur in skin cells, which can potentially lead to the development of cancer. However, as soon as a cell mutates, the body's immune system immediately notices this and destroys it, as a result of which cancer does not develop.

During radiation therapy, the number of mutations in healthy cells ( including in the skin through which ionizing radiation passes) can increase significantly, which is due to the negative effect of radiation on the genetic apparatus of the cell. At the same time, the load on the immune system increases significantly ( she has to deal with a large number of mutated cells at the same time). If a person begins to tan in the sun, the number of mutations may increase so much that the immune system cannot cope with its function, as a result of which the patient may develop a new tumor ( for example skin cancer).

What are the dangers of radiation therapy? consequences, complications and side effects)?

During radiotherapy, a number of complications may develop, which may be associated with the effect of ionizing radiation on the tumor itself or on healthy tissues of the body.

Hair loss

Hair loss in the scalp area is observed in most patients who have undergone radiation treatment for tumors in the head or neck area. Hair loss is caused by cell damage hair follicle. IN normal conditions namely division ( reproduction) of these cells and determines hair growth in length.
When exposed to radiotherapy, cell division of the hair follicle slows down, as a result of which the hair stops growing, its root weakens and it falls out.

It is worth noting that when other parts of the body are irradiated ( such as legs, chest, back and so on) hair may fall out of the area of ​​the skin through which a large dose of radiation is delivered. After the end of radiation therapy, hair growth resumes on average within a few weeks to months ( if no irreversible damage to the hair follicles occurred during treatment).

Burns after radiation therapy ( radiation dermatitis, radiation ulcer)

When exposed to high doses of radiation, certain changes occur in the skin, which in appearance resemble a burn clinic. In fact, there is no thermal damage to tissues ( like a real burn) is not observed in this case. The mechanism of burn development after radiotherapy is as follows. When skin is irradiated, small blood vessels are damaged, resulting in disruption of microcirculation of blood and lymph in the skin. The delivery of oxygen to the tissues is reduced, which leads to the death of some cells and their replacement with scar tissue. This, in turn, further disrupts the oxygen delivery process, thereby supporting the development of the pathological process.

Skin burns may appear:

• Erythema. This is the least dangerous manifestation of radiation damage to the skin, in which there is dilation of superficial blood vessels and redness of the affected area.
• Dry radiation dermatitis. In this case, an inflammatory process develops in the affected skin. At the same time, many biologically active substances enter the tissues from the dilated blood vessels, which act on special nerve receptors, causing a sensation of itching ( burning, irritation). In this case, scales may form on the surface of the skin.
• Wet radiation dermatitis. With this form of the disease, the skin swells and may become covered with small blisters filled with clear or cloudy liquid. After opening the blisters, small ulcerations form that do not heal for a long time.
• Radiation ulcer. Characterized by necrosis ( death) parts of the skin and deeper tissues. The skin in the area of ​​the ulcer is extremely painful, and the ulcer itself does not heal for a long time, which is due to impaired microcirculation in it.
• Radiation skin cancer. The most severe complication after radiation burn. The formation of cancer is facilitated by cellular mutations resulting from radiation exposure, as well as prolonged hypoxia ( lack of oxygen), developing against the background of microcirculation disorders.
• Skin atrophy. It is characterized by thinning and dry skin, hair loss, impaired sweating and other changes in the affected area of ​​the skin. The protective properties of atrophied skin are sharply reduced, resulting in an increased risk of developing infections.

Itchy skin

As mentioned earlier, exposure to radiation therapy leads to disruption of blood microcirculation in the skin area. In this case, the blood vessels dilate, and the permeability of the vascular wall increases significantly. As a result of these phenomena, the liquid part of the blood passes from the bloodstream into the surrounding tissues, as well as many biologically active substances, which include histamine and serotonin. These substances irritate specific nerve endings located in the skin, resulting in an itching or burning sensation.

For elimination skin itching Antihistamines may be used, which block the effects of histamine at the tissue level.

Edema

The occurrence of edema in the legs can be caused by the effects of radiation on the tissues of the human body, especially when irradiating abdominal tumors. The fact is that during irradiation, damage to the lymphatic vessels can be observed, through which, under normal conditions, lymph flows from the tissues and flows into the bloodstream. Impaired lymph outflow can lead to the accumulation of fluid in the tissues of the legs, which will be the direct cause of the development of edema.

Skin swelling during radiotherapy can also be caused by exposure to ionizing radiation. In this case, there is an expansion of the blood vessels of the skin and sweating of the liquid part of the blood into the surrounding tissue, as well as a violation of the outflow of lymph from the irradiated tissue, as a result of which edema develops.

At the same time, it is worth noting that the occurrence of edema may not be associated with the effects of radiotherapy. For example, in advanced cases of cancer, metastases may occur ( distant tumor foci) in various organs and tissues. These metastases ( or the tumor itself) can compress blood vessels and lymphatic vessels, thereby disrupting the outflow of blood and lymph from the tissues and provoking the development of edema.

Pain

Pain during radiation therapy can occur in case of radiation damage to the skin. At the same time, in the area of ​​the affected areas there is a violation of blood microcirculation, which leads to oxygen starvation cells and damage to nerve tissue. All this is accompanied by the emergence of pronounced pain syndrome, which patients describe as “burning”, “unbearable” pain. This pain syndrome cannot be eliminated with conventional painkillers, and therefore patients are prescribed other healing procedures (medicinal and non-medicinal). Their goal is to reduce swelling of affected tissues, as well as restore the patency of blood vessels and normalize microcirculation in the skin. This will help improve the delivery of oxygen to the tissues, which will reduce the severity or completely eliminate pain.

Damage to the stomach and intestines ( nausea, vomiting, diarrhea, diarrhea, constipation)

The cause of dysfunction of the gastrointestinal tract ( Gastrointestinal tract) there may be too much radiation dose ( especially when irradiating tumors of internal organs). In this case, there is damage to the mucous membrane of the stomach and intestines, as well as a violation of nervous regulation intestinal peristalsis (motor skills). In more severe cases, gastrointestinal tract may develop inflammatory processes (gastritis - inflammation of the stomach, enteritis - inflammation small intestine, colitis - inflammation of the large intestine, and so on) or even ulcers form. The process of moving intestinal contents and digesting food will be disrupted, which can cause the development of various clinical manifestations.

Damage to the gastrointestinal tract during radiation therapy can manifest itself:

• Nausea and vomiting– associated with delayed gastric emptying due to impaired gastrointestinal motility.
• Diarrhea ( diarrhea) – occurs due to inadequate digestion of food in the stomach and intestines.
• Constipation– can occur with severe damage to the mucous membrane of the large intestine.
• Tenesmus– frequent, painful urge to defecate, during which nothing is released from the intestines ( or a small amount of mucus is produced without stool).
• The appearance of blood in the stool– this symptom may be associated with damage to the blood vessels of the inflamed mucous membranes.
• Abdominal pain– occur due to inflammation of the mucous membrane of the stomach or intestines.

Cystitis

Cystitis is an inflammatory lesion of the mucous membrane of the bladder. The cause of the disease may be radiation therapy performed to treat a tumor of the bladder itself or other pelvic organs. At the initial stage of development of radiation cystitis, the mucous membrane becomes inflamed and swollen, but later ( as the radiation dose increases) it atrophies, that is, it becomes thinner and wrinkles. In this case, its protective properties are violated, which contributes to the development of infectious complications.

Clinically, radiation cystitis can manifest itself frequent urges to urination ( during which a small amount of urine is released), the appearance of a small amount of blood in the urine, periodic increases in body temperature, and so on. In severe cases, ulceration or necrosis of the mucous membrane may occur, which may lead to the development of a new cancerous tumor.

Treatment of radiation cystitis involves the use of anti-inflammatory drugs ( to eliminate symptoms of the disease) and antibiotics ( to combat infectious complications).

Fistulas

Fistulas are pathological channels through which various hollow organs can communicate with each other or with the environment. The causes of fistula formation can be inflammatory lesions of the mucous membranes of internal organs that develop during radiation therapy. If such lesions are not treated, over time deep ulcers form in the tissues, which gradually destroy the entire wall of the affected organ. The inflammatory process can spread to the tissue of a neighboring organ. Ultimately, the tissues of the two affected organs are “soldered” together, and a hole is formed between them through which their cavities can communicate.

During radiation therapy, fistulas can form:

• between the esophagus and trachea ( or large bronchi);
• between the rectum and vagina;
• honey of the rectum and bladder;
• between intestinal loops;
• between the intestines and the skin;
• between the bladder and the skin and so on.

Lung damage after radiation therapy ( pneumonia, fibrosis)

With prolonged exposure to ionizing radiation, inflammatory processes can develop in the lungs ( pneumonia, pneumonitis). In this case, ventilation of the affected areas of the lungs will be disrupted and fluid will begin to accumulate in them. This will manifest itself as a cough, a feeling of shortness of breath, chest pain, and sometimes hemoptysis ( producing a small amount of blood in sputum when coughing).

If these pathologies are not treated, over time this will lead to the development of complications, in particular to the replacement of normal lung tissue scar or fibrous tissue ( that is, to the development of fibrosis). Fibrous tissue is impermeable to oxygen, as a result of which its growth will be accompanied by the development of oxygen deficiency in the body. The patient will begin to experience a feeling of lack of air, and the frequency and depth of his breathing will increase ( that is, shortness of breath will appear).

If pneumonia develops, anti-inflammatory and antibacterial drugs, as well as agents that improve blood circulation in the lung tissue and thereby prevent the development of fibrosis.

Cough

Cough is a common complication of radiation therapy in cases where the chest is exposed to radiation. In this case, ionizing radiation affects the mucous membrane of the bronchial tree, as a result of which it becomes thinner and dry. At the same time, they significantly weaken it protective functions, which increases the risk of developing infectious complications. During the process of breathing, dust particles, which usually settle on the surface of the moist mucous membrane of the upper respiratory tract, can penetrate into the smaller bronchi and get stuck there. At the same time, they will irritate special nerve endings, which will activate the cough reflex.

Expectorants may be prescribed to treat cough during radiation therapy ( increasing mucus production in the bronchi) or procedures that promote hydration of the bronchial tree ( for example, inhalations).

Bleeding

Bleeding can develop as a result of the effect of radiotherapy on a malignant tumor growing into large blood vessels. During radiation therapy, the size of the tumor may decrease, which may be accompanied by thinning and a decrease in the strength of the wall of the affected vessel. A rupture of this wall will lead to bleeding, the location and volume of which will depend on the location of the tumor itself.

At the same time, it is worth noting that the cause of bleeding can also be the effect of radiation on healthy tissue. As mentioned earlier, when healthy tissues are irradiated, blood microcirculation is disrupted. As a result, blood vessels can dilate or even become damaged, and certain part blood will be released into the environment, which may cause bleeding. According to the described mechanism, bleeding can develop due to radiation damage to the lungs, mucous membranes of the oral cavity or nose, gastrointestinal tract, genitourinary organs, and so on.

Dry mouth

This symptom develops when tumors located in the head and neck area are irradiated. In this case, ionizing radiation affects the salivary glands ( parotid, sublingual and submandibular). This is accompanied by a disruption in the production and release of saliva into the oral cavity, as a result of which its mucous membrane becomes dry and hard.

Due to lack of saliva, taste perception is also impaired. This is explained by the fact that in order to determine the taste of a particular product, particles of the substance must be dissolved and delivered to the taste buds located deep in the papillae of the tongue. If the saliva in oral cavity no, the food product cannot reach the taste buds, as a result of which a person’s taste perception is disrupted or even distorted ( the patient may constantly experience a bitter feeling or a metallic taste in the mouth).

Dental damage

During radiation therapy for oral tumors, teeth darken and their strength is impaired, as a result of which they begin to crumble or even break. Also due to impaired blood supply to the dental pulp ( the inner tissue of the tooth, consisting of blood vessels and nerves) the metabolism in the teeth is disrupted, which increases their fragility. Moreover, disruption of saliva production and blood supply to the oral mucosa and gums leads to the development of oral infections, which also adversely affects dental tissue, contributing to the development and progression of caries.

Temperature increase

An increase in body temperature can be observed in many patients both during the course of radiation therapy and for several weeks after its completion, which is considered absolutely normal. At the same time, sometimes an increase in temperature may indicate the development of severe complications, as a result of which, if this symptom appears, it is recommended to consult with your doctor.

An increase in temperature during radiation therapy may be due to:

• The effectiveness of treatment. During the destruction of tumor cells, various biologically active substances are released from them, which enter the blood and reach the central nervous system, where they stimulate the thermoregulation center. The temperature can rise to 37.5 - 38 degrees.
• The effects of ionizing radiation on the body. When tissues are irradiated, a large amount of energy is transferred to them, which can also be accompanied by a temporary increase in body temperature. Moreover, a local increase in skin temperature may be due to the expansion of blood vessels in the area of ​​irradiation and the influx of “hot” blood into them.
• The main disease. With most malignant tumors, patients experience a constant increase in temperature to 37 - 37.5 degrees. This phenomenon may persist throughout the course of radiotherapy, as well as for several weeks after the end of treatment.
• Development of infectious complications. When the body is irradiated, its protective properties are significantly weakened, resulting in an increased risk of infections. The development of infection in any organ or tissue may be accompanied by an increase in body temperature to 38 - 39 degrees and above.

Decrease in leukocytes and hemoglobin in the blood

After radiation therapy, there may be a decrease in the concentration of leukocytes and hemoglobin in the patient’s blood, which is associated with the effect of ionizing radiation on the red bone marrow and other organs.

Under normal conditions, leukocytes ( cells of the immune system that protect the body from infections) are formed in the red bone marrow and lymph nodes, after which they are released into the peripheral bloodstream and perform their functions there. Red blood cells are also produced in the red bone marrow ( red blood cells), which contain the substance hemoglobin. It is hemoglobin that has the ability to bind oxygen and transport it to all tissues of the body.

Red during radiation therapy Bone marrow may be exposed to radiation, as a result of which the processes of cell division in it will slow down. In this case, the rate of formation of leukocytes and red blood cells may be disrupted, as a result of which the concentration of these cells and the level of hemoglobin in the blood will decrease. After cessation of radiation exposure, normalization of peripheral blood parameters can occur within several weeks or even months, which depends on the received dose of radiation and the general condition of the patient’s body.

Menstruation during radiation therapy

The regularity of the menstrual cycle may be disrupted during radiation therapy, depending on the area and intensity of radiation.

The period may be affected by:

• Irradiation of the uterus. In this case, there may be a violation of blood circulation in the area of ​​the uterine mucosa, as well as increased bleeding. This may be accompanied by the release of large amounts of blood during menstruation, the duration of which may also be increased.
• Irradiation of the ovaries. Under normal conditions the flow menstrual cycle, as well as the appearance of menstruation is controlled by female sex hormones produced in the ovaries. When these organs are irradiated, their hormone-producing function may be disrupted, resulting in various menstrual cycle disorders ( until the disappearance of menstruation).
• Irradiation of the head. In the head area is the pituitary gland, a gland that controls the activity of all other glands of the body, including the ovaries. When the pituitary gland is irradiated, its hormone-producing function may be disrupted, which will lead to dysfunction of the ovaries and disruption of the menstrual cycle.

Can cancer recur after radiation therapy?

Relapse ( re-development of the disease) can be observed during radiation therapy for any form of cancer. The fact is that during radiotherapy, doctors irradiate various tissues of the patient’s body, trying to destroy all the tumor cells that could be located in them. At the same time, it is worth remembering that it is never possible to exclude the possibility of metastasis 100%. Even with radical radiation therapy performed according to all the rules, 1 single tumor cell can survive, as a result of which, over time, it will again turn into a malignant tumor. That is why, after completing the treatment course, all patients should be regularly examined by a doctor. This will allow timely detection possible relapse and promptly treat it, thereby prolonging a person’s life.

A high likelihood of relapse may be indicated by:

• presence of metastases;
• tumor growth into neighboring tissues;
• low efficiency of radiotherapy;
• late start of treatment;
• incorrect treatment;
• exhaustion of the body;
• presence of relapses after previous courses of treatment;
• patient's failure to comply with doctor's recommendations ( If the patient continues to smoke, drink alcohol or be exposed to direct sunlight during treatment, the risk of cancer recurrence increases several times).

Is it possible to get pregnant and have children after radiation therapy?

The effect of radiation therapy on the possibility of bearing a fetus in the future depends on the type and location of the tumor, as well as on the dose of radiation received by the body.

The possibility of bearing and giving birth to a child may be affected by:

• Irradiation of the uterus. If the purpose of radiotherapy was to treat a large tumor of the body or cervix, at the end of treatment the organ itself may be so deformed that pregnancy cannot develop.
• Irradiation of the ovaries. As mentioned earlier, with tumor or radiation damage to the ovaries, the production of female sex hormones may be disrupted, as a result of which a woman will not be able to become pregnant and/or bear a fetus on her own. At the same time, hormone replacement therapy can help solve this problem.
• Pelvic irradiation. Irradiation of a tumor that is not associated with the uterus or ovaries, but is located in the pelvic cavity, can also create difficulties when planning a pregnancy in the future. The fact is that as a result of radiation exposure, the mucous membrane of the fallopian tubes can be damaged. As a result of this, the process of fertilization of the egg ( female reproductive cell) sperm ( male reproductive cell) will become impossible. The problem can be solved by in vitro fertilization, during which germ cells are combined in a laboratory outside the woman’s body and then placed in her uterus, where they continue to develop.
• Irradiation of the head. When irradiating the head, the pituitary gland may be damaged, which will disrupt the hormonal activity of the ovaries and other glands of the body. You can also try to solve the problem with hormone replacement therapy.
• Disruption of vital organs and systems. If during radiation therapy the functions of the heart are impaired or the lungs are damaged ( for example, severe fibrosis has developed), a woman may experience difficulties during pregnancy. The fact is that during pregnancy ( especially in the 3rd trimester) the load on the cardiovascular and respiratory system of the expectant mother increases significantly, which, in the presence of severe concomitant diseases, can cause the development dangerous complications. Such women should be constantly monitored by an obstetrician-gynecologist and take supportive therapy. They are also not recommended to give birth through the birth canal ( The method of choice is delivery via cesarean section at 36–37 weeks of pregnancy).

It is also worth noting that the time elapsed from the end of radiation therapy to the onset of pregnancy is of no small importance. The fact is that the tumor itself, as well as the treatment carried out, significantly deplete the female body, as a result of which it needs time to restore energy reserves. That is why it is recommended to plan pregnancy no earlier than six months after treatment and only in the absence of signs of metastasis or relapse ( re-development) cancer.

Is radiation therapy dangerous for others?

During radiation therapy, a person does not pose a danger to others. Even after irradiation of tissues with large doses of ionizing radiation, they ( fabrics) do not emit this radiation into the environment. Exception from of this rule is contact interstitial radiotherapy, during which radioactive elements can be installed in human tissue ( in the form of small balls, needles, staples or threads). This procedure is performed only in a specially equipped room. After installation of radioactive elements, the patient is placed in a special room, the walls and doors of which are covered with radioprotective screens. He must remain in this ward throughout the entire course of treatment, that is, until the radioactive substances are removed from the affected organ ( the procedure usually takes several days or weeks).

Access of medical personnel to such a patient will be strictly limited in time. Relatives can visit the patient, but before doing so they will need to wear special protective suits that will prevent radiation from affecting their internal organs. At the same time, children or pregnant women, as well as patients with existing tumor diseases of any organs, will not be allowed into the ward, since even minimal exposure to radiation can negatively affect their condition.

After removing sources of radiation from the body, the patient can return to Everyday life on the same day. It will not pose any radioactive threat to others.

Recovery and rehabilitation after radiation therapy

During radiation therapy, a number of recommendations should be followed that will save the body's strength and ensure maximum effectiveness of the treatment.

Diet ( nutrition) during and after radiation therapy

When drawing up a menu during radiation therapy, one should take into account the peculiarities of the influence of ionizing radiation on the tissues and organs of the digestive system.

During radiation therapy you should:

• Eat well processed foods. During radiotherapy ( especially when irradiating the gastrointestinal tract) damage occurs to the mucous membranes of the gastrointestinal tract - the oral cavity, esophagus, stomach, intestines. They can become thinner, inflamed, and become extremely sensitive to damage. That is why one of the main conditions for preparing food is its high-quality mechanical processing. It is recommended to avoid hard, coarse or tough foods that could damage the oral mucosa during chewing, as well as the esophageal or gastric mucosa when swallowing a bolus. Instead, it is recommended to consume all foods in the form of cereals, purees, and so on. Also, the food consumed should not be too hot, as this can easily cause a burn to the mucous membrane.
• Consume high-calorie foods. During radiation therapy, many patients complain of nausea and vomiting that occurs immediately after eating. That is why such patients are recommended to consume small amounts of food at a time. The products themselves must contain all the necessary nutrients to provide the body with energy.
• Eat 5-7 times a day. As mentioned earlier, patients are advised to eat small meals every 3 to 4 hours, which will reduce the likelihood of vomiting.
• Drink enough water. In the absence of contraindications ( for example, severe heart disease or edema caused by a tumor or radiation therapy) the patient is recommended to drink at least 2.5 - 3 liters of water per day. This will help cleanse the body and remove byproducts of tumor decay from the tissues.
• Eliminate carcinogens from your diet. Carcinogens are substances that can increase the risk of developing cancer. During radiation therapy, they should be excluded from the diet, which will increase the effectiveness of the treatment.

Nutrition during radiation therapy

What can you use?
cooked meat; wheat porridge; oatmeal; rice porridge; buckwheat porridge; mashed potatoes; boiled chicken eggs (1 – 2 per day); cottage cheese; fresh milk ; butter ( about 50 grams per day); baked apples ; walnuts (3 – 4 per day); natural honey; mineral water ( without gases); jelly.	fried food ( carcinogen); fatty foods ( carcinogen); smoked food ( carcinogen); spicy food ( carcinogen); salty food; strong coffee ; alcoholic drinks ( carcinogen); carbonated drinks; fast food ( including porridge and instant noodles); vegetables and fruits containing a large amount of dietary fiber ( mushrooms, dried fruits, beans and so on).

Vitamins for radiation therapy

When exposed to ionizing radiation, certain changes can also occur in the cells of healthy tissues ( their genetic apparatus may be destroyed). Also, the mechanism of cell damage is due to the formation of so-called free oxygen radicals, which aggressively affect all intracellular structures, leading to their destruction. The cell dies.

Over the course of many years of research, it was found that some vitamins have so-called antioxidant properties. This means that they can bind free radicals inside cells, thereby blocking their destructive effect. The use of such vitamins during radiation therapy ( in moderate doses) increases the body's resistance to radiation, without compromising the quality of the treatment provided.

They have antioxidant properties:

• some trace elements ( for example, selenium).

Is it possible to drink red wine during radiation therapy?

Red wine contains a number of vitamins, minerals and trace elements necessary for the normal functioning of many body systems. It has been scientifically proven that drinking 1 glass ( 200 ml) red wine per day helps normalize metabolism and also improves the removal of toxic products from the body. All this undoubtedly has a positive effect on the condition of the patient undergoing radiation therapy.

At the same time, it is worth remembering that abuse of this drink can negatively affect cardiovascular system and on many internal organs, increasing the risk of complications during and after radiation therapy.

Why are antibiotics prescribed during radiation therapy?

When irradiation is carried out, cells of the immune system are affected, as a result of which the body's defenses are weakened. Along with damage to the mucous membranes of the gastrointestinal tract, as well as the respiratory and genitourinary systems, this can contribute to the emergence and development of many bacterial infections. Their treatment may require antibacterial therapy. At the same time, it is worth remembering that antibiotics destroy not only pathogenic, but also normal microorganisms that live, for example, in the intestines healthy person and take an active part in the digestion process. That is why, after completing a course of radiotherapy and antibiotic therapy, it is recommended to take drugs that restore intestinal microflora.

Why are CT and MRI prescribed after radiation therapy?

CT ( CT scan) and MRI ( Magnetic resonance imaging) - This diagnostic procedures, allowing detailed examination of certain areas of the human body. Using these techniques, you can not only identify a tumor, determine its size and shape, but also monitor the process of treatment, noting weekly certain changes in the tumor tissue. For example, with the help of CT and MRI, it is possible to detect an increase or decrease in the size of a tumor, its growth into neighboring organs and tissues, the appearance or disappearance of distant metastases, and so on.

It is worth considering that during a CT scan, the human body is exposed to a small amount of X-ray radiation. This introduces certain restrictions on the use of this technique, especially during radiation therapy, when the radiation load on the body must be strictly dosed. At the same time, MRI is not accompanied by irradiation of tissues and does not cause any changes in them, as a result of which it can be performed daily ( or even more often), presenting absolutely no danger to the patient's health.

Before use, you should consult a specialist.

A large number of skin diseases are now known. Some of them are quite harmless, but there are also those that require special attention. This includes skin cancer. This pathology can develop in absolutely anyone; age and gender do not affect this in any way, but this disease is most often diagnosed in old age.

What is the disease

This pathology begins its development from squamous epithelial cells and is a cancerous tumor. Quite often such neoplasms can be seen on open areas of the body; on the limbs and trunk they form in only 10% of cases.

According to statistics, skin cancer on the face or other areas is often diagnosed; it ranks 3rd among cancer diseases.

Who is at risk

No one is immune from cancer pathologies, but there are categories of people whose risk of developing skin cancer is much greater. These include:

• Patients with fair skin are genetically designed to synthesize less melanin.
• Elderly people.
• Having a hereditary predisposition to the appearance various kinds neoplasms.
• Having precancerous diseases.
• Smokers.

• Bowen disease can also cause skin cancer.
• Patients diagnosed with xeroderma pigmentosum.
• Having inflammatory skin pathologies.
• Long-term exposure to ultraviolet rays.

Important. Visiting a solarium increases the risk of developing cancer several times.

A predisposition to a disease does not always mean that it will definitely develop. But often some factors become strong provocateurs and act as a trigger.

Causes of skin cancer

There are some causes that cause skin cancer:

• Constant contact with harmful substances that have a carcinogenic effect on the body. These include: cigarette components, lubricants, arsenic compounds.
• Long-term exposure to radioactive radiation on the skin.
• Constant exposure to thermal radiation.
• Mechanical injuries, damage to moles.
• Mechanical damage to old scars.
• Eating large amounts of foods that contain chemical additives, many of which may be carcinogenic.

The development of oncology is not always provoked by a single cause; most often, a complex influence of negative factors is observed.

Types of skin cancer

The skin contains a large number of cells belonging to various tissues. This is why developing tumors can differ from each other. Experts recognize several types of skin cancer:

1. Squamous. It can form in different places, but usually on exposed areas and lips. The causes are often mechanical damage and scarring of tissue after a burn.

Important. In 30% of cases, old scars subsequently become the cause of the development of cancer.

1. Basal skin cancer characterized by a tendency to relapse; the cause is most often a hereditary predisposition and problems in the functioning of the immune system. But experts also assign an important role in the development of pathology to the effects of carcinogens and ultraviolet radiation. Basalioma, as this type of cancer is also called, is often located on the head and can form single tumors or entire clusters.
2. Cell cancer has a similar course to basal cell carcinoma, but can produce “sprouts”, which significantly worsens the prognosis for the patient.
3. develops from pigment cells.

Skin cancer symptoms

Skin cancer symptoms can vary depending on the type of pathology, but there are general signs that always appear:

• Fatigue and rapid fatigue during any type of activity.
• Sudden weight loss for no apparent reason.

• Poor appetite.
• The temperature remains at 37 °C for a long time.
• The lymph nodes become enlarged and can be easily palpated.
• Moles can change their shape, color and size.
• If already late stage disease, then pain also becomes a sign.

But each type of cancer has its own features, which allow specialists to diagnose them.

Manifestations of various types of cancer

When visiting an oncologist, the first thing the doctor examines is the patient and pays attention to his tumors. Often, just by external signs, the type of cancer can be preliminarily determined, and then the diagnosis can be confirmed by other studies.. It is the different manifestations that help doctors distinguish one type of tumor from another.

Important. Depending on the type of cancer, the signs of pathology will differ.

For ease of study, the information is presented in the table.

Type of skin cancer	Symptoms
Squamous cell carcinoma	The neoplasm of this variety is often red in color, has a dense consistency, is lumpy and bleeds. The tumor is different accelerated growth and may appear as a plaque, ulcer or nodule. Sometimes the formation resembles cauliflower. This variety is characterized by rapid growth and easily spreads in width and depth.
Basal cell carcinoma	Unlike the previous form, it grows slowly and can develop over many years, but is distinguished by the presence of a variety of external forms. It can be: nodular-ulcerative, warty, flat, pigmented. It usually begins with the appearance of a small gray or pinkish nodule with a pearlescent sheen. The neoplasm has a smooth surface, and there are scales in the center. The favorite place of education is the face.
Melanoma	This is a pigmented tumor that is dark in color, ranging from brown to black. During development, it can increase in different directions, so there are horizontal and vertical forms. This variety is considered the most dangerous, as it metastasizes and spreads quickly. It does not appear on its own, but necessarily occurs at the site of a mole, freckles or other heavily pigmented areas. The affected area often itches and swelling appears, which forces patients to consult a doctor.
Adenocarcinoma	It is less common than other varieties. Favorite places are areas with a high content of sweat and sebaceous glands. In appearance it resembles a small nodule or tubercle. It grows slowly, but during development it affects muscle tissue.

Stages of development of skin cancer

All oncological pathologies pass through several stages in their development. The earlier the disease is diagnosed, the easier it is to treat. To recognize the extent of skin cancer, doctors may use computed tomography, blood tests, biopsies. Lymph nodes must be examined. Malignant skin tumors are characterized by the following stages of development:

• First. If skin cancer is at an early stage, then the tumor does not exceed 2 centimeters. Metastasis does not form, but the lower layers of the epidermis are affected. If therapy is started at this stage, then almost complete recovery occurs.

• Stage 2 cancer characterized by an increase in formation up to 4 centimeters. Sometimes, already at this stage, metastases can be detected in a neighboring lymph node. The site of injury causes discomfort and sometimes pain to the patient. The tumor grows into all layers of the skin. Therapy at this stage leads to recovery in 50% of cases.

• Stage 3 cancer affects the lymph nodes, but metastases have not yet penetrated the organs. The neoplasm takes on a lumpy appearance, and the patient experiences discomfort. The prognosis is favorable for only 30% of patients.

Need to know. At this stage of the disease, patients often experience elevated temperature bodies.

• Stage 4. The tumor is more than 5 centimeters in diameter. It has uneven outlines, the top is covered with crusts and bleeding ulcers. Patients lose a lot of weight, constantly feel weak, headache. Metastases appear in the lungs, liver and bones. Even after treatment, only 20% of patients survive.

You should know it. Basal cell cancer does not have stages in its development; the tumor simply gradually increases and negatively affects neighboring tissues.

Skin cancer treatment

The choice of therapy method is influenced by several factors:

• Stage of development of the neoplasm.
• The presence of concomitant diseases in the patient.
• General condition of the body.
• Patient's age.
• Location and type of cancer.

Important. Oncological diseases skin responds quite well to therapy if it is started in a timely manner.

Modern treatment methods include:

• Radiation therapy.
• Laser treatment.
• Surgical removal of the tumor.
• Cryodestruction.
• Drug therapy.

Sometimes, to achieve a complete cure, you have to resort to several types of therapy at once..

Getting rid of cancer with radiation therapy

Irradiation of skin cancer is a fairly effective method, since malignant cells are quite sensitive to radiation. The latest treatment regimens have now been developed that allow minimal impact on healthy cells.

Radiation therapy is often prescribed:

• If there are contraindications to surgery or general anesthesia.
• There is a relapse of the disease.
• A good cosmetic effect is important.
• The tumor is large.
• Located away from important organs.

Important. For each patient, the radiation dose is selected strictly individually, as well as the duration of treatment and the number of procedures. If such therapy is carried out at the first stage of cancer, the effectiveness reaches 95%.

Chemotherapy

This type of therapy comes down to the introduction into the body of substances that are harmful to cancer cells . Indications for such treatment are:

• Recurrence of basal cell carcinoma.
• Large tumors that cannot be operated on.
• Stages 3 and 4 cancer.

Medicines can be used externally, or do intravenous injections. The effectiveness of this method is good when it is an addition to radiation therapy or surgical removal tumors.

Safe treatments

They are also called gentle and include:

• Cryotherapy- freeze the tumor and cut it off.
• Laser treatment carried out using a laser, which burns out the tumor.
• Local therapy. It involves the use of drugs administered using electrophoresis, they stop the growth of malignant cells.

It is important to know. Skin cancer treatment should be carried out only in an oncology clinic. Folk remedies to get rid of illness can be used at your own peril and risk.

How to prevent the development of the disease

How skin cancer manifests itself is now clear, but the question arises: is it possible to prevent the development of pathology? Everyone knows that preventing any disease is much easier than treating it later. This also applies to cancer. Preventing skin cancer involves following these recommendations:

1. Everyone is looking forward to a vacation to go closer to the sea and soak up the warm rays of the sun, but this is not at all safe for health. It is necessary to protect your skin from prolonged exposure to ultraviolet radiation.

Important. Tanning is harmful to health and has serious consequences.

1. Every time you go outside in the summer, use sunglasses and protective creams.

A tanned body is beautiful, but prolonged exposure to straight sun rays not the best for our skin

1. If present on the skin for a long time non-healing wounds, ulcers, then you need to see a doctor.
2. If there are old scars, they should be protected from mechanical irritation.
3. Pay attention to moles; if their shape or color changes, visit an oncologist.
4. News healthy image life.
5. Limit consumption of foods containing carcinogens.
6. When working with household chemicals, be sure to use gloves.
7. Treat any skin diseases promptly.

Among all cancer pathologies, skin cancer is considered highly treatable. It is easy to diagnose, and can be cured in one day if you contact a specialist at the very beginning of the development of the disease.

It is important not to waste time, and for this you just need to be more attentive to yourself and your health.

Basalioma of the skin is considered a fairly common pathology among Europeans. This type of cancer occurs more often in older people. The most common is basal cell carcinoma of the face. The most effective method of eliminating this type of skin cancer is radiation therapy. Let's take a closer look at the main methods of treatment, removal, complications, and side effects that radiation therapy can cause for basal cell carcinoma.

Experts classify basal cell carcinoma as a borderline cancer. The growth of the formation occurs deep into the tissues, and the lump (depending on the type of oncology) can occupy a large area on the skin and take the form of an ulcer. Initially, the tumor appears on the basal layer of the epidermis. If basalioma is not treated for a long time, it will spread to cartilage and bone.

More often, this type of oncology develops in the dermis of the face and neck. Basal cell carcinoma can also appear in other areas that are negatively affected by aggressive factors. The most dangerous are basal cell carcinomas in the area of ​​the wings of the nose, on the ears, and near the eyes.

Treatment of basal cell carcinoma through the use of radiation therapy is possible at any stage of the disease. But now I use it less often due to the effectiveness of modern techniques such as laser and radio wave therapy.

The initial stage of basal cell carcinoma can be eliminated with medication or with minimal surgical intervention. To make basal cell carcinoma therapy faster and easier, it is necessary to detect the disease at the initial stages of its development.

Radiation therapy for basal cell carcinoma is indicated in the following cases:

• very large tumor;
• localization of a malignant tumor in an area that is considered difficult to reach;
• age (over 65 years);
• penetration of oncology deep into the skin, cartilage and bone tissue;
• the presence of diseases in the patient that are a contraindication to other therapeutic methods.

Radiation therapy is used in complex treatment oncology.

Ionizing exposure may be required after surgery if it is impossible to completely eliminate pathological basal cell carcinoma cells. Also, exposure to rays helps reduce pain and other signs of the disease.

Radiation therapy methods

Radiation therapy is effective due to the effect of ionizing rays on cell DNA. Y-irradiation destroys the DNA of the pathological cell, making it unable to divide, which means the spread of basal cell carcinoma stops.

The initial target of therapeutic radiation is considered to be cells that are dividing intensively. Y-rays also affect healthy tissue, provoking various consequences of treatment of basal cell carcinoma using this method.

Contact irradiation with isotopes of cobalt (Co60), iridium (Ir92), radium (Ra226) is carried out in such a dosage that could destroy malignant cells and prevent their further reproduction. Therapy is performed using applicators made of plastic material. They are prepared individually for each sick person.

A plate (1 cm thick) is placed in boiling water and applied to the affected area of ​​the dermis.. This applicator is modulated, giving the plate the relief of the skin. Radioactive substances and protection in the form of a lead plate are applied on top of the plate. Passing through tissue, the intensity of radiation decreases. Therefore, this method of eliminating basal cell carcinoma will not cause harm to internal organs.

Near focus therapy, which is carried out from a distance of less than 7.5 cm, requires the use of power ranging from 10 to 250 W. Changing the power changes the depth of impact, which is represented by several millimeters and reaches 7–8 cm.

The beams are focused using a tube. The area of ​​the dermis that should be irradiated is limited by filters made of different metals (brass, aluminum). The thickness of such filters is up to 3 mm. The level of absorption of rays by tissues is influenced by the stage of development of oncology and the patient’s condition. Taking into account these features, the dosage is selected individually by the oncologist.

A feature of β-irradiation is the use of radioactive isotopes of such substances:

• phosphorus (P32);
• thallium (TI204).

Before exposure to rays inside the basalioma, the doctor injects colloidal solutions such metals:

• silver (AG188);
• gold (Au111).

These solutions are administered by a specialist in the form of special granules, which are initially treated with catgut threads.

According to reviews from oncologists, it is quite difficult to perform this method of irradiation, and not all clinics have unique equipment for its implementation. The described treatment method is used to eliminate those forms of basal cell carcinoma that are resistant to other methods of radiation exposure.

What are the risks of basal cell carcinoma irradiation?

In any case, the consequence of radiation treatment of basal cell carcinoma is damage to healthy cells located in the tissues surrounding the tumor.

Following the rules of the procedure cannot prevent radiation damage to healthy tissues.

The sensitivity of the epidermis to radiation is influenced by many factors:

• excess weight (obese patients have more susceptible dermis);
• localization of oncology. The dermis of the anterior surface of the neck will be more delicate and sensitive to rays. The skin of the back of the head, wings of the nose, etc. is considered rougher;
• age-related changes;
• air temperature. Due to increased blood supply in the heat, the likelihood of complications increases;
• The permeability of the epithelium increases in the presence of scratches and cracks.

Side effects that occur during irradiation

The majority of patients treated for basal cell carcinoma with radiation therapy do not develop systemic consequences. Experts explain the manifestation of such effects by the reaction of the dermis. It is represented by the epidermite.

When carrying out each procedure, the following consequences appear on the epithelium:

• redness;
• edema;
• itching

During therapy for basal cell carcinoma with rays, these symptoms become more pronounced. They become brightest by the 3rd week of the course. Such consequences disappear 1 - 1.5 months after the course of treatment for basal cell carcinoma is completed. To reduce their severity, experts recommend using ointments with glucocorticoids (Sinaflan, Hydrocortisone, Prednisolone).

Minor ulcers and crusts may also appear. They indicate the development of radiation dermatitis, which will disappear at the end of the therapeutic course.

The following signs indicate the development of changes in the skin:

• pigmentation disorder;
• formation of “stars”;
• disappearance of the surface pattern on the skin;
• peeling, increased dryness.

If oncology occurs near the mucous membranes of the nose and mouth, there is a possibility of inflammation (mucositis). This pathology is accompanied by burning, dryness of the dermis, and pain after touching. Said consequence considered very rare. When exposed to radiation to basalioma localized in the eye area, there is a risk of recurrent conjunctivitis.

Long-term complications that may occur after radiation

Radiation therapy can cause not only immediate consequences, but also long-term complications. Exposure to radiation contributes to the thinning of the skin and the appearance of vascular networks. After a year or a year and a half after irradiation, lighter and darker areas of the epithelium may appear. The brightness of such manifestations depends on the duration of previous therapy, the radiation dose received by the skin, and the area of ​​exposure.

More dangerous consequence The described treatment method is considered to be a radiation ulcer. It is provoked by the effect of radioactive isotopes on the microcirculation of blood vessels localized under the layer of the epidermis. The likelihood of an ulcer increases in proportion to the depth of cancer penetration and the strength of radiation.

The most dangerous consequence of basal cell carcinoma therapy is the development squamous cell carcinoma, which is considered more dangerous pathology than basal cell carcinoma. Therefore, experts do not recommend undergoing radiation therapy for those under 50 years of age.. The considered method of treating basal cell carcinoma should not be carried out in the presence of a relapse of the disease.

The effects of radiation therapy carried out in the scalp area of ​​the skin are accompanied by hair loss. Gradually the hair grows back, but it is no longer as strong as before. The scalp is characterized by a faded color, increased fragility, and lack of healthy shine.

If therapy has been carried out for basal cell carcinoma localized near the eyes, there is a possibility of developing a consequence of therapy such as cataracts. Scientists have not yet been able to establish a threshold dose of radiation to the lens, so oncologists do not know how high the risk of developing such consequences as cataracts is.

Another consequence of basal cell carcinoma therapy is scarring.

This consequence, which appears after exposure to radiation, limits the mobility of muscle fibers, negatively affecting facial expressions. In order for the muscles to maintain mobility, as well as to prevent contracture (immobility caused by scars), experts recommend performing active and passive exercises in the area of ​​radiation exposure. Doctors also note changes in the functioning of the sebaceous and sweat glands.

Once the redness caused by radiation therapy disappears, patients are generally satisfied with the cosmetic result. But after several years, the scars become rougher and more noticeable.

How to relieve side effects after radiation therapy

Treatment of the epidermis surrounding basalioma with the following means is considered to prevent radiation dermatitis:

• "Petrolatum";
• a mixture of such medicines “Shostakovsky Balm” + vegetable oil;
• "Methacyl emulsion".

Doctors recommend using these measures after the first radiation therapy procedure. If an ulcer does appear, you need to do everything to prevent bacterial inflammation from starting. For this purpose, lotions with such solutions (dioxidine, silver) are placed on the irradiated area of ​​the epidermis.

The following gels help speed up wound healing after basal cell carcinoma:

• "Iruksol".
• "Solcoseryl".
• "Methyluracil ointment."
• "Actovegin".

Washing and rinsing with herbal decoctions (chamomile, sage), and chlorhexidine will help prevent the consequences after radiation therapy, which manifest themselves in the form of damage to the mucous membrane.

Conjunctival lesions should be treated with antibacterial drops. Exposure to the dermis of the sun's rays can provoke indurative edema, which is treated with antibiotics and anti-inflammatory drugs. They help prevent such a consequence of therapy as pigmentation ascorbic acid, vitamin R.

Prevention of complications

Before carrying out radiation therapy for basal cell carcinoma, doctors must conduct a thorough examination, collect anamnesis, and refer for diagnostics to detect concomitant diseases. Having all the necessary information, the doctor correctly calculates the dosage, duration of the procedure, and frequency of irradiation sessions. This helps reduce the risk of side effects from radiation therapy.

Considering the size of the basal cell carcinoma, the specialist in the process of performing radiation therapy capture several centimeters of healthy tissue (1 – 2 cm). This is considered necessary to prevent the re-development of basal cell carcinoma in this area.

To reduce the likelihood of developing consequences from radiation therapy used to eliminate basal cell carcinoma, lead plates are used. In these products, holes are made that correspond to the shape of the basal cell carcinoma. This plate is applied to the dermis during each procedure. Before each irradiation, the doctor notifies the patient that the skin should be protected from damage. You can reduce the likelihood of consequences after irradiation if you follow all the doctor’s recommendations:

1. Protect the epidermis from exposure to direct sun rays. You cannot visit the solarium. It is advisable to wear long sleeves when walking outside. The skin of the face should be covered with a wide-brimmed hat. To protect exposed areas of the dermis from negative impact ultraviolet radiation should be applied with a high SPF level.
2. It is important to perform carefully hygiene procedures so that the marks with which the doctor marked the radiation exposure area are not washed off.
3. It is forbidden to rub or massage the epidermis that has been exposed to rays. The use of mustard plasters, cupping, treatment with alcohol solutions, and antiseptics is also contraindicated if the doctor has not prescribed such procedures.
4. It is prohibited to use heating pads or compresses on the area exposed to rays.
5. Before using personal hygiene products (soap, cream-shower gel) with fragrances again, you should consult your doctor.
6. Before carrying out radiation therapy to eliminate basal cell carcinoma, it is necessary to remove decorative cosmetics 4 hours before the procedure.
7. Limit visits to the pool and bathhouse.

Radiation therapy is considered a very heavy burden on the body. Accordingly, any unusual consequences in the area of ​​the irradiated dermis require contacting a specialist for help. To make the consequences of basal cell carcinoma therapy milder, you need to follow all the recommendations of the oncologist. It is also worth consulting with him regarding changes in diet and climate.