Clinicians say the benefits of radiation treatment for many types of cancer far outweigh the potential risks of experiencing serious adverse effects years later, and say radiation is now a lot safer than it once was.
"There is more advanced technology nowadays, and we can see structures we want to avoid and can shape the dose to avoid certain areas," said Dr. Candace Correa, assistant member of the Radiation Oncology Program at Moffitt Cancer Center in Tampa. "Radiation is very important for cancer for many patients. It offers a very big treatment advantage."
"We try to use radiation as sparingly as possible, but unfortunately, it is frequently part of the cure in a lot of cancers and it's absolutely necessary," said Brawley.
Travis said that even though there are risks associated with radiation, there are certain changes patients can make to reduce their risk of secondary cancers.
"For example, patients can stop smoking. Smoking has been shown to multiply the risk of treatment-associated lung cancer after Hodgkin lymphoma," she said. "We need to reinforce basic health messages, such as advising patients to stop smoking or make dietary modifications."
Health promotion, she continued, should be a vital component of cancer treatment plans.
"There is increasing recognition that the time of cancer diagnosis is a teachable moment. The patient is interested in his or her health, and it's the point at which we can intervene in regard to their habits to ensure that health promotion is a part of their survivorship plan."
The committee also recommends that there be long-term follow-up of cancer patients to evaluate risks of developing secondary cancers and other treatment-related effects.
"The relationship between radiation and late adverse effects has been looked at extensively in certain populations, but there hasn't yet been a systematic approach to assessing risk," Correa said. "Many cancers don't show up until years later, so we have to wait and continue to follow survivors."
"It's not enough just to cure a cancer patient," Travis added. " We have to think downstream and ask what is the potential cost of the cure to the patient in the future."