Radiation therapy has been a cornerstone in cancer treatment for over a century, offering hope and healing to countless patients. However, many patients understandably wonder about its safety. With advancements in technology, the safety and effectiveness of radiation therapy have significantly improved. This article explores three primary types of radiation treatment—External Beam Radiation Therapy (EBRT), brachytherapy, and proton therapy—and compares their safety profiles. 

The Safety and Effectiveness of Radiation Therapy 

Radiation therapy is generally considered safe and has been used to treat cancer for over a century. Modern advancements have significantly improved its precision and safety. Radiation therapy has been safely used to treat cancer for more than 100 years, with many advancements improving its safety and effectiveness⁽¹⁾. Global organizations like the World Health Organization (WHO) have recognized these advancements, further validating the global impact of improved radiation therapy techniques. Additionally, Johns Hopkins Medicine highlights the extensive safety measures and quality assurance protocols to ensure the safe delivery of radiation therapy ⁽²⁾. Here are some key points: 

1. Precision: Modern radiation therapy techniques, such as external beam radiation and proton therapy, target cancer cells with high precision, minimizing damage to surrounding healthy tissue ⁽³⁾. 

2. Safety Measures: Treatment centers follow strict safety protocols to protect patients, healthcare workers, and visitors. This includes careful planning and monitoring of radiation doses ⁽¹⁾. 

3. Effectiveness: Radiation therapy is effective for treating various types of cancer, including breast, prostate, and brain cancers ⁽⁴⁾. It can also be used to control symptoms in advanced cancer cases. 

4. Side Effects: While generally well-tolerated, radiation therapy can cause side effects such as skin irritation, fatigue, and, in rare cases, long-term effects like secondary cancers. Your healthcare team will provide specific instructions on managing these side effects. 

Types of Radiation Therapy 

1. External Beam Radiation Therapy (EBRT) 

External Beam Radiation Therapy is non-invasive and versatile, though it may expose more surrounding healthy tissue to radiation. A machine directs radiation beams at the tumor from outside the body. It can treat larger areas or tumors that are challenging to reach with other methods. 

2. Brachytherapy 

Brachytherapy, or internal radiotherapy, is a highly targeted treatment performed inside the body with reduced exposure to healthy tissues. It involves placing needles or applicators to a high dose of radiation to a precise area, often used for prostate, cervical, and breast cancers. 

3. Proton Therapy 

Proton Therapy provides precise targeting with fewer side effects, making it ideal for tumors near critical structures. It uses protons instead of X-rays to target and destroy cancer cells. It is particularly beneficial for treating tumors near critical structures like the brain, spine, and eyes. 

4. Electronic Brachytherapy 

Electronic brachytherapy (eBT) is an advanced form of internal radiation therapy that uses a miniaturized X-ray source to deliver high doses of radiation directly to the tumor site. This portable technology minimizes damage to healthy tissues, enhances patient outcomes, and requires minimal shielding, making it a revolutionary and convenient option for cancer treatment. 

To learn more about radiation therapy, read here. 

Comparative Safety 

External Beam Radiation Therapy  

• Safety: EBRT is non-invasive and can treat larger areas or tumors that are difficult to reach with brachytherapy. However, it can expose more surrounding healthy tissue to radiation, which may increase the risk of side effects. 

• Side Effects: Common side effects include skin irritation, fatigue, and potential damage to nearby healthy tissues. A study comparing EBRT with EBRT plus low-dose-rate brachytherapy (EBRT-LDR) found that EBRT-LDR was associated with worse urinary irritative and bowel function over three years ⁽⁵⁾. 

Brachytherapy 

• Safety: Brachytherapy directly delivers a high radiation dose to the tumor or cancerous cells through applicators, minimizing exposure to surrounding healthy tissues. This targeted approach can reduce the risk of side effects compared to EBRT. 

• Side Effects: Common side effects include localized pain, swelling, and depending on the treatment area, bowel or urinary issues. Studies suggest that while brachytherapy may have some initial side effects, it often results in fewer long-term complications than other radiation treatments. 

Proton Therapy 

• Safety: Proton therapy uses protons, which can be more precisely controlled. This allows higher radiation doses to be delivered directly to the tumor with minimal impact on surrounding healthy tissues. This precision makes it particularly beneficial for treating tumors near critical structures. 

• Side Effects: Proton therapy generally has fewer side effects than traditional EBRT, but it can still cause fatigue and skin reactions.  

Electronic Brachytherapy   

• Safety: Electronic brachytherapy (eBx) utilizes advanced, electronically generated X-ray radiation to deliver precise, high-dose radiation. This targeted approach minimizes exposure to surrounding healthy tissues, enhancing safety compared to conventional radiation therapies. Electronic brachytherapy technology also reduces the need for extensive shielding, allowing safe administration in standard clinical settings. 

• Side Effects: Electronic brachytherapy generally results in fewer side effects and quicker recovery than conventional external beam radiation therapy. Patients often experience less localized pain and swelling and fewer long-term complications. 

Radiation therapy, including EBRT, brachytherapy, and proton therapy, has proven to be a safe and effective treatment for various types of cancer. Each method has its safety profile and potential side effects, but technological advancements have significantly improved their precision and minimized risks. 

Ultimately, the safety of radiation therapy depends on individual factors such as the type and stage of cancer, tumor location, and overall health. Consulting with your oncologist will help determine the most suitable and safe treatment option. 

References 

1. https://www.cancer.org/cancer/managing-cancer/treatment-types/radiation/safety.html 

2. https://www.hopkinsmedicine.org/-/media/radiation-oncology/_docs/radonc_introductory-information-for–patients-final.pdf 

3. https://www.mayoclinic.org/tests-procedures/radiation-therapy/about/pac-20385162 

4. Making radiation therapy more effective in the era of precision medicine | Precision Clinical Medicine | Oxford Academic (oup.com) 

5. 2021.06 – Cancer (Five-year outcomes brachy).pdf (vumc.org) 

6. New study compares long-term side effects from different prostate cancer treatments – Harvard Health