External Beam Radiation Therapy (EBRT): Purpose, Procedure, Benefits and Side Effects

External Beam Radiation Therapy (EBRT) is a form of radiation therapy that uses high energy beams from a machine outside the body to target cancerous cells inside the body. It is one of the most common forms of radiation therapy used to treat cancers such as prostate, breast, brain, and lung as well as other tumours.

• Three-Dimensional Conformal Radiation Therapy (3D-CRT): 3D-CRT is a highly targeted and precise form of external radiation delivery. It involves shaping multiple, narrow beams around the tumour or area being treated to deliver a higher radiation dose with fewer side effects than other forms.
• Intensity Modulated Radiation Therapy (IMRT): IMRT is another targeted form of external radiation delivery where multiple narrow beams are spatially manipulated such that the radiation dose is highest directly over the tumour while sparing normal tissues around it from excessive bombardment and toxic effects. IMRT also uses sophisticated computer optimization software to ensure that only healthy tissue around the target area receives minimal dose levels, making IMRT an especially effective treatment choice for those tumours located in sensitive areas and close to vital organs like the brain or spinal cord.
• Image Guided Radiation Therapy (IGRT): IGRT combines imaging with advanced image guidance systems to deliver a more precise dose of radiation therapy which helps improve outcomes as well as reduce undesirable side effects associated with traditional radiotherapy methodology.
• Proton Beam Radiation Therapy (PBRT): PBRT is an advanced type of external beam radiotherapy which utilises high energy protons instead of x-rays or photons in order to deliver more accurate doses directly into cancerous tumours without causing unnecessary damage to nearby healthy tissues by minimising off-target scatter dose levels compared traditional Radiotherapy options available today.

• Effective Treatment: It is highly effective for treating cancer because it targets the area directly with radiation, meaning that it can reach areas not easily accessible by surgery or other treatments. It can also be used to treat larger tumours that may not be removed through traditional surgery methods.
• Fast: With EBRT, treatments can be completed in as few as 5-10 days meaning less time spent in hospital visits and recovery time are reduced greatly.
• Noninvasive: As EBRT does not require surgery, there are no incisions or scars making it less invasive than other procedures such as chemotherapy or surgery removing larger tumours.
• Reversible Effects: Unlike chemotherapy, if treatment isn’t successful with this method it can be stopped at any point with minimal residual effects on remaining healthy cells around the tumour site.

• To treat cancer by destroying or damaging cancer cells: EBRT delivers precise, highly focused beams of radiation directly to the tumour, killing cancer cells while limiting damage to the surrounding healthy tissue.
• To reduce the size of a tumour before surgery: EBRT can be used to shrink a tumour before surgery, so that it is easier to remove during the operation.
  • To aid with early diagnosis: EBRT can be used along with medical imaging techniques such as computed tomography (CT) scans and magnetic resonance imaging (MRI) scans to improve accuracy in diagnosis of cancers and other diseases.
  • To alleviate pain from bone metastases: EBRT can provide relief from pain caused by the spread of some types of cancer such as breast cancer and prostate cancer to bones and other parts of the body.
  • To prevent recurrence after surgery: EBRT may be used after surgery for many kinds of cancer such as pancreatic, cervical, ovarian and bladder cancers to reduce rates of relapse or recurrence in some cases.

Some general potential risks associated with EBRT include:-

• Skin reactions such as redness, dryness, and rash.
• Hair loss in the area that is treated.
• Fatigue due to stress or side effects from treatment.
• A decrease in blood counts due to damage to bone marrow cells.
• Nausea and vomiting due to radiation exposure.
• Infertility resulting from high doses of radiation to reproductive organs or areas near them.
• Damage to kidneys due to higher doses of radiation reaching other parts of the body instead of focusing on just the targeted area.
• Stroke resulting from a weakened blood vessel in or around brain tissue affected by radiation therapy.
• Impaired cognitive function after receiving EBRT for brain tumours or other brain conditions.

• Steps that can help prepare for EBRT include:-
• Ask Questions: Be sure to ask questions and make sure you understand what will happen during your EBRT treatments and any instructions that you are given.
• Eat Healthy Foods. Eating healthy foods during EBRT can help give your body the necessary nutrition it needs for repair during radiation therapy.
• Rest Properly Before Treatments. Get adequate rest before each radiation therapy session in order to make sure that you do not feel fatigued or experience side effects from the radiation therapy treatments themselves.
• Protect Skin From Radiation Exposure During Treatments. Make sure that skin is protected from direct exposure to radiation especially when clothes are removed prior to treatments so as not to experience burns which can be painful after treatments have finished.

External Beam Radiation Therapy (EBRT) uses a beam or beams of high-energy x-rays to target and destroy cancer cells. The radiation is delivered outside the body through an external machine, such as a linear accelerator, so there are no invasive steps or procedures required. During treatment, the patient lies on a table while the machine moves around them, targeting the tumour with precise beams of radiation.

• Make sure to inform the radiation therapist, if you are allergic to medication or latex (rubber).
• Certain medications that could interact with EBRT should be discontinued before undergoing this treatment.
• It is important to inform the medical team if you are taking any supplements or over-the-counter medications as these can interfere with treatment.
• Depending on the type of tumour you have and location, a spinal tap may be needed prior to your procedure. This will help determine if there is cancer spread in the area.

• You will lie down on a padded table and remain still while imaging scans take place. This helps guide the radiation beams to accurately hit their targets. You should let your radiation therapist know right away if you feel any discomfort during this process.
• Radiation beams will then be sent from outside of your body into individual spots inside your body where tumours are located. how long this portion takes depends on the treatment plan designed for you, as well as its complexity.

• Depending on your specific treatment plan, it is possible that you may need follow up visits for more scans or additional radiation therapy sessions.
• Side effects from EBRT can occur immediately after treatment or weeks later; these can include fatigue, skin irritation and hair loss in the treated area (if applicable).
• It is important to eat healthy foods with adequate amounts of vitamins and minerals which can help speed healing during post radiation therapy recovery time.

The cost of external beam radiation therapy (EBRT) in India depends on the type and stage of cancer being treated, and the number of sessions required. Generally, the cost of a single session can range from Rs. 10,000 to Rs. 25,000 at leading cancer hospitals in India. A course of 10-20 sessions may cost anywhere between Rs. 1 lakh to Rs. 5 lakhs depending on the type and stage of cancer being treated.

The following foods are recommended for people undergoing EBRT:

• Fruits and vegetables: Fresh fruits and lightly cooked vegetables are high in antioxidants, which help protect cells from the effects of radiation.
• Lean proteins: Protein is necessary for tissue repair, so aiming for two to three servings a day is important. Sources include fish, eggs, poultry, beans, nuts and seeds.
• Healthy fats: Essential fatty acids are important for optimal nutrition, so consuming one to two servings a day of healthy omega-3 fatty acids (such as salmon or walnuts) can help aid healing during radiation treatment.
• Whole grains: Whole grains such as brown rice, quinoa or oats contain B vitamins that are important for energy production during treatment. Aim for three to four servings a day.
• Probiotic foods: Fermented foods such as yoghourt and kimchi contain probiotic bacteria that can restore balance in the gut microbiome after radiation therapy. Try to include these at least once daily.

External Beam Radiation Therapy (EBRT) is generally considered a safe form of cancer treatment when used properly. It is a highly effective form of radiation therapy that targets cancer cells and destroys them, but due to its use of high doses of radiation, the treatment itself can cause some side effects. However, these risks are significantly reduced with proper monitoring and care.

Recovery from External Beam Radiation Therapy (EBRT) will depend on the type and intensity of the radiation therapy. Generally, recovery from EBRT typically starts once treatment has been completed, and can take anywhere from a few weeks to a few months.

Some of the potential side effects of external beam radiation therapy (EBRT) include:

• Skin reactions, such as redness and dryness, itching or swelling.
• Fatigue
• Loss of appetite
• Nausea
• Diarrhoea
• Hair loss in the treated area.
• Pain in areas where radiation was given or near it.
• Increased risk of infection because radiation impairs immune system cells.

• Follow your healthcare provider's instructions for ongoing care and return visits.
• Avoid sun exposure, or wear a hat or sunscreen with a SPF of 15 or higher when outdoors.
• Eat a balanced diet, get adequate rest and regular exercise, and drink plenty of fluids to avoid dehydration.
• Talk to your doctor if you experience new symptoms such as pain, fever, swelling, redness, headaches, nausea or diarrhoea after EBRT in order to diagnose any possible side effects of treatment quickly and ensure proper care is given.
• Consider counselling to help you cope with the emotional stress of dealing with cancer treatment and its aftermath.

EBRT is one of the most commonly used treatments for cancer as it has been shown to be effective in both curing and palliating cancers. The success rate of EBRT is highly dependent on factors such as dose, radiation field size, dose rate, ability of the patient to withstand treatment side effects, etc. Due to its efficacy and accuracy, EBRT continues to be a viable option for those seeking to treat their cancer without needing invasive surgery.