Exposure with skin cancer. Radiation therapy (radiotherapy) - contraindications, consequences and complications

Radiation therapy destroys malignant cells in the body area where it is directed. Meanwhile, it affects some healthy cells located nearby. Radiotherapy can affect people in different ways, so it is difficult to predict exactly how the human body will react. Some people have very moderate side effects, others have more serious.

General side effects of radiation therapy

The impact of radiotherapy for blood

In some cases, radiation therapy reduces the amount of cells in the bone marrow producing blood cells. Most often it happens if a large body area is exposed to radiation, or a chest, an abdomen and pelvic area, the bones of the lower extremities.

If the content of red blood cells is reduced - erythrocytes, anemia develops, a person will feel shortness of breath and fatigue. It is possible that blood transfusion will be required to increase these cells. In case there are contraindications for this procedure, erythropoietin injections can be recommended. This is a hormone, a stimulating organism to synthesize red blood cells.

With a significant reduction in the number of leukocytes, which happens extremely rarely as a side effect of radiation therapy, neutropenia develops. The risk of infections is significantly increased. Most likely, in such a situation, the doctor will take a break in treatment so that the state is normal.

Patients who are assigned to the overall irradiation of the body to bone marrow or stem cell transplantation will have low blood indicators. During this treatment, for the purpose of monitoring the state, the doctors regularly explore blood.

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Fatigue as a side effect of radiation therapy

The patient may feel increased fatigue. This is due to the need for the body to send the forces to restore damage caused by radiotherapy as a result of impact on healthy cells. If possible, it is necessary to drink daily by 3 liters of water. Hydration will help the organism to recover.

Fatigue, as a rule, increases as treatment. The patient may not feel tired at the beginning of therapy, but by the end, most likely will be. Within 1-2 weeks after irradiation, the patient may feel increased fatigue, weakness, lack of energy. Over the course of a number of months, a person may be in such a state.

Some studies show that it is important to balance physical exertion and rest. Try to enter a daily walk for a few minutes. Gradually, it will be possible to increase the distance. It is important to choose the time when a person feels the least tired.

• Try not to rush.
• When possible, plan in advance.
• Do not move somewhere in the rush hour.
• It is important to receive professional consultation therapist.
• Wear loose clothes that does not require the use of iron, cook it in advance.
• When it is possible to perform some dwellings sitting.
• Orders help with purchases, work around the house and with children.
• It is possible that it will be easier to take food more often than stick to three meals.
• For snacks, you can choose various nutritional snacks, drinks. Also buy ready-made dishes that require only heating.

Fatigue as a consequence after radiotherapy of the brain

With radiotherapy of the brain, fatigue can especially manifest itself, especially if steroids are assigned. It reaches its maximum for 1-2 weeks after completing treatment. A small number of people sleep almost all day after a long-term course of radiation therapy.

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Diet during radiation therapy

During irradiation, a healthy diet is important, as far as it is possible. The body needs protein and in a large number of calories for recovery. Clinical oncologist can give recommendations how to eat. In the event of food problems, a nutritionist will help. Important during treatment does not adhere to any diets. The specific plan for radiation therapy depends on the size of the body. If the weight is seriously changed, it will be necessary to refine the plan.

If the patient is able to use normal products, it is important that he choose food with high protein - meat, fish, eggs, cheese, milk, beans, beans.

In case there is no appetite, you can give preference to high-energy drinks in the form of milk cocktails or soups. There is an option to add protein powders to normal food.

If possible, it is necessary to consume about 3 liters of fluid. Hydration speeds up the recovery process.

If problems arose, it can be useful:

1. Small snacks instead of large meals.
2. With difficulties with swallowing, a soft or liquid diet. Avoid sharp products.
3. The elimination of strong alcohol, he aggravates the inflammatory process in the oral cavity or worsens the digestion.
4. If necessary, it is worth consulting about the reception of the BAA.

If there are difficulties with food, you can give preference to food with a high fat content instead of protein and carbohydrates. During radiation therapy, a person can lose some weight.

Side effects of radiation therapy on the skin

Radiotherapy can provoke redness or darkening of skin in the field of treatment. Some people develop reactions, others have no actual depends on the type of skin and the area that has been treated.

Redness can be accompanied by painful sensations similar to routine. Sometimes blisters arise that go. This state is developing after several sessions. It is important to inform about the reactions of the attending physician. Usually symptoms pass after 2-4 weeks after the end of therapy.

Sometimes skin reactions on the back are observed, where irradiation comes from - redness or darkening. If they cause significant pain, therapy is temporarily stopped while the skin does not recover.

Skin care

In different clinics, consultations may differ. It is best to stick to the instructions that directly the attending team of doctors.

It is usually recommended to use warm or cool water, soft smell soft soap, a soft towel. Do not use cream or bandages on the treatment area, if not appointed oncologist. No need to use talc, since it may contain tiny metal particles and strengthen soreness after radiation therapy. You can use a deodorant odorless if it does not irritate the skin. You can try baby soap or liquid baby soap, but first consult with doctors. Men when appointing radiation therapy in the head and neck is worth using an electric razor instead of a wet shave.

Clothing during radiotherapy

In the course of treatment and some time after it, the skin is sensitive. During this period, it can be convenient:

1. Wear loose clothes.
2. Use clothing from natural fibers.
3. Avoid narrow collars and ties, especially if the irradiation affects the neck.
4. With radiation therapy in the field of breasts, women should not use hard bra, try, for example, a sports bra size more than usual.

Outdoor stay

The areas of the skin that were undergoing treatment are very sensitive, so it is important to avoid staying on the hot sun or in the cold wind.

Being under the influence of sun rays, recommended:

1. Use sunscreen with a high protection coefficient.
2. Wearing a hat or shirt with long sleeves.
3. If the radiation therapy of the head or neck was performed, you can try to wear a hat or a scarf of silk or cotton, going out.

Swimming

If the patient loves swimming, you will need consultation with your doctor. Sailing in chlorinated water may cause irritation in the treated area.

Long-term side effects of radiation therapy on the skin

After the completion of the treatment, a person may find that the tinge is permanent. How such harm is not. You can use makeup to hide.

Later it is possible to appear such a state as telegangioectasia, expanding small blood vessels - vascular meshes. Also, they can be hidden by makeup.

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Consequences after radiation therapy on fertility and sex life of a woman

Radiation therapy, acting on the lower part of the abdomen in women during premopause, as a rule, leads to menopause. The production of female sex cells and hormones ceases. The exposure also affects the uterus, there is a chance that there will be no children subsequently.

Symptoms of menopause

After radiotherapy in the pelvis area, the following signs of menopause are possible for several weeks:

• tides and sweating;
• dry skin;
• dryness of the vagina;
• lack of energy;
• irregular menstrual cycle or lack of menstruation;
• decline in sexual interest;
• poor mood, drops.

Before starting radiation therapy, the doctor will discuss with the patient the possibility of infertility.

Replacement hormone therapy can be assigned to help overcome the symptoms of menopause. If there are problems, it is necessary to talk to a clinical oncologist.

Radiation therapy and sex life

Pelvic irradiation can make the vaginal tissue with more rigid and less elastic for a long time. This condition is called fibrosis. In addition, radiation therapy is able to narrow and make the vagina shorter, which will affect sexual life. In addition, dryness and pain during sexual interchange can be observed. There are ways to reduce both of these side effects of radiation therapy.

Narrowing vagina

To prevent or minimize the reduction and narrowing of the vagina, it is important to use vaginal expander after radiation therapy. Radiation oncologist will explain how to apply. If not to use them, after treatment, difficulties are possible when sexual intercourse.

Expansionists are made of plastic or metal, there are different sizes. As a rule, they begin to be used between 2 and 8 weeks after the end of therapy.

The extender is inserted into the vagina for 5-10 minutes 3 times a week. He stretches the body and prevents its narrowing. But if a woman has sex sessions, at least twice a week, there is no need to use extenders.

Dry vagina and pain

After radiation therapy in the area of \u200b\u200bthe pelvis, dryness of the vagina and pain during sexual interchange is possible. In this case, the doctor's consultation is necessary. Hormonal cream or UGT can be appointed.

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Consequences after radiation therapy for fertility and sex life in men

After exposure, some sex problems are possible:

• loss of interest in sex;
• acute pain during ejaculation;
• problem with erection.

Loss of interest in sex

Such a reaction may be caused by concerns about the disease or the future. Also, the reason may be fatigue caused by irradiation. It will take time to recover after therapy.

Acute pain during ejaculation

Radiation therapy may cause irritation of the ureas channel, which leads to pain in the process of ejaculation. After a few weeks, the condition is normalized.

After internal radiation therapy during prostate cancer (brachytherapy) during the first month, condoms must be used. Very rarely, but radiation may be present in sperm.

Problems with erection

The radiotherapy in the area of \u200b\u200bthe pelvis can cause temporary or constant problems with the erection, impact on the nerves in this area. Some medicines or medical devices can help solve this problem. It will be necessary to consult a doctor.

Fertility after radiation therapy

Radiotherapy, as a rule, does not affect the ability of a man to have children. Many men who transferred irradiation, healthy children were born.

When radiotherapy in the field of pelvis, doctors will notify the need to use effective contraception over the next period of time - from 6 months to 2 years - the opinions of the doctors are diverted. This is due to the fact that after irradiation, sperm can be damaged, it will lead to anomalies in a child.

In the treatment of cancer, eggs, radiation therapy is rarely given by both organs. This can lead to temporary or constant infertility. Before such treatment, the doctor will discuss this risk with the patient.

If the patient is young and plans to have children, it is possible to keep sperm.

Banks sperm

In the case when irradiation can cause infertility, you can save part of the sperm in the cum bank. For a number of weeks, the patient gives several samples. They are frozen and stored. Later, when time comes, samples are sampled and used for partner insemination.

Consequences after radiotherapy brain

Fatigue

Radiotherapy can provoke increased fatigue. This type of irradiation is used if:

• There is a primary brain tumor.
• Cancer cells from another hearth were penetrated into the brain - secondary neoplasm.

Fatigue gradually increases, the treatment program lasts a few weeks. By the end of the course, the patient may feel very tired.

Fatigue is a direct consequence of treatment caused by the need to direct energy reserves for the repair of damaged healthy cells. The reception of steroids further aggravates the lack of forces. The state is normalized when the treatment ends in about six weeks.

Some people a few weeks after the completion of therapy, the fatigue is very serious, combined with drowsiness and a sense of irritability. This is a rare side effect that does not require treatment is in itself within a few weeks.

Hair loss as a side effect of radiation therapy

Radiation therapy in the head area always causes a certain hair loss. If only a certain part of the head is exposed to irradiation, the hair will fall out only on it. But it happens that there is a hair loss on the opposite side of the head, from where the rays come from.

When the treatment ends, the hair resumes its height. They can be different thickness or inhomogeneous, have another shade, or the structure (there were straight - they will become curly).

Hair care

During treatment, you need to wash your hair carefully, so as not to hurt the skin. It is worth using warm or cold water, children or not perfumed shampoo.

It is better not to use a hairdryer, carefully dry your hair with a soft towel, or give them to dry by naturally.

You can use hats, scarves, gangs, wigs as hats.

To make it easier to handle hair loss, the situation seemed less dramatic, you can briefly comprehend the hair before starting treatment.

Nausea as a consequence after radiation therapy

The irradiation of the lower part of the brain can provoke nausea. It is rarely observed this side effect of radiation therapy. Nausea can last within a few weeks after the end of therapy is completed. Medicines, diet, and sometimes additional treatments help improve state.

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Medicine

Nausea is successfully monitored with antiwest drugs. Radiation oncologist can assign them. Some take tablets 20-60 minutes before the start of treatment, others regularly during the day.

If some drugs are not effective, others can help.

Additional treatments

To manage such symptoms as nausea and vomiting, relaxation techniques, hypnotherapy and acupuncture are successfully used.

Food can have a serious impact on the state:

1. Eating or cooking should be avoided when a person feels nauseous.
2. You should not use fried, fatty products that have a strong smell.
3. If the smell or preparation cause irritation, you can use cold or slightly warm food.
4. You can eat several small dishes and snacks every day, carefully burn food.
5. It is worth it in a small quantity a few hours before the start of treatment.
6. You need to drink plenty of liquid, small sips, slowly during the day.
7. It is necessary to avoid filling the stomach with a large amount of fluid before meals.

Deterioration of symptoms as a consequence after radiation therapy

In some people, symptoms caused by a brain tumor increase after the start of treatment for a while. This should not lead to thoughts that treatment does not work or tumor grows.

Radiation therapy in the brain area may provoke swelling in the processing zone for a short time, which leads to an increase in pressure. Accordingly, the symptoms deteriorate on time - headaches arise, nausea, convulsions. The doctor appoints steroids, and swelling leaves. After the end of treatment, the dose of steroids gradually reduce. If steroids cannot be taken for any reason, targeted therapy can be offered - Avastin, which will reduce the pressure in the brain, changing the development of blood vessels around the tumor.

Consequences after radiation therapy of the breast

Problems with swallowing during and after radiotherapy

The irradiation for breast cancer can cause swelling and soreness in the throat area. There are difficulties with swallowing hard food. To solve this problem, a soft, simple diet is used. Products, irritating throats (crushing, spicy products, hot drinks, alcohol, etc.) are excluded. Medications are used to reduce soreness - painkillers, rinse with aspirin.

Nausea after radiation therapy

Radiotherapy may cause nausea, there is irradiation affects the area close to the stomach. Mostly nausea manifests itself in a soft form, can last a few weeks after the end of treatment. The state will help control the medicines, diet and some additional treatments previously mentioned.

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The frequency of skin epithelium depends on environmental conditions, professional impact and pigmentation of the patient's skin.
In many tropical and subtropical zones, there is a high frequency of unemmal skin cancers among people with light skin. Tumors arise mainly in areas subjected to intense solar exposure. Skin cancer associated with insolation are the most frequent neoplasms in white people living close to the equator. Among the populations with different degrees of skin pigmentation (melanin), the frequency of diseases is lower in those whose pigmentation is deeper. This confirms the assumption that melanin protects the skin from the harmful effects of ultraviolet rays.
However, rural residents have the prevalence of the skin cancer of the lower limbs seem to be associated with the presence of chronic ulcers of various nature, including burns. These tumors are exclusively flat-belling cancers (as opposed to basal cell cancer in white). These tumors are often common, with deep invasion to the fabric and metastases into regional lymph nodes. Basal cell cancer, on the contrary, rarely metasizes.
Skin cancer in general is divided into melanoma and non-melanomous malignant tumors. For melanoma, the best generally accepted method of treatment is considered surgical, it is not considered in this book.

1. Clinical picture and flow

To understand the origin of the skin neoplasms and make the choice of the treatment method helps knowledge of the basis structures of the skin. The thickness of the epidermis ranges from 60 microns (0.06 mm) in century and vulva to 1 mm in open areas of the skin, such as palms and feet. The cells of the epidermis are applied to the dermis (dense connecting tissue) and sometimes in the free subcutaneous connecting tissue and include fat and sweat glands and hair follicles. They play an important role in epidermis re-epidermis after damage. The growth of the epithelium is often noted from the hair follicles zone and sweat glands after surface lunches due to thermal burns or radiation therapy. The occurrence of basal cell crayfish is associated with sall glands.

1. Pathochistology

Skin epitheliums are divided into basal cell and flat-cell cancer.

1. DIAGNOSTICS

The simplest method of surveying groups of risk is the standard inspection of the skin.
The epitheliums look like raised, sometimes ulcerated lesions, often with pearl edges and rather dense consistency. Any non-healing ulcerative lesion is suspicious and must be investigated and, if necessary, biopsyned at an early stage.
Differentiated diagnosis with typical tropical diseases, such as tropical granuloma and other tropical ulcers, based on the absence of an effect from adequate antibiotic therapy.

1. Studying and forecast

An assessment of the skin cancer stage is based on inspection and palpation of the affected area and regional lymph
Table 25.1 Classification of skin cancer

Stage	Definition
Primary tumor (T)
T1. T2. TZ. T4.	Tumor in the greatest measurement<2 см Опухоль 2-5 см в наибольшем измерении Опухоль > 5 cm in the greatest measurement tumor germinates in deep subcutaneous structures, for example cartilage, skeletal muscles, bones
Lymph nodes (N)
NX. N0. N1.	The condition of lymph nodes is not amenable to evaluate regional lymph nodes intact There are metastases in regional lymph nodes
Remote metastases (m)
MX. MO ML.	The presence of remote metastases is not amenable to estimating remote metastases. There are no remote metastases.

Table 25.2 Grouping in Stages

Stage	TNM classification

nodes. Sometimes, with a common tumor, an x-ray study is needed by bone structures. Classifications are shown in Table. 25.1 and 25.2.

1. Choosing a method of treatment

Typically, tumors in the stages T1 and T2 are healing with excision, radiation therapy or other procedures, such as cryosoperation, laser therapy and diathermy or curetzh. Initial epitheliums that actually can be hyperkeratosis are curable with simple electricity with or without caution. This is an important method in individuals with multiple lesions, but such treatment is quite laborious. The use of 5% fluorouracyl ointment (fluorouracil-5) is useful for patients with common prepubrase changes. The use of this ointment twice a day for 6 weeks. Eliminates most of the hyperkeratosis and superficial epithelomes and leaves deeper epitheliums manifested by redness and sometimes edema, which serves as a reference for subsequent final treatment with excision or radiation therapy.

1. Radical radiation therapy

(a) physical prerequisites (photon beams)
Skin cancer is growing on the body surface, and it is only rarely available to irradiation with opposite fields (as with a tumor of ear shell). Most techniques provide for the use of one field. With a massive lesion, a beam at an angle with wedge-shaped filters is used. The task is to limit the irradiation only the zone of the tumor location. In practice, it is necessary to take into account a number of such parameters (radiation quality, the distance source-tumor and irradiation area), which will capture the lateral borders of the tumor together with the zones of possible microscopic propagation and make the exposure to the minimum. To achieve this, a thorough assessment of the tumor prevalence is needed by measuring with a roulette or circulation, the determination of microscopic invasion and the depth of germination using adequate biopsy along the edge and other methods such as radiography. The electronic beam mostly satisfies the tasks at the location of the tumor within several centimeters from the surface. However, at present, in most radiological departments there are only X-ray therapy and gamma beams with a certain energy and a fixed distance from the source to the tumor.
For all possible clinical situations, a very diverse spectrum of energies are needed, starting from 30 square meters up to megavital radiation. Tumors located at a depth of several millimeters to several centimeters can be effectively irradiated with the creation of a sufficient homogeneous dose in the tumor and with an acceptable restriction of the penetrating dose.
Ideal conditions for irradiation only the volume of the tumor cannot be achieved when using external X-ray radiation. The reasonable selection of treatment and protection factors is able to minimize the penetrating dose. However, the irradiation of the eyes, the middle ear and the brain should be considered particularly, and the planning should be carried out in such a way as to reduce the dose on these bodies to the absolute minimum. The generally accepted dose on the lens is considered to be 5 grams, and on the brain 50 c with the protracted course for 5-6 weeks. If the adequate protection of these or other vital organs cannot be provided, then such a situation is a relative contraindication to radiation therapy.
Other irradiation options include urban gamma therapy, outdoor short-circuit gamma-making and electron beam irradiation. Only the last option has physical advantages over external X-ray irradiation.
(b) Collimation of outer beams
The edges of the irradiation zone must be installed during clinical evaluation. The establishment of fixed boundaries by 0.5 or 1 cm around the visible or palpable tumor in some situations only leads to the useless irradiation of healthy tissues with a small and non-indigenous tumor, while at large and infiltratively growing tumors confirmed by histological research data, establishing such edges will lead to propulsion.
With radiobiological positions, it makes sense to bring 2 / s or 3/4 doses to the tumor and its edges, then reduce the irradiated volume to the size of the tumor defined and bring a full dose to it. This option is based on the installed high sensitivity of microscopic sections of tumor cells due to their small number and good oxygenation. Such a "controlled fabric" allows you to reduce the dose on healthy fabrics and, therefore, improve the cosmetic result. If possible, it is vital to protect critical structures, as shown in Fig. 25.1. This should be done, even if the optimal dosic distribution is achieved, since the penetrating radiation is not necessary. In zones in which subject to structures cannot be protected, special precautions should be taken in the selection of optical

(D)
Fig. 25.1. Charts showing the possibility of protecting the subject and peripheral tissues at radiation therapy of tumors (a) century, (b) lips, (c) of the nose and (d) ear. Lead protection must be covered with paraffin or plastic. It is also possible to use candidated rubber. Protection is depicted in the form of a shaded area.

the most radiation quality in order to minimize the penetrating dose.
The volume of irradiation must be limited to the tumor and its edges. This is easiest to achieve if you apply a field on a transparent film or cellophane and, according to this pattern, make a lead screen that does not pass more than 5% of the radiation energy. You cannot use only a tube, since the patient's movements can lead to geometric errors. It is best to use special screens or a lead mask on the face and irradiate through the appropriate hole with a wide beam.
(c) dosing
The dose required to cure skin cancer increases with increasing tumor volume. So, a small lesion with a diameter of less than 1 cm may be cured by one-time irradiation at a dose of 27-30 gr. However, the cosmetic result is better with fractionated irradiation. If it is practically feasible, the treatment must be fractional by 1-2 weeks. The number of fractions should increase with an increase in the size of the field to ensure the best cosmetic results. In tab. 25.3, based on the experiment, the recommended number of fractions and total doses are presented.
(d) benign lesions
Radiation therapy is mainly used with two types of benign skin diseases: keloids and keratoacanta.
Table 25.3 Recommended doses

Diameter (cm)	fields Minimum number of fractions	Total dose (gr)	Dose for fraction (gr)

Keloids
These diseases are especially common in Africa, tumors often become big and manifested by symptoms. Such lesions were treated with surgical excision, but the frequency of recurrences is high. It has been established that postoperative irradiation effectively reduces the frequency of recurrence of these lesions.
One radiation therapy is effective only with small and fresh keloids. Therefore, the method of choice is excision and emergency irradiation. It is possible that the interval between the operation and irradiation should not be more

1. h and treatment on the same day is justified and more efficiently. Almost always a single dose. The recommended dose is 12 grams, but with large keloids it can be increased. The technique involves the inclusion of edges, departing 1 cm from the operating scar, and the use of surface irradiation with energy in the range of 50-200 kV depending on the skin thickness.

Keratoacanta
The reason for this disease is still unknown, although there is a connection with chemical compounds, such as oil in industry, injury and radiation exposure. Clinical diagnosis is possible due to the original flow of keratoacant. The disease often begins in the form of a papule, reaching a diameter of 1-2 cm for weeks. The tumor has a central recess and ulceration. With conservative treatment or only observation, it often reaches large sizes and destroys the surrounding tissues, which requires large operations and plastics. This fact outweighs the possibility of a rare spontaneous regression of Keratoacanta and indicates the need for early treatment. It has been established that it is very radical sensitive, perhaps mostly than malignant epithelioma. Therefore, the early use of radiation therapy is shown. In general, a dose is recommended for 3/4 from the dose used in the treatment of malignant epitheliums.
Sarcoma Caposhi
This disease is the main component of the AIDS complex. The treatment of malignant disseminated sarcoma capsis is considered in chapter 26.

1. Palliative radiation therapy

It is used at the impossibility of curing the skin cancer, for example, with a massive local germination to the subjects, including bones, and in the presence of large and / or multiple metastases in the lymph nodes. Exposure can improve the situation in painful ulcers, bleeding and sepsis, but more importantly in such situations supporting therapy, including antibiotics and analgesics. When conducting radiation therapy, the course should be short, the dose should be about 2 / s from therapeutic. It should be summed up with a small number of fractions in combination with supporting therapy.

According to statistics, in recent years, the number of people with octopias of the skin is rapidly increasing, regardless of their age and gender. Despite the use of advanced diagnostic and treatment methods and the treatment of oncopathologies, on the disturbing of all the question: "Is it possible to cure skin cancer?" There is still no unambiguous response.

The concept of "skin cancer" includes a group of cancer neoplasms developing from cells of various layers of epidermis, and localized on the surface of the skin.

Depending on the structure of affected cells, several forms of this disease are distinguished.

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Basaloma or basal cell cancer, develops from the top layer of the epidermis, is the most common form of oncopathology. It is characterized by germination in tissue and lack of metastases.

PlateLock carcalete cancer It comes from the cells of the spinged layer of the epidermis, develops against the background of leather pathology, and is diagnosed less often than basaloma. For this form, the aggressive course and metastasis in the early stages of development is characteristic. In the development of this form, the skin is defeated.

Metatypic cancer It has clinical manifestations similar to the symptoms of basalomas, but the features of the flow are similar to the nature of the development of flat-stacked cancer. This form occupies an intermediate position between these two species.

Melanoma Develops from melanocytes - epidermis pigment cells. Differs on rapid development and extreme malignancy. It may arise as a result of pathological changes in non-residents (payable spots).

Sarcoma Caposhi It develops from the endothelium of blood vessels, and is distinguished by a multi-grade malignant lesion of the dermis and the variety of clinical forms. There are red, nodule, infiltrative, disseminated (lymphadenopathic) tumor forms. The sarcoma of the capos is characterized by multiple spots of the blue-red shade, which are gradually transformed into tumor formations of up to 5 cm.

The choice of the most effective tactics of treatment depends on the form of a neoplasm, its localization, degree of differentiation, prevalence of the process, as well as the age of the patient.

Video: skin cancer. Species, symptoms, treatment

Surgical treatment (surgery)

The main goal in the treatment of necabolic skin is a radical removal of the neoplasm, which is carried out by excision using the primary tumor to healthy tissues. Currently, there are several ways to surgical treatment.

Classic excision . This method is applicable to any form of a tumor in the early stages of development. The surgeon produces a tumor removal by grabbing 1-2 cm adjacent healthy skin. It is subsequently investigated under a microscope for the presence of cancer cells in intact tissue.

Microsurgery MOHS . This method is most effective in the development of basaloma or flat-stacked cancer. A feature of this operation is layer-by-layer tumor removal and an instant microscopic study of each layer for the presence of cancer cells. Slices are produced until under the microscope, fabric will not be healthy without cancer. The microsurgical operation is carried out in order to minimal removal of healthy tissue and the preservation of the cosmetic effect.

Fuligration (electrocoagulation) and Curetzh . This simple method is also suitable for removing flat-cell or basal shape of a small size. The operation is carried out using a curette - a small tool in the form of a spoon. During the removal of damaged tissue, an electrical current is supplied to this area to destroy the remaining cancer cells and prevent bleeding. For complete removal it is necessary to spend several stages of treatment.

Cryotherapy . This method is used when removing the sarcoma of caps, melanoma, basalomas, or flat-stacked cancer when the neoplasm has small sizes. The essence of the operation consists in removing the cancerium tumor with liquid nitrogen, which is applied directly to the place of lesion.

As a result of a shock freezing of the tumor, cancer cells are destroyed, but at the same time damage to nerves can occur, which often leads to loss of sensitivity in this area.

Laser therapy . The removal of cancer cells with a laser refers to modern and highly efficient methods, since with layer-by-layer removal of the affected tissues, which is made with high accuracy, healthy tissues are not injured. Laser therapy is carried out quickly and with local anesthesia.

Radiation therapy

Very often, the treatment of skin cancer is carried out using the laser therapy method. At 1-2 stages of the development of basaloma, near its small sizes shows close-focused radiotherapy. With extensive damage, combined treatment is prescribed using remote gamma therapy.

This method of treatment is shown in the early stages of the tumor process, or after the surgical removal of flat-cell and metatype cancer in the event of a recurrence. It shows a good effect, because with the help of a powerful flux of radiol, the structure of cancer cells occurs, as a result of which they cease to multiply and die. In some situations, radiotherapy is prescribed in combination with the preparation of recipidine.

The radiation therapy is prescribed to the elderly, if the primary tumor reaches up to 20 mm in diameter. In this case, a tolerant dose of irradiation is selected, which is calculated individually for each patient. The advantage of radiation therapy is the destruction of cancer cells and the preservation of healthy, intact. However, after it can develop local complications in the form of perichondrite, dermatitis, conjunctivitis.

If the patient is diagnosed with melanoma, radiation therapy is appointed at the stage when the tumor begins to progress, and only in complex treatment with chemotherapy or immunotherapy, since very often melanoma shows resistance to the effects of radiation radiation.

In the case of the patient in the patient, the sarcoma caposi, namely, when the detection of large painful lesions, the lesion is carried out a local effect of radiation radiation. However, this is indicative only for HIV-infected patients. For patients in the AIDS stage of the desired result, it is almost impossible to achieve.

Chemotherapy

Chemotherapeutic method is the most effective field of surgical intervention. It is appointed with all possible forms of skin cancer. Chemotherapy is particularly effective when returning recurrence or at critical sizes of the tumor, which prevents the operation. In this case, chemotherapy products are prescribed, destructive tumor cells.

With basal cell tumor, local chemotherapy is assigned using outer ointment from cancer (recipidine or 5-fluorouracyl), which should be applied locally twice a day for several weeks.

Most often, chemotherapy involves the use of local applications using cytostatics (fluorouracil, doxorubicin, metathenixate, etc.)

To know how to cure a flat-cell skin cancer with the help of chemotherapy, it is necessary to determine the stage of the development of the process, since this method is effective only in tumors of small sizes or when recurrence occurs. Local chemotherapy is prescribed to the patient using 0.5% omaine or 5-fluorouracyl ointment. Otherwise, highly efficient chemotherapy are prescribed.

Metastatic cancer of the epidermis, which can cause damage to the skin of the nose, cheeks, forehead and in general the face, is treated in the same way as a flat-belling cancer, since the clinical manifestations of both forms are practically similar.

For the treatment of melanoma, as a rule, chemotherapy is not shown, or is shown at the last stage of the disease, when extensive metastasis occurs, and the primary tumor reaches critical sizes. The destruction of cancer cells both in the primary and secondary tumor occurs when the chemotherapies are exposed directly to the tumor.

When diagnosing the sarcoma of the capos to the patient, chemotherapy is prescribed on a par with other methods of treatment: antiretroviral therapy, interferonotherapy. "Vinblastine", "Wincristine", "Pospiden", "Taxol", Etoposide and other preparations of the last generation are appointed for chemotherapy.

Modern methods allow you to expand the possibilities of complete cure of oncological diseases. But only depending on the form of the skin oncupportion, at a timely manner, the properly chosen treatment protocol can be reliably determined, whether skin cancer is curing, and is possible a recurrence.

Is radiation therapy. It was revealed that young, malignant cells cease to multiply under the influence of radioactive radiation.

Concept

With radiation therapy, the impact of ionized study occurs. His goals:

• damage to malignant cells,
• cancer growth restriction
• prevention of metastasis.

Used in a complex with surgical treatment and chemotherapy.

During the radiation impact, the cell decay does not occur, but their DNA varies. The advantage of the method is that healthy structures are not subjected to any changes.

Strengthening effect is achieved and due to the fact that the doctor can adjust the direction of the rays. This makes it possible to use maximum doses in the lesion focus.

Sometimes this method is used for the treatment of neonqualistic pathologies. For example, to combat bone outflows.

Video of the final preparation:

Indications

The method is used in 60-70% of patients with cancer. It is considered basic to treat tumors, which are distinguished by a high degree of radio sensitivity, rapid progression, as well as in some features of the localization of education.

Radiation therapy is shown in cancer:

• nasopharynx and rings Pipped almonds,
• cervical cervical
• large,
• skin, breast,
• lung
• language
• bodies uterus
• some other organs.

Types of radiation therapy

There are several methods of treatment. Alpha radiation implies the use of isotopes, for example, radon, products from Toron. This species has a wide type of application, positively wagged on the CNS, the endocrine system, the heart.

Beta therapy is based on the therapeutic effect based on the effect of beta particles. Various radioactive isotopes are used. The decay of the latter is accompanied by the emission of particles. There is such therapy of intramanex, intramilia, appliquational.

X-ray therapy is effective for the treatment of surface lesions of the skin, mucous membranes. The energy of X-ray examination is selected depending on the location of the pathological focus.

Separate radiation therapy and on other grounds.

Contact

The species differs from the rest of the fact that the sources of the rays are directly on the tumor. For it, the dose distribution is typical so that its main part remains in the tumor.

The method is good if the size of education is no more than 2 cm. This type is divided into several types.

Name	Features
Near-focus	Irradiation affects the formation cells themselves.
Domestic	The source of irradiation is introduced into the cavities of the body. It remains throughout the entire course of contact radiation therapy.
Intraknevaya	The source of irradiation is introduced into the tumor. Impact occurs in continuous mode.
Radiosurgical	The rays are affected after surgery. The place is exposed to the place where the tumor was located.
Application	The radiation source is superimposed on the skin using a special applicator.
Election accumulation of isotopes	Mulotoxic radioactive substances are used.

Remote

It implies that the source of irradiation is at some distance from the human body. A bundle includes a body through a certain plot.

More often used gamma therapy. This method is good because it allows the formation to bring a high dose of irradiation, while maintaining healthy cells intact.

For small cancers, protons and neurons are used. Remote therapy is static or movable. In the first case, the source of irradiation is fixed.

In modern oncological dispensaries, the method is rarely applied. The movable technique allows you to direct the source by different trajectories. It provides the greatest efficiency.

Radionuclide

The specificity is to be carried out in the body of the patient of radiopharmaceuticals. They affect the foci. Address delivery of substances forms in the foci of very high doses with small side effects and minimal affecting healthy tissues.

Popular is radio pooderity. The method is used not only for oncological patients, but also for the treatment of people with thyrotoxicosis. If there are bone metastases, several connections are used immediately.

Conformable

Radiation impact when three-dimensional irradiation planning is used to obtain a field form. The method allows you to bring adequate doses of radiation to tumors. This significantly increases the chance of healing.

To eliminate the exit of the tumor from the irradiated zone, special devices are used, for example, equipment for active breathing control.

Protonna

Radiation therapy based on the use of protons that are accelerated to large values. This allows you to provide a unique dose distribution in depth, when the maximum dose is concentrated at the end of the mileage.

In this case, the load on other surface cells is minimal. Radiation does not dissipate by the patient's body.

Typically, the method is used for small formations, tumors located close to critical radio sensitive structures.

Domestic

This species has several types. Allows preventive recurrence and metastasis. The source is introduced into the body cavity and is located during the entire irradiation session.

It is used to create a maximum dose in tumor tissues.

Usually this method is combined with remote. The radiation therapy of this species is used to treat the female sex sphere cancer, rectum and esophagus.

Stereotaxic

This method reduces cancer treatment time.

It is used for treatment, internal organs, blood circulation systems. Rays affect very accurately on the tumor.

Stock Foto Stereotactic radiation therapy

It is carried out with full control over the location of the tumor, it allows you to adapt to the patient's breathing and any other movement.

The result of such an impact is not visible immediately, but after a few weeks, since the cells of the tumor die gradually.

Contraindications

There are several situations where radiation therapy is contraindicated:

• general serious condition with signs of body intoxication,
• fever,
• extensive damage to cancer cells accompanied by bleeding,
• radiation sickness,
• severe forms of concomitant diseases
• pronounced anemia.

The limitation is a sharp decrease in leukocyte blood or platelets.

How is the radiation therapy?

First, additional procedures are carried out, allowing to accurately determine the localization of the tumor and its dimensions. Dose is selected from this. With the help of a special machine, the exposure field is determined. There may be several such sites.

In the process of treatment with radiation methods, the patient is in the situation lying. It is important during irradiation not to move, as this may lead to the fact that the rays damage healthy fabrics. If a person can not move long, then the doctor records the patient or body area.

Some parts of the machines can move and noise, it should not be afraid. Already at the beginning of treatment it is possible to reduce pain, but the greatest effect is achieved after the course is completed.

Course duration

Treatment is more often conducted outpatient. Session, depending on the method used, lasts 15-45 minutes.

Most of the time it occupies the correct placement of the patient and the direction of the exposure instrument. The process itself lasts a few minutes. Personnel at this time leaves the room.

The course is from 4 to 7 weeks. In some situations, it decreases to 14 days. It is advisable if it is necessary to reduce the size of the tumor or improve the patient's condition. Sessions are held 5 times a week. Sometimes the dose is divided into 2-3 sessions.

How is the procedure transferred?

The radiation therapy itself does not cause painful sensations. After the procedure, it is recommended to rest for several hours. This will help restore forces, as well as reduce the risk of side effects.

If the irradiation was subjected to throat or mouth, then after it is recommended to rinse her herbs champs or sea buckthorn oil to remove unpleasant sensations.

Symptoms after irradiation

After the course of radiation therapy may appear:

• fatigue
• mood and sleep violation
• reactions from the skin and mucous membranes.

If the impact was carried out on the region of the chest, shortness of breath appears, the difficulty of breathing, cough.

Effects

Most often the skin suffers. It becomes gentle, sensitive. May change color.

The skin reaction to irradiation is approximately the same as with a sunburn, but it develops gradually.

Perhaps the appearance of blisters. In the absence of proper care, such sites can be infected.

If the effects of the respiratory system were exposed, the ray lesions are developing over the next three months. An unproductive cough appears, the body temperature rises, there is a deterioration in general well-being.

Experts note that often by the on-board phenomena become:

• hair loss,
• reduced hearing and vision
• increasing the number of heartbreaks,
• change blood composition.

Restoration after irradiation

The recovery process can occur at different times, doctors recommend tighter for a long way.

Treatment of burns

Redness usually appear immediately, but some people have burns begin to be discovered immediately. After each session it is worth lubricate with protective cream.

At the same time, it should not be done before the procedure, since this can reduce the effectiveness of the manipulation. For processing, D-Panthenol is used and other drugs, allowing to remove inflammation and restore the dermis.

How to raise leukocytes after radiotherapy?

You can increase the number of leukocytes only after the permission received from the doctor. Be sure to diversify your menu with raw vegetables, buckwheat, fresh fruit, Hercules.

Positive on the composition of blood is affected by pomegranate juice and beet. If these methods do not help, the doctor will write special medicines.

What to do at temperatures?

The temperature in most cases is a sign of infection. After radiation therapy requires a lot of time to restore immunity.

It is better to immediately consult a doctor who will help identify the cause and prescribe treatment. If there is no possibility, observe the bed mode, use antipyretic agents, not contraindicated with your ailment.

Pneumonite

Their treatment is carried out using high doses of steroids. Then the symptoms disappear after 24-48 hours. The dose is reduced gradually.

Additionally, respiratory gymnastics, massage, inhalation and electrophoresis are used.

The treatment program is drawn up individually taking into account the type of tumor and its prevalence, the presence of other complications.

Hemorrhoids

For treatment, it is necessary to strictly comply with the diet and bedding, use medicines and means of traditional medicine. Radiation radiation leads to a violation of the ripening of the epithelium, inflammatory processes on the mucous membranes.

For treatment, local therapy is applied, allowing to clean the intestines and eliminate inflammatory processes.

Proktits

To eliminate the problem, laxatives are used, cleaning belizes. High efficiency showed a warm shower, directed to the area of \u200b\u200bthe rectum, baths with manganese.

The doctor can assign hormones, rectal candles and anesthetics.

Diet nutrition

Full nutrition is one of the main methods of treatment of radiation damage. It is necessary to take soft products. If the mouth cavity suffered from irradiation, then efficiently use oil, novocaine solution.

During the radiation therapy itself, patients are usually complaining about the absence of appetite. At this time, add nuts, honey, eggs, whipped cream in the menu. They contain many nutrients. To obtain protein, soups-puree are added in the diet, low-fat fish and meat broths.

Contraindicated products containing large amounts of cholesterol, fatty meat, mushrooms, tangerines, sausage.

Answers on questions

• What is the difference between chemistry therapy from radiation therapy?

Chemotherapy-cutting on cancer using medicines. Radiation therapy is based on the principle of cell destruction under the influence of rays.

The global standards provide a combination of these two techniques, since the curing chance in this case increases.

• Does hair fall out after radiation therapy?

After radiation exposure, the hair falls only at the time of the ray. Usually doctors warn about the possibility of baldness. It is best to make a short haircut in this case.

When caring for hair from the moment of the start of treatment, use a crest with rare teeth or buy a comb for newborns. Before bed, use a special mesh for sleep so that the hair is not pressed and did not stretch.

• Is it possible to get pregnant after radiation therapy?

Many treatments leave a negative trail, affect reproductive functions. After radiation therapy, it was recommended for several years to be protected.

This will allow the body to recover, give birth to a healthy child. The term usually says oncologist depending on the stage of cancer, the results of treatment.