Radiotherapy, also known as radiation therapy, is a vital pillar in the treatment of cancer worldwide. Despite its proven effectiveness and wide application across different types and stages of cancer, radiotherapy utilization rates vary significantly across countries. It has been long suggested that approximately 50% of all cancer patients should receive radiotherapy at some point during their treatment journey. However, actual utilization often falls short of this benchmark in many regions.
Understanding why this disparity exists — and how radiotherapy works — is essential for improving cancer care and patient outcomes globally.
What Is Radiotherapy?
Radiotherapy is a medical treatment that uses high-energy radiation, typically in the form of x-rays, gamma rays, or charged particles, to destroy cancer cells. It works by damaging the DNA of cancer cells, which prevents them from growing and dividing. Over time, these damaged cancer cells die and are naturally removed from the body.
While normal cells can also be affected, they generally recover better than cancer cells, which makes radiotherapy an effective tool to target malignancies while sparing healthy tissues as much as possible.
Types of Radiotherapy
Radiotherapy can be administered in two main forms:
1. External Radiotherapy (External Beam Radiation Therapy)
- The most common type
- Delivers high-energy beams to a specific part of the body using a machine (like a linear accelerator)
- Aimed directly at the tumor site
2. Internal Radiotherapy (Brachytherapy)
- Involves placing a radioactive material inside the body, near or within the tumor
- Used in cancers such as prostate, cervix, and breast
- Allows for higher doses of localized radiation with less effect on surrounding tissues
Why Radiotherapy Is Used
Radiotherapy is not a one-size-fits-all solution. It can be used alone or in combination with other treatments like chemotherapy or surgery, depending on the type and stage of cancer.
Common Goals of Radiotherapy:
- Curative Treatment: To destroy a tumor completely and eliminate cancer
- Adjuvant Therapy: To kill any remaining cancer cells after surgery
- Neoadjuvant Therapy: To shrink a tumor before surgery
- Palliative Care: To relieve symptoms and improve quality of life when a cure isn’t possible
Radiation Oncology: A Precision-Based Specialty
The field of radiation oncology focuses on the controlled and precise application of radiation. With advancements in technology, treatment planning is highly tailored to individual patients using imaging techniques like CT, MRI, and PET scans.
Each treatment plan considers:
- The type and stage of cancer
- The location of the tumor
- The overall health and preferences of the patient
- The severity and complexity of the case
In some situations, radiotherapy is combined with chemotherapy to enhance the effectiveness of treatment — a method called chemo-radiation.
Global Disparities in Radiotherapy Utilization
While it’s estimated that 50–60% of cancer patients would benefit from radiotherapy, global data reveals significant underutilization in many low- and middle-income countries. This can be due to:
- Limited access to radiation therapy facilities
- Shortage of trained cancer specialists doctors
- High setup and maintenance costs for radiotherapy equipment
- Lack of awareness among patients and healthcare providers
- Delayed diagnosis and referral
In contrast, high-income countries generally have greater access to advanced radiotherapy technologies, better infrastructure, and a multidisciplinary approach to cancer care.
Challenges and Side Effects
While radiotherapy is a powerful tool, it’s not without challenges. Side effects depend on the treatment area and dose, and can include:
- Fatigue
- Skin irritation
- Nausea or digestive issues
- Hair loss (in treated area)
- Long-term tissue or organ damage (rare)
Fortunately, most side effects are temporary and manageable, with ongoing improvements in precision and patient care reducing risks significantly.
Looking Ahead: Bridging the Gap
To address the global inequality in radiotherapy utilization, healthcare systems must:
- Invest in infrastructure and equipment
- Train more radiation oncologists, physicists, and technologists
- Increase awareness and timely referrals
- Incorporate radiotherapy into national cancer control programs
Organizations like the IAEA and WHO continue to advocate for expanding access to radiotherapy as a critical component of cancer care.
Conclusion
Radiotherapy is a cornerstone in the fight against cancer — from curing early-stage disease to managing pain and improving life in advanced stages. As technology and treatment protocols advance, it’s imperative that access to radiotherapy becomes more equitable across the globe.
Greater awareness, investment, and policy support are key to ensuring that more cancer patients receive the care they need, when they need it.