Cancer and electromagnetic radiation therapy: Quo Vadis?

📝 Abstract

In oncology, treating cancer with a beam of photons is a well established therapeutic technique, developed over 100 years, and today over 50% of cancer patients will undergo traditional X-ray radiotherapy. However, ionizing radiation therapy is not the only option, as the high-energy photons delivering their cell-killing radiation energy into cancerous tumor can lead to significant damage to healthy tissues surrounding the tumor, located throughout the beam’s path. Therefore, in nowadays, advances in ionizing radiation therapy are competitive to non-ionizing ones, as for example the laser light based therapy, resulting in a synergism that has revolutionized medicine. The use of non-invasive or minimally invasive (e.g. through flexible endoscopes) therapeutic procedures in the management of patients represents a very interesting treatment option. Moreover, as the major breakthrough in cancer management is the individualized patient treatment, new biophotonic techniques, e.g. photo-activated drug carriers, help the improvement of treatment efficacy and/or normal tissue toxicity. Additionally, recent studies support that laser technology progresses could revolutionize cancer proton therapy, by reducing the cost of the needed installations. The aim of this review is to present some laser-based future objectives for cancer radiation therapy, aiming to address the relevant advances in the ionizing and non-ionizing radiation therapy, i.e. protons and heavy ions therapy, as well as photodynamic targeted and molecular therapies.

💡 Analysis

In oncology, treating cancer with a beam of photons is a well established therapeutic technique, developed over 100 years, and today over 50% of cancer patients will undergo traditional X-ray radiotherapy. However, ionizing radiation therapy is not the only option, as the high-energy photons delivering their cell-killing radiation energy into cancerous tumor can lead to significant damage to healthy tissues surrounding the tumor, located throughout the beam’s path. Therefore, in nowadays, advances in ionizing radiation therapy are competitive to non-ionizing ones, as for example the laser light based therapy, resulting in a synergism that has revolutionized medicine. The use of non-invasive or minimally invasive (e.g. through flexible endoscopes) therapeutic procedures in the management of patients represents a very interesting treatment option. Moreover, as the major breakthrough in cancer management is the individualized patient treatment, new biophotonic techniques, e.g. photo-activated drug carriers, help the improvement of treatment efficacy and/or normal tissue toxicity. Additionally, recent studies support that laser technology progresses could revolutionize cancer proton therapy, by reducing the cost of the needed installations. The aim of this review is to present some laser-based future objectives for cancer radiation therapy, aiming to address the relevant advances in the ionizing and non-ionizing radiation therapy, i.e. protons and heavy ions therapy, as well as photodynamic targeted and molecular therapies.

📄 Content

Cancer and electromagnetic radiation therapy: Quo Vadis?

Μersini Μakropoulou Physics Department, School of Applied Mathematical and Physical Sciences, National Technical University of Athens, Zografou Campus, Athens, Greece. E-mail: mmakro@central.ntua.gr

Abstract

      In oncology, treating cancer with a beam of photons is a well established 

therapeutic technique, developed over 100 years, and today over 50% of cancer patients will undergo traditional X-ray radiotherapy. However, ionizing radiation therapy is not the only option, as the high-energy photons delivering their cell-killing radiation energy into cancerous tumor can lead to significant damage to healthy tissues surrounding the tumor, located throughout the beam’s path. Therefore, in nowadays, advances in ionizing radiation therapy are competitive to non-ionizing ones, as for example the laser light based therapy, resulting in a synergism that has revolutionized medicine. The use of non-invasive or minimally invasive (e.g. through flexible endoscopes) therapeutic procedures in the management of patients represents a very interesting treatment option. Moreover, as the major breakthrough in cancer management is the individualized patient treatment, new biophotonic techniques, e.g. photo-activated drug carriers, help the improvement of treatment efficacy and/or normal tissue toxicity. Additionally, recent studies support that laser technology progresses could revolutionize cancer proton therapy, by reducing the cost of the needed installations.
The aim of this review is to present some laser-based future objectives for cancer radiation therapy, aiming to address the relevant advances in the ionizing and non-ionizing radiation therapy, i.e. protons and heavy ions therapy, as well as photodynamic targeted and molecular therapies.

1. INTRODUCTION

Today, one of the major health problems for mankind is cancer. Cancer is the second most common cause of death in the US, exceeded only by heart disease, accounting for nearly 1 of every 4 deaths [1]. In developed countries every year some 40,000 per 10 million inhabitants are diagnosed as having cancer, while the World Health Organization has projected cancer-related mortalities to rise to over 11 million by 2030 [2]. Obviously, the universal demand in oncology is early cancer diagnosis on one part, and to remove cancer or precancerous growths or to relieve symptoms of cancer in the case of disease. The armamentarium of cancer treatment includes surgery, radiotherapy and chemotherapy. Among them, treating cancer with a high- energy photons beam is a well established therapeutic technique, developed over 100 years, and today is the most widely used modern cancer treatment - over 50% of cancer patients in developed countries will undergo traditional X-ray radiotherapy to cure their disease. Typically, the higher the dose, the more effective the radiotherapy is in destroying cancer. However, ionizing radiation therapy has also side effects, as the high-energy photons releasing their energy into malignant cells can also lead to significant damage to healthy tissues surrounding the tumor. Therefore, in nowadays, advances in cancer radiation therapy stare at a shift in the electromagnetic radiation spectrum to non-ionizing photons. For example, the laser based surgery and new biophotonic techniques, such as photodynamic therapy and targeted nanomedicine with photo-activated drug carriers, are used to improve cancer treatment efficacy concomitantly reducing normal tissue toxicity.
The year 2015 it was proclaimed by the UN General Assembly and it was celebrated worldwide as the ―International Year of Light‖, just four years after the 50th anniversary of the discovery of the laser radiation. During the first 50 years laser light period, both research developments and applications of laser radiation are impressive, particularly in medicine (in all areas: diagnosis, therapy, rehabilitation and biomedical research and technology). In oncology, there are as well several biophotonic applications and ongoing research efforts in both early diagnosis and imaging, as well as in novel treatment options. Based on the relevant realizations, several groups worldwide protract the idea that, after the predominance of ionizing radiation therapy in the 20th century, the 21st century raised as the Biophotonics era for life sciences. Is this an optimistic target for human health improvement? In an attempt to answer this and the rhetoric question set in the title of this work ―Cancer and electromagnetic radiation therapy: Quo Vadis??‖, it is useful to review first the basic concepts of what is cancer and what is expected in our days from cancer radiation therapy.

What is cancer?

Cancer is a group of diseases caused by normal cells changing so that they grow in an uncontrolled way. Cancer is characterized by this uncontrolled growth or cell prol

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