Intro: This is Weekly Dose of Wellness from Memorial Care Health System. Here's Deborah Howell.

Deborah Howell (Host): Hearing that you need to have radiation therapy can cause a whole cascade of emotions, but what will the experience really be like? Welcome. I'm Deborah Howell. And today, we'll try to debunk some of the common misconceptions about radiation treatment. Our guest is Dr. Asif Harsolia, Medical Director of Radiation-Oncology Memorial Care Cancer Institute at Orange Coast Medical Center. Welcome back to you, Dr. Harsolia.

Asif Harsolia, MD: Thank you for having me, Deborah. I appreciate it.

Host: So, what is radiation treatment?

Asif Harsolia, MD: So, radiation therapy is a type of cancer treatment that uses high energy x-rays or particles to destroy cancer cells. It essentially works by damaging the DNA of the cancer cells. And it kind of takes advantage of the fact that cancer cells cannot easily repair the DNA damage to those cells. And so, what happens is when they try to divide, they essentially die off versus regular healthy cells are able to oftentimes repair that DNA damage. And so, radiation sort of takes advantage of that fact.

Host: That is very, very well. And I mean, you gave me a picture of that and very easy to understand, so we appreciate that. Are there different types of radiation treatment?

Asif Harsolia, MD: Yeah. There's a large number of different types of radiation, but you can kind of put them into two large categories. One is sort of external radiation where the radiation comes from the outside in. And then, the other type of radiation is internal radiation called brachytherapy where radioactive sources are placed directly inside of the tumor.

Now, there's been a lot of sort of technological advances over the years, particularly with the external type, where it's gone from, you know, 2D to 3D to 4D to image guidance, and some of the latest stuff is stereotactic radiosurgery, which is a way of delivering really high doses of radiation with submillimeter precision.

Host: All right. And what are some common misconceptions about radiation treatment?

Asif Harsolia, MD: You know, I think in the general society, probably some of the biggest misconceptions is that people see things on TV and on Hollywood of like three-headed fish or nuclear bombs are going in the dark or Spider Man or things like that. And people don't realize that modern radiation therapy has evolved to the point where we can three-dimensionally map out the tumor and the organs in the body such that we can target the cancers with submillimeter precision, while oftentimes sparing some of the normal healthy tissue around. So, it's not the common perception. And some of the other big misconceptions are that radiation therapy can cause cancer. So, how can it treat cancer? With modern radiation, oftentimes the risk of getting cancer from radiation is minuscule compared to the potential benefit for a patient who already has cancer.

Host: Got it. And then, what are some common misconceptions about life during radiation treatment?

Asif Harsolia, MD: One of the things that people kind of tend to confuse, you know, older chemotherapy techniques or radiation, and they feel they're going to be very sick during the radiation. The reality is that the vast majority of patients who are undergoing radiation, sometimes with a combination of surgery and chemotherapy, they find the radiation-- a portion of their treatment course-- to be sometimes the easiest part. Patients are able to drive themselves oftentimes to their treatments. And after they get the treatment, they can go about their daily lives and go grocery shopping and do things. So, they're not sort of bedridden. And oftentimes many people even continue to work during the radiation treatments.

Host: I have a spouse who did that very same thing, and he just kind of sailed right through it. I was very surprised. What are some misconceptions about life after radiation treatment?

Asif Harsolia, MD: I think that many people think that they will be disabled or that they'll never be able to go back to their normal lives. The situation, most of the acute side effects of radiation treatment generally tend to resolve about four to six weeks after patients complete their course. And most people, the long-term side effects tend to be minimal or tolerable such that it doesn't generally have a big impact on their quality of life. They're able to sort of resume their normal lives and go back to working. There are some long-term side effects, depending on the type of cancer the patient's being treated for. And the physicians can talk to the patients and kind of counsel them about it, you know, before they actually start their treatments.

Host: And how long is a typical course of treatment?

Asif Harsolia, MD: So, in the olden days, most of the treatments could be as long as, you know, six to even nine weeks in duration given on a daily basis, but there are newer radiation techniques which have significantly shortened the treatment course down to as little as even one day now on the one end to the standard radiation treatment courses.

Host: Wow, that's great news indeed. How is radiation therapy beneficial to your patients?

Asif Harsolia, MD: Radiation therapy is a very important part as part of a multidisciplinary team approach to the treatment of cancer. It's been extensively studied and numerous studies, depending on the cancer type, have shown that patients who receive radiation therapy often have higher chances of survival, less chance of the cancer recurring within the radiation field, less chance of the cancer spreading. And the majority of time, radiation treatment is used in a curative sense. But even when it's used palliatively to alleviate symptoms, it can have a significant benefit in terms of getting rid of pain and improving patient's quality of life.

Host: Good to know. And how does Memorial Care Cancer Institute stand apart in their radiation therapy offerings?

Asif Harsolia, MD: Memorial Care is very well known for radiation therapy. It's actually one of the oldest and most established radiation groups in Southern California. My partners have been amongst, my senior partner actually founded the American Brachytherapy Society. A number of innovations have come out of Memorial Care, along with a number of publications. Patients, you know, the physicians, many people in our group are internationally and nationally recognized. And Memorial Care offers access to some of the latest, cutting-edge technology and clinical trials.

But I think the biggest thing that sets us apart is, in addition to having access to some of these world-class treatments, is that the physicians and the staff at Memorial Care genuinely tend to care about their patients. They see it as more than just a job. They actually, genuinely go the extra mile to provide the best care for their patients that they would want their own family members or friends to receive. And I think that's what really sets us apart.

Host: Such a measure of support is what a patient really needs. And are there any social services also available to patients?

Asif Harsolia, MD: Yes. As part of a comprehensive Memorial Care Cancer Institute, we have on staff social workers, nutritionists. There are cancer support groups. So, it's a holistic approach to cancer care. So, there's a number of different resources that are available for patients.

Host: That is so wonderful. Anything else you'd like to add to our conversation?

Asif Harsolia, MD: Well, I'm glad that we're talking about this to dispel some of the misconceptions. I think one of the most unfortunate things that we sometimes see is when patients have a type of cancer in which radiation therapy can potentially be life-saving or can significantly improve their quality of life. But due to misunderstandings or fear of the unknown, sometimes the services are underutilized for patients who may really benefit from them. So, it's great that, you know, doing a podcast like this to kind of dispel some of the misconceptions is fantastic.

Host: Yeah. We really, really are glad that you're here to help spread the word. It's been so interesting. Where can people go to learn more?

Asif Harsolia, MD: Our website has a large number of resources that are available. They can visit us at memorialcare.org/occancer, and there's a number of great resources there. Another great resource is a website called rtanswers.org and it has number of, you know, a plethora of information about radiation therapy for patients.

Host: It sounds wonderful. Well, thank you so much, Dr. Harsolia, for your time and your expertise today, and of course, everything you do for our patients.

Asif Harsolia, MD: Thank you for having me. Appreciate it.

Host: For more info or to listen to a podcast of this show, please visit memorialcare.org. That's memorialcare.org. That's all for this time. I'm Deborah Howell. Have yourself a terrific day.