Maggie McKay (Host): Radiation therapy is a common treatment method for cancer. Useful for about 60% of all cancers. Today, I'll chat with Dr. Brian Fuller, Radiation Oncologist and Medical Director at San Juan Regional Cancer Center to find out more This is Celebrate Health from San Juan Regional Medical Center. I'm your host, Maggie McKay.

Thank you for joining us today, Dr. Fuller.

Brian Fuller, MD: You're very welcome. It's my pleasure.

Host: So before we dig into the topic, can I ask you what drew you to the field of radiation oncology?

Brian Fuller, MD: Well, growing up when I did, I was really interested in science fiction and also very fascinated by cancer team dominous and scary. And, so it remained an interest of mine when I decided to go to medical school. I knew I wanted to be an oncologist or treat cancer in some way. And, I was lucky enough to get a student rotation at Stanford, and it was the best experience I've had.

I fell in love with radiation oncology and knew that's what I wanted to do.

Host: That's awesome. What exactly is radiation therapy and how effective is it?

Brian Fuller, MD: Radiation therapy has been around for 120 years. As soon as radioactivity was discovered, they began to use it to try to treat tumors, and it showed promise and efficacy very early on. Not modern radiation may radiation these days is high energy. There are several forms, but the most common form is high energy photons or x-rays.

Very similar to a CT scan or chest x-ray, higher in energy and the concentration of fluence, the density of radiation coming out is much higher. It causes ionizing damage, the creation of oxygen radicals that break molecules and break DNA, and it makes it difficult for cells to divide and it sends a death signal to the cell, and that's how we believe it works.

Host: How long does each session take, and how many treatments do patients typically need?

Brian Fuller, MD: Well, there's quite a variety depending on the goals and the actual site treated. But sessions can be, they're typically anywhere from five to 15 or 20 minutes per session. And we can treat some patients with brain metastases, cancer that spread to the brain in just a single session. But typically, sessions we would prescribe anywhere from five to these days up to 28 or so sessions, depending on the site and the amount of normal tissue that, receives radiation.

Host: And what are the side effects of radiation?

Brian Fuller, MD: Radiation therapy is a local modality. The side effects of treatment are determined by where we treat. So it depends on where. If we were to treat somebody's leg for a soft tissue tumor, like a sarcoma, the side effects would be quite different than if we were to treat a lung cancer, for instance.

But side effects typically include things like some skin irritation, perhaps some swelling. If we're treating a mucosal site, like the esophagus or the throat, maybe some difficulty swallowing or a sore throat. These are temporary side effects. Long-term side effects are relatively rare and again, it really depends on the site that we're treating.

Host: So receiving a cancer diagnosis has got to be understandably so scary. What do you tell patients who are beginning their treatment journey?

Brian Fuller, MD: Well, I tell them that they're not taking the journey by themselves. I establish a relationship of trust and I tell them to take it one day at a time, and I tell them that I'm working for them as a member of their team. And we provide education, counseling. We discuss the statistics, the risks and benefits.

The statistics in particular are important. They can be confusing. And I try to discuss that with patients and make things very clear. And I really, kind of like to look at the glass as being half full rather than half empty and provide some hope and encouragement to patients because that's a very important component of the cancer journey as well, is how patients feel, the hope that they need to get through something that can be very, very stressful and very, scary, uh, at times.

Host: Can you tell us more about the specialized equipment that you have at San Juan Regional Cancer Center?

Brian Fuller, MD: We have a state-of-the-art linear accelerator. It's a high energy photon x-ray machine. It is specifically designed for precise high dose treatments that can be given that allow us to give courses of therapy in one to five sessions. It is a very fine machine that incorporates imaging elements and allows us to deliver very precise high dose treatments with great accuracy and safety.

Host: Dr. Fuller, what other services does the Cancer Center offer patients?

Brian Fuller, MD: Well, our Cancer Center is blessed to have a nurse navigator who provides some social service to patients and can guide them along their cancer journey, along with the rest of the staff. We also have a fantastic nutritionist, Susie Young, who provides nutritional counseling and support. We also are able to give IV hydration when patients are having difficulty swallowing or for whatever reason come in and require hydration.

And we have a number of cancer support groups that meet regularly here at the Cancer Center.

Host: Well, that's all very reassuring and especially, what you discuss with them and the glass half full. That's a good way to start that journey, which has gotta be a tough one. Is there anything else you'd like to add that you think people should know who are facing radiation therapy?

Brian Fuller, MD: I think that patients who are facing radiation therapy should get expert opinion from a radiation oncologist. It's a very misunderstood field in medicine. There's a lot of nihilism associated with radiation oncology that's unnecessary and incorrect. And patients who have radiation very often are receiving it with curative intent in a curative setting.

It's not as devastating as sometimes it's meant out to be, or it's described as. So I think that my message to patients who are going to get radiation therapy is to come and have a discussion and to believe in the power of radiation as a curative modality and to get the information from an expert such as the ones we have here in our Cancer Center.

Host: Well, thank you so much for sharing your expertise with us. It was very informative and we appreciate your time.

Brian Fuller, MD: Well, you're quite welcome.

Host: Once again, that was Dr. Brian Fuller. And for more information on San Juan Regional Cancer Center Services, you can visit sanjuanregional.com.

And if you found this podcast helpful, please share it on your social channels and check out our full library of prior podcast episodes for topics of interest to you. I'm Maggie McKay, and this has been Celebrate Health from San Juan Regional Medical Center. Thanks for listening.