Scott Webb (Host): Though radiation has been used for years to treat patients for a multitude of ailments, radiation therapy for the treatment of certain cancers is proven to be safe and effective and leading to positive outcomes for cancer patients. And joining me today to explain how radiation therapy works is Dr. Anand Desai. He's a radiation oncologist and Interim Medical Director for the Radiation Oncology Program at Summa Health.

 This is Healthy Vitals, a podcast from Summa Health. I'm Scott Webb. Doctor, thanks so much for your time today. We're going to talk about radiation therapy and what that means and how it works. So, great to have you here. Great to have your expertise. And let's just start there. At a high level, what is radiation therapy used for?

Dr. Anand Desai: Radiation is one part of how we treat cancer. So, I think most folks are familiar with chemotherapy or drug therapy and then, obviously, surgery. Radiation is the third pillar in that, where we work with those other two disciplines to figure out how best to cure or treat cancer.

Host: So doctor, when is radiation considered as a treatment option for cancer?

Dr. Anand Desai: So whenever we're evaluating someone with cancer, you know, we usually approach it in a multidisciplinary way. So here at Summa, we'll have the surgeon in the room, the medical oncologist, or the chemo doctor in a room and ourselves in the room. And so, radiation, we've used for decades. And to your point, it's evolved over those decades. So, what we offer today is far removed from what we used to offer. And so today, radiation is safer, it's more effective, and it's leading to more cures as part of that.

Host: Yeah, it definitely is. And when people talk about radiation treatments, it seems like they usually describe them as a series of treatments. Is that always the case?

Dr. Anand Desai: Yes. So, radiation can be dosed in a variety of fashions. Some folks will be done very quickly in one treatment. Other folks, because of their tumor types or where their tumors are located, may have a protracted course over the course of weeks.

Host: Yeah. So, it's variable, it's very patient specific. Of course, there's no sort of one-size-fits-all. And you talked about how it's so much more safe and effective now than it used to be. How is radiation therapy quality and safety measured?

Dr. Anand Desai: Yeah. So, the technique of radiation has evolved to what I think a lot of folks are familiar with called IMRT or intensity-modulated radiation therapy. I think the best way to think about that is, in the past, we would have a homogenous beam of radiation, and we would point it where we wanted it, but everything in that volume, in that area, received radiation. And now, what we're able to do with IMRT is take that beam of radiation and break it up into individual beam lights that we can actually exert control over and so we can sculpt to the radiation dose better than ever.

I think the other piece too where quality comes into play is IGRT or image-guided radiation therapy. That's where we're able to take a picture on a daily basis in real time of the tumor, and ensure we're targeting what we need to and targeting and avoiding things we don't need to target. And so that combination, IMRT and IGRT, speaks really to how modern radiation can be delivered very effectively and safely.

Host: Yeah, safely for sure. Let's talk about some of the latest advancements that Summa has implemented for radiation therapy.

Dr. Anand Desai: Yeah. So right now at Summa, it's an exciting time in terms of the new technology we've brought in over the past year. And one of that is a highly precise machine. It's a linear accelerator that allows us to image in real time and precisely deliver radiation where we want it to go. So, we use it often in brain tumors near a lot of sensitive structures to the point that, you know, folks come in, get their brain tumor treated and are able to leave and have a normal day after that. And so, that technology allows us to sort of deliver this radiation non-invasively and without anesthesia, no one's put to sleep. We use that type of precise radiation in various locations aside from the brain. So, we use it in the prostate. We may use it for certain liver and pancreas cancers as well.

Host: It's really amazing. You can't see me, of course, neither can the listeners, but I'm just sort of shaking my head like, "Well, that's amazing. How is that possible? How can someone have radiation therapy on their brains and then head off to work or the golf course or wherever they're off to?" I mean, it really speaks to how far things have come, right?

Dr. Anand Desai: It does. And it speaks to how the team has grown over the years. So, we talk about this multidisciplinary facet of oncology care. But within our own radiation oncology department, we have a number of players pulling in the same direction, whether it's myself and my colleagues as physicians, medical physicists who work alongside us to ensure that what we are delivering or what we think we're delivering is being delivered, to the dosimetrists who plan the radiation to radiation therapists who are the ones front and center delivering the radiation, and then our trustee nurses to ensure that, you know, when folks are finishing or going through treatment courses, they're tolerating it well and we're addressing things as it comes up.

Host: Yeah, that's awesome. Teamwork is always one of the common threads when I host these for Summa. A lot of multidisciplinary teamwork, and I know Summa really prides itself on, you know, these teams of experts working together and really serving the community, you know, in every way possible. And we've talked about the advancements and all that, and I'm sort of geeking out over it a little bit, but let's talk about patient outcomes. How are they?

Dr. Anand Desai: Yeah. So, they're improving. So, we know that more people yearly are surviving cancer. And we're in some instances able to turn cancer into a chronic disease, like you would think of diabetes or high blood pressure, something people are living with and alongside with, rather than succumbing to. Certainly, there's difficult cases at times as well. But all in all, compared to even, I would say 10 years ago, outcomes are much better.

Host: I mean, that's just incredible that patients now, some of them anyway, maybe even many of them are sort of living with cancer, are managing cancer and not dying from it. I mean, it just must make you look forward to going to work, right?

Dr. Anand Desai: it's definitely rewarding. I think the other piece to radiation is, when you look globally, probably about 50-60% of patients will have a course of radiation in their journey. And some of that is what we call definitive or curative, and the intent is to wipe out every single cancer cell in them and get them to that cured stage.

But I think sometimes, a rewarding aspect of radiation oncology is the ability to palliate symptoms. So, some folks, our goal is not necessarily curative, but our goal is to get them comfortable and feeling good. Radiation has been used for, again, decades to help people with bone pain or breathing difficulties quite effectively. So, yes, it's rewarding through the whole gamut of a patient's cancer journey.

Host: That's great. This has been really educational. There are some that I get a little more excited about than others. And I saw radiation therapy. I was like, "Yes!" That's the sci-fi fan in me, of course, but it's so amazing. And we talked about the quality and safety and, you know, just how safe and effective it is. All good stuff. As we wrap up, doctor, any last thoughts, takeaways. When it comes to this, if someone's been diagnosed with cancer, brain, prostate or otherwise, and they're facing radiation therapy, what would you want them to know?

Dr. Anand Desai: I think it's very important to sit down and talk with your radiation oncologist. I think a lot of folks may come in with some idea of a distant relative or someone years ago had an experience and I would say that it's important to not discount what today has available for folks and sit down and really piece through what options are available because there's probably more than you realize.

Host: Yeah, I'm certain that there is. And you know, I sort of host these for a living and I'm always amazed. I almost always end up shaking my head thinking, "Well, that's amazing. There's another thing that I didn't know." So hopefully, listeners feel the same way and they're nodding their heads. Doctor, thanks so much. You stay well.

Dr. Anand Desai: Great. Thank you, Scott.

Host: And for more information on radiation therapy, go to summahealth.org/cancer. And if you found this podcast to be helpful and informative, please share it on your social channels and be sure to check out the full podcast library for additional topics of interest. This is Healthy Vitals, a podcast from Summa Health. I'm Scott Webb. Stay well, and we'll talk again next time.