Ionising radiation: both cure and cause of cancer

Ionising radiation is a two-edged sword with respect to cancer. On the one hand it is successfully used for treating malignant tumours; on the other hand it is a well-known carcinogen.

Photo credit Madanelu, used under Creative Commons licence (CC BY-NC-ND 2.0)
Photo credit Madanelu, used under Creative Commons licence (CC BY-NC-ND 2.0)

During the last decades the life expectancy for many cancer patients has increased due to improvements in both early detection and therapy methods and therefore late effects become a matter of concern for the long term survivors of cancer therapy. Radiation-induced cancers are increasingly mentioned among these concerns, albeit they are still regarded as the inevitable price for success of modern radiation treatment. However, a broad array of treatment techniques and equipment, including heavy ions and protons, are nowadays available which are capable of delivering variable, but therapeutically isoeffective dose distribution patterns to tumours and healthy tissues. Hence, including the aspect of cancer risk in the treatment optimisation process is possible and becomes increasingly important. Nevertheless, major concerns are uncertainties about the level of risk from modern techniques, the lack of appropriate control groups in epidemiological studies, insufficient knowledge about mechanisms of cancers induced by radiotherapy, including the influence of reverse causation, and the lack of data about the relationship between cancer-inducing genetic effects and cell killing in tissues receiving fractionated radiation doses and dosimetric uncertainties.

A workshop on the the risk of secondary cancer following radiotherapy, will take place in Stockholm on the 8th and 9th of September 2016. Iuliana Toma-Dasu of the Medical Radiation Physics at the Physics department is one of the two organisers together with Prof. Andrzej Wojcik, from the Centre for Radiation Protection Research, MBW Department, Stockholm University.

This workshop aims to revisit the Janus-faced nature of radiotherapy with respect to cancer from a multidisciplinary perspective. It will address the four pillars on which the study of the risk of secondary cancer stand: Epidemiology, Radiobiology, Dosimetry and Mathematical Modelling. Each of these will have a dedicated session complemented by discussion sessions merging the different perspectives. We hope that the workshop will generate new ideas and approaches to estimate the risk of secondary cancers leading to a safer use of radiotherapy.

For more information and the detailed program see the webpage: www.crpr-su.se/smn.

Reference list:

1. Alexandru Dasu and Iuliana Toma-Dasu
Long-term effects and secondary tumours Comprehensive Biomedical Physics 2014 223-233
2. Irena Gudowska, Oscar Ardenfors, Iuliana Toma-Dasu and Alexandru Dasu
Radiation burden from secondary doses to patients undergoing radiation therapy with photons and light ions and radiation doses from imaging modalities Radiation Protection Dosimetry 2014 161(1-4):357-62
3. Oscar Ardenfors, Dan Josefsson and Alexandru Dasu Are IMRT treatments in the head and neck region increasing the risk of secondary cancers? Acta Oncologica 2014 53(8):1041-7

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