When fighting cancer, it's normal to feel a little scared and nervous when you hear the word 'radiation therapy'. However, when you hear the word 'radiation to the whole body', that fear can be even greater. But the Total Body Irradiation (TBI) we're talking about today, if understood correctly, can be a very important and safe step in your treatment journey. So let's find the answers to all your questions about it, shall we?
What is Total Body Irradiation (TBI)?
Simply put, this is also a type of radiation therapy. But it's not like other radiation treatments. Instead of typically targeting a high dose of radiation to just the tumor, TBI delivers a very low dose of radiation to the entire body in a controlled manner.
Think of it like preparing the soil in your entire garden by adding a little fertilizer, not just pulling out a few weeds. The main goal of this is to prepare you for the next big step in treatment, which is a bone marrow transplant or stem cell transplant.
Why do you need this treatment?
There are several main reasons why your doctor may recommend this treatment.
- Destroy cancer cells: This helps destroy cancer cells that are hidden in hard-to-reach places, especially in the bone marrow and nervous system.
- To make room for a bone marrow transplant: If you are scheduled to have a bone marrow transplant, this treatment helps reduce the number of old bone marrow cells to make room for new, healthy cells inside your body.
- Control your immune system: For a bone marrow transplant to be successful, your body's immune system must not reject the new cells. This treatment safely controls the activity of that immune system, increasing the chances of the transplant being successful.
What conditions is TBI treatment used for?
Total Body Irradiation is usually given in conjunction with other cancer treatments, such as chemotherapy. Here are some of the conditions that can be treated with it.
| Name of the disease (Condition) | A brief introduction |
|---|---|
| Leukemia | A cancer of the blood and bone marrow. |
| Lymphoma | A cancer that occurs in the lymphatic system. |
| Multiple Myeloma | A cancer of the plasma cells in the bone marrow. |
| Myelodysplastic Syndrome | A disease in which the production of healthy blood cells in the bone marrow is irregular. |
What happens before and during treatment?
Planning before treatment
This is like a rehearsal for a play. Before the actual radiation is given, there is a 'planning meeting' (simulation) to plan everything exactly. At this time, you undergo a CT scan, and the radiation therapist takes the necessary measurements. Your body is placed in a very specific position, and a few small marks are placed on the skin to maintain that position throughout the treatment. These are often permanent, but very small, like a dot in a tattoo.
During treatment
You may need to stay in the hospital for a few days while you receive TBI treatment. Here's what happens during treatment:
- The radiation therapist will position you in the correct position as planned.
- To reduce the radiation dose to certain organs, such as the lungs, special shields can be placed over those areas.
- The radiation therapist will leave the room. You will be alone during the treatment. But don't worry, they will be watching you with cameras, and you can talk to them through an intercom.
- A large machine called a linear accelerator moves around you and delivers beams of radiation.
Typically, a single treatment session can last up to 60 minutes. You may also have the opportunity to do other things during this time, such as listening to music, if you wish. Most people receive this treatment two or three times a day, for three to five days.
Most importantly, this treatment is completely painless . You won't feel any radiation or feel the machine hitting your body.
What are the side effects and risks?
Like any cancer treatment, TBI can have side effects. But these are often manageable. These side effects can vary depending on the number of treatments you receive, the dose of radiation, and your overall health.
| Type of side effect | What to expect |
|---|---|
| Short-term side effects (a few days or weeks after treatment) | |
| Nausea and vomiting | Nausea and vomiting. There are medications to control these. |
| Fatigue | Feeling very tired and exhausted. |
| Hair loss | Hair loss and body hair loss (often temporary) |
| Diarrhea | Flatulence. |
| Skin changes | Itchy, dry, or discolored skin. |
| Decreased blood cells | This can lead to increased risk of infections, bleeding (e.g. nosebleeds , bleeding gums), and iron-deficiency anemia. |
| Long-term side effects (may occur rarely) | |
| Cataracts | Clouding of the lens of the eye. |
| Effects on the ability to have children (Infertility) | There is a risk of infertility. |
| Scarring of the lungs (Pulmonary Fibrosis) | Scarring of lung tissue. |
| Hypothyroidism | Decreased thyroid hormone production. |
Important: While the risk of developing a second cancer after a bone marrow transplant may be slightly increased, it is important to remember that the health risks of not having a transplant are much greater .
How do I take care of myself after treatment?
Managing side effects can make this time easier.
- If you feel nauseous, ask for medicine for it.
- Follow your doctor's advice on skin care. If they tell you to use a moisturizer, be sure to do so.
- Sleep well, and if possible, aim for at least 8 hours of sleep a night .
- Talk about your feelings, fears, and sadness with someone you trust or a counselor.
- After leaving the hospital, if possible, take some time off from work and rest.
What time should I call the doctor?
If you experience anything like this during or after treatment, you should talk to your doctor immediately .
- Symptoms of chills
- Fever without a reason
- Skin changes such as blistering and peeling skin
Take-Home Message
- Total Body Irradiation (TBI) is a special radiation treatment that is given to your entire body at a low dose to prepare you for a bone marrow transplant.
- This treatment is not painful, but there may be short-term side effects (such as nausea, fatigue, hair loss). These can be managed.
- Talk openly with your doctor about your treatment plan, side effects, and any fears or concerns you may have.
- The goal of this treatment is to destroy cancer cells in hard-to-reach areas and help your bone marrow transplant succeed.
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