Dr. Ashok Ramalingam, MD

EBRT can be delivered through several different methods, which may be combined or used alone. The type and length of treatment vary based on the location of the cancer or tumor and its size. Techniques for EBRT include:

• Conventional external beam radiation therapy, which delivers a single beam of radiation from multiple directions. Conventional EBRT is commonly used to treat brain tumors, particularly when the entire brain needs treatment.
• Intensity-modulated radiation therapy (IMRT), which uses smaller beams with adjustable intensity levels, so the most intense beams can be directed at the tumor. IMRT is used in several types of cancers, including prostate, gastrointestinal, brain, and lung cancers.
• Orthovoltage, which uses low energy X-rays that do not penetrate the skin very deeply. Orthovoltage is typically used for skin cancers or other skin conditions.
• Proton therapy, which uses a particle accelerator to deliver positively charged particles (protons) for cancer treatment. Proton beams can be controlled more precisely than X-rays, so there is less risk of damage to healthy tissue. This makes proton therapy a good option for younger patients, as other types of EBRT pose long-term risks such as growth problems and heart disease.
• Stereotactic radiosurgery (SRS), which is a non-surgical type of radiation therapy that uses 3-D imaging to directly target tumors and avoid healthy tissue. SRS is often used for small tumors, particularly those in the brain (cranial radiosurgery) and spine (spinal radiosurgery). When performed outside of the brain and spine, it is called stereotactic body radiation therapy (SBRT).

Typically, patients will undergo treatment for five days a week over the course of several weeks, and they should be able to go home the same day. Each session can take less than an hour, with most of the time spent determining proper positioning of the body. Actual delivery of the radiation may only take a few minutes, and patients will wear a lead shield to protect healthy body tissues while receiving their treatment.

EBRT is painless, but it does come with some side effects, such as fatigue. Over the course of the therapy, oncologists will monitor patients' conditions and adjust their dosage, number of sessions, and length of treatment based on their body's response to the radiation.

Asthma is a chronic disease where swollen, inflamed airways make it hard to breathe. It is often brought on by specific triggers. While asthma is a common condition, affecting millions of people, it can also be serious and even fatal in severe cases. Treatment involves avoiding triggers and using inhaled corticosteroid medications.

COPD, or Chronic Obstructive Pulmonary Disease, is the name given to two illnesses that both cause difficulty breathing: emphysema and chronic bronchitis. In emphysema, the air sacs of the lungs become damaged, while with bronchitis they become clogged with mucus. COPD is the fourth leading cause of death in the United States. It is almost always caused by breathing irritants into the lungs, such as smoking or heavy pollution.

Pneumonia is a lung infection that can be caused by bacteria, a virus, or fungi. Most healthy people recover from pneumonia in a week or two, but for some people pneumonia can be fatal. There are treatments available for pneumonia, but the best treatment is to prevent getting sick in the first place. People who are at risk should make sure they get a flu shot every year. There is also a vaccine available for the type of bacteria that causes pneumonia.

Lung cancer occurs when abnormal cells inside the lung grow into a tumor, destroying healthy tissue. Because it is so difficult to detect lung cancer in early stages when it has few symptoms, it is the deadliest form of cancer, responsible for the most cancer deaths both in the U.S. and worldwide. Most lung cancer is caused by exposure to tobacco smoke, but between 10-15% of cases are not linked to smoking.

Some problems with the lungs are minor and are not cause for concern. However if symptoms have lasted for a month or more, even if they are minor, it is worth checking with a healthcare professional. A cough, shortness of breath, or excess mucus production that lingers for weeks are all worth getting looked at.

Hashimoto's is the leading cause of hypothyroidism, which is when the thyroid does not produce enough hormones to stimulate adequate metabolism. The condition is diagnosed by blood tests that measure TSH (thyroid stimulating hormone) and detect Hashimoto's antibodies. Symptoms of hypothyroidism include sluggish metabolism, inflammation, fatigue, weight gain, brittle hair, dry skin, and sensitivity to cold. To supplement impaired thyroid function, patients with Hashimoto's are typically prescribed synthetic thyroid hormone pills. Such patients may need to consume synthetic thyroids for the rest of their lives. Other treatments may include dietary changes, such as the avoidance of certain foods and medication to reduce inflammation. Frequent blood tests can inform patients if their TSH levels are within a normal range.

Grave's disease is most frequently the cause of hyperthyroidism, which is when the thyroid produces too many hormones, overstimulating one's metabolism. The condition is also diagnosed by blood tests that measure TSH and detect Grave's antibodies. Elevated heart rate, high blood pressure, sweating, bulging eyes, and weight loss are common symptoms of hyperthyroidism. Treatments for hyperthyroidism include oral radioactive iodine, which slowly shrinks the thyroid, slowing the production of excess thyroid hormone. Other anti-thyroid medications such as methimazole (Tapazole) also reduce the production of thyroid hormones. Blood pressure medications known as beta blockers can ease the increased heart rate caused by hyperthyroidism. If treatments are unsuccessful, patients may be prescribed a thyroidectomy, or surgery to remove part or all of the thyroid. Some patients with hyperthyroidism may require ophthalmological (eye medicine) treatments such as eye drops, prednisone, and surgery to reduce eye swelling and bulging.

Untreated thyroid disorders frequently lead to goiters or thyroid nodules. A thyroid goiter is a large lump that can be felt near the base of the neck and is made of swollen thyroid tissue or nodules (excess cell growth). Nodules and goiters are diagnosed by CT scan or ultrasound. Obstructive goiters can cause pain, coughing, and abnormal breathing. The most common cause of goiters is hyperthyroidism (overactive thyroid). However, Hashimoto's is also known to cause goiters or nodules. Goiters develop from continued damage from antibodies to the thyroid over time. At times, a goiter can result from a cancerous thyroid tumor. Most goiters and nodules are themselves benign.

The exact causes of thyroid cancer are unknown. People who develop thyroid cancer may or may not have another thyroid problem such as Hashimoto's or Grave's disease. Symptoms of thyroid cancer include a nodule that can be felt on the neck, hoarseness, difficulty swallowing, swelling in the neck, and neck and throat pain. CT and MRI scans are used to diagnose thyroid cancer. There are four types of thyroid cancer which vary in intensity. Thyroidectomy (thyroid removal surgery) is usually prescribed to treat thyroid cancer.

Thyroid problems are often long-term conditions that require some form of treatment. With regular monitoring and medication, many people with thyroid problems are able to lead active and fulfilling lives.