40% of cancer patients receive radiotherapy, a treatment closely associated with oncological processes which, however, has other, still largely unknown, uses. Ionizing radiation is also effective in benign pathologies, such as some non-cancerous tumors. And, in very low doses, radiotherapy has an anti-inflammatory and anti-proliferative effect that can be beneficial against inflammatory and degenerative diseases.
The Spanish Society of Radiotherapy Oncology (SEOR) has created the Benign Pathology group, which aims to publicize, implement and develop the use of radiotherapy in non-oncological processes. "The application is very diverse in both inflammatory and hyperproliferative and functional processes, with a high degree of effectiveness that substantially improves the quality of life of patients", he says. The alternative is widely used in countries such as Germany, where 20% of radiotherapy treatments are for benign processes, Switzerland or Great Britain, but in Spain it is quite incipient, although it is in the process of expansion.
According to Albert Biete, professor emeritus of the Faculty of Medicine of the UB, former head of the Radiotherapy Oncology service at the Clinic and now linked to Atrys Health, the lack of equipment and waiting lists for oncological treatments have slowed down until recently the development of radiotherapy for non-cancerous diseases. "Fortunately, we now have a good supply of linear accelerators and we have practically no waiting lists, so we have been able to start touching on these issues", he explains.
Radiation is indicated in inflammatory diseases such as fasciitis and tendinitis, in degenerative joint pathologies. It is also applied in non-cancerous tissue growths, such as heterotopic ossification of the hip. In the case of degenerative processes it acts on inflammation, reduces pain and facilitates mobility, and in the case of inflammatory diseases it acts on the cause.
"Trochanteritis (pain located on the side of the hip), for example, mostly affects women over the age of 60. In eight out of ten treatments there is a significant improvement in pain, which in half of the cases is maintained after five years", says Biete. But radiation is not for everyone, but the last option: "They send us patients who no longer know what to do after going through the traumatologist, the rheumatologist, the anesthetist... who have undergone physiotherapy, infiltrations, and that they have taken drugs".
Despite the fact that the radiation doses are very low (a total of 3 to 6 grays in several sessions, when a lung cancer requires 60 grays in doses of 2 grays per session) and for this reason no side effects have been described (skin effects , tumor induction), the treatment is not indicated for young people.
The average age of Dr. Biete's patients is almost 70 years old, and the therapy can prevent them from consuming anti-inflammatory drugs or corticosteroids, which, at these ages, can be poorly tolerated.
Even without cancer, the linear accelerator commands respect. "Some patients come very scared, and you explain to them that the machine is the same, but it has nothing to do with cancer", says the doctor.
At Clínic de Barcelona, between 20 and 25 radiotherapy treatments are performed annually for benign diseases on patients who have exhausted all previous treatments. Despite the fact that in Germany there is a long tradition of irradiating in inflammatory or degenerative diseases and that, in low doses, anti-inflammatory effects are produced, it is difficult to evaluate the success of the option, explains the head of Radiotherapy Oncology at the Clinic, Meritxell Mollà. In his opinion, the placebo effect is not discriminated enough. "It's not that I'm saying it shouldn't be done, not by a long shot, but more well-designed studies are needed to see the effects on patients, and that's very expensive."
