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The Methodist Center for Restorative Pelvic Medicine
6550 Fannin Street
Houston, TX 77030
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The Methodist Hospital provides excellence in caring for our cancer patients – before, during and after treatment. The effects of radiation can be difficult to cope with and patients require care beyond their therapy. One of the services at The Methodist Hospital is post radiation injury care.
When radiation passes through the body to kill damaged or cancerous cells, it can also damage healthy cells by destroying the chemical compound. Ionizing radiation (IR) can tear atoms and molecules apart causing what we call radiation injury. Any person can be exposed to IR just by stepping outside in the sunlight, by X-ray machines and, less commonly, by radioactive elements.
There are numerous sources of radiation to be aware of:
- Therapeutic – Radiation applied to the diagnosis and treatment of cancer
- Natural – Exposure to sunlight and cosmic radiation
- Intentional – Exposure is rare and related to use of nuclear weapons such as hydrogen and atomic bombs
- Accidental – Exposure within a controlled area such as a laboratory by mistake (when radioactive elements are accidentally spilled)
When physicians assess radiation damage there are a number of factors to consider:
- Type of radiation exposure
- Proximity of source of the radiation exposure
- Extent of the exposure
The range of damage can be anywhere from a mild sunburn to severe damage resulting in death. It is very unlikely any patient receiving radiation therapy as part of a cancer treatment would be exposed to a radiation element leading to death. For nearly every patient that decides to undergo radiation therapy, the benefit of the exposure greatly outweighs the potential risks. More than 60 percent of cancer patients will undergo radiation therapy, or radiotherapy, to prevent cancerous cells from spreading throughout the body. It has been proven to only to reduce symptoms but to also to stop or slow the growth of cancer.
Cancer begins when cells from organs or tissues grow out of control and form a tumor. These cells will eventually displace normal healthy cells in the body causing the disease. When tumors spread to other areas of the body, rapid cell growth can occur. Radiation therapy is a common technique of treating cancer. It is estimated that over 60 percent of cancer patients will undergo some kind of radiation therapy, either externally or internally.
Although the technique is remarkable in reducing the symptoms and effects of tumors, the radiation energy that impedes the growth of cancer cells can also affect normal tissue and hinder wound healing, resulting in a longer recovery time; and some incisions may not heal at all. Standard radiation treatments of gynecologic, urologic and soft tissue tumors have included radiation therapy. As a result, irradiated, chronic open wounds of the pelvic, perineal, or genital areas are not uncommon among patients who have received radiation therapy. Radiation also affects the blood vessels near the wounds and interferes with the delivery of antibiotics; therefore infection is difficult to treat.
A skin flap is used to treat irradiated wounds. The flap can be transported to the wound and survive on its own blood vessels, which will bring additional nutrition and antibiotics to the damaged wound. The irradiated wound has a better chance of healing using this technique verses using a skin graft for coverage since blood vessels cannot grow in the area. The muscle or skin flaps are generally harvested from the abdominal wall, the buttocks area and the thighs to cover wounds in the pelvic region. Other areas for muscle flap harvesting are the abdomen, the gracilis (a muscle near the thigh) and the gluteus muscles.