Radioisotopes are used in the branch of nuclear medicine to convey information on the operation of a person’s organs, or to treat specific diseases. Most of the time, radioisotopes are used by physicians and other scientists such as chemists, to make a quick and precise diagnoses of the patient’s illness. The bones, heart, and thyroid can easily be viewed or imaged with the use of radioisotopes in medicine. Additionally, in some cases radioisotopes can be used to treat diseased organs or even tumors. This treatment is expended in most forms of cancer.
Over 10,000 hospitals worldwide use radioisotopes in medicine. Approximately 90% of all procedures are for diagnoses. The most popular radioisotope for diagnoses is technetium-99, used for roughly 40 million procedures on a years scale, accounting for a total of 80% of all nuclear medicine procedures. Techetium-99 is a strong choice for diagnoses, because it emits only beta particles and not gamma rays. This causes minimal amounts particles infiltrate too far into the human body, as beta particles do not contain the persistence.
However, technetium-99 does have a rather large half-life of 211,00 years. Still however, it is more or less safe, as it only emits beta particles. The isotope is capable of evaluating the medical condition of the heart, lungs, kidneys, liver, the spleen, bones, and can conduct general blood flow study. (http://www. worldnuclear. org/info/Non-Power-Nuclear-Applications/Radioisotopes/Radioisotopes-in-Medicine/) Diagnostic techniques within nuclear medicine use radioactive tracers. These tracers emit gamma rays from within the body.
The tracers are generally short-lived chemical compounds, which allow specific physiological processes to be destroyed. The tracers can be given to the subject by injection, inhalation, or orally. Initially, photons are detected by the ‘gamma camera’, which has the ability to view organs from a variety of different angles. The camera then gains images signifying which radiations are emitted from various organs. The images are then enhanced using computers, and are further analyzed by a physician, taxing to find any indications of abnormal conditions. A malignant brain tumor is a cancerous growth within the brain.
A tumor is a mass of cells that hold the capability to reproduce themselves in an unrestrained manner. The tumor can either be benign, or malignant. Benign brain tumors contain masses of cells that grow slowly, and do not usually spread. Malignant brain tumors on the other hand, have the ability to reproduce abnormally, and grow quickly. As a result, malignant brain tumors are considerably difficult to remove without damaging other areas of the brain itself. Many medical doctors, physicians and chemists have devoted their lives to finding a suitable cure, a treatment for this cancer.
Charles Wilson, founder of the Brain Tumor Research Center (BTRC) in Tulane University, Louisiana, was one of the original pioneers for research of the malignant brain tumor. There were many instances where Wilson believed he had found the grand solution, however, this never turned out to be so. One of the treatments Wilson discovered was chemotherapy; a research that originated from medical observations of soldiers, that were exposed to lethal sulfur mustard during the First World War. By the year 1950, injections of nitrogen mustard were being used in some practices as a treatment for brain cancer, and other malignancies.
Nowadays, chemotherapy is approached in a much more diverse manor. Chemotherapy uses drugs to kill the tumor cells within the brain. Chemotherapy drugs can be taken orally in the form of a pill, or can be injected into a vein. However, the chemotherapeutic drug which is most often used in the case of malignant brain tumors is known as temozolomide. This drug is taken in the form of a pill. There are numerous chemotherapy drugs available, and may be used depending patient’s form of cancer. The function of chemo therapy drugs is to kill the cells that are reproducing.
As a result, the drugs are capable of killing healthy cells alongside the cancerous ones. This is why treatment of chemotherapy, is not necessarily referred to as a cure. Today, chemotherapy is one of the world’s most viable options for a patient suffering from brain cancer; however, it comes with a number of side effects. Patients often undergo lowered resistance to infection (neutropenia); meaning lowered immunity, and greater chance of infection and fever. Patients also encounter anemia (low number of red blood cells), as the chemotherapeutic drugs kill them.
Additionally, patients experience bruising, bleeding, nausea, and hair loss or thinning. This being said, most can agree that chemotherapy is definitely not a cure, but a viable treatment. Radiation therapy uses energy beams, such as x-rays, or gamma rays, to kill tumor cells within the brain. Radiation therapy can originate from an external machine (external beam radiation), or from within the body, however, this is not a commonly done practice. External beam radiation is capable of focusing on just a specific area in the brain, or on the brain as a whole depending on the patient’s situation.
Generally, if the tumor is malignant, the entire brain undergoes radiation, as the cells are capable of multiplying at extremely high rates. Whereas on the other hand, benign brain tumors tend to grow slowly, causing the external beam to be focused on only the tumor. But how does radiotherapy work exactly? The use of radioisotopes is immense in radiation therapy. These isotopes emit gamma rays that are able to infiltrate the patient’s body, and kill the cancerous mass of cells (the tumors). As explained, the gamma beams can be directed towards the brain as a whole, or a specific area.
In the case of malignant brain tumors, the radioisotope Cobalt-60 is primarily used (Cobalt-60 therapy). Cobalt-60 consists of a half-life of approximately 5. 3 years. The Cobalt-60 particles should last for around eight to ten half-lives, depending on the quantity used during treatment. During treatment, approximately 200 beams of gamma radiations are targeted towards the patient’s brain tumor. Once the oncologist can identify that the desired mass of cells have been killed, the treatment is ended. Treatments can take from several minutes, to several hours to complete.
Cobalt-60 therapy is painless. Those who are treated with this form of therapy, tend to have fewer side effects than those who are treated with conventional radiation therapy. However, there are some minor side effects, including fatigue, scalp irritation, and headaches. With this being said, one can also agree that radiation therapy, along with chemotherapy, is not a cure, but a viable treatment. Radiation therapy and chemotherapy both have benefits. The treatments share a common goal; to kill masses of cancerous cells. However, they are done by different means.
Radiation therapy is accomplished using radioisotopes that attack the malignant brain tumor using beams of gamma rays, usually given off of Cobalt-60. On the other hand, chemotherapy (chemical therapy), uses the chemicals Cyclophosphamide, Methotrexate, and 5-flourocouracil to attack malignant brain tumors. In the end, they both have the same function, and goal. The only important thing that differs between the two is the side effects. The side effects of chemo therapy tend to be much harsher than that of radiation therapy.
This is mainly due to the fact that chemotherapy is exceptionally destructive, and kills both healthy and cancerous cells. On the other hand, oncologists are capable of directing the gamma rays towards only the tumor, by means of radiation therapy. This leads to say that in most cases, radiation therapy is more effective than chemotherapy, as it efficiently kills cancerous cells, with minimal destruction of healthy cells, thus causing fewer side effects. Many patients, who suffer from brain cancer and other related diseases, undergo excessive amounts of pain and stress.
In some instances, this escalates to a point in which patients cannot bare life anymore. At this point, patients can ask for a mercy death (death by choice due to pain or suffering); however, this only applies in select countries, depending on policies. During a mercy death, doctors of medicine are consulted by the patient. After this is completed, the patient is given a lethal injection that kills them. However, mercy killing is looked down upon in numerous nations. This is because it is practically murder. Most believe that all human beings have the right to survive, till the very end of their potential.
Others believe that they should not be able to make such a decision in an ill state of mind, and that generally, mercy killing is not ethical. In some cases, the doctors of medicine who conduct the mercy killing are charged by court, for murder. However once again, in most scenarios, they are able to win their case, as it is generally done with the patient’s consent. Just in 2002, patient Haley Bloomberg diagnosed with malignant brain cancer; stated after seven years of treatment that she has a right to die. Haley Bloomberg was consensually killed on March 25th 2009. Is mercy killing ethical?
This is a rhetorical question; it can’t be answered. Brain metastases occur frequently in cancer patients and can lead to neurological complications that result in decreased quantity and quality of life. Treatment alternatives include whole-brain radiation therapy, neurosurgery and the newest modality, stereotactic radiosurgery (SRS). This article reviews economic evaluations of SRS in the metastatic setting compared with other treatment options. Studies were included if they were published in peer-reviewed journals, primarily focused on patients with malignant brain metastasis and included a cost analysis between interventions.
Uncertainty surrounding the cost-effectiveness of SRS is due to a lack of efficacy information between treatment alternatives, methodological limitations and design differences between the available studies. When cost-effectiveness ratios are available, SRS appears to be a reasonable option in resource-limited settings, with incremental cost-effectiveness ratios just below the US$50,000 range. However, better-designed economic analysis in the setting of randomized clinical trials or observational studies needs to be conducted to fully understand the economic value of SRS.