Stereotactic Body Radiotherapy (SBRT)

Stereotactic body radiation therapy (SBRT), also referred to as stereotactic ablative radiation therapy (SABR), is an advanced cancer treatment method in Singapore used to treat small, well-defined tumours in the body. It can be used to treat both primary and metastatic (sometimes referred to as secondary) tumours.

The specialised technology delivers multiple, highly-precise radiation beams to the tumour accurately. This is made possible with the use of advanced imaging technology (e.g. CT scans, PET scans, MRI scans) to identify the precise location of the tumour.

Due to the larger dosage, treatments can be completed within 3 to 5 sessions. Each daily session usually takes no longer than 20 minutes. This cancer treatment is done on an outpatient basis, and patients can resume normal activities thereafter.

Benefits of SBRT radiotherapy

Conventional radiation therapy is typically administered in relatively small doses over several weeks. This can delay or interfere with other cancer treatments, such as chemotherapy. Conversely, SBRT radiotherapy can generally be completed within five or fewer daily sessions. As a result, doctors and patients need not worry about the procedure interfering with the other planned cancer treatments. Furthermore, patients do not require anaesthesia for this treatment. Overall, SBRT radiotherapy can result in better outcomes and fewer side effects for patients compared to conventional radiation therapy.

Risks of SBRT radiotherapy

There are usually fewer side effects with SBRT radiotherapy compared to conventional radiation therapy since only a small area of your body is exposed to radiation. Moreover, these effects are often temporary.

After you are done with your SBRT radiotherapy, you may experience fatigue and skin issues, such as redness, swelling, and itching around the treatment site. Additionally, you may experience side effects specific to your treatment site.

Lung

• Cough – You may develop a dry cough after the procedure due to inflammation of the lung from radiation.
• Shortness of breath – You may experience shortness of breath after the treatment due to inflammation of the lung from radiation.
• Chest wall pain – You may notice pain in the chest wall or ribs after the procedure due to inflammation of the nerve endings in the chest wall.

Prostate

• Urinary irritation – You may need to visit the toilet frequently after your treatment sessions due to urinary irritations.

Liver and pancreas

• Nausea and diarrhoea – You may experience nausea or diarrhoea after your treatment. This is a common side effect, as the liver is sensitive to radiation.

If you are experiencing prolonged side effects from the cancer treatment, you should speak to your doctor immediately.

Treatment and recovery

After the cancer treatment, your doctor will instruct you on how to care for any potential side effects from the SBRT radiotherapy, depending on the treatment site. The doctor will then schedule a follow-up session to assess your response to the cancer treatment and monitor and treat any delayed side effects from the procedure.

Aftercare

To aid in your recovery after your SBRT radiotherapy, we recommend getting as much rest as possible and maintaining a healthy diet. Furthermore, you should avoid sun exposure as much as possible. If you are encountering any side effects from the cancer treatment, you should talk to your doctor immediately.

Consenting to radiation therapy 

At our oncology centres, we understand that the healing journey to overcome cancer can be emotionally and physically straining for patients and their caregivers. Therefore, our doctors strive to provide patients with a holistic care environment. We will provide a thorough analysis of your condition to determine the best course of action. In some cases, radiation therapy will be recommended as a standalone procedure or in combination with other treatment plans like chemotherapy or surgery.

However, every radiation therapy procedure, including SBRT radiotherapy, carries inherent risks and side effects. Therefore, it is essential for patients and caregivers to have a basic understanding of the treatment programme. This is why we often encourage patients to seek a second opinion and consult a radiation oncologist to learn about the procedure before consenting to the treatment plan. 

Before the patient decides to undergo radiation therapy, they will schedule an appointment with a radiation oncologist to begin the treatment planning process. The oncology doctor will first recommend that the patient undergo a scan to locate the tumour site. With this information, the radiation therapy team can identify the exact treatment area, the optimal dosage required, and the safest way to administer the treatment. Once the tumour has been located, the team will indicate the area with a skin marking.

In addition to skin markings, patients may be asked to undergo mould casting. The body mould is designed to keep the patient still during treatment. As facial and body hair can interfere with the mould casting process, patients may be asked to trim their hair before the procedure.

Patients will also be asked to sign a consent form prior to treatment to grant the oncology doctor permission to administer the treatment. It is essential for patients to have a thorough understanding of the procedure before consenting. Staying informed can help them feel in control of their condition. Moreover, it is crucial for patients to be aware of the risks associated with the available treatment plans. This way, they can weigh their options and make an informed decision.

If you have received a diagnosis, we recommend scheduling an appointment with your oncology doctor as soon as possible to have detailed discussions about what the recommended treatment entails. Here are some questions to ask your oncology doctor during the consultation.

Questions to ask your doctor about radiation therapy

Before radiation therapy

1. 1. What are my treatment options? Why radiation therapy in particular?
2. 2. How is the treatment method expected to help me?
3. 3. Are there any options besides radiation therapy?
4. 4. What type of radiation therapy is recommended for me?
5. 5. How many treatment sessions will I need?
6. 6. What are the side effects of radiation therapy? Does the treatment hurt?

During radiation therapy

1. 1. Will the treatment make me radioactive?
2. 2. Do I need to take any precautions during treatment?
3. 3. Do I need to undergo a special diet?
4. 4. What happens when I miss a treatment session?

After radiation therapy

1. 1. How would I know if the treatment is successful?
2. 2. What are the chances of a recurrence?
3. 3. Do I require follow-up appointments after treatment is completed?

In addition to these questions, we have also shared a list of common questions patients may have about SBRT radiotherapy. We hope this FAQ guide can shed more light on what to expect from this treatment procedure.