Radiation causes damage, short and long term, and has risks of other complications. So why choose it? Mainly because Cancer kills people. Radiation can kill cancer cells. Given a choice, most people would probably prefer to be alive, with damage that they could live with, or face years later. 

And radiation does not only save lives from cancer, it can lengthen survival time, decrease pain, and prevent amputations. 

<b>For Leiomyosarcomas, surgery is almost always the best therapeutic choice, as well as the chance for cure.</b> But in situations where the tumor is inoperable, radiation can be used to shrink it, so the tumor can be surgically removed. 

For brain tumors, focused radiation as in the 'gamma knife' or proton beam offers a chance of tumor control, or even of killing the tumor completely. 

In certain selected instances, radiation might be used against other metastases as well. 

In some situations, when a primary or recurrent tumor is removed, use of radiation might increase the time to next recurrence.
 
When surgical resection does not leave clear margins, radiation therapy might kill the cancer cells left behind.
 
But radiation has its longterm consequences, as well as the short term ones. The tissues that are exposed to radiation are usually not just the cancer. All of the organs around the tumor and in the path of the radiation can be damaged by radiation aimed at the tumor. Some of the longterm consequences can be very serious. It is one of the purposes of this web page to help people understand some of the problems that could develop. This treatment modality can be effective, but is not without risk. And awareness of possible long term complications of radiation may make it easier for cancer survivors to notice the complications sooner, with possibly better outcomes and less suffering.  Furthermore, the use of protectants [like amifostine], or radiation sensitizers could, perhaps, ameliorate some of the effects on normal tissue and intensity the effects on the cancerous tissue. 

The type of radiation will also make a difference to the amount of damage done to surrounding normal tissue, and other risks as well.  If it is at all possible, proton beam radiation is the treatment of choice for treating tumors or clearing up dirty margins.  Proton beam radiation can be calibrated to "drop" most of its energy in the target area.  While the normal tissues on the way in are exposed, proton beam radiation is sparing of skin, and does not penetrate the tissue beyond the target.  

There are currently three proton beam facilities that treat metastatic disease, Loma Linda in California, the University of Indiana, and Massachusetts General Hospital in Boston.  They may decide not to take someone with extensive disease.  In which case, IMRT, stereotactic radiosurgery, or the gamma knife, are all relatively concentrated Xray beams that try to spare normal tissue.

There is also the possibility of using radioisotopes directly into excised tumor beds, or as Sirspheres, into the capillaries that feed the tumor.  

High energy neutrons have also been successful at dealing with large LMS tumors.

It is worth discussing the different types, and perhaps making the effort to go to another facility, rather than just accept whatever is available at the hospital where you are being treated.  
