Eli5 How does radiation therapy actually work? Like how doesnt it break down more of the body and make the cancer worse or something like that? And does it target only cancer area or everything?
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Modern radiotherapy takes several forms including the gamma knife and proton beam. These advanced forms can really target the tumor much much more than the surrounding healthy tissue. Even with older kinds of radiotherapy the beam path is divided into multiple less energetic beams which intersect in the tumor and reduce damage to healthy tissues.
Whichever type is used the radiation fragments the DNA of the cells, with cells that are rapidly dividing and those that have reduced ability to repair their DNA (both features of cancer) being more susceptible.
Ultimately the immune system plays a significant role in mediating the response to radiotherapy. The radiation-induced damage causes cells to be stressed, and allows them to be recognized by the immune system, especially by NK cells which can help induce broader immune responses to cancer.
Just occasionally the immune system does such a good job after being alerted to the tumor by radiotherapy that tumors everywhere including those that never were irradiated shrink and disappear. On rare occasions the patient is cured.
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