Are we demeaning whole brain radiation in pursuit of portraying superiority of newer molecules?

Radiotherapy, with its colloquial use, is widely known to be painful and to cause damage to the skin by burning or scarring. This has led to fear, anxiety and aversion among many patients to proceed with radiation many times. Even doctors and oncologists from other specialities sometimes fear the side effects of radiation and do not want to subject their patients to the perils of the treatment and hence, put the patients on some other form of treatment that might be less effective or more expensive. Radiation, however, is a very effective treatment for various cancers with a very tolerable toxicity profile when done at an experienced centre under the supervision of an experienced and properly trained radiation oncologist. In this modern era when everything is technologydriven, radiotherapy also has improved by leaps and bounds with modern linear accelerators having utmost precision being widely available for treatment. Radiotherapy plays a crucial role in the treatment of various head and neck malignancies, brain tumours, gynaecological malignancies, lung cancer, breast cancer, palliation of skeletal and brain metastases and many more. Apart from achieving palliation, radiation can also decrease the disease burden or at least stabilize it. Achieving adequate local control is also important on many occasions to provide a better quality of life. It is important to understand that even for widespread metastatic disease, the end of life should be respectful, and the way of dying should also be socially and emotionally acceptable both to patients and caregivers. For example, controlling raised intracranial pressure or symptoms arising out of brain metastases should be important in terms of providing a better quality of life.