What Is Radiation Therapy and How Does it Work?
Radiation therapy, sometimes called radiotherapy, effectively treats cancer by using high-energy rays to pinpoint and destroy cancerous cells in your body. Although radiation therapy is similar to having an x-ray taken of a broken bone, the dose of radiation in cancer treatment is stronger and is given over a longer period of time. Many forms of radiation are available. The best choice depends on the type of cancer you have, the extent of the cancer, and its location.
Cancers are growths of abnormal cells. Different types of cancer react to radiation in different ways, so treatments vary. Also, it takes time for the body to get rid of dead cancer cells. After you have completed treatment, months often pass before the tumor is completely gone. With careful planning, radiation can be directed to the cancer and away from most normal tissues. This means you may receive treatment on more than one side of your body or from different angles. You may also need more than one type of radiation, which may require the use of more than one machine.
What are the Benefits and Goals of Radiation Therapy?
Radiation therapy is an effective way to treat many kinds of cancer in almost any part of the body. Half of all people with cancer are treated with radiation, and the number of cancer patients who have been cured is rising every day. For many patients, radiation is the only kind of treatment needed. Thousands of people are free of cancer after having radiation treatments alone or in combination with surgery, chemotherapy, or biological therapy.
Doctors can use radiation before surgery to shrink a tumor. After surgery, radiation therapy may be used to stop the growth of any cancer cells that remain. Your doctor may choose to use radiation therapy and surgery at the same time. This procedure is known as intraoperative radiation. In some cases, doctors use radiation along with anticancer drugs (chemotherapy) to destroy the cancer, instead of surgery. Even when curing the cancer is not possible, radiation therapy still can bring relief. Many patients find the quality of their lives improved when radiation therapy is used to shrink tumors and reduce pressure, bleeding, pain, or other symptoms of cancer. This is called palliative care.
Will Radiation Therapy Make Me Radioactive?
No, during external radiation treatment and after, you will not be radioactive. You can continue to enjoy the same contact with your family and friends as before your diagnosis without fear of exposing them to radiation. Internal radioactive sources, if you need this type of radiation, will be explained in detail by your doctor prior to treatment.
Will the Treatment Hurt When it is Given?
No, the treatments do not hurt. However, the treatment table is firm and can be a little uncomfortable. Over time, you may experience side effects from your treatment. Before you start treatment, your doctor will review with you the potential side effects that you may expect.
Are There Risks Involved?
There are risks for patients who are receiving radiation therapy. The brief high doses of radiation that damage or destroy cancer cells can also hurt normal cells. When this happens, you may experience side effects. The risk of side effects is usually less than the benefits of killing cancer cells. Your radiation oncologist will advise you not to have any treatment unless the benefits (such as control of the disease and relief from symptoms) are greater than the known risks.
Who Administers My Treatment?
Your radiation oncologist, specifies what body site is to be treated and for how long. This includes the amount of radiation you will receive each day and the total number of treatment days. He or she will also manage any medical problems that may develop during your treatment. Each patient under treatment has a scheduled appointment at least once a week with his or her radiation oncologist. If a problem must be resolved outside of this scheduled appointment time, arrangements can be made to meet with the radiation oncologist, PA (physician assistant) or nurse. A Radiation therapist delivers the prescribed treatment and will help you before and after your treatments.
Why Must I Remain Alone During Treatment?
If the radiation therapists stayed in the treatment room with every patient each day, they would receive extremely high doses of radiation over a period of time, thus placing their health at risk. Even though the radiation therapist is not in the treatment room with you, you are not alone. You are always being monitored by video camera and intercom. If you ever need assistance during your treatment, please speak up. The radiation therapist can immediately stop the treatment and attend to your needs.
Will I Be Able to Drive Myself to and from Therapy?
Most patients who are able to drive prior to starting radiation treatments will be able to continue to do so during treatments. Your radiation oncologist will caution you if there is a problem with you driving yourself to and from treatments. It's a good idea to have a backup plan just in case you don't feel up to driving. If you need help with transportation, speak with your radiation oncologist, PA (physician assistant) or nurse so that they can help you with arrangements.
How Often Will I Get Radiation Treatments?
Your treatments will probably be scheduled every weekday, Monday through Friday, allowing you to rest on Saturday and Sunday. Your daily appointment schedule will be as convenient for you as possible. Your radiation therapist will notify you of any holidays on which you will not receive treatments. Your radiation oncologist will examine you and review your progress once a week. This scheduled check-up will take longer than the treatment visits. The PAs (physician assistants) and nurses who see you during the check-up will work closely with you and the radiation oncologist to help you manage any side effects you may have. This is also a good time to request refills for any medications that you may need to manage side effects.
What Should I Do About My Medications?
Tell your radiation oncologist, PA, or nurse if you are taking a prescription or any over-the-counter medicines. He or she will review your current medications, which usually can be continued throughout your treatment. Your primary care physician will still prescribe any medications you are taking for problems other than cancer. You may continue to buy your routine medications at your local drugstore.
What Can I Do to Help Myself While Undergoing Treatment?
- Eat a well-balanced diet every day. Your radiation oncologist, PA, or nurse will discuss all diet concerns at the time of consultation.
- Eat enough food to keep your weight at the same level as before treatment. Your body needs more calories now, so you may need to eat more than usual. Tell your radiation oncologist, PA, or nurse if you lose or gain 5 or more pounds.
- Drink at least 8 cups of fluid every day. Fluids may include water, gelatin, ice pops, iced tea, soup, and milk.
- Drink fluids that are high in calories, such as milk shakes or nutritional supplements if necessary to help keep weight on.
- Try to sleep at least six hours a night, and take naps during the day if possible.
What Can I Expect When I Come for Treatment?
At each radiation therapy session:
- You will be asked to put on a gown or remove some clothes to allow the treatment area marks to show.
- Although the actual treatment will last only a few minutes, you may spend 15 to 20 minutes getting ready. You will be helped onto a treatment table. Your position on the table will be the same for each treatment.
- Once you are positioned, do not move until the treatment is finished.
- After the Radiation Therapist has helped position you on the table, he or she will leave the room, monitor you by closed-circuit television, and be in contact with you through an intercom.
Keep in mind that the treatment machines are large and sometimes noisy while in use. Just relax and breathe normally. You should not feel any pain. If you need something or are in pain, tell the radiation therapist. He or she can turn off the machine immediately and come into the room. The radiation stops when the machine is turned off.
What Are the Possible Side Effects and How Long Will They Last?
Side effects depend on the part of the body being treated. Most go away a few weeks after treatment is stopped. You will receive specific information about the type of radiation therapy you will receive. Some common side effects include:
- Red, itching, and peeling skin in the treatment area. This may occur after a couple of weeks of radiation therapy.
- Fatigue. You may feel more tired than usual. Getting plenty of rest, and not overexerting will help minimize fatigue.
- Loss of appetite. You may not feel like eating. This side effect is common if the abdomen or mouth is being treated. Eating several small meals or snacks (dry toast, crackers) throughout the day is helpful, instead of attempting three big meals.
- Hair loss. If hair loss occurs, it will be only in the area being treated.
How Will I Know if my Treatments Have Been Successful?
Unfortunately we often do not know immediately if the treatment has been successful. Radiation enters the cancer cells and causes them to die when they would normally be multiplying. So, the cancer cell may not die until after the radiotherapy treatments have been completed. It may take up to several months or even a year to know whether all the cancer cells have been killed. All the doctors who have been caring for you will see you periodically after the treatments are completed. Sometimes blood tests or x-rays can help to assess the shrinkage of the tumor or decrease in tumor cells. Sometimes we can tell from your clinical response. Other times, it is simply a waiting game.