What is radiation therapy?
Radiation therapy is a technique for treating cancer. It involves directing a very high-energy beam of radiation at a specific part of the body to kill cancer cells while sparing the surrounding normal tissue from damage.
How does the radiation work?
As the radiation beam passes through the body, changes take place in the tissues. These changes affect the DNA in tumor cells, rendering them incapable of dividing and reproducing. Tumor cells die when they try to divide. Radiation may also cause an effect on specific genes within the DNA, which results in tumor cell death.
Doesn’t the radiation also kill the normal cells?
Radiation does have an effect on normal cells, which is why certain side effects are encountered. However, the normal cells are able to repair damage much better than tumor cells.
How is radiation administered?
Radiation therapy is administered either externally, by using a machine that generates a radiation beam (external radiation therapy), or internally, by placing radioactive material into body tissues or cavities (brachytherapy or implants).
What happens during my external radiation therapy treatments?
Before starting the actual treatment, you may need to change into a gown. The therapists then set up and position the equipment in the treatment room. During this time, you will be asked to lie on the treatment table beneath the radiation therapy unit. The therapists will ensure that you are safe and comfortable while they align you in the proper position. Once you are positioned properly, it is important that you remain as still as possible and that you breathe normally. Sometimes a special immobilization device or tumor targeting system is used to decrease movement and improve accuracy.
The therapists will leave the room during the few minutes of your treatment, but they will observe you closely from outside the room on the closed circuit television monitor. The intercom system is always “on” and, if necessary, you may also talk to the therapists.
During the treatment you may hear sounds or see a red light. These merely indicate that the equipment is on.
At the end of the treatment, the therapists will assist you off the treatment table and direct you to the dressing area.
Does the treatment hurt?
Radiation treatments do not hurt at all. The treatment is painless.
What are Implants or Brachytherapy?
Internal radiation, also called brachytherapy or implants, may be temporary or permanent.
They may be given as the only radiation treatment or in conjunction with external beam radiation.
Temporary implants are brachytherapy treatments that utilize radioactive materials that are placed temporarily in body tissues or cavities. These implants can be done with high intensity sources that oscillate within the radiation carrier and then are removed within minutes (high dose rate or HDR) or with moderate intensity sources that are maintained within the tumor for hours to days (low dose rate or LDR). Hollow plastic tubes or catheters are placed in the area requiring treatment. The plastic tubes are then filled with the radioactive materials which are located within another plastic ribbon or catheter. When the desired dose of radiation has been delivered, the radioactive ribbons and catheters rare removed. Temporary implants may be performed on an inpatient or outpatient basis depending on the situation.
Permanent implants, also known as “seed implants”, are LDR brachytherapy treatments that utilize radioactive materials that are implanted permanently within the tumor to provide highly localized radiation. This is usually an outpatient procedure, and you will be discharged home on the same day.
Will I become radioactive after receiving radiation treatment?
Neither you nor your clothing will become radioactive, after receiving external beam radiation therapy or high-dose rate (HDR) brachytherapy. It is perfectly safe for you to be around your family and loved ones.
If you receive a “seed implant” or low-dose rate (LDR) brachytherapy you will be given instructions regarding temporary restrictions surrounding close contact with children and pregnant women.
How many treatments will I need?
Your radiation oncologist will determine and prescribe the amount of radiation that you will receive. When determining the amount of radiation needed, the physician will consider the area of your body where the tumor is located and the types of cells that make up the tumor.
To help protect normal tissues, radiation treatments are often given in a series of small doses called fractions. This fractionation allows normal tissue to recover more quickly. Most types of radiation cannot be given in a large single dose because of the likelihood that it would cause damage to normal surrounding tissue.
Depending on your condition, the total treatment course may be as short as one day or as long as eight to ten weeks. A typical series may consist of five treatments a week over a four-to-six week period. Most treatment is delivered daily, Monday through Friday, with Saturday and Sunday off. With some diseases, two treatments per day are prescribed, with at least a six-hour interval between the two treatments.
How long will my daily treatment take?
Although the treatment itself may take only a few minutes, preparation time varies depending on the complexity of your treatment set-up. Please plan on spending at least one hour for your first treatment appointment and approximately 30 to 40 minutes thereafter.
Can I miss a treatment?
To receive maximum benefit from therapy, it is essential that you receive all your prescribed radiation treatments. If you think you cannot report for a scheduled appointment, please call the nurse or therapist. Missed appointments are made up, and you will receive the prescribed amount of radiation, but over a longer period of time. It is essential that you complete your treatments within a reasonable time period, as treatment may be less effective if extended over a longer period of time.
If you have a special scheduling need (i.e. a conflict with another doctor’s appointment), please speak with the therapist a day or two in advance. We will make every attempt to accommodate your scheduling needs.
What happens if I miss a treatment?
In general, missing one day does not change the overall effectiveness of the prescribed treatments. Your physician may prescribe a short treatment “break” if you are experiencing significant side effects. This allows normal tissues a chance to recover from the effects of radiation.
Will I be treated on holidays?
The radiation treatment center is usually closed on national holidays. However, in cases where this would negatively impact the effectiveness of the treatments, special arrangements are made for treatment on holidays.
Will I experience side effects from treatment?
Any side effects you may experience depend on the amount and frequency of radiation, and the area of the body that is treated. Side effects vary from person to person due to individual sensitivity to radiation.
Before treatment begins, the radiation oncologist and nurse will discuss with you any side effects that may occur and what you can do to control or relieve them. It is important to remember that most side effects are temporary. They generally subside within a few weeks after treatment, although some may take longer to resolve.
Most patients experience fatigue at some point during the course of therapy. It may persist for a few weeks after the completion of therapy. Please remember that fatigue is a usual side effect of radiation and is not an indication of progression of disease. Lay people commonly believe that nausea, vomiting, diarrhea and hair loss are universal side effects of radiation. Nausea, vomiting and diarrhea may occur when the abdomen is radiated. Hair loss will probably occur in the area of treatment. Scalp hair or beard will likely fall out if the scalp, mouth or throat is radiated. The size of the radiation field and the dose of radiation determine whether you will have these side effects.
Will radiation affect my skin?
For many treatments, there are no skin reactions. For others, the skin exposed to radiation may become red, itchy or tanned. In some circumstances, blisters may form. These reactions are temporary and will disappear within a few weeks after completion of therapy.
Recommended care of skin exposed to radiation:
- Keep the irradiated skin clean and dry. Cleanse with mild soap and water, pat dry. Avoid vigorous rubbing or massaging.
- Avoid wearing tight clothing that could rub, chafe or otherwise irritate your skin. Cotton fabrics are better than synthetics next to your skin.
- Do not use heating pads, heat or sun lamps, hot water bottles or ice packs on the treated area.
- Do not expose the treated skin to sun. Wear protective clothing over the treated area. Sunscreen does not provide enough protection.
- Do not apply deodorants, cosmetics, lotions, powders, petroleum jelly or alcohol containing preparations to the irradiated skin. If you have any questions about a particular skin preparation, ask your nurse or therapist.
What should I do if these reactions occur?
Report any reactions to the radiation oncologist, nurse or therapists before your treatment. There are many comfort measures and medications available to relieve these side effects.
Are there any restrictions on my activities?
You are encouraged to carry on your normal daily activities as much as possible, avoiding feeling overstressed. Many people continue to work full-time without experiencing adverse effects. If you feel you cannot continue working, please talk to your physician and/or nurse. Try to balance your daily activities with periods of rest, if necessary.
Should I continue to take my medications?
Yes. Your regularly prescribed medications will not interfere with your radiation treatments. Make sure your radiation oncologist or nurse has a list of all the medications you are taking.
What about driving?
Radiation is usually given on an outpatient basis, and most people are able to drive themselves to therapy. In some cases, you may need to arrange for a friend or relative to drive you. Various transportation services may be available to you depending on where you live.
Do I need a special diet?
Depending on your specific treatment area and side effects, you may need to modify your diet. In general, you should eat a well-balanced diet that is high in protein and calories. A high-protein, high-calorie diet will help you maintain your weight and will provide the nutrients necessary for normal tissue to recover. We will refer you to a dietitian, if necessary.
Will extra vitamins help?
When feeling tired, many people want to take vitamin supplements. We advise our patients not to take supplementary antioxidants, such as vitamins A, C and E, selenium and beta carotene. Radiation is an oxidant, and we are concerned that taking extra antioxidants along with the radiation may decrease effectiveness of the treatments. One multi-vitamin tablet per day is permissible.
What happens when my treatment course is finished?
Your radiation oncologist will continue to follow you along with your other physicians. The first follow-up visit will be scheduled for 2 to 4 weeks after you complete your treatment. Additional follow-up visits are usually every 3-4 months during the first two years, depending on your condition. Your physician will determine the frequency of visits and diagnostic tests to be performed.
Will I receive a bill for my treatment?
You or your insurance company will receive a bill for treatments provided at the radiation treatment center. You may also receive other bills for certain tests (lab, X-ray, etc.) ordered by your radiation oncologist and performed by other health care providers.
Most insurance plans cover the cost of radiation therapy. If you have any questions, please contact our billing specialists.
