What to know about radiation therapy?
What is it?
Side effects
Radiation and other treatments
Types
What to expect
Uses
Outlook
Radiation therapy is a treatment for cancer and, less commonly, thyroid disease, blood disorders, and noncancerous growths.
A doctor may recommend radiation for cancer at different stages. In the early stages, radiation therapy can help reduce the size of a tumor before surgery or kill remaining cancer cells afterward. In the later stages, it may help relieve pain as part of palliative care.
One form of radiation treatment involves using a machine that produces a beam of radiation. The beam targets a specific area of the body. Another type involves putting a radioactive substance inside the body, either permanently or temporarily.
In this article, we focus mainly on radiation therapy as a cancer treatment.
What is radiation therapy?
Technicians administer external beam radiation therapy using a linear accelerator.
Radiation therapy uses waves of energy, such as light or heat, to treat cancers and other tumors and conditions. The form of radiation used in cancer therapy is a high-energy type known as ionizing radiation.
Scientists still do not know exactly how radiation works as a treatment for cancer.
They do know, however, that it breaks up the DNA of cancer cells in a way that disrupts their growth and division. In this way, radiation can kill cancer cells, preventing or slowing the spread of the disease.
Sometimes a doctor prescribes radiation therapy alone, but usually, they recommend it in combination with other treatments, such as chemotherapy, surgery, or both.
Side effects
Radiation can affect healthy cells as well as cancerous ones. When this happens, a person experiences side effects.
Specific side effects depend on factors such as:
the area receiving treatment
the person’s overall health
the type and doses of radiation
Short term side effects
Short term side effects radiation therapy include fatigue, skin changes, and nausea.
Short term side effects vary, depending on the part of the body receiving radiation.
They can include:
fatigue
hair loss
diarrhea
skin changes
nausea and vomiting
A 2018 study published in BMJ Open recommends screening for anxiety and depression in people undergoing radiation therapy and offering counseling services to those who may benefit from them.
Long term side effects
Long term side effects also depend on the treatment site.
They include:
heart or lung problems, if radiation affects the chest
thyroid problems, leading to hormonal changes, if radiation affects the neck area
lymphedema, which involves lymph fluid building up and causing pain
hormonal changes, including a possibility of early menopause, from radiation in the pelvic area
There is a slight chance that high doses of radiation in certain areas can increase the risk of another form of cancer developing. A doctor will provide more specific information and help with weighing the risks and benefits.
Not everyone who has radiation therapy experiences long term side effects. The risk depends on the doses, the area of treatment, and other individual factors.
Radiation therapy and other treatments
Radiation therapy is one of several cancer treatments. A doctor may prescribe these separately or in combination.
As well as radiation, a person may have:
surgery
chemotherapy
hormone therapy
targeted therapy
The treatment plan will depend on the type of cancer, among other factors.
When a person receives radiation therapy and chemotherapy at the same time, the doctor may call this “chemoradiation.” It can lead to severe adverse effects.
When cancer is at an early stage, a person may have radiation therapy before surgery, to reduce the size of a tumor. Or, they may have it after surgery to help remove any remaining cancerous cells.
Radiation is only effective in targeted areas. It is less effective when cancer has spread to distant parts of the body.
Types
There are two forms of radiation therapy.
External beam radiation therapy
This is the most common type. It involves an external machine emitting a beam of radiation that targets the treatment area.
Different forms are available, depending on the need. High-energy beams, for example, can target cancer that is deeper within the body.
Internal radiation therapy
There are different types of internal radiation therapy. Both involve implanting or introducing a radioactive substance into the body.
Brachytherapy involves inserting a radioactive implant in or close to the cancerous tissue. The implant may be temporary or permanent. Another type of internal radiation therapy involves drinking or receiving an injection of radioactive liquid.
The goal is to limit the extent to which healthy tissue around the cancer is exposed to the radiation. Doctors may recommend this treatment for prostate or ovarian cancer, for example.
A doctor may recommend undergoing both main types of radiation therapy. The decision will depend on:
the type of cancer
the size of the tumor
the tumor’s location, including the types of tissue nearby
the person’s age and overall health
other treatments
Scientists continue to explore ways of improving radiation techniques to achieve more effective outcomes with the least possible risk.
What to expect
The doctor will discuss radiation therapy and other options and help weigh the pros and cons. Before treatment starts, they will determine the right type and dosage of radiation.
A person receiving external beam radiation may undergo a CT or MRI scan before treatment. This is to pinpoint the exact location and size of the tumor. A doctor may make a permanent but small mark on the skin to ensure that the radiation therapist will target the beam correctly.
A person may need to wear a plaster cast or use a headrest or another device to ensure that they stay still during treatment. The first session may be a simulation, in which the team runs through the procedure.
Many people have five sessions per week for 3–9 weeks, but this depends on specific factors. Each session lasts for around 15 minutes. Radiation therapy is painless, but there will be damage to surrounding tissue. This is why the treatment occurs on only 5 days per week. The 2-day break allows for some healing.
A person who has internal radiation therapy may require an anesthetic before the doctor can implant the radioactive substance. Overall, several sessions and some time in the hospital may be necessary.
The details of the process depend on the type of radiation therapy and the type and location of the cancer.
Aftercare
After receiving external treatment, a person can go home and continue with their daily routine.
However, they may experience:
tiredness
sensitivity around the treatment site
emotional distress
To help manage these effects, it is important to:
get plenty of rest
eat healthfully
talk to friends and family about any side effects
follow instructions, which may involve skin care, from the treatment team
avoid spending time in the sun, due to a risk of photosensitivity
Also, monitor for adverse effects and tell the doctor if they occur. The doctor may recommend additional treatments aimed at relieving these.
People may need to speak to their employers about adjusting work schedules or taking medical leave.
Uses
A doctor may recommend radiation therapy to kill cancerous cells.
Radiation therapy can help shrink tumors and kill cancerous cells in the early stages.
This kind of treatment, in combination with other appropriate therapies, can cause cancer to go into remission. In many cases, it does not come back again.
Radiation therapy can also help treat symptoms when cancer has spread widely. At this point, the radiation is part of palliative care, which aims to relieve a person’s symptoms and improve their quality of life. It may also extend a person’s life, in some cases.
Palliative radiation treatment usually involves lower doses and fewer treatment sessions than curative treatment.
In some people with bone cancer, for example, palliative radiation treatment can help stop painful tumors from developing.
Other ways that palliative radiation treatment can help include:
relieving pressure or a blockage by reducing tumor size
treating symptoms of brain cancer, such as headaches, nausea, and dizziness
reducing symptoms of lung cancer, such as chest pain and breathlessness
controlling ulcerating tumors, bleeding, and infections
In people with head and neck cancers, an obstruction in the superior vena cava can affect the return of blood to the heart. Radiation therapy can help relieve this.
Outlook
Some people feel anxiety and concern about radiation therapy. It has various uses in treating cancer, and it can help achieve complete remission, in some cases.
The National Cancer Institute (NCI) points out that radiation can be costly.
People with health insurance should speak with their provider about coverage. Also, some organizations provide financial support and other help to people who need treatment. The NCI provide a list of options.
Discuss any concerns with the doctor and ask as many questions as possible. Knowing what to expect can help.
Q:
Will my hair grow back after radiation therapy?
A:
Radiation therapy only causes hair loss at the site receiving the therapy. Hair loss may be temporary or permanent, depending on the site and the doses. Higher doses of radiation may be more likely to result in permanent hair loss.
And Also:
What Can One Expect During Treatment
It is normal to feel worried or overwhelmed when you learn that you will need radiation therapy. However, learning more about this type of cancer treatment may help you feel more prepared and comfortable. The information in this article can help you prepare for your first treatment.
Who is on my radiation therapy team?
A highly trained medical team will work together to provide you with the best possible care. This team may include the following health care professionals:
Radiation oncologist. This type of doctor specializes in giving radiation therapy to treat cancer. A radiation oncologist oversees radiation therapy treatments. They work closely with other team members to develop the treatment plan.
Radiation oncology nurse. This nurse specializes in caring for people receiving radiation therapy. A radiation oncology nurse plays many roles, including:
Answering questions about treatments
Monitoring your health during treatment
Helping you manage side effects of treatment
Medical radiation physicist. This professional helps design treatment plans. They are experts at using radiation equipment.
Dosimetrist. The dosimetrist helps your radiation oncologist calculate the right dose of radiation.
Radiation therapist or radiation therapy technologist. This professional operates the treatment machines and gives people their scheduled treatments.
Other health care professionals. Additional team members may help care for physical, emotional, and social needs during radiation therapy. These professionals include:
Social workers
Nutritionists or dietitians
Rehabilitation therapists, such as physical therapists or speech therapists
Dentists
What happens before radiation therapy treatment?
Each treatment plan is created to meet a patient's individual needs, but there are some general steps. You can expect these steps before beginning treatment:
Meeting with your radiation oncologist. The doctor will review your medical records, perform a physical exam, and recommend tests. You will also learn about the potential risks and benefits of radiation therapy. This is a great time to ask any questions or share concerns you may have.
Giving permission for radiation therapy. If you choose to receive radiation therapy, your health care team will ask you to sign an "informed consent" form. Signing the document means:
Your team gave you information about your treatment options.
You choose to have radiation therapy.
You give permission for the health care professionals to deliver the treatment.
You understand the treatment is not guaranteed to give the intended results.
Simulating and planning treatment. Your first radiation therapy session is a simulation. This means it is a practice run without giving radiation therapy. Your team will use imaging scans to identify the tumor location. These may include:
A computed tomography (CT) scan
Magnetic resonance imaging (MRI)
An x-ray
Depending on the area being treated, you may receive a small mark on your skin. This will help your team aim the radiation beam at the tumor.
You may also be fitted for an immobilization device. This could include using:
Tape, Foam sponges, Headrests, Molds, Plaster casts
These items help you stay in the same position throughout treatment.
For radiation therapy to the head or neck, you may receive a thermoplastic mask. This is a mesh mask that is molded to your face and secured to the table. It gently holds your head in place.
It is important for your body to be in the same position for each treatment. Your radiation oncology team cares about your comfort. Talk with the team to find a comfortable position that you can be in every time you come in for radiation therapy. Tell them if you experience anxiety lying still in an immobilization device. Your doctor can prescribe medication to help you relax.
After the simulation at your first session, your radiation therapy team will review your information and design a treatment plan. Computer software helps the team develop the plan.
What happens during radiation therapy treatment?
What happens during your radiation therapy treatment depends on the kind of radiation therapy you receive.
External-beam radiation therapy
External-beam radiation therapy delivers radiation from a machine outside the body. It is the most common radiation therapy treatment for cancer.
Each session is quick, lasting about 15 minutes. Radiation does not hurt, sting, or burn when it enters the body. You will hear clicking or buzzing throughout the treatment and there may be a smell from the machine. Typically, people have treatment sessions 5 times per week, Monday through Friday. This schedule usually continues for 3 to 9 weeks, depending on your personal treatment plan.
This type of radiation therapy targets only the tumor. But it will affect some healthy tissue surrounding the tumor. While most people feel no pain when each treatment is being delivered, effects of treatment slowly build up over time and may include discomfort, skin changes, or other side effects, depending on where in the body treatment is being delivered. The 2-day break in treatment each week allows your body some time to repair this damage. Some of the effects may not go away until the treatment period is completed. Let the health care professionals if you are experiencing side effects. Read more about the side effects of radiation therapy.
Internal radiation therapy
Internal radiation therapy is also called brachytherapy. This includes both temporary and permanent placement of radioactive sources at the site of the tumor.
Typically, you will have repeated treatments across a number of days and weeks. These treatments may require a brief hospital stay. You may need anesthesia to block the awareness of pain while the radioactive sources are placed in the body. Most people feel little to no discomfort during this treatment. But some may experience weakness or nausea from the anesthesia.
You will need to take precautions to protect others from radiation exposure. Your radiation therapy team will provide these instructions. The need for such precautions ends when:
The permanent implant loses it radioactivity
The temporary implant is removed
Weekly reports
During your treatment, your radiation oncologist will check how well it is working. Typically, this will happen at least once a week. If needed, they may adjust your treatment plan.
Personal care
Many people experience fatigue, sensitive skin at the site of radiation exposure, and emotional distress during radiation therapy. It is important to rest and take care of yourself during radiation therapy. Consider these ways to care of yourself:
Plan for extra rest.
Eat a balanced diet.
Drink liquids regularly.
Treat affected skin with lotion approved by your health care team.
Protect your affected skin from sunlight.
Seek emotional support.
Learn more about coping during treatment. And, be sure to talk with your health care team about how you are feeling throughout your treatment period.
What happens after radiation therapy treatment ends?
Once treatment ends, you will have follow-up appointments with the radiation oncologist. It's important to continue your follow-up care, which includes:
Checking on your recovery
Watching for treatment side effects, which may not happen right away
As your body heals, you will need fewer follow-up visits. Ask your doctor for a written record of your treatment. This is a helpful resource as you manage your long-term health care.
Questions to ask the health care team
Who is creating my radiation therapy treatment plan? How often will the plan be reviewed?
Which health care professionals will I see at every treatment session?
Can you describe what my first session, or simulation, will be like?
Will I need any tests or scans before treatment begins?
Will my skin be marked as part of treatment planning?
Who can I talk with if I'm feeling anxious or upset about having this treatment?
How long will each treatment session take? How often will I have radiation therapy?
Can I bring someone with me to each session?
Are there special services for patients receiving radiation therapy, such as certain parking spaces or parking rates?
Who should I talk with about any side effects I experience?
Which lotions do you recommend for skin-related side effects? When should I apply it?
How else can I take care of myself during the treatment period?
Will special precautions be needed to protect my family and others from radiation exposure during my treatment period?
What will my follow-up care schedule be?