Radiation Therapy for Cancer Treatment & What to Expect

Radiation therapy is a common, effective, and painless cancer treatment. It can be used as a standalone treatment or can be part of a comprehensive plan that includes surgery or chemotherapy. Radiation therapy is used to kill cancer cells with concentrated X-ray beams.

If you or a loved one has recently received a cancer diagnosis, there is a good chance that radiation therapy will be a part of the treatment plan. With that in mind, the Charlotte area cancer treatment team at SERO wants to ensure that our patients and their families have access to the information that they need.

Below, we answer common questions about radiation therapy so that you and your loved ones can have peace of mind when you begin this journey.

Radiation therapy, sometimes called radiotherapy, uses various forms of radiation to safely and effectively treat cancer and other diseases. When most patients hear the phrase radiation, they think of X-rays. While this is one typical example, it is not the only way radiation is used in the medical field.

In addition to taking X-rays, doctors use radiation therapy to try to cure cancer. Radiation therapy aims to control cancer’s growth and relieve symptoms, such as pain.

Radiation therapy works by damaging the DNA within cancer cells and destroying the ability of the cancer cells to reproduce. When these damaged cells die, the body naturally eliminates them. Normal cells are also affected by radiation, but they can repair themselves in a way that cancer cells cannot.

While you undergo radiation therapy, a team of highly trained medical professionals will be working together to make sure you receive the best care possible. A radiation oncologist—a doctor who specializes in using radiation to treat cancer—leads this team.

There are several instances when our team will use radiation for cancer treatment. Radiation therapy can be used to:

• Shrink a tumor
• Eliminate remaining cancer cells after surgery
• Destroy tumors that cannot be removed surgically

Our care team will utilize advanced imaging equipment to identify your tumor’s exact dimensions and location during the treatment planning phase. After they have done so, your care team will be able to determine which treatment approach is best suited for your diagnosis.

Any side effects that you will experience vary depending on the exact location of your treatment. With that said, fatigue is a common side effect felt by virtually every patient that undergoes radiation therapy.

Another common side effect is nausea. Fortunately, our team has some proven medications that can provide much-needed relief. Other typical side effects include diarrhea and skin redness.

The side effects listed above usually present themselves shortly after the onset of treatment. Some others do not show up for months or even years. These long-term side effects may include darkening or hardening of the skin at the treatment site.

The best way to manage these side effects is to voice any concerns early. Some patients are more prone to experience certain side effects than others. During the pre-treatment phase, be sure to speak with your care team so that you can stay ahead of symptoms.

Generally, radiation treatment is divided into three distinct phases. The first is known as the “before-treatment” or “consultation” phase.

During this phase, you will meet with your physician to determine if radiation is suitable for you. You will also be fitted for any treatment devices, as described below. The before-treatment phase generally lasts a few weeks.

The active treatment phase will begin as soon as possible. When it comes to treating your cancer, consistency is vital. Unless special circumstances dictate otherwise, you will be receiving radiation therapy five days per week for 3-10 weeks. Your care team will monitor your progress and make adjustments to the treatment protocol as needed.

Once your treatment is complete, you will need to meet with the care team at regular intervals. The goal of this post-treatment protocol is to monitor your overall health. As time goes on, these appointments can be spaced out at greater intervals. However, your care team is always available should you need anything.

If you are considering radiation therapy, you must first schedule a visit with a radiation oncologist to see if radiation therapy is appropriate for you. During your initial visit, the doctor will evaluate your need for radiation therapy and its likely results, including reviewing your current medical problems, past medical history, past surgical history, family history, medications, allergies, and lifestyle.

The doctor will also perform a physical examination to assess the extent of your disease and judge your general physical condition. Depending on your radiation oncologist’s practice, you may also see a nurse practitioner or a physician assistant.

After reviewing your medical tests—including CT scans, MRI scans, and positron emission tomography scans (PET scans)—and completing a thorough examination, your radiation oncologist will thoroughly discuss the potential benefits and risks of radiation therapy with you. They will also answer your questions.

Effective radiation therapy must be aimed precisely at the same target (or targets) every treatment session. The process of measuring your anatomy and marking your skin to help your team direct the beams of radiation safely and precisely to their intended locations is called simulation.

During simulation, your radiation oncologist and radiation therapist place you on the simulation machine in the exact position you will be in during the actual treatment. Under your doctor’s supervision, your radiation therapist then marks the area to be treated directly on your skin or immobilization devices.

Immobilization devices are molds, casts, headrests, or other devices constructed and placed on a specific part of your body to help you remain in the same position during the entire treatment. The radiation therapist marks your skin or the immobilization devices either with bright, temporary paint or a set of small permanent tattoos.

Your radiation oncologist may request that special blocks or shields be made for you. This equipment is put in the external beam therapy machine before each treatment to shape the radiation to your tumor and keep the rays from hitting normal tissue. Some treatment machines have built-in blocks or shutters called multileaf collimators, which also help shape the radiation.

Although simulation is typically only one session, your physician may schedule additional sessions depending on your cancer and radiation therapy type.

After simulation, your radiation oncologist and other treatment team members review the information they obtained during simulation along with your previous medical tests to develop a treatment plan. Often, a special treatment planning CT scan is done to help with the simulation and treatment planning. This CT scan is in addition to your diagnostic CT scan.

Frequently, sophisticated treatment-planning computer software is used to help design the best possible treatment plan. After reviewing all of this information, your doctor writes a prescription that outlines the exact course of your radiation therapy treatment.

External beam radiation therapy is administered differently from brachytherapy. You may receive one or both of these treatments. The following sections describe what you may experience during treatment administration.

When you undergo external beam radiation therapy treatment, each session is painless, like getting an X-ray. The radiation is directed to your tumor from a machine located outside of your body. One of the benefits of radiation therapy is that it’s usually given as a series of outpatient treatments. You may not need to miss work or experience the type of recuperation period that can follow other treatments.

Treatments are usually scheduled five days a week, every day except Saturday and Sunday, and continue for 3 to 10 weeks. Some patients receive hyperfractionated (or superfractionated) radiation therapy, in which radiation treatments are given more than once a day.

Other times, only one or few treatments are required (e.g., for the treatment of cancer that has spread to the bone). This treatment is called hypofractionated radiation therapy.

The number of radiation treatments you will need depends on the size, location, type of cancer you have, your general health, and other medical treatments you may receive.

The radiation therapist will administer your external beam treatment following your radiation oncologist’s instructions. It will take roughly 5 to 15 minutes to position you and set up the equipment. If an immobilization device was made during simulation, doctors would use it during every treatment to ensure that you are in the same position every day.

Once you are positioned correctly, the therapist will leave the room and go into an adjoining control room to closely monitor you on a television screen while administering the radiation. There is a microphone in the treatment room, so you can always talk with the therapist if you have any concerns. A doctor can stop the machine at any time if you are feeling ill or uncomfortable.

The radiation therapist may move the treatment machine and treatment table to target the radiation beam to the exact area of the tumor. The device might make clicking or whirring noises during treatment. These sounds are nothing to be afraid of, and the radiation therapist is in complete control of the machine at all times.

The radiation therapy team carefully aims the radiation to decrease the dose to the tumor’s normal tissues. Still, radiation will affect some healthy cells.

The time in between daily treatments allows your healthy cells to repair much of the radiation damage. Most patients get treatment on an outpatient basis, and many can continue with regular daily activities.

Sometimes, a course of treatment is interrupted for a day or more. Delays may happen if you develop side effects. You can make up for missed treatments by adding sessions at the end. Try to arrive on time and not miss any of your appointments.

Your radiation oncologist monitors your daily treatment and may alter your radiation dose based on these observations. Also, your doctor may order blood tests, X-ray examinations, and other tests to see how your body is responding to treatment.

If the tumor shrinks, another simulation may be done. Tumor lessening allows your radiation oncologist to change the treatment to destroy the rest of the tumor and spare even more normal tissue.

During radiation therapy, your radiation oncologist and nurse will see you regularly to follow your progress, monitor side effects, recommend treatments for those side effects (such as medication or diet changes), and address any concerns you may have. As treatment progresses, your doctor may make changes in the schedule or treatment plan depending on your response or reaction to the therapy.

Your radiation therapy team may gather regularly with other healthcare professionals to review your case to ensure your treatment is proceeding as planned. During this session, all the members of the team discuss your progress and any concerns they have.

Your treatment team will routinely use the machines to take special X-rays called beam or port films during treatment. Your treatment team routinely reviews these films to ensure that the treatment beams remain precisely aimed at the proper target. These X-rays are not used to evaluate your tumor.

Once you complete treatment, you’ll schedule follow-up appointments so that your radiation oncologist can ensure your recovery is normal and your health is good. Your radiation oncologist may also order additional diagnostic tests. Reports on your treatment can be sent to your other doctors, too.

As time goes on, the frequency of your visits will reduce. However, you should know that your radiation oncology team will always be available should you need to speak to someone about your treatment.