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Radiation Therapy
Nearly 60 percent of all cancer patients receive some time of radiation therapy during treatment. In some cases radiation therapy may be the only treatment required.
*Source: RadiologyInfo™
 

Understanding Radiation Therapy

Radiation therapy, also called radiotherapy, uses carefully targeted doses of high-energy radiation to kill cancer cells. Doctors use radiation therapy to treat just about every type of cancer. It does this by altering the DNA within cancer cells—preventing the cancer cells from reproducing and growing. Radiation therapy is also useful in treating some noncancerous (benign) tumors.

 


The goal of radiation therapy is to control cancer locally, that is, to shrink a tumor so that it will not spread to other organs. Sometimes, radiation therapy may destroy a tumor, and no other therapy is needed. Radiation may sometimes be used before surgery to shrink a tumor, or to minimize the need for invasive surgery. Sometimes, radiation therapy may be used to treat the symptoms of cancer even when cancer has progressed beyond a cure.

The term "radiation therapy" most often refers to external beam radiation therapy. During this type of radiation, the high-energy beams come from a machine outside of your body that aims the beams at a precise point in your body.


While both healthy and cancerous cells are damaged by radiation therapy, the goal of radiation therapy is to destroy as few normal, healthy cells as possible.


Radiation therapy has been used to treat cancer successfully for more than 100 years, after a German physicist discovered the powerful X-ray. Over the decades, radiation therapy has become extremely sophisticated, with radiation oncologists and the team of specialists who work with them now able to target tumors more precisely than ever. Also, advances have allowed for greater levels of intensity to smaller areas, thus minimizing damage to nearby tissues.


Different kinds of cancer have varying sensitivity to radiation, and the type and dosage of radiation you receive will be tailored to your specific cancer. While most radiation is administered externally, some radiation therapy today is internally administered. In those cases, such things are radioactive “seeds” or balloons are surgically implanted or sometimes inserted into a body cavity that is affected by cancer.


With external radiation, also known as external beam radiation therapy (EBRT), patients generally receive radiation for about 20 to 30 minutes, five days a week, for about six weeks.


To precisely “aim” radiation at the specific cancer cells that need to be targeted, your WellStar doctors may use a computed topography (CT) scan and a computer that helps target the beam. This technology is called three dimensional conformal radiation technology (3D-CRT). Your WellStar team is expert in determining whether 3D-CRT may be beneficial to you.


Other, new radiation techniques have been developed that may allow patients to receive a more intense dosage for a shorter period of time. This can allow patients to complete their full radiation regimen in a shorter time. Ask your WellStar physician if you might be a candidate for these treatments.


WellStar is a leader in the use of an advanced radiation technique known as intensity modulated radiation therapy (IMRT), an advanced form of 3D-CRT. IMRT allows your WellStar physician to precisely control the intensity of the radiation that different parts of a tumor receive. This happens through the use of computer-controlled, movable “leaves” that either aim or block beams aimed at the treatment area. The leaves are carefully adjusted according to the size, shape and location of the tumor. WellStar is a leader in the use of IMRT, which helps protect nearby, healthy cells while maximizing the treatment to cancer cells.


The size of your tumor, the type of cancer cell that you have, and other factors influence the choice of radiation therapy. Talk to your WellStar physician about options. Radiation is sometimes administered internally into or near the cancer. This is called brachytherapy. Brachytherapy allows for a higher dose of radiation over a shorter period of time. In brachytherapy, radioactive material is inserted via small wires, balloons, needles or, as in the case of prostate cancer, even seeds the size of rice grains that may be left in the body permanently. (Their radioactive properties diminish over time).


Brachytherapy is sometimes used to boost the effectiveness of external radiation, and sometimes used on its own. It has been shown to be effective in treating prostate, cervical, uterine, vaginal, and head and neck cancers. Breast cancer has its own type of brachytherapy. For breast cancer patients who have breast-conserving surgery rather than mastectomy, radiation can be administered internally for five days, twice a day. In breast brachytherapy, a small balloon is administered into the cavity where the cancer was removed. A catheter leads from the balloon to the outside of the body. The balloon is filled with saline solution. When treatment is administered, a radioactive seed is inserted into the solution. The balloon and catheter are removed at the end of the five days, and no radioactive material remains in the woman’s body after the treatment.


In rare cases, such as for thyroid cancer, radiation can be administered intravenously. In thyroid cancer, radioactive iodine is administered and naturally absorbed by the thyroid gland.


Radiation is not without side effects and complications. While most people tolerate radiation therapy relatively well, fatigue is a common symptom. Side effects of radiation therapy greatly depend on which part of your body is being exposed to radiation and how much radiation is used. You may experience no side effects, or you may experience several. Most side effects are temporary, can be controlled and generally disappear over time once treatment has ended.


BODY PART COMMON SIDE EFFECTS
Any Part Hair loss at treatment site (sometimes permanent), skin irritation at treatment site, fatigue
Head and Neck Dry mouth, thickened saliva, difficulty swallowing, sore throat, changes in the way food tastes, earaches, sore jaw, nausea
Chest Difficulty swallowing, cough, shortness of breath
Abdomen Nausea, vomiting, diarrhea
Pelvis Diarrhea, bladder irritation, frequent urination, sexual dysfunction

Some side effects may develop later. For example, in rare circumstances a new cancer (second primary cancer) that's different from the first one treated with radiation may develop years later. Ask your doctor about potential side effects, both short and long term that may occur after your treatment. Talk to your WellStar physician about these issues; he or she is always ready to talk to you about any of your concerns.


Procedures:

Before the Procedure

  • You will have a consultation with your radiation oncologist to discuss your cancer and to devise a treatment plan. It is a good idea to have a family member or friend with you at this time, because a great deal of information will be exchanged. It will be important to ask questions and for you to understand the information your radiation oncologist is providing you. Take notes if you can, or ask your family member or friend to take notes.
  • A simulation of your radiation therapy will take place before your radiation treatment. This may take the longest time, because your WellStar radiation oncologist is working diligently with a team of specialists to tailor a treatment plan that works just for you. Your WellStar physician will determine the precise treatment fields using a CT simulator, which will show the exact location and extent of your tumor. You may notice the red light of a laser; this will not hurt or burn you. It is simply allowing the technologist to mark precise treatment areas.
  • During simulation your radiation therapy team works with you to find a comfortable position for you during treatment. It's imperative that you lie still during treatment, so finding a comfortable position is vital. To do this, you'll lie on the same type of table that's used during radiation therapy. Cushions and restraints are used to position you in the right way and to help you hold still. Your radiation therapy team will mark the area of your body that will receive the radiation.
  • The radiation fields will be marked on your body with a marker. After the technologist makes a simulation X-ray to show exactly where the beams are to go, the marks will be replaced by “tattoos,” very tiny specks of ink that will appear on your skin like a freckle. These marks allow the technologist to see precisely where the treatment beams should be aimed, while allowing you to bathe and wash without fear of washing away the marks.
  • Your WellStar team will devise a treatment plan based on the findings from the preliminary exams and in consultation with your treatment team.

During the Procedure

During a treatment session, you'll lie down in the position determined during your radiation simulation session. You might be positioned with molds to hold you in place and shields may be placed to block radiation from reaching certain parts of your body.


  • The machine delivering the radiation, called a linear accelerator, and the treatment table may rotate as much as 360 degrees, depending on the angles at which the tumor must be irradiated.
  • The linear accelerator machine may rotate around your body to reach the target from different directions. The machine makes a buzzing sound. You'll lie still and breathe normally during the treatment. Follow any directions given to you by the radiation technologist.
  • You will be in the treatment room by yourself, but you will be monitored by video camera. There also is audio connection so that you may communicate with the technologist.
  • The treatment may last up to 30 minutes. You will not feel any pain or discomfort.

After the Procedure

  • You may feel fatigue, dry mouth, dry skin or nausea. You may also lose your appetite. Sometimes, a patient will not feel any side effects for a few days or weeks. Make sure you talk to your WellStar team about any side effects. They are expert in helping to minimize the effects of radiation. A range of solutions can help, depending on the side effects you present. For example, special creams can be used to soothe dry skin. Also, you can make minor adjustments in your daily routine that can help, such as using a mild shampoo for your hair, and patting yourself dry rather than rubbing after you leave the shower. If you are suffering from loss of appetite, you or your family or other loved ones can help make mealtime more attractive by eating by candlelight, playing soft music and taking your time to eat. It is very important to eat during treatment so that you can keep your strength up. It is extremely important to keep each appointment for the number of days and weeks that have been prescribed. The radiation treatment plan is a very precise plan, and you do not want to vary from it.
  • Exercise each day if you can, even if only a bit. Exercise will help you keep your strength, and it also can help with your mood.
  • Drink three quarts of fluid each day.
  • Accept offers of help from family and friends, and don’t be shy about asking them for help.
  • You typically receive external beam radiation on an outpatient basis five days a week over a period of at least two to 10 weeks. Treatments are usually spread out over several weeks to allow your healthy cells to recover in between radiation therapy sessions. Expect each treatment session to last approximately 10 minutes to 30 minutes. In some cases, a single treatment may be used to help relieve pain or other symptoms associated with more advanced cancers.

Before the Procedure

  • You will meet with a WellStar radiation oncologist who will answer any questions you have about the procedure. Make sure you have a friend or family member with you to help you write down and remember important points.
  • CT scans or X-rays may be taken to help your WellStar team know exactly where the tumor lies.
  • Your doctor may order other scans, depending on your specific diagnosis. These procedures will mainly require you to lie still.

During the Procedure

  • A device containing radioactive material will be inserted into the cavity (such as the vagina or windpipe). The device may be a tube or cylinder.
  • Your radiation team may insert the device by hand or may use a computerized machine to help place the device. General anesthesia may be used, depending on the size and number of implants. If you do not receive general anesthesia, you may experience some mild discomfort.

After the Procedure

  • The device will be removed after a period of time, depending on whether you are receiving low-dose or high-dose radiation, your type of tumor and your specific treatment plan. In high-dose radiation, the device may be removed after 20 minutes. In low-dose radiation, the radiation may be administered over a few days. In such cases, you will be admitted to the hospital.
  • Though very little radiation will remain in your body, your WellStar physician may instruct you to keep a distance from young children and pregnant women for a short time.
  • Make sure you follow all instructions.
  • Make time for rest, and eat well. It is also important to exercise.

Before the Procedure

  • You will meet with a radiation oncologist who will review your treatment plan with you. Make sure you have a family member or friend with you to write down questions and answers.
  • Your WellStar physician may order more CT scans or X-rays. These images will help your treatment team know the best location for the seeds, wires or, in the case of breast cancer, balloons, to be inserted.

During the Procedure

  • In some cases, surgery is required to place the radioactive material. In such cases, you will not be aware of anything that is going on. The surgery is typically quick. It may involve the insertion of tubes or catheters that later will be filled with radioactive material (such as in breast brachytherapy).
  • Needles or insertion tubes are sometimes inserted into the tissue. These needles or tubes contain radioactive material that is inserted into the tissue through the needle. You will need to lie still during the time that the radiation is being administered, which may be about three days for low-dose radiation. During that time, you will have a private room because of the radiation in your body, and children will not be permitted to visit.

After the Procedure

  • The radioactive material will be removed from your body, and you will be discharged from the hospital.
  • You may feel tired for a few days. It is important to rest and to eat well.
  • Ask your doctor about whether it is safe to be around children and pregnant women. In most cases, it will be safe to do so, but it is a good idea to check.

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