Radiation Therapy

What is radiation therapy?

Radiation therapy uses high-energy radiation (X-rays) to kill cancer cells and shrink or destroy tumors.

Radiation therapy:

• Can cure some cancers
• May shrink some tumors (benign or cancerous) and lessen the symptoms
• May help stop the spread of cancer.

Radiation therapy is sometimes called X-ray therapy, radiotherapy, or irradiation.

When is it used?

Radiation therapy may be used to treat cancerous or noncancerous tumors. Cancer cells grow and multiply more quickly than normal cells. Carefully planned doses of radiation can kill or stop the growth of the fast-growing cancer cells. Most normal cells can recover from the radiation.

Some examples of the uses of radiation therapy are:

• shrinking a tumor before surgery, making it easier to remove the tumor
• destroying cancer cells that remain after surgery or other treatments
• using it with chemotherapy to destroy cancer
• controlling the size of the tumor and limiting its spread to treat pain, pressure, and other symptoms of cancer even if a cure is not possible

Radiation therapy alone can cure some cancers, such as Hodgkin's disease. However, for most cancers it is combined with surgery or chemotherapy.

Instead of this procedure, other treatments may include:

• chemotherapy (using medicine to destroy cancer cells)
• removing cancer or other tumors with surgery

You may choose not to have treatment. Ask your healthcare provider about your choices for treatment and the risks.

How do I prepare for this procedure?

Ask your radiation doctor what your schedule will be and how you should expect to feel.

• Make plans for your care and recovery after you have the procedure. Find someone to give you a ride home after the procedure. Allow for time to rest and try to find people to help with your day-to-day tasks while you recover.
• Follow any instructions your healthcare provider gives you.
• Ask any questions you have before the procedure. You should understand what your healthcare provider is going to do and how the treatments are likely to make you feel.
• You will have one appointment before you start getting radiation to mark the areas that will be getting radiation. These ink marks on your skin will come off when your treatments are finished.

What happens during the procedure?

There are 2 kinds of radiation therapy: external and internal.

• External radiation is delivered from outside the body.
• For internal radiation (also called brachytherapy), a radiation source is placed next to or into a tumor.

External radiation

External radiation is usually given during outpatient visits to a hospital or treatment center.

The temporary marks on your skin will show the radiation technologist the exact area to be treated. The dose of radiation to use on the tumor is calculated by a radiation oncologist. (A radiation oncologist is a doctor who specializes in treating tumors with radiation.) You will lie on a treatment table. A machine will direct a beam of radiation at the tumor.

Each external radiation treatment lasts just a few minutes. The treatment is painless.

Everyone’s treatment schedule is different. You may have a few short treatments over a few days or your may have treatments every day for weeks. Often small doses are given daily or every other day. This helps the body tolerate the treatment. The total dose may be given over a couple weeks or several weeks. For example, you may have treatment for several days in a row and then you may not have any treatment for several days. This pattern of treatment may be repeated until you have received the total dose of radiation.

After your last session, the therapist will wipe the ink marks off your body.

Talk with your healthcare provider about any side effects you should expect, your diet and caring for your skin. Ask how active you can be and how often you should return to the radiation and oncology clinic for checkups.

During the weeks of radiation treatment the therapist will weigh you and may do tests, such as blood cell counts, to check the effect the radiation is having on your body.

Internal radiation

For internal radiation therapy, a radioactive material is put inside your body near the tumor. This may be done in different ways.

• The radioactive material can be inserted through a tiny tube called a catheter.
• Tiny metal irradiated rods may be placed in the tumor or the tissue around the tumor.
• The internal radiation may be given as a liquid. You may swallow the radioactive material or it may be injected into your body.

Internal radiation allows the treatment to affect only the cancerous area and limits exposure of healthy tissues to radiation. The radioactive material or tubes may be left in place for a few hours or many hours. Once it is in place, the radioactive material generally does not cause any pain. If you have any discomfort, you will be given pain medicine. When the treatment is completed, the radiation oncologist or the technician will remove the radiation material.

What are the side effects of radiation therapy?

While it is killing tumor cells, radiation therapy can also damage normal cells in the area of the tumor. Side effects depend on the part of the body that is getting the treatment. Some possible side effects are:

• skin sores or darkening of the skin
• loss of head and body hair
• increased risk of infection
• bleeding problems
• nausea, vomiting, and diarrhea
• weakness, tiredness, and fatigue
• sores in the mouth
• loss of appetite.

To help relieve skin problems caused by radiation treatment:

• Avoid tight or scratchy clothing that irritates the skin.
• Use lukewarm water and mild soap for bathing.
• Avoid being in the sun. When you are outside, put sunscreen with an SPF of 15 or higher on exposed parts of the body.
• Do not use any powders, creams, perfumes, deodorants, body oils, ointments, or lotions without first checking with your provider. They may interfere with your treatment.

To help you cope with the fatigue, get plenty of rest and sleep.

If you have a loss of appetite:

• Eat frequent small meals.
• Eat small snacks between meals.
• Add extra protein to your diet by eating more cheese, meat, fish, nuts, and soy products.
• Use nutritional supplements, such as Boost and Ensure, as directed by your provider.
• If cooking odors bother you, ask a friend or family member to prepare food at another location and bring it to you.

To reduce nausea and vomiting:

• Eat small meals throughout the day.
• Suck on hard candy. Avoid other sweets and fried or fatty foods.
• Eat dry foods like toast or crackers to help ease an upset stomach.
• Avoid food odors that increase nausea.
• Drink cool, unsweetened, and noncarbonated drinks, such as apple juice or flat ginger ale.

To help relieve diarrhea:

• Try drinking just clear liquids, such as water, weak tea, broth, or flat ginger ale. You may need to drink just small amounts at a time to avoid nausea and vomiting.
• Avoid coffee, strong tea, colas and other caffeinated drinks.
• Avoid milk and other dairy products if they make the diarrhea worse.
• Eat breads, soft cereals (such as cream of wheat and oatmeal), eggs, yogurt, potatoes, rice, and bananas.

If you keep having vomiting or diarrhea that just won’t stop, contact your healthcare provider. You may need to be checked for dehydration and weight loss. Your provider may prescribe medicines to help stop nausea, vomiting, or diarrhea. When you are feeling better, you may also need a prescription for an appetite stimulant to help you keep your weight or to help you gain weight.

If the side effects get severe, treatment may be stopped for a while, or the dose may be lowered. In extreme cases, treatment may be stopped completely and other treatment options may be considered.

What happens after the procedure?

While it is killing tumor cells, radiation therapy can also damage normal cells in the area of the tumor. This can result in some side effects. The side effects you have depend on the part of the body that is getting the treatment. The side effects should go away a few days or weeks after the end of therapy. Your healthcare provider will tell you what to expect.

Talk with your healthcare provider about your diet and caring for your skin. Ask how active you can be and how often you should return to the clinic for checkups.

If you have internal radiation therapy, the radioactive material may send its high-energy rays outside your body. This means that other people in close range may be exposed to small doses of radiation. To help keep others safe from radiation exposure, you may need to stay in a hospital room while the implant is in place. Visitors and hospital staff can usually spend time in your room as long as they are not too close and don’t stay too long. Hospital staff members may wear a lead apron or shield because they are exposed to radiation more often than your visitors. If you are treated as an outpatient, you will be given instructions about if, when, and how long other people can be around you while you have the implant.

You don’t have to worry about exposing others to radiation if you are treated with external radiation.

What are the risks of this procedure?

Your healthcare provider will explain the procedure and any risks. Some possible risks include:

• You may have some unpleasant side effects from the radiation.
• There is a risk of hurting healthy cells.
• Your skin could be injured and become scarred or get darker.
• Depending on the area being treated, your bowel, or bladder, or other organs could be injured.
• If you are having both radiation therapy and chemotherapy, you may have more side effects.
• The radiation therapy may not destroy all of the cancer.
• The cancer may come back.

Every procedure or treatment has risks. The technology for giving radiation treatment has improved so that there are fewer side effects and less risk of damage to other tissues than there used to be. Ask your healthcare provider how the risks apply to you. Be sure to discuss any questions or concerns that you may have.

Developed by RelayHealth.
Adult Advisor 2012.1 published by RelayHealth.
Last modified: 2012-01-18
Last reviewed: 2011-10-09
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
© 2012 RelayHealth and/or its affiliates. All rights reserved.