Radiation Therapy

Friday 1 December, 2017

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On this page:  What is radiation therapy? | How does radiation therapy work? | How is radiation therapy given? | Where will I have treatment? | Why have radiation therapy? | Will I be able to work during radiation therapy? | Can I have radiation therapy if I am pregnant? | How do I prepare for radiation therapy? | How will I know if the treatment has worked? | Which health professionals will I see?

What is radiation therapy?

Radiation therapy uses a controlled dose of radiation to kill cancer cells or damage them so they cannot grow, multiply or spread. The radiation is usually in the form of focused x-ray beams, also known as photons. It can also be in other forms such as electron beams, proton beams or gamma rays from radioactive sources. It is a localised treatment, which means it generally affects only the part of the body where the radiation is targeted.

How does radiation therapy work?

Radiation therapy kills or damages cancer cells in the area being treated. Cancer cells begin to die days or weeks after treatment starts, and continue to die for weeks or months after it finishes. Although the radiation can also damage healthy cells, these tend to be less sensitive than the cancer cells and can usually repair themselves. You should not feel any pain or heat during radiation therapy, but some side effects can cause pain or discomfort. Read about ways to prevent or manage side effects.

How is radiation therapy given?

There are two main ways of giving radiation therapy:

External beam radiation therapy (EBRT)

Radiation beams from a large machine are aimed at the area of the body where the cancer is located. The process is similar to having an x-ray. You will lie on a treatment table underneath the machine, which will move around your body. You won't see or feel the radiation, although the machine can make noise as it moves. See more information about EBRT.

Internal radiation therapy

A radiation source is placed inside the body or, more rarely, injected into a vein or swallowed. The most common form of internal radiation therapy is brachytherapy, where temporary or permanent radiation sources are placed inside the body next to or inside the cancer. See more information about internal radiation therapy.

You may have one or both types of radiation therapy, depending on the type of cancer and other factors.

Where will I have treatment?

Radiation therapy is usually given in the radiation oncology department of a large hospital or treatment centre, or in private clinics. The large machines used for external beam radiation therapy will be in a dedicated room.

While treatment schedules vary, most people have radiation therapy as an outpatient. This means you do not stay in hospital, but travel to the treatment centre for each session. Radiation therapy centres will try to arrange treatment times that suit you. For some types of internal radiation therapy, you will need to stay in hospital overnight or for a few days.

Why have radiation therapy?

Research shows that about one in two people with cancer would benefit from radiation therapy. 1 It can be used for different reasons:

As the main treatment to achieve remission or cure

Radiation therapy may be given as the main treatment with the aim of causing the signs and symptoms of cancer to reduce or disappear. This is called curative or definitive radiation therapy.

To help other treatments achieve remission or cure

Radiation therapy is often used before (neoadjuvant) or after (adjuvant) treatments such as surgery to make the treatment more effective. It can also be used at the same time as some treatments – when it is combined with chemotherapy, it is known as chemoradiation or chemoradiotherapy.

For symptom relief

Radiation therapy can help to relieve pain and other symptoms by making the cancer smaller or stopping it from spreading. This is known as palliative treatment.

Will I be able to work during radiation therapy?

Many people can continue to work during their treatment and feel well enough to do all their usual activities. Others may need to reduce their hours or take time off. How much you will be able to work depends on the type of radiation therapy you have, how the treatment makes you feel and the type of work you do. You may be able to organise your radiation therapy appointments for the beginning or end of the day.

Talk to your employer about your working arrangements. Explain that it is hard to predict how radiation therapy will affect you, and discuss the options of flexible hours, modifying duties or taking leave.

Your treatment team will encourage you to be as active as possible, and they can answer your questions about working during treatment.

Can I have radiation therapy if I am pregnant?

You probably won't be able to have radiation therapy if you are pregnant, as radiation can harm a developing baby. It's important that you don't become pregnant during the course of treatment. If you suspect you may be pregnant at any stage, it is important to tell your doctor. Men who have radiation therapy should avoid getting their partner pregnant during treatment and for about six months afterwards, as radiation can damage sperm.

Your doctor will be able to give you more information about radiation therapy and pregnancy.

How do I prepare for radiation therapy?

The effects of radiation therapy depend on the part of the body being treated and the number of treatments required. Your treatment team will tell you the likely effects for you. It can be hard to know how to prepare, but a number of general issues are worth considering in advance.

Find out about quitting

If you smoke, try to quit or cut down before radiation therapy starts as smoking may make the treatment less effective and side effects worse. Quitting can be difficult, especially if you're already feeling anxious about the cancer diagnosis, so it is important to seek support – talk to your doctor, call Quitline on 13 7848 or visit quitnow.gov.au.

Explore ways to relax

Waiting for and having radiation therapy can make people feel anxious. Take something to read or listen to while you wait, ask a friend or family member to keep you company, or try chatting to other people waiting for treatment. To help you relax during the session, try meditation or breathing exercises, or ask the radiation therapists if you can listen to music.

Organise help at home

You may become very tired during the later weeks of treatment. Some support with housework, meals and errands can ease the load. If you have young children, you may need to arrange for someone to look after them during treatment sessions and possibly afterwards. Older children may need lifts to and from school and activities. Consider asking one friend or family member to coordinate offers of help.

Arrange transport

Talk to the hospital social worker or clinic receptionist about parking arrangements as there will often be spots set aside for radiation therapy patients. At first, you may feel well enough to drive yourself or catch public transport to radiation therapy sessions. However, you are likely to feel more tired as the treatment goes on, so try to arrange for a relative, friend or volunteer to drive you. You may be able to get community transport through your local council or Cancer Council.

Mention metal implants

Let your treatment team know if you have any medical devices in your body, such as a pacemaker, cochlear implant or another metal implant. Radiation therapy can affect these devices.

Ask about travel assistance

If the treatment centre is a long distance from your home, you may be eligible for financial assistance towards the cost of accommodation or travel. Your local Cancer Council may also provide accommodation services. For details, speak to the hospital social worker or clinic receptionist, call Cancer Council 13 11 20.

Discuss your concerns

Keep a list of questions for your treatment team. If you are feeling anxious about the diagnosis and treatment, try talking to a member of the radiation therapy team, your GP, or a family member or friend. You can also call Cancer Council 13 11 20 to speak to a health professional.

Consider fertility

Some types of radiation therapy can affect your fertility. If you think you may want to have children in the future, talk to your treatment team about your options before radiation therapy begins.

How will I know the treatment has worked?

Because cancer cells continue to die for weeks or months

after treatment ends, your radiation oncologist most likely won't be able to tell you how the cancer is responding during treatment. However, they can help you manage any side effects. After treatment finishes, you will have regular checkups. Your radiation oncologist will do a physical examination and arrange tests or scans to check whether the cancer has responded to treatment. It may be some time after radiation therapy finishes before the full benefit is known.

If radiation therapy is given as palliative treatment, the relief of symptoms will indicate that the treatment has worked. This may take a few days or weeks. Until then, you may need to have symptoms treated in others ways, e.g. medicine for pain.

Which health professionals will I see?

After a diagnosis of cancer, you will usually be cared for by a range of health professionals who specialise in different areas of your treatment. This is called a multidisciplinary team (MDT). For external beam radiation therapy and brachytherapy, the main specialist doctor will be a radiation oncologist. You may be referred to a radiation oncologist by your GP or by another specialist such as a surgeon or medical oncologist. Some of the health professionals you may see during and after treatment are listed in the table below.

Health professional Role
radiation oncologist* assesses you for radiation therapy, prescribes and coordinates the course of radiation therapy
radiation therapist plans and delivers radiation therapy
radiation oncology nurses help you manage emotional and physical problems, including side effects that you may experience during treatment
radiation oncology medical physicist ensures radiation therapy is delivered accurately and safely by checking radiation treatment plan and ensuring radiation therapy machines are running correctly
dietitian recommends an eating plan to follow while you are in treatment and recovery
speech pathologist helps with communication and swallowing
social worker links you to support services and helps you with emotional, practical or financial issues
psychologist uses counselling to help you manage your emotional response to diagnosis and treatment
physiotherapist helps you with any physical or practical issues associated with cancer and treatment
occupational therapist assists in adapting your living and working environment to help you resume usual activities
lymphoedema practitioner/therapist educates people about lymphoedema prevention and management, and provides treatment if lymphoedema occurs

* Specialist doctor

Reviewed by: Dr Tiffany Daly, Radiation Oncologist, Radiation Oncology Princess Alexandra Raymond Terrace (ROPART), South Brisbane, QLD; Elly Keating, Acting Principal Radiation Therapist, Northern Territory Radiation Oncology, Alan Walker Cancer Care Centre, NT; Julie O'Rourke, Clinical Nurse Consultant, Radiation Oncology, Canberra Hospital, ACT; Ching Tsao, 13 11 20 Consultant, Cancer Council NSW; A/Prof Sandra Turner, Clinical Lead, Targeting Cancer Campaign, Faculty of Radiation Oncology, Royal Australian and New Zealand College of Radiologists (RANZCR), NSW; Dr David Waterhouse, Acting Principal Radiation Oncology Medical Physicist, Sir Charles Gairdner Hospital, WA; David Wells, Consumer.

1. MB Barton et al., “Estimating the demand for radiotherapy from the evidence: a review of changes from 2003 to 2012”, Radiotherapy and Oncology, vol. 112, no. 1, 2014, pages 140–44. doi: 10.1016/j.radonc.2014.03.024.

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