What to Expect with Radiation Therapy

For some cancer patients radiation therapy may be a part of the recommended treatment. In this section, we’ll address what to expect before, during and after radiation treatment.

Watch a video on An Introduction to External Beam Radiation Therapy – Patient from ASTRO.

Before Radiation Therapy

You will meet with a radiation oncologist. The radiation oncologists of Arizona Oncology will help determine if radiation therapy is the best option for you and if so, what type of radiation therapy is recommended.

The doctor will review your records, perform a medical exam, and potentially order more tests that will help give us more information about your cancer and/or plan your treatment. Your doctor will also discuss the potential risks and benefits of radiation therapy with you, as well as give you the opportunity to ask any questions you may have.

You will then have a planning session called a simulation prior to the start of treatment. This appointment isn’t a treatment, but rather a necessary procedure as part of the process to help us define the target i.e. tumor and potential sites of involvement, with the help of imaging scans such as a computed tomography (CT) scan, magnetic resonance image (MRI), or PET/CT. To help reproduce your setup precisely at each visit, devices will be utilized to help you remain still during treatment these can include things as simple as tape, molds, headrests, or maybe even customized thermoplastic masks, a special mesh mask which will help secure you in place throughout each treatment.  Once ideal positioning is obtained, local marks are often made on your skin. The radiation oncology team wants each patient to be as comfortable as possible during treatment. Since external radiation therapy is given multiple times, it’s important that you let the team know if you feel uncomfortable or anxious during the simulation so they can help find a solution.

Once the simulation is complete, your team will review your information and design a treatment plan using highly sophisticated computer software allowing us to incorporate the information obtained from the multiple imaging studies. Your doctor will then write a prescription for the specific course of your radiation treatment.

During Radiation Therapy

There are two main types of radiation therapy: external beam radiation (teletherapy) and internal radiation therapy (brachytherapy). Your experiences will differ based on the type of therapy you receive.

  • External Beam Radiation Therapy: This form of radiation comes from a machine located outside the body. Sessions are quick and painless, typically lasting about 15 minutes. Most of this time is for set up and reproducing the position from simulation with a much shorter “Beam on” time.  Treatments usually occur five times a week (Monday through Friday) and continue for three to nine weeks. Although the radiation beam is positioned to only target the tumor, some healthy tissue surrounding the tumor may be affected. The two-day break on the weekends allows your body to rest and repair.
  • Internal Radiation Therapy: Brachytherapy involves placing radiation sources as close as possible to the tumor site. Because of this, you may need to have anesthesia, usually as an outpatient procedure. Often times the radioactive material only has to be placed for short periods (15-30 minutes) and you would not be radioactive at all as soon as it is removed.  If the material is implanted like seeds are for the prostate, you will be given instructions on any precautions that may need to be taken to protect others from radiation exposure.

Your progress will be assessed weekly. Weekly assessments by your radiation oncologist will help determine how well your treatment is working and if any adjustments need to be made. In some cases, image guidance may be used to ensure the radiation beam is always aimed correctly.

You may experience side effects. There are two kinds of radiation side effects: early (acute) and late (chronic). Your radiation oncologist will do everything possible to minimize side effects by making sure the dose is as carefully directed towards the at risk areas while minimizing exposure to surrounding normal tissues.

The most common acute side effect is fatigue and local skin irritation. Nausea and vomiting are not common. Treatments are available to help diminish side effects and most will completely go away after treatment is done.

Late side effects, also known as chronic, may or may not appear after treatment is over. The type of late side effects depends on where radiation therapy was given on the body. These are highly dependent on the location treated, and are often minor, but regardless, will be discussed with you by your Radiation Oncologist.

Rarely is another type of cancer caused by radiation therapy. For most the benefits of radiation therapy outweigh the risks.

Talk with your cancer care team about the possible side effects to help you make an informed treatment decision and help you know what to watch for during and after treatment. You may also want to see our section on radiation side effects.

Personal care will be important. It’s very important to take care of yourself while undergoing treatments. The best way to care for yourself is to get extra rest, eat a healthy diet, and seek emotional support. Treating your skin with physician-approved lotions and limiting your sun exposure will also help.

After Radiation Therapy

Once your treatment ends, you will need to see your radiation oncologist for follow-up visits so that he or she can monitor your recovery and watch for any side effects. Your follow-up care might also include other types of cancer treatment, rehabilitation, and counseling.

Some patients may need to continue some of the special care used during treatment until they are completely healed. Extra rest and limiting your activities may be required for some while others are encouraged to remain active and often increase exercise as part of a healthy lifestyle. Some may need help managing side effects that lingers after radiation therapy. Talk with your radiation oncologist about anything you may notice or have concerns about.