What to Expect: Radiation Therapy

Before beginning your treatment at Monongahela Valley Hospital's Regional Cancer Center, you will meet with your radiation oncologist for a physical exam and to review your medical records. It may be necessary to order additional tests to locate the exact size and type of the cancer; this is known as staging. Based on the size and location of your cancer, your age, your health and a number of other factors, your doctor will work with you to develop a personalized treatment plan. The plan may include radiation therapy, which treats cancer by using painless, high energy x-rays to destroy tumor cells. The goal is to damage the cancer cells without harming healthy cells. Your doctor, who is a radiation oncologist, will discuss the potential risks and benefits of radiation therapy with you. If you decide to receive this form of treatment, you will be asked to give written permission or informed consent. The consent form confirms that you have received information about your treatment plan and any potential side effects. It also confirms that you are willing to undergo therapy.

What should you expect during your radiation therapy?

Radiation therapy only affects the part of the body being treated. State-of-the-art devices send high doses of radiation to destroy cancer cells or tumors.

Simulation and Treatment Planning

Simulation must occur before radiation can be administered. Simulation is typically performed in one session. It is very important to identify the exact location on the body where the radiation should be directed. The radiation must be aimed precisely at the same target(s) every time treatment is performed. Your radiation oncologist and radiation therapist will place you on the computerized tomography (CT) Scanner in the exact position you will be in during the actual treatment. Your anatomy will be measured and marks will be placed directly on your skin on an immobilization device where the treatment will be administered. Some people need an immobilization device, which are molds, casts, headrests or other devices that are placed on certain parts of the body to help them stay in one position during the entire treatment. The radiation therapy team uses special software to perform the scan so that your radiation oncologist can create the best treatment plan for you. The radiation oncologist will request that special blocks and shields be used to shape the radiation exactly to your tumor and to keep the beams from affecting healthy tissue. The built-in blocks are called multi-leaf collimators (MLCs). Prior to your first treatment, another set of verification films will be taken on the treatment table to ensure the correct treatment location.

What happens during treatment?

Radiation treatment can be given by the following methods:

  • External beam radiation
  • Brachytherapy
  • A combination of both

External Beam Radiation Treatment

If your radiation oncologist prescribes external beam radiation treatment sessions, relax - they are painless - like getting an X-ray. A machine directs the radiation to your tumor from outside the body. Treatments are usually scheduled Monday through Friday and continue for two to eight weeks. The number of treatments you will need depends on the type of cancer you have, the location and size of the tumor, your general health and other medical treatments that you may be receiving. Radiation therapy is scheduled as a series of outpatient treatments and you may not need to miss work or experience any type of recuperation period that can follow other treatments. The board certified radiation therapists will administer the external beam treatments prescribed by your radiation oncologist. It will take approximately five to 15 minutes to position you for treatment and to set up the equipment. If an immobilization device was made during simulation, staff use it for every treatment to ensure that you are in the exact same position each time. Once you are correctly positioned, the therapists will leave the room and go into the control room to closely monitor you on a television screen. They will clearly hear you through an intercom system. The machine can be stopped at any time if you are uncomfortable. You may feel the table move and see the parts of the treatment machine move around you. In addition, you will hear noises during treatments that may sound like buzzing, clicking or whirring. These noises are normal. The radiation therapist is in complete control of the machine at all times. The radiation therapy team carefully aims the radiation to minimize the dose to normal tissues surrounding the tumor. However, radiation may affect some healthy cells and sometimes treatment is interrupted for a day or more if you develop side effects that require a break in treatment. The missed treatments may be added at the end.

Brachytherapy

Brachytherapy also is called internal radiation or seed implants. There are two types of brachytherapy: low-dose rate (LDR) and high-dose rate (HDR). With this form of treatment, radioactive sources are placed inside or just beside the tumor using small tubes, called catheters. For high-dose rate brachytherapy (HDR), the radioactive sources temporarily remain in place while the treatment occurs and you will not be radioactive following the treatment. The treatments take approximately 10 to 20 minutes and are done as an outpatient visit. For low-dose rate brachytherapy (LDR), radioactive seeds could be permanently placed inside the tumor and will lose their radioactivity over time.

Weekly Checks

During the course of the treatments, your radiation oncologist and nurse will see you regularly to follow your progress, check for side effects and address your questions and/or concerns. In addition, your radiation therapy team will meet on a regular basis with other health care professionals to review your case to ensure that your treatments are proceeding as planned.

Radiation Therapy appointment photo

What to expect after your radiation therapy treatment

Everyone reacts to radiation therapy differently. Some people do not experience any side effects, while others do. The most common side effects are:

  • Fatigue or feeling very tired
  • Skin changes
  • Loss of appetite

Other side effects depend on the part of the body being treated. Radiation to the head may lead to hair loss; to the chest may trigger a sore throat or cough. The skin of the treated area may appear sunburned. In time, most side effects go away. If you find the side effects too bothersome, your radiation oncologist may temporarily stop your treatments, change your schedule or change your treatment type. Be sure to report any side effects to your doctor, nurse or radiation therapist so they can help make you more comfortable. If you do feel tired from the radiation therapy, it can affect your emotions. Some people also may feel depressed, afraid, angry, alone or helpless. Talking to others sometimes helps.

Helpful Guidelines to Assist During Your Treatment

During your radiation therapy, you will need to take special care of yourself. While your radiation oncologist and nurse will give you specific instructions, listed below are some helpful basic tips.

  • Get plenty of rest. The feeling of fatigue can last for four to six weeks after your treatment ends.
  • Eat healthy foods. Your body needs certain foods. Talk with your doctor or nurse who may make changes in your diet to reduce side effects — especially if your stomach or throat are being treated.
  • Take care of the skin in the treatment area. Clean the skin every day with mild soap and warm water. Ask your nurse to recommend a safe, mild soap. Clean very gently — do not rub. Do not use lotions, deodorants, medicines, perfumes, makeup, powders or other products on the treatment area unless you have permission from your medical team.
  • Wear loose, soft clothing. Tight clothes such as pantyhose, tight collars and tight undergarments can rub the treatment area. Wear clothes without starch.
  • Do not rub, scrub, scratch or use tape on the skin.
  • Be careful not to rub off the ink marks needed for your radiation treatments.
  • Do not put any bandages on the treatment area unless recommended by your nurse.
  • Do not put heating pads or ice packs on the skin.
  • Protect your skin from the sun. Wear a hat and clothing to protect your skin. Ask your doctor if you should use sunscreen. The skin in the treatment area will always burn more quickly so always use extra sun protection.
  • Tell your doctor about all medicines that you are taking. It is important your doctor knows about all medications including vitamins, herbs, etc., that you are taking before you start radiation.
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