Frequently Asked Questions (FAQ) About Radiation Therapy
Q: How is radiation therapy given?A. Radiation therapy can be external beam (when a machine outside your body aims radiation at cancer cells) or internal (when radiation is put inside your body, in or near the cancer cells). Sometimes people get both forms of radiation therapy.
Q. Who gets radiation therapy?A. Many people with cancer need radiation therapy. In fact, more than half (about 60 percent) of people with cancer get radiation therapy. Sometimes, radiation therapy is the only kind of cancer treatment people need.
Q. What does radiation therapy do to cancer cells?A. Given in high doses, radiation kills or slows the growth of cancer cells. Radiation therapy is used to:
• Treat cancer. Radiation can be used to cure, stop, or slow the growth of cancer
• Reduce symptoms. When a cure is not possible, radiation may be used to shrink cancer tumors in order to reduce pressure. Radiation therapy used in this way can treat problems such as pain, or it can prevent problems such as blindness or loss of bowel and bladder control.
Q. How long does radiation therapy take to work?A. Radiation therapy does not kill cancer cells right away. It takes days or weeks of treatment before cancer cells start to die. Then, cancer cells keep dying for weeks or months after radiation therapy ends.
Q. What does radiation therapy do to healthy cells?A. Radiation not only kills or slows the growth of cancer cells, it can also affect nearby healthy cells. The healthy cells almost always recover after treatment is over. But sometimes people may have side effects that do not get better or are severe. Doctors try to protect healthy cells during treatment by:
• Using as low a dose of radiation as possible. The radiation dose is balanced between being high enough to kill cancer cells yet low enough to limit damage to healthy cells.
• Spreading out treatment over time. You may get radiation therapy once a day for several weeks or in smaller doses twice a day. Spreading out the radiation dose allows normal cells to recover while cancer cells die.
• Aiming radiation at a precise part of your body. New techniques, such as IMRT and 3-D conformal radiation therapy, allow your doctor to aim higher doses of radiation at your cancer while reducing the radiation to nearby healthy tissue.
• Using medicines. Some drugs can help protect certain parts of your body, such as the salivary glands that make saliva (spit).
Q. Does radiation therapy hurt?A. No, radiation therapy does not hurt while it is being given. But the side effects that people may get from radiation therapy can cause pain or discomfort. This book has a lot of information about ways that you, your doctor, and your nurse can help manage side effects.
Q. Is radiation therapy used with other types of cancer treatment?A. Yes, radiation therapy is often used with other cancer treatments. Here are some examples:
Radiation therapy and surgery. Radiation may be given before, during, or after surgery. Doctors may use radiation to shrink the size of the cancer before surgery, or they may use radiation after surgery to kill any cancer cells that remain. Sometimes, radiation therapy is given during surgery so that it goes straight to the cancer without passing through the skin. This is called intraoperative radiation.
Radiation therapy and chemotherapy. Radiation may be given before, during, or after chemotherapy. Before or during chemotherapy, radiation therapy can shrink the cancer so that chemotherapy works better. Sometimes, chemotherapy is given to help radiation therapy work better. After chemotherapy, radiation therapy can be used to kill any cancer cells that remain.
Q. Who is on my radiation therapy team?A. Many people help with your radiation treatment and care. This group of health care providers is often called the “radiation therapy team.” They work together to provide care that is just right for you. Your radiation therapy team can include:
• Radiation oncologist. This is a doctor who specializes in using radiation therapy to treat cancer. He or she prescribes how much radiation you will receive, plans how your treatment will be given, closely follows you during your course of treatment, and prescribes care you may need to help with side effects. He or she works closely with the other doctors, nurses, and health care providers on your team. After you are finished with radiation therapy, your radiation oncologist will see you for follow-up visits. During these visits, this doctor will check for late side effects and assess how well the radiation has worked.
• Nurse practitioner. This is a nurse with advanced training. He or she can take your medical history, do physical exams, order tests, manage side effects, and closely watch your response to treatment. After you are finished with radiation therapy, your nurse practitioner may see you for follow-up visits to check for late side effects and assess how well the radiation has worked.
• Radiation nurse. This person provides nursing care during radiation therapy, working with all the members of your radiation therapy team. He or she will talk with you about your radiation treatment and help you manage side effects.
• Radiation therapist. This person works with you during each radiation therapy session. He or she positions you for treatment and runs the machines to make sure you get the dose of radiation prescribed by your radiation oncologist.
• Other health care providers. Your team may also include a dietitian, physical therapist, social worker, and others.
• You. You are also part of the radiation therapy team. Your role is to: Arrive on time for all radiation therapy sessions, Ask questions and talk about your concerns, let someone on your radiation therapy team know when you have side effects, Tell your doctor or nurse if you are in pain, Follow the advice of your doctors and nurses about how to care for yourself at home, such as: Taking care of your skin, Drinking liquids, Eating foods that they suggest. Keeping your weight the same.
Q. Is radiation therapy expensive?A. Yes, radiation therapy costs a lot of money. It uses complex machines and involves the services of many health care providers. The exact cost of your radiation therapy depends on the cost of health care where you live, what kind of radiation therapy you get, and how many treatments you need. Talk with your health insurance company about what services it will pay for. Most insurance plans pay for radiation therapy for their members.
Q. Should I follow a special diet while I am getting radiation therapy?A. Your body uses a lot of energy to heal during radiation therapy. It is important that you eat enough calories and protein to keep your weight the same during this time. Ask your doctor or nurse if you need a special diet while you are getting radiation therapy. You might also find it helpful to speak with a dietitian.
Q. Can I go to work during radiation therapy?A. Some people are able to work full-time during radiation therapy. Others can only work part-time or not at all. How much you are able to work depends on how you feel. Ask your doctor or nurse what you may expect based on the treatment you are getting.
You are likely to feel well enough to work when you start radiation therapy. As time goes on, do not be surprised if you are more tired, have less energy, or feel weak. Once you have finished your treatment, it may take a few weeks or many months for you to feel better.
You may get to a point during your radiation therapy when you feel too sick to work. Talk with your employer to find out if you can go on medical leave. Make sure that your health insurance will pay for treatment when you are on medical leave.
Q. What happens when radiation therapy is over?A. Once you have finished radiation therapy, you will need follow-up care for the rest of your life. Follow-up care refers to checkups with your radiation oncologist or nurse practitioner after your course of radiation therapy is over. During these checkups, your doctor or nurse will see how well the radiation therapy worked, check for other signs of cancer, look for late side effects, and talk with you about your treatment and care. Your doctor or nurse will:
• Examine you and review how you have been feeling. Your doctor or nurse practitioner can prescribe medicine or suggest other ways to treat any side effects you may have.
• Order lab and imaging tests. These may include blood tests, x-rays, or CT, MRI, or PET scans.
• Discuss treatment. Your doctor or nurse practitioner may suggest that you have more treatment, such as extra radiation treatments, chemotherapy, or both.
• Answer your questions and respond to your concerns. It may be helpful to write down your questions ahead of time and bring them with you.
Q. After radiation therapy is over, what symptoms should I look for?A. You have gone through a lot with cancer and radiation therapy. Now you may be even more aware of your body and how you feel each day. Pay attention to changes in your body and let your doctor or nurse know if you have:
• A pain that does not go away
• New lumps, bumps, swellings, rashes, bruises, or bleeding
• Appetite changes, nausea, vomiting, diarrhea, or constipation
• Weight loss that you cannot explain
• A fever, cough, or hoarseness that does not go away
• Any other symptoms that worry you
Your Feelings During Radiation Therapy
At some point during radiation therapy, you may feel:
It is normal to have these kinds of feelings. Living with cancer and going through treatment is stressful. You may also feel fatigue, which can make it harder to cope with these feelings.
There are many things you can do to cope with your feelings during treatment. Here are some things that have worked for other people:
- Relax and meditate. You might try thinking of yourself in a favorite place, breathing slowly while paying attention to each breath, or listening to soothing music. These kinds of activities can help you feel calmer and less stressed.
- Exercise. Many people find that light exercise (such as walking, biking, yoga, or water aerobics) helps them feel better. Talk with your doctor or nurse about types of exercise that you can do.
- Talk with others. Talk about your feelings with someone you trust. You may choose a close friend, family member, chaplain, nurse, social worker, or psychologist. You may also find it helpful to talk to someone else who is going through radiation therapy.
- Join a support group. Cancer support groups are meetings for people with cancer. These groups allow you to meet others facing the same problems. You will have a chance to talk about your feelings and listen to other people talk about theirs. You can learn how others cope with cancer, radiation therapy, and side effects. Your doctor, nurse, or social worker can tell you about support groups near where you live. Some support groups also meet over the Internet, which can be helpful if you cannot travel or find a meeting in your area.
- Talk to your doctor or nurse about things that worry or upset you. You may want to ask about seeing a counselor. Your doctor may also suggest that you take medicine if you find it very hard to cope with these feelings.
Remember, you are not alone! We are here to help! Please do not hesitate to contact us regarding any questions or concerns you may have on radiation therapy.
Radiation Therapy Side Effects
Side effects are problems that can happen as a result of treatment. They may happen with radiation therapy because the high doses of radiation used to kill cancer cells can also damage healthy cells in the treatment area. Side effects are different for each person. Some people have many side effects; others have hardly any. Side effects may be more severe if you also receive chemotherapy before, during, or after your radiation therapy.
Talk to your radiation therapy team about your chances of having side effects. The team will watch you closely and ask if you notice any problems. If you do have side effects or other problems, your doctor or nurse will talk with you about ways to manage them.
Common Side Effects:
Many people who get radiation therapy have skin changes and some fatigue. Other side effects depend on the part of your body being treated.
Skin changes may include dryness, itching, peeling, or blistering. These changes occur because radiation therapy damages healthy skin cells in the treatment area. You will need to take special care of your skin during radiation therapy.
Fatigue is often described as feeling worn out or exhausted. There are many ways to manage fatigue.
Depending on the part of your body being treated, you may also have:
- Hair loss in the treatment area
- Mouth problems
- Nausea and vomiting
- Sexual changes
- Trouble swallowing
- Urinary and bladder changes
Most of these side effects go away within 2 months after radiation therapy is finished.
Late side effects may first occur 6 or more months after radiation therapy is over. They vary by the part of your body that was treated and the dose of radiation you received. Late side effects may include infertility, joint problems, lymphedema, mouth problems, and secondary cancer. Everyone is different, so talk to your doctor or nurse about whether you might have late side effects and what signs to look for.
Questions to Ask Your Doctor Regarding Radiation Therapy
- What kind of radiation therapy will I get?
- How can radiation therapy help?
- How many weeks will my course of radiation therapy last?
- What kinds of side effects should I expect during my course of radiation therapy?
- Will these side effects go away after radiation therapy is over?
- What kind of late side effects should I expect after radiation therapy is over?
- What can I do to manage these side effects?
- What will you do to manage these side effects?
- How can I learn more about radiation therapy?