Frequently Asked Questions (FAQ) About External Beam Radiation Therapy
Q: How often will I get external beam radiation therapy?A. Most people get external beam radiation therapy once a day, 5 days a week, Monday through Friday. Treatment lasts for 2 to 10 weeks, depending on the type of cancer you have and the goal of your treatment. You will get radiation for only 1 to 5 minutes, but you may be in the treatment room for 10 to 30 minutes. The time between your first and last radiation therapy sessions is called a course of treatment.
Radiation is sometimes given in smaller doses twice a day (hyperfractionated radiation therapy). Your doctor may prescribe this type of treatment if he or she feels that it will work better. Although side effects may be more severe, there may be fewer late side effects. Doctors are doing research to see which types of cancer are best treated this way.
Q. Where do I go for external beam radiation therapy?A. Most of the time, you will get external beam radiation therapy as an outpatient. This means that you will have treatment at a clinic or radiation therapy center and will not have to stay in the hospital.
Q. What happens before my first external beam radiation treatment?A. You will have a 1- to 2-hour meeting with your doctor or nurse before you begin radiation therapy. At this time, you will have a physical exam, talk about your medical history, and maybe have imaging tests. Your doctor or nurse will discuss external beam radiation therapy, its benefits and side effects, and ways you can care for yourself during and after treatment. You can then choose whether to have external beam radiation therapy.
If you agree to have external beam radiation therapy, you will be scheduled for a treatment planning session called a simulation. At this time:
- A radiation oncologist and radiation therapist will define your treatment area (also called a treatment port or treatment field). This refers to the places in your body that will get radiation. You will be asked to lie very still while x-rays or scans are taken to define the treatment area.
- The radiation therapist will then put small marks (tattoos or dots of colored ink) on your skin to mark the treatment area. You will need these marks throughout the course of radiation therapy. The radiation therapist will use them each day to make sure you are in the correct position. Tattoos are about the size of a freckle and will remain on your skin for the rest of your life. Ink markings will fade over time. Be careful not to remove them and make sure to tell the radiation therapist if they fade or lose color.
- You may need a body mold. This is a plastic or plaster form that helps keep you from moving during treatment. It also helps make sure that you are in the exact same position each day of treatment.
- If you are getting radiation to the head, you may need a mask. The mask has air holes, and holes can be cut for your eyes, nose, and mouth. It attaches to the table where you will lie to receive your treatments. The mask helps keep your head from moving so that you are in the exact same position for each treatment.
During your treatment:
- You will lie down on a treatment table
- Your Radiation Therapist will be in the next room to control the machine. He or she will be able to see, hear, and talk with you through a speaker at all times
- You will need to stay very still, but you won’t have to hold your breath
- You may see lights pointed at you. They are safe and show the therapist where to aim the radiation
When you go for treatment:
- Do NOT have powder, deodorant, Band-Aids, or jewelry near your treatment area
Wear loose-fitting, comfortable clothes
- If you have any questions or concerns, do not hesitate to ask your doctor.
Frequently Asked Questions (FAQ) About Internal Radiation Therapy
Q: What happens before my first internal radiation treatment?A. You will have a 1- to 2-hour meeting with your doctor or nurse before you begin internal radiation therapy. At this time, you will have a physical exam, talk about your medical history, and maybe have imaging tests. Your doctor will discuss the type of internal radiation therapy that is best for you, its benefits and side effects, and ways you can care for yourself during and after treatment. You can then choose whether to have internal radiation therapy.
Q. How is brachytherapy put in place?A. Most brachytherapy is put in place through a catheter, which is a small, stretchy tube. Sometimes, it is put in place through a larger device called an applicator. When you decide to have brachytherapy, your doctor will place the catheter or applicator into the part of your body that will be treated.
Q. What happens when the catheter or applicator is put in place?A. You will most likely be in the hospital when your catheter or applicator is put in place. Here is what to expect:
- You will either be put to sleep or the area where the catheter or applicator goes will be numbed. This will help prevent pain when it is put in.
- Your doctor will place the catheter or applicator in your body.
- If you are awake, you may be asked to lie very still while the catheter or applicator is put in place. If you feel any discomfort, tell your doctor or nurse so he or she can give you medicine to help manage the pain.
Q. What happens after the catheter or applicator is placed in my body?A. Once your treatment plan is complete, radiation will be placed inside the catheter or applicator. The radiation source may be kept in place for a few minutes, many days, or the rest of your life. How long the radiation is in place depends on which type of brachytherapy you get, your type of cancer, where the cancer is in your body, your health, and other cancer treatments you have had.
Q. What are the types of brachytherapy?A. There are three types of brachytherapy:
- Low-dose rate (LDR) implants. In this type of brachytherapy, radiation stays in place for 1 to 7 days. You are likely to be in the hospital during this time. Once your treatment is finished, your doctor will remove the radiation sources and your catheter or applicator.
- High-dose rate (HDR) implants. In this type of brachytherapy, the radiation source is in place for 10 to 20 minutes at a time and then taken out. You may have treatment twice a day for 2 to 5 days or once a week for 2 to 5 weeks. The schedule depends on your type of cancer. During the course of treatment, your catheter or applicator may stay in place, or it may be put in place before each treatment. You may be in the hospital during this time, or you may make daily trips to the hospital to have the radiation source put in place. Like LDR implants, your doctor will remove your catheter or applicator once you have finished treatment.
- Permanent implants. After the radiation source is put in place, the catheter is removed. The implants always stay in your body, while the radiation gets weaker each day. You may need to limit your time around other people when the radiation is first put in place. Be extra careful not to spend time with children or pregnant women. As time goes by, almost all the radiation will go away, even though the implant stays in your body.
Q. What happens while the radiation is in place?A. There are three types of brachytherapy:
- Your body will give off radiation once the radiation source is in place. With brachytherapy, your body fluids (urine, sweat, and saliva) will not give off radiation. With liquid radiation, your body fluids will give off radiation for a while.
- Your doctor or nurse will talk with you about safety measures that you need to take.
- If the radiation you receive is a very high dose, safety measures may include: • Staying in a private hospital room to protect others from radiation coming from your body • Being treated quickly by nurses and other hospital staff. They will provide all the care you need, but they may stand at a distance and talk with you from the doorway to your room.
Your visitors will also need to follow safety measures, which may include:
Not being allowed to visit when the radiation is first put in
- Needing to check with the hospital staff before they go to your room
- Keeping visits short (30 minutes or less each day). The length of visits depends on the type of radiation being used and the part of your body being treated.
- Standing by the doorway rather than going into your hospital room
- Not having visits from children younger than 18 and pregnant women
You may also need to follow safety measures once you leave the hospital, such as not spending much time with other people. Your doctor or nurse will talk with you about the safety measures you should follow when you go home.
Q. What happens when the catheter is taken out after treatment with LDR or HDR implants?A.
- You will get medicine for pain before the catheter or applicator is removed.
- The area where the catheter or applicator was might be tender for a few months.
- There is no radiation in your body after the catheter or applicator is removed. It is safe for people to be near you – even young children and pregnant women.
- For 1 to 2 weeks, you may need to limit