Patient Guide to Radiation Therapy
What is radiation therapy and how does it work?
Radiation therapy, sometimes called radiotherapy, effectively treats cancer by using high-energy rays to pinpoint and destroy cancerous cells in your body. Although radiation therapy is similar to having an X-ray taken of a broken bone, the dose of radiation in cancer treatment is stronger and is given over a longer period of time. Many forms of radiation are available. The best choice for you depends on the type of cancer you have, the extent of the cancer, and its location.
Cancers are growths of abnormal cells. Different types of cancer react to radiation in different ways, so treatments vary. Also, it takes time for the body to get rid of dead cancer cells. After you have completed treatment, months often pass before the tumor is completely gone.
With careful planning, radiation can be directed to the cancer and away from most normal tissues. This means you may receive treatment on more than one side of your body or from different angles. You may also need more than one type of radiation, which may require the use of more than one machine.
What will happen on my first visit to the center?
For your initial visit, the Radiation Oncology team usually meets you at the Radiation Oncology Center.
If, after evaluation, you decide to proceed with treatment, you will receive more information about the radiation therapy treatment process and side effects that you might experience. Before you leave, an appointment will be made for your planning session (simulation).
The simulation visit includes seeing your doctor and setting up your treatment plan. This visit in the Radiation Oncology Center will take from one hour to three hours. You will be asked to sign a consent form agreeing to your treatment. Actual treatment time on subsequent visits takes only a few minutes, but preparation may add 15 to 20 minutes.
Will radiation therapy make me radioactive?
You will not be radioactive after getting external radiation therapy, so don't worry about hurting your family and friends.
If you are hospitalized for insertion of internal radioactive sources, you will stay in a protected room until the source of radiation is removed. If you need this type of radiation, your doctor will explain it to you in detail.
Who will administer the treatment?
A health care team will work together to administer your radiation therapy. The team is led by a radiation oncologist, a doctor who specializes in radiation therapy. This is the person referred to as "your doctor" throughout this text.
A radiation therapist actually delivers the prescribed treatment and will assist you before and after your treatments. A radiation therapy nurse works closely with the radiation oncologist to help you throughout your course of treatment. The health care team also includes other physicians, dosimetrists (specialists who use computers to help design treatment plans), social workers, dietitians, and chaplains.
What can I expect after I am told I need radiation therapy?
You will see your doctor in the Radiation Oncology Center or in your primary clinic. An appointment will be made for a planning session (simulation). This visit includes seeing your doctor and setting up your treatment plan. Be prepared to spend one to three hours in the Radiation Oncology Center. You will be asked to sign a consent form agreeing to your treatment.
Simulation is done to locate the exact area to be treated. The radiation therapist will move you into a position that will be the same during your actual treatments. During the simulation, the radiation therapist will take a CT scan of the area that needs to be in the treatment field.
As the treatment progresses, the treatment area may change as directed by your doctor.
What will happen on my treatment days?
On each treatment day, you will be asked to put on a gown or remove some clothing to expose the treatment area.
Although the actual treatment will last only a few minutes, you may spend 15 to 20 minutes getting ready. You will be helped onto a treatment table. Your position on the table will be the same for each treatment.
Once you are positioned, do not move until the treatment is finished.
After the radiation therapist has helped position you on the table, he or she will leave the room, monitor you by closed-circuit television, and be in contact with you through an intercom.
Keep in mind that the treatment machines are large and sometimes noisy while in use. Just relax and breathe normally. You should not feel any pain.
If you need something or are in pain, tell the radiation therapist. He or she can turn off the machine immediately and come into the room. The radiation stops when the machine is turned off.
How often will I get a treatment?
Your treatments will probably be scheduled every weekday, Monday through Friday, allowing you to rest on Saturday and Sunday. The treatment cycle usually takes from two to six weeks.
Your daily appointment schedule will be as convenient for you as possible. Your radiation therapist will notify you of any holidays on which you will not receive treatments.
Your doctor will examine you and review your progress once a week. This scheduled check-up will take longer than the treatment visits. The nurses who see you during the check-up will work closely with you and the doctor to help you manage any side effects you may have. This is also the proper time to request refills for any medications that you may need to manage side effects.
What delays can I expect?
Sometimes you may have to wait for your treatment or to see the doctor because the Radiation Oncology Center is very busy. However, if you wait longer than 30 minutes, please check with the front desk.
The most frequent cause of delay is equipment downtime. This happens when a radiation therapy machine cannot be used because it is being serviced. In most cases of downtime, you will be asked to wait, or you may be treated on another machine.
Will I have side effects, and how long will they last?
Side effects depend on the part of the body being treated. Most go away a few weeks after treatment is stopped.
Some common side effects include:
Red, itching, and peeling skin in your treatment area. This usually happens after about four weeks of radiation therapy. Report any skin problems to your nurse or doctor. Refer to the next section for skin care information.
You may feel more tired than usual. Make sure to get plenty of rest, and do not overexert yourself.
- Loss of appetite
You may not feel like eating. This side effect is common if your abdomen or mouth is in the treatment area. If so, try eating several small meals or snacks (dry toast, crackers) throughout the day, instead of three big meals. A dietitian can give you more tips on eating during treatment.
- Hair loss
Hair loss may occur, but only in the area being treated.
You will receive specific information about your type of radiation therapy. This information will include what to do in case of problems and how to manage your specific side effects. Be sure to tell your nurse if you have any side effects.
How do I take care of my skin while I am getting radiation therapy?
Toward the end of your treatment, the radiated skin may become pink and itchy. In some cases, the skin will blister and flake like a sunburn.
What to do:
Leave the marks on your skin until all of your treatments are finished. In some cases, you may rinse the treatment area with warm water, but do not rub or scrub off the marks. Your nurse will talk with you in more detail about care of your treatment area.
Do not use soap on the marks.
Wear loose-fitting, cotton clothing that does not rub the treatment area.
Do not put any source of heat or cold on the treatment area, and do not let the sun shine on the area.
If your skin itches in the treatment area, do not scratch it. If this is a problem for you, tell your nurse or doctor. Some medicines may relieve the itching.
Do not put anything (cream, lotion, powder, makeup) on the treatment area unless your doctor or nurse says it is okay to do so. After your treatment is complete, your doctor may give you an ointment to soothe the skin.
Before shaving any part of your treatment area, check with your nurse or doctor. If you are allowed to shave, use an electric shaver.
Will I be able to have sex?
You may have sex if it is comfortable for you. You are not radioactive, and your partner is in no danger from the radiation treatments or the cancer.
If you are a woman of childbearing age and have sex during treatment, you must use some type of birth control. Your doctor can help you decide what kind of birth control is best for you.
If you want or need to talk with someone about other sexual health concerns, you may schedule an appointment with a social worker. Coping with the diagnosis of cancer and its treatment can be difficult. The radiation therapy health care team is here to help you. Please tell your nurse or doctor about your concerns.
What other things can I do to help myself during treatment?
Eat a well-balanced diet. Every day, choose foods from these groups: breads and cereals; meats, eggs or beans; milk or milk products; vegetables and fruits.
Try to eat enough food to keep your weight at the same level as before treatment. Your body needs more calories now, so you may need to eat more than usual. A dietitian from the radiation therapy clinic can help you set up a food plan.
Tell your doctor or nurse if you lose or gain 10 or more pounds.
Drink at least eight cups of fluid every day. Fluids may include water, gelatin, ice pops, juices, iced tea, soup, and milk.
If you notice your weight going down, try to drink fluids that are high in calories, such as milk shakes or nutritional supplements.
At MemorialCare, you can watch the video Good Nutrition and the Radiotherapy Patient. You or your nurse may call us and ask to view the videotape.
Get some exercise and plenty of rest. It is okay to continue your regular activities as long as you take rest periods and do not overexert yourself. Your doctor will talk with you about how much exercise you should get.
Try to sleep at least six hours at night, and take naps during the day if you can.
What should I do about medicine?
Tell your doctor or radiation therapy nurse if you are taking prescription or over-the-counter medicines. He or she will review your current medications, which usually can be continued throughout your treatment. Your local doctor will still prescribe any medications you are taking for problems other than cancer.
You may continue to buy your routine medications at your local drugstore. The hospital pharmacy dispenses medication only for the treatment of cancer.
What if I have other questions?
If you or your family have any questions about your care, please ask your nurse or doctor. You may also speak with a social worker.
Being told that you have cancer can affect you and your family in many different ways. Social workers may be able to help you with individual counseling, support groups, community resources, transportation, and housing while you are being treated in the Radiation Oncology Center.
With your help, your radiation therapy team can give you the best care possible.