What is Radiation Therapy?

Radiation therapy (also known as Radiation Oncology) is one of the most common treatments for cancer, used in more than half of all cancer cases. In radiation therapy, we use high-energy x-rays or electron beams to destroy cancer cells in your body. The radiation is delivered by a special machine called a linear accelerator, or by radioactive substances that are implanted or injected. Radiation therapy has been used successfully for treating cancer for over 100 years! In simple terms, cancer cells are killed when they absorb a given amount of ionizing radiation. By delivering a calculated amount of radiation over a specific amount of time, the malignant cells are destroyed. Healthy tissue that is irradiated has the ability to repair itself, where as the cancer cells can not.

What is cancer?

Cancer occurs as a result of changes in the chromosomes (DNA) of cells causing them to reproduce abnormally. These damaged cells continue to grow and multiply, resulting in tumors. Some tumors are benign, or non-cancerous while others are malignant or cancerous. Only a biopsy, or examination of a small piece of the tumor, can confirm the diagnosis of cancer.

Is there more than one type of cancer?

There are literally hundreds of different types of cancers, and a cancer may occur in almost any organ or area of the body. These cancers all have different responses to the various types of treatments currently available. Your oncologists utilize their knowledge and years of experience to design a treatment plan that will most effectively utilize these therapies in order to treat a particular cancer.

What causes cancer?

Cancer can be caused by anything that damages the DNA in a cell. This includes certain chemicals, ionizing radiation, some types of viruses, genetics, and other external factors. Naturally occurring mutations in the cell’s chromosomes or aging of the cell may also lead to the development of a cancer. The process by which cancers may develop in a particular individual is not fully understood and appears to be quite complicated.

What types of cancer treatment are currently available?

The three main treatment modalities are surgery, chemotherapy, and radiation therapy. Frequently, a combination of two or three treatment modalities is utilized to achieve maximum benefit for the patient. Every treatment modality has certain risks and benefits that should be considered before starting treatment. Consultation with a board certified oncologist in each specialty is highly recommended before deciding upon a particular course of therapy.

What Can I Expect?

During your first visit to our department you will see a Radiation Oncologist (physician), who will obtain a complete history and perform a physical examination. A second appointment may be needed for treatment planning (simulation). This involves taking some regular X-rays in order to accurately plan the area to be treated. It may not be until the third appointment, therefore, that you will receive your first treatment. In a few cases, however, patients may be treated during their first or second visit. The treatment itself is painless. You will be required to lie completely still during treatment; however, this should not be uncomfortable, since the treatment rarely takes more than a few minutes. You will be alone in the room while you are receiving the radiation, but the technologist can see you on at TV screen and can hear you through an intercom.

When Are Treatments Usually Given?

Treatments are usually given each day of the week, Monday – Friday for 2 to 9 weeks, depending on the tumor type and location. In most cases, you will be treated at the same time every day. Occasionally, scheduling conflicts arise and your appointment time may have to be changed or delayed.

The Radiation Oncologist will meet with you weekly while you are on treatment. This will be done immediately after your radiation treatment. The nurse is available daily for any concerns you may have. During the course of Radiation Therapy it is important that you eat a well-balanced diet and plan for adequate rest. In many cases your level of daily activity does not have to be restricted. However, you should ask your physician or nurse about any restrictions that might apply to you.

How long do the treatments take?

The actual time it takes to deliver the dose of radiation is very short, usually less than a minute. However, it usually takes 5 to 10 minutes to correctly position a patient for their daily treatment. Once the treatment routine has established for a patient, they are usually treated and on their way again in about 15 minutes. The treatment planning process (simulation) and the very first treatment involve more activities and therefore require more time. Patients should allow at least an hour for the treatment planning process (simulation) and 30 minutes for their first treatment.

No Two People Are Exactly Alike

It is important to remember that no two centers or treatment plans are exactly alike either. The experience of other patients may not apply to you. Your doctor and nurse know you as an individual. They can provide you with the best answers to your questions or concerns.

What is a Portal Film?

X-Ray films are periodically taken during the course of radiation therapy treatments. The therapist will be taking verification x-rays or portal films once a week as part of our quality assurance program. These films are necessary to check treatment alignment. The films simply verify that the markings that have been placed on you or on your immobilatization device, used during your treatment have not shifted from their original placement. It is critical that your treatment positions are reproduced on a daily basis in order to have the best results. The films do not give us information about tumor response during radiation therapy.

Can my family watch the treatments?

Governmental regulations prohibit anyone who is not a patient or who has not been issued a film badge to be in a radiation control area while radiation equipment is being operated. No one under 18 years of age is allowed to be in a radiation control area unless they are being treated. Additionally, in order to protect the privacy of all of our patients, we only allow patients and staff in the treatment area during treatment hours.

Why does everyone leave the room during my treatments?

This also is a governmental regulation. We also observe the policy that staff should receive the least amount of exposure to radiation as possible in the performance of their duties.

Will I feel the radiation or will the treatment be painful?

No; the treatments are completely painless. The radiation is not detectable by touch, taste, sight, sound or smell. All that is required of the patient is that they hold very still while the treatment is being given.

If There Are Any Problems

Please notify your doctor or nurse of any change in your condition, especially if you are experiencing any discomfort. If you are unable to make a scheduled appointment because of an emergency or any other reason, please call the Cleveland Regional Cancer Center at (423)472-2171. In order to reach the Radiation Oncologist at nights or on weekends, please call (423)472-2171 and ask the page operator to contact the Radiation Oncologist on Call.

What is a Radiation Oncologist?

The radiation oncologist is a physician who specializes in using radiation to treat cancer and some benign diseases. During your consultation the radiation oncologist discusses treatment options and advises on the best treatment for you. The radiation oncologist works closely with other cancer specialists and healthcare professionals involved in your care, and meets with you on a regular basis to check on the status of your treatment.

Who Else is on My Treatment Team?

A team of medical professionals, in addition to your radiation oncologist, cares for you during your therapy. A radiation nurse helps coordinate your care, answers questions about your treatment, and helps manage side effects. Radiation therapists position you for daily treatments and ensure the accuracy of the radiation delivery. Behind the scenes, other professionals ensure that the treatment machine consistently delivers the correct dose of radiation required for your treatment.

The Nurse or Medical Assistant will give you specific instructions related to your care during radiation therapy. She will meet with you frequently to discuss any problems, questions, or concerns you may have regarding your treatment.

The Therapist will actually be giving you your daily treatment. The therapist, who has been specially trained in a certified school of radiation therapy, works closely with your physician and nurse. The technologist will deal with any requests you may have related to your appointments for treatment.

Each patient is treated as an individual, and receives the focused attention of a team of physicians, oncology nurses, and other professionals who are expert in serving the broad needs of cancer patients.

What are the side effects of radiation therapy?

Radiation therapy will cause side effects only to those areas directly in the path of the beam or located in the treatment field. These side effects are specific to the area of the body being treated and may vary greatly from person to person. The side effects a person may experience will also vary depending upon the dose received and the size of the field being treated.

Will radiation therapy damage normal tissue?

Radiation therapy is designed to treat tumor-containing tissue. Occasionally, normal tissue receives radiation, too. During radiation treatments, some normal tissues are temporarily irritated. This irritation usually resolves shortly after treatment. Rarely, delayed or chronic complications may occur. Please check with your physician for further information.

How many treatments will I be having?

The number of treatments will vary between individual patients and the various diseases being treated. Some patients receive only a single treatment, others as many as 45. The doctor will review the treatment objectives and goals and number of treatments being planned for you.

I have a planned vacation. Can I take time off from my radiation therapy treatments?

Radiation treatments provide the optimal outcome if delivered in succession. Breaks in treatment are not in the patients best interest, unless there is a family crisis or medical reason. Discuss vacation plans with doctor early in planning.

Are you going to burn me with radiation?

Reactions to radiation vary from patient to patient and are dependent upon the site of treatment. The dose given to a given area or depth of tissue determine surface reaction of the skin. Tumors deeper from surface area, like prostate or endometrial, have very little skin reaction. Tumors closer to the skin surface, like larynx or throat, have potential for increased skin reaction.

Are there any restrictions on who I may visit, i.e., do I have to stay away from children or pregnant women?

No, patients receiving external beam radiation as outpatients do not become radioactive.

Do I become radioactive after a treatment? Will I "glow in the dark"?

Patients do not become radioactive by being exposed to radiation from the treatment machines (linear accelerators) or the simulator. If a procedure calls for placing radioactive materials in to the body (an implant) then the patient will be “radioactive” only for the time the radioactive material is in their body. As soon as it removed, the patient’s body ceases to be radioactive.

Will I lose my hair?

Radiation affects only the area receiving treatment. If your head is not being irradiated, you will not lose your hair. If the scalp or facial hair area is in the treated field, then hair loss may occur. This hair loss may be temporary or permanent depending upon the total dose received by the patient.

I have heard that radiation can cause cancer. Will I get cancer from this treatment?

There is a very small risk of getting cancer from this treatment. These cancers usually take more than 10 years to develop and occur in the region that was irradiated. Your greatest risk is dying from the cancer you have now; the chance that the radiation will help you is much, much greater than it will hurt you. Unfortunately, all treatments have side effects, and we are actively researching methods of decreasing those side effects.

Can I continue my regular routine or activities while undergoing radiation treatments?

Most of our patients continue with their occupations or leisure activities during radiation therapy. We do advise patients to avoid exposing treated skin areas to sunlight and to refrain from using potentially irritating chemicals on the irradiated skin sites. For example, do not use an underarm deodorant if we are treating the area around your shoulder or armpit. In general, you can do whatever you feel you are capable of doing.

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