How is radiation administered?
Radiation therapy is administered either externally, by using a machine that generates a radiation beam, or internally, by placing radioactive material into body tissues or cavities. (See section on implants.)

Will I become radioactive after receiving external radiation treatment?
No. Neither you nor your clothing will become radioactive, and it is perfectly safe for you to be around your family and loved ones.

What happens during my treatment?
Before starting the actual treatment, you may need to change into a gown. The therapists then set up and position the equipment in the treatment room. During this time, you will be asked to lie on the treatment table beneath the radiation therapy unit.
The therapists will ensure that you are safe and comfortable while they align you in the proper position. Once you are positioned properly, it is important that you remain as still as possible and that you breathe normally. Sometimes a special immobilization device, such as a face mask, is used to decrease movement and improve accuracy.
The therapists will leave the room during the few minutes of your treatment but they will observe you closely from outside the room on the closed circuit television monitor. The intercom system is always “on” and, if necessary, you may also talk to the therapists. During treatment you may hear sounds or see colored lights. These merely indicate that the equipment is on. At the end of the treatment, the therapists will assist you off the treatment table and direct you to the dressing area.

How long will my daily treatment take?
Although the treatment itself may take only a few minutes, preparation time varies depending on the complexity of your treatment set-up. Please plan on spending at least an hour for your first appointment and approximately 30 to 40 minutes thereafter.

How many treatments will I need?
Your radiation oncologist will determine and prescribe the amount of radiation that you will receive. When determining the amount of radiation needed, the physician will consider the anatomic location and the pathology of the cancer. To help protect normal tissues, radiation treatments are often given in a series of small doses called fractions. This fractionation allows normal tissue to recover more readily. Depending on your condition, the total treatment course may be as short as one day or as long as eight weeks. A typical series may consist of five treatments a week over a four-to-six week period. Most treatment is delivered daily, Monday through Friday, with Saturday and Sunday off. With some diseases, two treatments per day are prescribed, with at least a six-hour interval between the two treatments. In special circumstances and when normal tissue can be protected, larger doses may be given.

Can I miss a treatment?
To receive maximum benefit from therapy, it is essential that you receive all your prescribed radiation treatments. If you think you cannot report for a scheduled appointment, please call the nurse or therapist. Missed appointments are made up and you will receive the prescribed amount of radiation, but over a longer period of time.It is essential that you complete your treatments within a reasonable time period as treatment may be less effective if extended over a longer period of time.
If you have a special scheduling need, i.e., a conflict with another doctor’s appointment, please speak with the therapist a day or two in advance. We will make every attempt to accommodate your scheduling needs. Sometimes your radiation oncologist may prescribe a treatment “break.” This allows normal tissues a chance to recover from the effects of radiation.

Does the treatment hurt?
Radiation treatments do not hurt at all. The treatment is painless.

Will I experience side effects from treatment?
Any side effects you may experience depend on the amount and frequency of radiation and the anatomic area that is treated. Side effects vary from person to person due to individual sensitivity to radiation.
Before treatment begins, the radiation oncologist and nurse will discuss with you any side effects that may occur and what you can do to control or relieve them. It is important to remember that most side effects are temporary. They generally subside within a few weeks after treatment, although some may take longer to resolve.
Most patients experience fatigue at some point during the course of therapy. It may persist for a few weeks after the completion of therapy. Please remember that fatigue is a usual side effect of radiation and is not an indication of progression of disease. Nausea, vomiting, and diarrhea may occur when the abdomen is radiated.
Hair loss will probably occur in the area of treatment. Scalp hair or a beard will likely fall out if the scalp, mouth, or throat are radiated. The size of the radiation field and the dose of radiation determine whether you will have these side effects.

What should I do if these reactions occur?
Report any reactions to the radiation oncologist, nurse, or therapists before your treatment. There are many comfort measures and medications
available to relieve these side effects.

Will radiation affect my skin?
For many treatments, there are no skin reactions. For others, the skin exposed to radiation may become red, itchy, or tanned. In some circumstances, blisters may form. These reactions are temporary and disappear within a few weeks after completion of therapy.
Recommended care for skin exposed to radiation

• Keep the irradiated skin clean and dry. Cleanse with mild soap and water, then pat dry. Avoid vigorous rubbing or massaging.
• Avoid wearing tight clothing that could rub, chafe, or otherwise irritate your skin. Cotton fabrics are better than synthetics next to your skin.
• Do not use heating pads, heat or sun lamps, hot water bottles or ice packs on the treated area.
• Do not expose the treated skin to sun. Wear protective clothing over the treated area. Sunscreen does not provide enough protection.
• Do not apply perfume, cosmetics, lotions, powders, petroleum jelly, or alcohol containing preparations to the irradiated skin. If you have any questions about a particular skin preparation ask your nurse.

Are there any restrictions on my activities?
You are encouraged to carry on your normal daily activities as much as possible, without feeling overstressed. Many people continue to work full time without experiencing adverse effects. If you feel you cannot continue working, please talk to your physician and/or nurse. Try to balance your daily activities with periods of rest, if necessary.

Do I need a special diet?
Depending on your specific treatment area and side effects, you may need to modify your diet. In general, you should eat a well-balanced diet that is high in protein and calories. A high protein, high calorie diet will help you maintain your weight and will provide the nutrients necessary for normal tissue to recover. We will refer you to a dietitian when appropriate.

Will extra vitamins help?
When feeling tired many people want to take vitamin supplements. We advise our patients not to take supplementary antioxidants, such as Vitamin A, C, and E, selenium and beta carotene or omega-3s. Radiation is an oxidant, and we are concerned that taking extra antioxidants at the same time as the radiation may decrease the effectiveness of the treatments. One multivitamin tablet per day is fine.

What about driving?
Radiation is usually given on an outpatient basis, and most people are able to drive themselves to therapy. In some cases, you may need to arrange for a friend or relative to drive you.

Will I be treated on holidays?
The Department is usually closed on national holidays. However, in cases where this would negatively impact the effectiveness of the treatments, special arrangements are made for treatment on holidays.

Why do the radiation oncologist and hospital bill me separately?
The law requires all charges from hospital-based physicians, such as radiation oncologists, be issued separately. You should expect to receive several separate statements after your treatment is completed.
These charges cover many aspects of your care, such as consultations, treatment planning, administration of treatment, and follow-up visits. Most insurance plans cover the cost of radiation therapy. If you have any questions, please contact our financial counselor.

Back to Radiation Oncology