Radiation Oncology

Commonly Asked Questions

What is Radiation Therapy?

Radiation is a special kind of energy carried by waves or a stream of particles. It can come from special machines or from radioactive substances. Many years ago doctors learned how to use this energy to see inside the body and find disease. You've probably seen a chest x-ray or x-ray pictures of your teeth or your bones. When radiation is used at high levels (many times those used for x-ray exams) this energy can be used to treat cancer and other illnesses. Special equipment is used to aim the radiation at tumors or areas of the body where there is disease. The use of high-energy rays or particles to treat disease is called radiation therapy. Sometimes it's called radiotherapy, x-ray therapy, cobalt therapy, electron beam therapy, or irradiation.

How does radiation therapy work?

High levels of radiation can kill cells or keep them from growing and dividing. Radiation therapy is a useful tool for treating cancer because cancer cells are growing and dividing more rapidly than many of the normal cells around them. In addition, most normal cells appear to recover more fully from radiation effects than cancer cells. Doctors carefully limit the intensity of treatments and the amount of normal tissue being treated so that the cancer will be harmed more than you will.

What are the benefits of radiation therapy?

Radiation therapy is an effective way to treat many kinds of cancer in almost any part of the body. Half of all people with cancer are treated with radiation, and the number of cancer patients who have been cured is rising every day. For many patients, radiation is the only kind of treatment needed. Thousands of people are free of cancer after having radiation treatments alone or in combination with surgery, chemotherapy, and biological therapy. Doctors can use radiation before surgery to shrink a tumor. After surgery radiation therapy may be used to stop the growth of any cancer cells that remain. In some cases doctors use radiation along with anticancer drugs to destroy the cancer, instead of surgery. Even when curing the cancer is not possible, radiation therapy can still bring relief. Many patients find the quality of their lives improved when radiation therapy is used to shrink tumors and reduce pressure, bleeding, pain, or other symptoms of cancer. This is called palliative treatment.

Are there risks involved?

As with many other treatments for disease, there are risks for patients who are receiving radiation therapy. The doses of radiation that damage or destroy cancer cells can also hurt normal cells. When this happens, the patient has side effects. The risks and benefits of treatment are extensively discussed with each individual patient.

Your doctor will not advise you to have any treatment unless the benefits - control of disease and relief from symptoms - are greater than the known risks. Although it will be many years before scientists know all of the possible risks of radiation therapy, we do know that it can control cancer and help prevent its spread throughout the body.

How is radiation therapy given?

Radiation therapy can be in either of two forms: external or internal. Some patients have both forms, one after the other.

Most people who receive radiation therapy for cancer have the external type. It is usually given during outpatient visits to a hospital or treatment center. In external therapy, a machine directs the high-energy rays or particles at the cancer and a margin of normal tissue near it.

One type of machine that is used for radiation therapy is called a linear accelerator. This machine uses accelerates electrons to produce high-energy radiation for treatment. High-energy rays may also come from a machine that contains a radioactive substance such as cobalt-60. Some people call this cobalt therapy but it is only one of several different kinds of radiation therapy.

The various machines used for external radiation work in slightly different ways. Some are better for treating cancers near the skin surface; others work best on cancers deeper in the body. Your doctor decides which machine is best for you.

When internal radiation therapy is used, a radioactive substance, or source, is sealed in small containers such as thin wires or tubes called implants. The implant is placed directly into a tumor or inserted into a body cavity. Sometimes after a tumor has been removed by surgery, implants are put into the area around the incision to kill any tumor cells that may remain.

Another type of internal radiation therapy uses unsealed radioactive sources. The material is either taken by mouth or is injected into the body . If you have this type of treatment, you will probably need to stay in the hospital for several days.

Who gives radiation treatments?

A doctor who has had special training in using radiation to treat disease - a Radiation Oncologist - will prescribe the type and amount of treatment that best suits your needs.

The radiation oncologist heads a highly trained health care team. Your radiation therapy team will include:

• The radiation physicist, who makes sure that the equipment is working properly and ensures that the machines deliver the right dose of radiation.
• The dosimetrists who helps carry out your treatment plan by calculating the number of treatments and how long each treatment should last.
• The radiation therapy nurse, who provides nursing care and helps you learn about treatment and how to manage side effects.
• The radiation therapist, who sets you up for your treatments and runs the equipment that delivers the radiation. Some hospitals and treatment centers use the title "radiation technologist."
• You may also use the services of a dietitian, a physical therapist, a social worker, and other health care professionals.
• Medical physicists provide physics support for clinical radiation procedures. They also develop, test, and implement new technologies in radiation therapy that come from conducting basic medical physics research.

Is radiation therapy expensive?

Treatment of cancer with radiation can be costly. It requires very complex equipment as well as the services of many health care professionals. The exact cost of your radiation therapy will depend on the type and number of treatments you need.

Most health insurance policies, including Part B of Medicare, cover charges for radiation therapy. It is a good idea to talk with your doctor's office staff or the hospital business office about your policy and how expected costs will be paid.

In some states, the Medicaid program may help you pay for treatments. You can find out from the office that handles social services in your city or county whether you are eligible for Medicaid and whether your radiation therapy is a covered expense.

If you need financial aid, contact the hospital social service office, the Cancer Information Service or the local office of the American Cancer Society. They may be able to direct you to sources of help.

What about physical activity during treatment?

While undergoing radiation therapy, patients should remain as active as they like. If after several weeks of treatment you begin to feel more tired than usual, a midday nap will often help.

Is good nutrition important to radiation therapy?

Good nutrition will help you feel better during therapy. A dietician is available to help you plan your diet during treatment.

What happens after radiation treatment is completed?

You will usually be asked to return for a follow-up visit one month after the last treatment and again at three months. They you will be checked at frequent intervals (usually at six months or one year) for several years in order to determine what effect the therapy has had on your cancer. We will also check for cancer elsewhere in the body.

Certain diagnostic tests such as blood studies, x-rays, and nuclear medicine scans may be requested both during treatment and at follow-up visits. Your follow-up visits are important to us. We can help coordinate your follow-up care with your referring physician, if you live a great distance from UWMC or SCCA. To learn more about radiation oncology options at UWMC, click here UWMC's Cancer Center

September 2007