When is radiotherapy used?
Radiotherapy may be used in the early stages of cancer or after it has started to spread.
It can be used to:
- Try to cure the cancer completely (curative radiotherapy)
- Make other treatments more effective – for example, it can be combined with
chemotherapy or used before surgery (neo-adjuvant radiotherapy) - Reduce the risk of the cancer coming back after surgery (adjuvant radiotherapy)
- Alleviate symptoms if a cure is not possible (palliative radiotherapy)
Radiotherapy is generally considered the most effective cancer treatment post-surgery, but its effectiveness varies among individuals.
What is radiotherapy?
Radiotherapy is the treatment of cancer with radiation. This can be done in a variety of ways, depending on the nature of the cancer. The most commonly used method is called external beam therapy (from a machine outside of the body), which directs radiation at the tumour.
How does radiotherapy work?
Although the radiation affects both cancer and normal cells, it has a greater effect on the cancer cells. Treatment intended to cure the cancer will give the highest possible dose of radiation to the cancer area (within safe limits) in an attempt to kill all of the cancer cells.
Who will be looking after me?
A cancer specialist doctor is known as a radiation therapist or radiation oncologist. In this guide we will refer to him/her as a radiation oncologist. The radiation oncologist will plan and oversee your treatment, which will be carried out by radiation therapists. In addition, the team looking after you may include nurses, health care assistants, specialist nurses, counsellors and dietitians, according to your needs during your treatment.
How is the treatment planned?
Every radiotherapy course is tailored to meet the specific needs of each patient. As part of this process, you will typically be asked to attend a preliminary visit to the treatment centre for treatment planning. This planning is conducted by a radiation oncologist and radiation therapists, using X-rays and scans with a specialised machine called a simulator. To ensure precise targeting, your skin will be marked with coloured pens or removable skin markers, indicating the areas where treatment will be administered.
These marks help radiation therapists accurately identify the treatment area during each session. If a head shell has been created for you, the guidance marks will be placed on the shell instead of your skin.
For patients receiving radiotherapy to the mouth and/or throat, a dental assessment will be required at this stage, as certain dental treatments may be necessary before beginning radiotherapy.
Do I have to stay in hospital?
If you are able to travel to the hospital for treatment, there is typically no need for you to be admitted during the course of treatment. Most individuals are treated as outpatients, but your radiation oncologist will inform you if it is best for you to be admitted.
Will I have any tests during treatment?
During your course of treatment, you may need to have occasional blood test and/or urine test, depending on the part of your body being treated. Some patients may also undergo X-rays and/or scans during their treatment course. This is a routine procedure and nothing to be concerned about.
Are there particular things I should or should not do during my course of treatment?
Try to maintain your normal routine as much as possible throughout your treatment. Think of radiotherapy as a temporary interruption rather than the central focus of your day.
How will radiotheraphy be given?
Radiotherapy is administered using either a linear accelerator or, in the case of some skin tumours, a superficial X-ray unit. During treatment, you will lie on a treatment couch beneath the machine and will be asked to remain still throughout the procedure.
Will the radiotherapy hurt?
No. The treatment is completely painless. Radiation cannot be seen or felt while it is being administered.
Will the treatment make me radioactive?
No. There is no possibility of this whatsoever.
How long will the course of treatment last?
Your radiation oncologist will inform you once the appropriate treatment plan has been determined. The duration of a course can vary, ranging from a single session to five treatments per week for up to six weeks, depending on several factors, such as the area being treated and the treatment objective. Most treatments are administered daily, Monday through Friday.
How long is each treatment session?
The duration of treatment sessions can vary depending on the machine used. Some machines operate faster than others, and the treatment plan also affects the time. Sessions typically last between five and fifteen minutes. Occasionally, a session may take longer, and this will be explained on an individual basis. Your radiation therapist will inform you of the expected duration during your first treatment.
Do:
- Drink plenty of fluids every day during treatment, e.g. tea, coffee, milk, fruit juice, water or fizzy drinks (ideally sugar-free).
- Eat regularly and maintain a balanced diet. If you are unable to eat large meals, try consuming smaller, more frequent meals. If needed, the dietitian can assist in creating a tailored diet plan for you.
- Shower or bath as usual during treatment. You may shower or bathe as usual during treatment, using a mild or baby soap. Be sure to gently pat the treated area dry instead of rubbing it.
Do not:
- Drink spirits, eat spicy food, or consume very hot or cold food if you are receiving treatment to your mouth, neck, or chest. If you need more information, feel free to ask the radiation oncologists.
- Expose the treated area to the sun during your radiotherapy treatment course, as it will be more prone to burning and will take longer to heal. However, it is recommended to always apply sunscreen to protect against sunburn.
- Apply creams or deodorants on the treated area, as these may worsen your skin reaction.
Can I carry on working?
If you wish to continue working, you may do so as long as your radiation oncologist does not advise against it. However, feel free to ask for advice if needed.
What will happen when the treatment is finished?
The immediate side effects of the treatment described above will begin to subside within one to two weeks after completing your treatment. However, the full benefits of the treatment are typically not realised until several weeks after the final session.
Will I have any check-ups after my treatment?
After your treatment, you will either return to the hospital where you first received care or be referred back to your family doctor. The first follow-up appointment is typically scheduled 4 to 6 weeks after the completion of your treatment, and this will be discussed with you before you finish at the treatment centre. Your radiation oncologist will provide you with details regarding your follow-up appointments.
Can radiotherapy cause permanent damage?
Radiotherapy treatment is planned and administered with the utmost care; however, sensitive areas of the body may sometimes be affected. To treat the cancer effectively, high doses of radiation are sometimes required, which may be close to the limits of what normal tissues can tolerate. The bowel, bladder, and nervous system are particularly sensitive, although other areas of the body may also experience long-term changes.
If you are receiving radiotherapy aimed at eliminating cancer cells, there is a small risk (approximately 5%) of side effects that may significantly impact your lifestyle. However, it is important to weigh this against the much higher potential risks to your life if the cancer worsens or recurs without treatment. On the other hand, if you are undergoing radiotherapy to shrink the tumour and/or alleviate symptoms, the lower doses of radiation used are unlikely to cause any permanent damage.
If your radiotherapy treatment involves the gonads (ovaries in women, testicles in men), it may affect fertility and hormone function. It is important to discuss these potential effects with your oncologist before treatment begins.
If you experience any difficulties in the future that you believe may be related to your radiotherapy, do not hesitate to contact your oncologist or GP. Should there be any specific risks or concerns in your case, your oncologist will discuss them with you.
Please remember that radiotherapy is being recommended because the benefits significantly outweigh the risks.
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