There are two main types of Radiation therapy:

• The most common type is called external-beam radiation therapy, which is radiation given from a machine located outside the body (LINAC) using high energy x-rays
• Internal Radiotherapy or Brachytherapy is the use of a radioactive material placed inside the body for a specific time to deliver the required dose of radiation

• Radiation therapy aims to kill or damage cancer cells in the area being treated through damaging their DNA.
• Cancer cells begin to die days or weeks after treatment starts, and continue to die for weeks or months after it finishes.
• The radiation can also damage healthy cells, most of these cells tend to receive a lower dose and can usually repair themselves.
• The patient will not feel any pain or heat during radiation therapy.
• Many patients will develop temporary side effects during or shortly after treatment which can be treated and controlled.

• A specially trained physician, called a radiation oncologist, is responsible for prescribing a patient’s radiation therapy treatment.
• The radiation oncologist works with a specially trained team of health care professionals, including medical physicists, dosimetrists, radiation therapists and radiation oncology nurses.
• This team works and cooperates to ensure high quality care for patients.

→  Consultation
Your first visit to radiation oncology is a consultation with the radiation oncologist. For most patients the visit will include:

• Physical examination
• Review medical history, MRI, CT or other imaging, and medication review
• Discussion of treatment options
• Explain the possible side effects and how to minimize or treat them.
• Sign the informed consent.

→  CT-Simulation

• For most types of treatment, a CT-Simulation appointment will be scheduled. The purpose of this visit is to outline or map the exact area to be treated.
• If needed, immobilization devices such as a face mask or a leg mold will be made at this time. Your skin will be marked with small dots to ensure that the precise area is treated each time.
• During this visit the radiation therapist will discuss treatment times and reserve a space for you depending on how many treatments you will be receiving.

→  Treatment planning

• After simulation, you will have 2-3 days to relax while your radiation oncology team creates a unique radiation plan of treatment taking into account your diagnosis, the amount of radiation needed and the number of treatments to be given.

→  Treatment delivery

• The number of treatments prescribed will vary depending on your specific cancer type and its location.
• A full course of radiation therapy may take several weeks, while other treatments may be just a few days or even one day.
• Treatments are given five days a week for the number of visits determined during planning. Typically, your treatment is scheduled for the same time each day.

→  Follow-up Appointments

• When your course of treatment is completed, your radiation oncologist will need to see you for follow-up visits. You will be given instructions about the intervals at which you will need to be seen and also if any diagnostic imaging or blood tests are needed.

• The total number of treatments varies with the type of cancer and the stage of disease and can range from one to maximum forty treatments.
• The actual treatment is painless, but there can be side effects depending on what part of the body is being treated.

• It’s very important when you speak to your doctor you understand exactly why radiation is being used and what the purpose is.
• We may use radiation in different ways:
  • As the only treatment to eradicate cancer (primary)
  • Before surgery, to shrink a cancer to make the surgery possible (neoadjuvant)
  • After surgery, to kill cancer cells that may be left behind after surgery (adjuvant)
  • In advanced stages of cancer to relief symptoms caused by the cancer (palliative)

• Many studies have shown that combinations of treatment for cancer are more effective, therefore we frequently give radiation in addition to surgery or chemotherapy or sometimes even both.
• For you as a patient is very important to understand how these different treatments are going to be used, what their side effects are and what the sequence is going to be.
• Sometimes these combinations of treatment may last many months.

• You need never go through cancer treatment alone.
• There is support available through a large number of sources:
  • Family and friends
  • Your physicians and nurses, social workers and therapists
  • Many patient support groups

• Radiation therapy is a local treatment, that means it only affects the area of the body that is targeted.
• Common physical side effects of radiation therapy include:
  • Skin changes (redness, itching, dryness). Skin changes from radiation therapy usually go away a few weeks after treatment ends.
  • Fatigue / tiredness: The severity of fatigue depends on your treatment plan. For example, radiation therapy combined with chemotherapy may result in more fatigue.
  • Long-term side effects: Most side effects go away after treatment. But some continue, come back, or develop later. These are called long-term or late effects. One possible late effect is the development of a second cancer yeaars later. This is a new type of cancer that develops because of the original cancer treatment. The risk of this late effect is very low. And the risk is often smaller than the benefit of treating the first cancer.

1. Head and neck Radiation therapy:

• Dry mouth
• Mouth and gum sores
• Difficulty swallowing
• Stiffness in the jaw
• Nausea
• Hair loss
• A type of swelling called lymphedema
• Tooth decay

2. Chest Radiation therapy:

• Difficulty swallowing
• Shortness of breath
• Shoulder stiffness
• Cough, fever, and fullness of the chest, known as radiation pneumonitis.
• Radiation fibrosis, which causes permanent lung scars from untreated radiation pneumonitis.

3. Stomach and abdomen Radiation therapy:

• Loss of appetite
• Nausea and vomiting
• Bowel cramping
• Loose stool or diarrhea

4. Pelvis Radiation therapy:

• Loose stool (diarrhea)
• Rectal bleeding
• Frequent urination
• Bladder irritation
• Lowered sperm counts and reduced sperm activity.
• Vaginal itching, burning, dryness, and other changes to sexual health for women.
• Infertility if both ovaries receive radiation therapy.

Yes, but it depends on the treated site and the interval between the two radiotherapy courses.