Radiotherapy
Radiotherapy involves the use of x-rays and other types of radiation to treat cancer. It destroys or damages cancer cells in order to stop them from growing. Radiotherapy can be used to treat primary cancer or to treat the symptoms of advanced (or secondary) cancer. In some cases, radiotherapy is the only treatment used, however it may also be used along with surgery, chemotherapy and/or other medications.
Your doctor, a radiation oncologist, will assess your particular situation and decide on the radiotherapy you need - including how, where, and how often it is to be given.
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Radiotherapy can be given in two ways: internally and externally. External radiotherapy involves a machine directing rays at the site of the cancer. When receiving external radiotherapy you are not radioactive - it is safe to be with other people over the course of your treatment. Depending on your specific situation and your overall health, external radiotherapy is usually given on an outpatient basis. This means that you won't have to stay in hospital overnight, but can attend each day for your treatment.
Internal radiotherapy involves having radioactive implants put into your body, on or near the cancer. This treatment is called brachytherapy and involves an inpatient stay (generally admission to hospital for a few days). While your implant is inside you it is radioactive and it may send some radiation outside your body. There may be special rules to follow while it is in place eg: limiting your visitors, as it is important not to expose family, friends and others to any radiation. Once your implant is removed it's then completely safe for you to be with other people and interact as you usually do.
Depending on the type of cancer you have, you may be given internal or external radiotherapy, or even a combination of both.
Radiotherapy is usually given daily over a five day period with a two-day break. A course of radiotherapy is usually given over 2-6 weeks, however this varies depending on your diagnosis and the schedule of treatmentyour doctor decides is best for you.
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Before you begin radiotherapy, your treatment must be planned in detail. This is to make sure that the cancer cells receive the correct amount of radiation, with little damage to normal cells. You may have extra tests, scans and x-rays as part of this planning. When your treatment plan is completed you will be given an appointment for your first radiotherapy treatment.
- The Simulator - A simulator is a special kind of x-ray machine that helps pinpoint the area to be treated.
- The Mould Room - It is important that exactly the same area is treated each time you have radiotherapy. Some people may need a special mould or cast to keep parts of the body still during treatment. This is to make sure that the radiation is directed at the cancer cells, and as little harm as possible is done to normal cells. In the "mould room" an impression of the area to be treated is taken. From this impression a mould or cast is made which is worn during each radiotherapy treatment. Your radiation therapist or doctor may need to mark your skin with special inks to make sure that therapy is directed at the same place each time. Sometimes permanent black "tattoos" (the size of a tiny dot) may be necessary to direct the radiation accurately.
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When you arrive for treatment you will be directed to the radiotherapy waiting area. Your Radiation Therapist will collect you and show you to a changing room. You will be given a gown (which will remain yours during your treatment) to change into. When ready, you will be taken into the treatment room and asked to lie down under the radiotherapy machine. The radiation therapists will position you carefully. If you had any moulds, casts or special support devices made, they will be used at this time. These steps ensure the radiation is directed at the cancer cells and that exactly the same area is treated each time.
Once everything is in place, the radiation therapist will go into a room next door and turn on the machine for a few seconds. Treatments usually only take 10 minutes. The radiation therapists can see you through a T.V monitor or window while you are having your treatment and you can generally speak to them through an intercom. Your radiation therapist will tell you when your treatment has finished and when it's ok to go. You will then be able to change back into your own clothes. Before you leave, the staff will check your appointment for the following day.
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Radiotherapy does not hurt - it is just like having an x-ray. However, although it is painless, there may be some side effects. These side effects can vary depending on the sort of treatment you have, where you have it and the dose. Your doctor and nurse will discuss with you in detail the possible side effects of the treatment and how to cope with them. Some of the side effects are:
- Fatigue/tiredness - your body uses a lot of energy dealing with the effects of radiation on normal cells. Some weakness and tiredness may build up over the course of your treatment, but this should gradually settle down after your treatment has finished.
- Skin problems - radiotherapy may cause your skin to become dry, red and itchy across the treatment area, or you may develop a "sunburnt" look. Sorbolene cream applied often helps this problem. Your skin will also be more sensitive to the sun, and you will need to take extra care to cover up and to protect your treatment areas. If you have any skin problems it is important to let your treating doctor, radiation therapist and/or primary nurse know.
Other side effects are treatment site specific ie: the effects will vary depending on the area you are having treated. You will be given information during the planning of your radiotherapy about any possible specific side effects. Your doctor will see you on a regular basis throughout your treatment. You should let your doctor, primary nurse or radiation therapist know about any side effects or problems you have.
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While having radiotherapy, some people are able to maintain their everyday lifestyle and routines of home, work or study. However, most people receiving radiotherapy feel tired. You may need to take on less than you normally do and rest more often. Try to avoid becoming over-tired by planning your activities and allowing some time out for resting throughout the day. An Occupational Therapist or other members of your team can give you some tips about how best to manage tiredness and fatigue.
Your nurse and radiation therapist will give you more information about radiotherapy on your first day of treatment and are also available whenever you feel the need for further advice or information. Other members of your treating team are also happy to help.
