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Do the treatments hurt? Will I be
able to feel the radiation? |
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The treatments are much like getting a
diagnostic x-ray, such as a chest x-ray. The machine makes some
noise, but there is no sensation to the radiation itself. The
treatment table is hard, and some patients are treated in positions
they may find uncomfortable. We do our best to minimize any
discomfort. |
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Why does the table need to be so
hard? |
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Each treatment needs to be given in
exactly the same position each day. This is impossible with a soft
table. In addition, radiation treatment tables are specially
constructed so that there is only a small amount of solid material
between the radiation beam and the patient; adding padding would
increase the dose to the skin. |
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Will I lose my hair? |
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Radiation causes hair loss only in the
skin exposed to the radiation, and only after a particular dose has
been reached (usually more than 10 treatments). Patients who receive
certain chemotherapy drugs along with radiation may lose their hair
from the chemotherapy. |
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Will I be sick to my stomach? |
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Radiation causes nausea only if we are
treating over the abdomen, and then not always. |
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What sort of side effects will there
be? |
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Side effects from radiation depend on
many factors including the part of the body being treated, the dose
of radiation, and whether the patient is having or has had
chemotherapy. Side effects and complications are discussed by the
radiation oncologist before a treatment course is started. The
radiation oncology nurses also discuss the side effects, as well as
specific ways to help relieve them. Each patient is seen by the
radiation oncologist at least once a week during a course of
treatment. Patients are encouraged to discuss their problems with
the radiation therapist, who will then notify the nursing staff and
the radiation oncologist. |
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Will I be able to drive? |
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Most people in good general health are
able to drive during a course of radiation. A patient who is in poor
health or who is at risk for seizures may be instructed not to
drive. |
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How many treatments will there be? |
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In general, patients being treated in a
curative fashion will receive the most treatments. Typical treatment
courses would be 25-30 treatments for patients with rectal cancer,
30-35 treatments for patients with breast cancer, 38-40 treatments
for patients with prostate cancer when only external beam radiation
is prescribed, and 30-35 treatments for patients with lung cancer or
cancers of the head and neck. Shorter courses are given to patients
being treated palliatively, i.e., for relief of symptoms caused by
cancer. These patients generally receive between 15 and 20
treatments. A typical indication for palliative treatment is bone
pain due to spread of cancer, or brain metastases causing
interference with function. |
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Why must there be so many treatments? |
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Because long-term complications are more
likely to occur when larger doses are given in fewer treatments. |
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What happens if I must miss a
treatment? |
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This is a concern mainly for patients
being treated with curative intent. If one or two treatments are
missed, usually we only continue the planned treatment course. If
there is a longer interruption, one or more additional treatments
may be added. Prolonged interruptions are discouraged because long
breaks in treatment may decrease the efficiency of the treatment
course. |
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What if there's a snowstorm? |
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Do not come for treatment if you feel
travel is hazardous, but do please call at any time you need to miss
an appointment. If weather conditions force us to close our office,
all patients are notified by phone and a message is left on our
answering machine. |
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What if a machine breaks down? |
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Our equipment is reliable but also
complex. If there is a malfunction we do our best to call patients
before they leave home, and to let patients already here know
whether they should wait or not. A repairman can usually be here
within 1 to 2 hours, but some parts need to be shipped in. If a
machine malfunctions while a patient is receiving treatment the
machine automatically stops. The radiation therapist records how
much of the treatment was given and the radiation physicist and
radiation oncologist determine the best way to make up the
difference. |
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How often must I come for treatment? |
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Treatments are usually given once a day,
Monday through Friday. Some patients being treated palliatively may
be treated only 3 to 4 times per week. A very few patients may be
treated twice daily, once each morning and once each afternoon for
some or all of a course of treatment. |
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Will radiation have an effect on my
skin? |
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Most people develop only a mild skin
irritation with dry, reddened skin at the site where the radiation
beam enters or exits the body. Raw spots generally develop only if
treatment includes areas where there are skin folds, such as under
the breast, the underarm, behind the ears, or between the buttocks,
or if we use techniques to deliberately increase the dose of
radiation to skin that is at risk for cancer involvement. Skin
reactions are usually worst in people with fair skin or who have
received or are receiving chemotherapy. Special skin care
instructions are given to minimize the effects upon the skin. |
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Will my throat get sore? |
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Patients being treated for cancers of
the head and neck may have severe soreness of the mouth and throat.
Patients being treated to the chest may have irritation of the
esophagus with the sensation of heartburn. |
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Will I be radioactive? |
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External beam radiation does not make a
patient radioactive. Patients who receive permanent implants, or
injected or ingested radioisotopes are temporarily radioactive and
appropriate precautions are instituted to protect others from
exposure. Patients who undergo temporary implants are released from
the hospital only after all radioactive sources have been removed. |
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Can I be close to family members
after treatment? |
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As long as only external beam radiation
is given, there is no risk to anyone who comes near a patient. |
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How do I know if it's working? |
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Patients who are being treated for
relief of symptoms often improve during a treatment course. Patients
treated for cure are followed after a treatment course is over.
Unfortunately, there is often no way to tell early on if the
treatment has been successful, and often the best we can do is to
document that there is no apparent recurrence of cancer. |
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I just had a CAT scan. Why do I need
another one? |
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Most of our patients have a special CAT
scan done as part of the treatment planning process. This scan is
done in the exact treatment position with special markers placed so
that we can know exactly how the CT films line up with the planned
radiation fields. The radiation oncologist draws in the structures
which require treatment, and the scan is used for computerized
treatment planning. Use of other CT scans does not allow for precise
treatment planning. |
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How long do treatments take? |
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A simulation usually takes between 1
hour to 1-1/2 hours depending on complexity. Treatments generally
take 12-20 minutes depending on the number of fields being treated.
Most of this time is spent in positioning the patient and the
treatment beam so that the treatment plan is reproduced precisely. |
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Will I need to hold my breath? |
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Patients breathe normally during
treatment. The radiation beam is usually on for 30 to 45 seconds, so
holding the breath would be very difficult. |
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How does radiation work? |
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Most of the effect of radiation on both
the cancer cells, and normal cells is caused by chemical changes in
the cellular DNA, which either causes cell death directly or
prevents reproduction. Rapidly dividing cells are more easily
damaged by radiation, and most cancer cells divide more rapidly than
most normal cells. Normal skin cells and the cells lining the mouth,
throat and intestines divide rapidly, and damage to these cells
results in some of the side effects of radiation. These normal
structures also have cells at rest, which help them heal; cancerous
tissues do not. Many cancer cells are generally less capable of
repairing radiation damage than are normal cells. |
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Can radiation cause cancer? |
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Radiation can cause cancer, but this is
an uncommon complication, which has been associated mostly with the
use of older lower energy x-ray, and usually takes longer than 15
years to develop. If there are concerns about this, you should
discuss it with your radiation oncologist. |
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Why does it take so long to get a
course of radiation started? Why can't I start the same day I see
the doctor? |
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Some patients do start treatment on an
emergency basis, on the same day they first see the radiation
oncologist. For most patients, however, a detailed and complex
planning process is followed to more precisely treat the cancer
while minimizing radiation to normal tissues. |
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Will I be wearing a lead shield or
apron for treatment? |
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No. With the high-energy x-ray beams
used for external radiation treatment; lead shielding on the body
would not significantly reduce exposure to other body parts.
However, the beam of x-ray is shaped by shields that are inserted
into the treatment machine at the point where the beam exits from
the machine. |
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When is radiation used and when is
chemotherapy used? What is the role of surgery? |
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Surgery is used in patients with early
disease when the cancer can be safely and completely removed.
Radiation may be added to surgery if the cancer has not been
completely removed. Radiation may be used instead of surgery if a
cancer cannot be removed safely. Radiation is also used for
controlling symptoms of cancer. Chemotherapy is used when a cancer
has spread to many areas of the body, or when there is a risk of
this happening. Chemotherapy may be used to enhance the
effectiveness of radiation. Many patients receive radiation and
chemotherapy together with surgery. |
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What is hyperfractionation? |
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Hyperfractionation is the use of more
than one radiation treatment per day. Hyperfractionation is used
when a higher dose in a shorter time can produce a higher rate of
cure or local control. In the 4 to 6 hours between the two daily
doses the body repairs some of the radiation damage to normal
tissues. |
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Why do I need to be alone in the
treatment room? |
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The radiation therapists who treat
patients are legally allowed a low total radiation exposure. This is
for the protection of staff members who expect to be treating
patients for many years. Friends and family members also cannot be
in the room for similar reasons. While exposure of the cancer to
radiation has the potential for destroying cancer, the normal
tissues may be affected and cause side effects. These side effects
are considered acceptable in the circumstance where the benefit of
destruction of cancer is to be gained. However, injury or side
effects due to radiation exposure are not acceptable for those who
stand to gain no benefit from exposure - the therapists, physicians,
friends, and family. Being in the treatment room during radiation
treatment would expose the bystander to the damaging effects of
radiation. |
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I'm having a tough time dealing with
this diagnosis. None of my friends or family really understands. |
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Dealing with a cancer diagnosis is one
of the most difficult life events that there is. Feelings of shock
are very common. Our staff is very knowledgeable, skilled, and
caring and can help in dealing with the emotional as well as the
physical effects of the illness. For patients who wish additional
support, an oncology social worker specialized in cancer care is
available through Clifton Springs Hospital and the Finger Lakes
Community Cancer Center. |
