Frequently asked questions: Radiation Oncology

Q. What is Radiation Oncology?
A. Radiation Oncology is the clinical discipline that attends to treatment of cancer with high energy X-Rays along with care of the patients undergoing such a treatment.

Q. What is radiation therapy?
A. Radiation therapy (also called radiotherapy) is a treatment that uses X-Rays to kill cancer cells and stop them from spreading.

Q. How is radiation therapy given?
A. Radiation therapy can be external beam (when a machine outside the body aims radiation at cancer cells) or internal (when the source of radiation is placed inside the body at or near the cancer site).

Q. Who gets radiation therapy?
A. Many people with cancer need radiation therapy. In fact, more than half (about 60 percent) of people with cancer get radiation therapy. Sometimes, radiation therapy is the only kind of cancer treatment people need.

Q. What does radiation therapy do to cancer cells?
A. Radiation kills or slows the growth of cancer cells. Radiation therapy is used to:

(I) Treat cancer. Radiation can be used to cure, stop or slow the growth of cancer.
(II) Reduce symptoms. When a cure is not possible, radiation may be used to shrink cancer tumours in order to reduce pressure. Radiation therapy used in this way can treat problems such as pain, or it can prevent problems such as blindness or loss of bowel and bladder control.

Q. How long does radiation therapy take to work?
A. Radiation therapy does not kill cancer cells right away. It takes days or weeks of treatment before cancer cells start to die. After completion of treatment cancer cells keep dying for weeks or months after radiation therapy ends.

Q. What does radiation therapy do to healthy cells?
A. Since radiation has to pass through normal body tissues, it can also affect nearby healthy cells. The healthy cells almost always recover after treatment is over. Doctors try to protect healthy cells during treatment by:

(I) Reducing the dose to healthy tissues:The radiation dose is balanced between being high enough to kill cancer cells yet low enough to limit damage to healthy cells.
(II) Spreading out treatment over time. Radiation is delivered @daily fractionation over a few weeks. Spreading out the radiation dose allows normal cells to recover while cancer cells die.
(III) Aiming radiation at a precise part of your body. New techniques, such as Stereotactic Radiotherapy, IMRT and 3-D conformal radiation therapy, allow higher doses of radiation to be directed to cancer while reducing the radiation to nearby healthy tissues.
(IV) Using medicines. Some drugs can help protect certain parts of your body, such as the salivary glands that make saliva (spit).

Q. Does radiation therapy hurt?
A. No, radiation therapy does not hurt while it is being given. The side effects that people may get from radiation therapy can cause pain or discomfort. There are ways that the doctor and a radiation care nurse can help manage side effects.

Q. Is radiation therapy used with other types of cancer treatment?
A. Yes, radiation therapy is often used with other cancer treatments. Here are some examples:

(I) Radiation therapy and surgery. Radiation may be given before, during, or after surgery. Doctors may use radiation to shrink the size of the cancer before surgery, or they may use radiation after surgery to kill any cancer cells that remain. Sometimes, radiation therapy is given during surgery so that it goes straight to the cancer site without passing through the skin. This is called intra operative radiation.
(II) Radiation therapy and chemotherapy. Radiation may be given before, during, or after chemotherapy. Before or during chemotherapy, radiation therapy can shrink the cancer so that chemotherapy works better. Sometimes, chemotherapy is given to make radiation therapy more effective. After chemotherapy, radiation therapy can be used to sterilize any cancer cells that remain.

Q. Who is on a radiation therapy team?
A. Many people help with radiation treatment and care. This group of health care providers is often called the "radiation therapy team". The radiation therapy team can include:

(I) Radiation oncologist. This is a doctor who specializes in using radiation therapy to treat cancer. He or she prescribes how much radiation you will receive, plans how your treatment will be given, closely follows you during your course of treatment, and prescribes care you may need to help with side effects. He or she works closely with other doctors, nurses, and health care providers. After radiation therapy is finished, the radiation oncologist will see the patient for follow-up visits. During these visits, this doctor will check for late side effects and assess how well the radiation has worked.
(II) Radiation nurse. This person provides nursing care during radiation therapy, working with all the members of radiation therapy team. He or she will talk about the radiation treatment and help in managing the side effects.
(III) Radiation therapist. This person works during each radiation therapy session. He or she positions the patient for treatment and runs the machines.
(IV) Other health care providers. The team may also include a dietician, physical therapist, social worker, and a counsellor.
(V) Patients are the most important part of the radiation therapy team. Their role is to:

• Arrive on time for all radiation therapy sessions
• Ask questions and talk about your concerns
• Let someone on your radiation therapy team know when you have side effects
• Tell the doctor or nurse if they are in pain
• Follow the advice of your doctors and nurses about how to care at home, such as:

- Taking care of your skin
- Drinking liquids
- Eating foods that they suggest
- Maintaining weight

Q. Should one follow a special diet during radiation therapy treatment?
A. Our body uses a lot of energy to heal during radiation therapy. It is important that you eat enough calories and protein to keep your weight the same during this time. Ask the doctor or nurse if there is a need for special diet. It is also helpful to speak with a dietician.

Q. Can I go to work during radiation therapy?
A. Some people are able to work full-time during radiation therapy. Others can only work part-time or not at all. How much you are able to work depends on how you feel. Ask your doctor or nurse what you may expect based on the treatment you are getting. You are likely to feel well enough to work when you start radiation therapy. As time goes on, do not be surprised if you are more tired, have less energy, or feel weak. Once you have finished your treatment, it may take a few weeks for you to feel better. Talk with your employer to find out if you can go on medical leave.

Q. What happens when radiation therapy is over?
A. Once radiation therapy is finished, there is a need for follow-up care. Follow-up care refers to checkups with the radiation oncologist. During these checkups, the doctor or nurse will see how well the radiation therapy worked, check for other signs of cancer, look for late side effects, and talk about treatment and care. The doctor will:

(I) Examine and review. The doctor can prescribe medicine or suggest other ways to treat any side effects.
(II) Order lab and imaging tests. These may include blood tests, x-rays, or CT, MRI, or PET scans.
(III) Discuss treatment. The doctor may suggest to have more treatment, such as radiation treatments, surgery or chemotherapy.

Q. After radiation therapy is over, what symptoms should one look for?
A. Pay attention to changes in the body and let the doctor or nurse know if one has:
(I) A pain that does not go away
(II) New lumps, bumps, swellings, rashes, bruises, or bleeding
(III) Appetite changes, nausea, vomiting, diarrhoea, or constipation
(IV) Weight loss that cannot be explained
(V) A fever, cough, or hoarseness that does not go away after nominal treatment for 1 week
(VI) Any other symptoms that worries.