Types Of Radiation Treatment
Radiation treatment can be given outside the body or internally by placing a radioactive source inside the body.
External radiation treatment
During treatment, you will lie still and the machine will move around you so that the radiation can be directed at the tumour from different angles, similar to having an X-ray.
Internal radiation treatment
If you have internal radiation treatment, a radioactive source will be placed into the body close to your cancer, or into the cancer itself.
Life After Radiation Therapy
For most people, the cancer experience doesnt end on the last day of radiation therapy. Radiation therapy usually does not have an immediate effect, and it could take days, weeks or months to see any change in the cancer. The cancer cells may keep dying for weeks or months after the end of treatment. It may be some time before you know whether the radiation therapy has controlled the cancer.
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If I Have Radiation Therapy Once To A Breast Can I Ever Get It Again To The Same Breast
Dr. Jay Harris answers the question: ‘Radiation twice to the same breast?’
& #151 — Question: If I have radiation therapy once to a breast, can I ever get it again to that breast or area of my chest?
Answer: Now, with current techniques, when we do treatment and long-term follow-up, we know that that area looks very, very similar to the opposite breast. These techniques have been developed and perfected, over a long period of time.
We do know, however, that the body does not completely forget the effects of radiation. And that if we were to deliver the same course of treatment to the area, we would have complications, which are much greater than with just a single course of treatment. So that our current understanding is that, except for very unusual situations, we would not give a radiation to a previously treated area, because of the concern about a much higher rate of complication.
So, the answer is: no, we would, in most circumstances, not re-treat a previously treated area.
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How Should I Care For Myself During Radiation Therapy
What Happens After Treatment Finishes
After radiation therapy has finished, your treatment team will tell you how to look after the treatment area and recommend ways to manage side effects. They will also advise who to call if you have any concerns.
Life after cancer treatment can present its own challenges. You may have mixed feelings when treatment ends, and worry that every ache and pain means the cancer is coming back.
Some people say that they feel pressure to return to normal life. It is important to allow yourself time to adjust to the physical and emotional changes, and establish a new daily routine at your own pace. Your family and friends may also need time to adjust.
Cancer Council 13 11 20 can help you connect with other people who have had cancer, and provide you with information about the emotional and practical aspects of living well after cancer.
For more on this, see Living well after cancer.
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Who Are The Members Of The Radiation Therapy Team
A team of highly trained medical professionals will be involved in your care during radiation therapy. This team is led by a radiation oncologist, a doctor who specializes in using radiation to treat cancer.
Radiation oncologists are the doctors who will oversee your radiation therapy treatments. These physicians work with the other members of the radiation therapy team to develop and prescribe your treatment plan and make sure that each treatment is given accurately. Your radiation oncologist will also track your progress and adjust the treatment as necessary to make sure you receive the best care. Radiation oncologists help identify and treat any side effects that may occur due to radiation therapy. They work closely with other cancer doctors, including medical oncologists and surgeons, and all members of the radiation oncology team.
Radiation oncologists have completed at least four years of college, four years of medical school, one year of general medical training and four years of residency training in radiation oncology. They have extensive training in cancer medicine and the safe use of radiation to treat disease. If they pass a special examination, they are certified by the American Board of Radiology. You should ask if your doctor is board certified.
Radiation Oncology Nurses
Other Healthcare professionals
Questions To Ask About Radiation Therapy
Before treatment, youll be asked to sign a consent form saying that your doctor has explained how radiation therapy may help, the possible risks, the type of radiation to be used, and your other treatment options. Before signing the consent form, be sure that you have had a chance to get all your questions answered. Here are some of the things you may want to ask about:
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Planning Your Radiation Treatment
Before your treatment begins, you will meet with a radiation oncologist, who will explain why you need this treatment, what will happen and when it will take place.
While you are having radiation treatment you will need to use a reliable form of birth control.
It is important that neither you nor your partner becomes pregnant, as radiation treatment may harm a developing baby.
If you are pregnant now, talk to your treatment team immediately.
Decide If Radiation Therapy Is Right For You
Your medical team will consider many factors before discussing this treatment option with you. At Johns Hopkins, your care team is made up of some of the best medical oncologists, radiation therapists and neurosurgeons in the country.
Drawing from thousands of hours of training and experience, our team works together to determine which treatment or combination of treatments is right for each person who walks through our doors.
When we take care of patients with brain metastases, we take into consideration many factors, such as the type of tumor, a patients symptoms and number of lesions. However, our goals of therapy all revolve around how to make your life better, says Lim.
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Can You Receive Radiation To The Same Are More Than Once Specifically The Foot
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Can Radiotherapy Be Repeated
The goal of any cancer treatment is to control the growth of the tumor with minimal side effects and minimal impairments in the patients quality of life. In the past, patients who received radiation therapy once could not be treated with radiation a second time. This was because the area targeted by the radiation could not be mapped precisely enough. As a result, the healthy tissue surrounding the tumor was at risk of a radiation overdose. Survival rates after repeat radiation treatment were not good. Life-threatening side effects meant that only 50% of all patients who received repeat radiation therapy were alive after one year, and only 20% were alive after three years. Also, there is a long-term risk of developing a second cancer from the radiotherapy itself. While this risk is low, it depends on how much radiation is given. A second round of radiation treatment can increase the risk of a second cancer.
The body doesnt forget its first encounter with radiation, so you cant treat it a second time like you did the first time.
In recent years, however, advances in radiation oncology have made it possible for some patients to undergo repeat radiotherapy. In particular, repeat external beam radiotherapy for locally recurrent head and neck tumors has been given with an intent to cure. Unfortunately, this is possible in only a few carefully selected patients. The initial results from a few small trials are encouraging, but repeat radiation therapy remains experimental.
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Treatment By Stage Of Prostate Cancer
Different treatments may be recommended for each stage of prostate cancer. Your doctor will recommend a specific treatment plan for you based on the cancers stage and other factors. Detailed descriptions of each type of treatment are provided earlier on this same page. Clinical trials may also be a treatment option for each stage.
Early-stage prostate cancer
Early-stage prostate cancer usually grows very slowly and may take years to cause any symptoms or other health problems, if it ever does at all. As a result, active surveillance or watchful waiting may be recommended. Radiation therapy or surgery may also be suggested, as well as treatment in clinical trials. For those with a higher Gleason score, the cancer may be faster growing, so radical prostatectomy and radiation therapy are often recommended. Your doctor will consider your age and general health before recommending a treatment plan.
ASCO, the American Urological Association, American Society of Radiation Oncology, and the Society of Urologic Oncology recommend that patients with high-risk early-stage prostate cancer that has not spread to other areas of the body should receive radical prostatectomy or radiation therapy with hormonal therapy as standard treatment options.
Locally advanced prostate cancer
Watchful waiting may be considered for older adults who are not expected to live for a long time and whose cancer is not causing symptoms or for those who have another, more serious illness.
Treating Stage Iii Colon Cancer
Stage III colon cancers have spread to nearby lymph nodes, but they have not yet spread to other parts of the body.
Surgery to remove the section of the colon with the cancer along with nearby lymph nodes, followed by adjuvant chemo is the standard treatment for this stage.
For chemo, either the FOLFOX or CapeOx regimens are used most often, but some patients may get 5-FU with leucovorin or capecitabine alone based on their age and health needs.
For some advanced colon cancers that cannot be removed completely by surgery, neoadjuvant chemotherapy given along with radiation might be recommended to shrink the cancer so it can be removed later with surgery. For some advanced cancers that have been removed by surgery, but were found to be attached to a nearby organ or have positive margins , adjuvant radiation might be recommended. Radiation therapy and/or chemo may be options for people who arent healthy enough for surgery.
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What Is Cancer Recurrence
Even after removal and treatment, cancer sometimes returns. Doctors call this a cancer recurrence. It may resurface in the same area where it was first found or turn up at another spot in the body.
- Local recurrence means its in the same spot.
- Regional recurrence refers to the original cancer showing up in tissue or lymph nodes near the original site.
- Distant recurrence means the cancer has been found in tissue away from the original location.
Your care team names the cancer based on where it originated. So if you had cancer in a breast and it recurred in your bones, its still considered breast cancer. When cancer spreads to one or more spots in your body, its said to have metastasized.
Cancer may return weeks to years after initial treatment. If cancer is found only a few months after it couldnt be detected, its likely because surgery and treatment didnt get all of it initially, and a tiny amount remained. This risk exists even though no remaining cancer could be found with scans or tests.
Sometimes cancer cells survive radiation and chemotherapy and become resistant to these treatments. In these cases, cancer may be considered not to have recurred but progressed, and it may be faster-growing or harder to kill. In general, the shorter the time between when cancer is first treated and when it reappears, the more severe the cancer risk.
Recurrence differs from developing a second form of cancer, which is a less common problem.
Intensity Modulated Radiation Therapy
Intensity modulated radiation therapy, or IMRT, is a specialized form of 3D-CRT that allows radiation to be more exactly shaped to fit the tumor. With IMRT, the radiation beam can be broken up into many “beamlets,” and the intensity of each beamlet can be adjusted individually. Using IMRT, it may be possible to further limit the amount of radiation that is received by healthy tissue near the tumor. In some situations, this may also allow a higher dose of radiation to be delivered to the tumor, potentially increasing the chance of a cure.
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Does Cancer Always Come Back
While cancer doesnt always return, recurrence is common for some hard-to-treat forms of cancer. These recurrences usually follow certain patterns that patients may be aware of in order to catch things as early as possible.
Theres no way to guarantee that cancer wont return. That said, recurrences are less likely the more time has passed from the original cancer.
Today, many cancers have treatments that may help manage the disease for the rest of a patients life. The likelihood of recurrence depends on:
- The type of cancer
- How fast it grew initially
- How advanced it was when doctors first discovered it
Cancer may be more likely to return if it had already spread when it was first detected.
Why People With Cancer Receive Radiation Therapy
Radiation therapy is used to treat cancer and ease cancer symptoms.
When used to treat cancer, radiation therapy can cure cancer, prevent it from returning, or stop or slow its growth.
When treatments are used to ease symptoms, they are known as palliative treatments. External beam radiation may shrink tumors to treat pain and other problems caused by the tumor, such as trouble breathing or loss of bowel and bladder control. Pain from cancer that has spread to the bone can be treated with systemic radiation therapy drugs called radiopharmaceuticals.
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How Long Will Side Effects Last
In time, most side effects go away. However, some may be permanent and others may not appear until after treatment has finished.
If the side effects are severe, the radiation oncologist may change the treatment or prescribe a break. If the doctor thinks pausing treatment could affect how well the treatment is working then a break may not be possible.
To Cure Or Shrink Early
Some cancers are very sensitive to radiation. Radiation may be used by itself in these cases to make the cancer shrink or completely go away. In some cases, chemotherapy or other anti-cancer drugs may be given first. For other cancers, radiation may be used before surgery to shrink the tumor , or after surgery to help keep the cancer from coming back .
For certain cancers that can be cured either by radiation or by surgery, radiation may be the preferred treatment. This is because radiation can cause less damage and the part of the body involved may be more likely to work the way it should after treatment.
For some types of cancer, radiation and chemotherapy or other types of anti-cancer drugs might be used together. Certain drugs help radiation work better by making cancer cells more sensitive to radiation. Research has shown that when anti-cancer drugs and radiation are given together for certain types of cancer, they can help each other work even better than if they were given alone. One drawback, though, is that side effects are often worse when they are given together.
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What Happens During Each Treatment Visit
External radiation is a lot like getting a regular x-ray. The treatment itself is painless and takes only a few minutes. But each session can last 15 to 30 minutes because of the time it takes to set up the equipment and put you in the right position.
External radiation therapy is usually given with a machine called a linear accelerator which delivers a beam of radiation. The machine has a wide arm that extends over the treatment table. The radiation comes out of this arm. The machine can move around the table to change the angle of the radiation, if needed, but it wont touch you. The radiation beams are invisible and you will not feel anything, but the machine will make noise.
Depending on the area being treated, you might need to undress, so wear clothes that are easy to take off and put on. Youll be asked to lie on the treatment table next to the radiation machine.
The radiation therapist might put special heavy shields between the machine and parts of your body that arent being treated to help protect normal tissues and organs.
Once youre in the right position, the radiation therapist will go into a nearby room to operate the machine and watch you on a TV screen. The room is shielded, or protected from the radiation so that the therapist isnt exposed to it. You can talk with the therapist over an intercom. Youll be asked to lie still during the treatment, but you wont have to hold your breath.