Things To Know Before Radiation Therapy
As part of my vulvar cancer treatment, I underwent five days of radiation therapy treatments for six weeks.Going into it, I had no idea what to expect, and after about two weeks, I started to feel like a baked potato that had been left in the microwave too long.Today, I’m cancer-free, so in the end it was worth it. But it was difficult at times. Here are some things I wish I would have known before starting radiation therapy.
- It’s important to be flexible. Your scheduled appointments will be “fluid”. This means from one day to the next, your appointment could be anywhere from an hour early to an hour later. There will be people who cancel at the last minute and others who require more time than expected. Just be ready, and try not get upset by the changes.
- You will be fitted for a cradle. Not the kind you slept in as a child. Similar to a beanbag chair that hardens to your shape, the cradle will help keep you in place for radiation therapy. Every day I was grateful for the cradle. It allowed the radiation to reach the tumor while protecting the healthy parts of my body.
- Your skin will begin breaking down, or at least that’s how the doctors describe it. What does that mean exactly? It means your skin will become red and sensitive in the affected area, and then will dissolve. You will have some open burns, but Aquaphor or some other healing ointment can help.
Ways To Prepare For Radiation Therapy
More than 50% of people diagnosed with cancer will receive some type of radiation therapy. Its no secret that for most people, radiation therapy can be an uncomfortable and exhausting venture. Its important to be prepared before, during, and after your radiation therapy plan begins. In this article, we will list a few ways to prepare for radiation therapy.
What Are Radiation Therapy Side Effects
Most people receive radiation therapy spread out over multiple treatment sessions so they dont receive the full dose all at once. The treatment schedule gives your healthy tissue time to recover between sessions. The healing time reduces side effects.
Still, you may experience unpleasant side effects that your radiation oncologist will help manage. Usually, these side effects only affect the part of your body receiving radiation directly.
Side effects may include:
- A burning feeling in your throat or chest.
- Pain or a burning sensation when you pee.
- The need to pee frequently .
- Abdominal bloating or cramps.
- Sense of urgency to have a bowel movement.
Ask your radiation oncologist what side effects to expect, given the kind of radiation therapy recommended for the kind of cancer you have.
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Questions To Ask The Health Care Team
Consider asking the health care team these questions about your radiation therapy appointments:
Who is creating my radiation therapy treatment plan? How often will the plan be reviewed?
Which health care professionals will I see at every treatment session?
Can you describe what my first session, or simulation, will be like?
Will I need any tests or scans before treatment begins?
Will my skin be marked as part of treatment planning?
Will I need an immobilization device during radiation therapy? If so, can you describe that to me?
Who can I talk with if I’m feeling anxious or upset about having this type of treatment?
How long will each treatment session take? How often will I have radiation therapy?
Can I bring someone with me to each session?
Are there special services for patients receiving daily radiation therapy, such as certain parking spaces or parking rates?
Who should I talk with about any side effects I experience?
Which lotions do you recommend for skin-related side effects? When should I apply it?
How else can I take care of myself during the treatment period?
Will special precautions be needed to protect my family and others from radiation exposure during my treatment period?
What will my follow-up care schedule be?
Possible Side Effects Of External Beam Radiation
The main short-term side effects of external beam radiation therapy to the breast are:
- Swelling in the breast
- Skin changes in the treated area similar to a sunburn
Your health care team may advise you to avoid exposing the treated skin to the sun because it could make the skin changes worse. Most skin changes get better within a few months. Changes to the breast tissue usually go away in 6 to 12 months, but it can take longer.
External beam radiation therapy can also cause side effects later on:
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How To Contact Komen About Breast Cancer
If you or a loved one needs more information about breast health or breast cancer, call the Komen Breast Care Helpline at 1-877 GO KOMEN . All calls are answered by a trained specialist or oncology social worker in English and Spanish, Monday through Friday from 9:00 a.m. to 10:00 p.m. ET. You can also email the helpline at email@example.com.
What Happens Before During And After Treatment
Once a diagnosis has been made, you will probably talk with your primary care physician along with several cancer specialists, such as a surgeon, a medical oncologist and a radiation oncologist. You will want to ask these doctors about all your treatment options. In many cases, but not all cases, your cancer will need to be treated by using more than one type of treatment.
If it is determined that you would benefit from radiation oncology, your radiation oncologist will review any scans that have been ordered, including CT scans, MRI scans and PET scans, and complete a thorough examination. He or she will then discuss with you the potential benefits and risks of radiation therapy and answer your questions.
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Side Effects Of Radiation Therapy
Some people have side effects from radiation therapy. This section has information about the most common side effects.
You may have all, some, or none of these side effects. The ones you have and how strong they are depends on many things, such as:
- The area of your body being treated.
- The dose of radiation youre getting.
- The number of radiation treatments youre getting.
- Your overall health.
The side effects may be worse if youre also getting chemotherapy.
You and your radiation therapy care team will work together to prevent and manage side effects.
Who Will Be Involved In This Procedure
Brachytherapy requires a treatment team. This team includes a radiation oncologist, medical physicist, dosimetrist, radiation therapist, nurse and, sometimes, a surgeon. The radiation oncologist is a highly trained doctor who specializes in treating cancer with radiotherapy. The oncologist evaluates the patient, identifies the treatment and determines the appropriate therapy and radiation dose. In some cases, a surgeon will assist by placing treatment devices in the patient. The medical physicist, dosimetrist and oncologist determine how to deliver the radiation and how much the patient can tolerate. The physicist and the dosimetrist then make detailed treatment calculations. The radiation therapist, a specially trained technologist, may help deliver treatment. The nurse provides information about the treatment and possible side effects. The nurse also helps manage care for treatment catheters.
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Planning Your External Radiotherapy
The radiotherapy team plans your external beam radiotherapy before you start treatment. This means working out the dose of radiotherapy you need and exactly where you need it. Your planning appointment takes from 15 minutes to 2 hours.
You usually have a planning CT scan in the radiotherapy department.
The scan shows the cancer and the area around it. You might have had other types of scans or x-rays before this appointment to help diagnose or stage your cancer. Your treatment team might also use these scans to plan your radiotherapy. The plan they create is just for you.
To plan the treatment your doctor thinks about:
- your type of cancer
- the position of the cancer in your body
- the size of the cancer
- whether the cancer is close to structures in your body that are sensitive to radiation
- how far the radiation needs to travel into your body
- your general health and medical history
Before your planning starts, your nurse or radiographer asks you to sign a consent form. If you’re a woman they check with you that youre not pregnant and remind you not to get pregnant during treatment. This is because radiation can damage an unborn baby. Very occasionally it can be possible to have radiotherapy if youre pregnant. But this depends on where youre having treatment to.
Your Radiation Therapy Care Team
At the Stanford Cancer Center, we offer health care from multiple medical specialists who come together for your individual treatment. That means your doctors will help to coordinate your care as you move from one phase to another including radiation therapy and possibly surgery and drug therapy as well.
You will have a care team for each type of treatment you have. Learn more about your care team for radiation therapy in the description below:
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Questions To Ask Your Radiation Oncologist
Before your appointment, its helpful to write down the questions you want to ask your radiation therapy care team. Examples of questions you can ask are listed below. Write down the answers during your appointment so you can review them later.
What kind of radiation therapy will I get?
How many radiation treatments will I get?
What side effects should I expect during my radiation therapy?
Will these side effects go away after I finish my radiation therapy?
What kind of late side effects should I expect after my radiation therapy?
Types Of Radiation Therapy
At the Stanford Cancer Center, we use two main types of radiation therapy:
Our radiation oncologists deliver this type of radiation to the cancer using machines outside the body. The radiation machine moves around your body without touching you.
External radiation therapy does not cause pain, so you wont feel anything during your treatments.
This treatment, also called external beam radiation therapy , does not make you radioactive. You can safely be around other people, including children.
External beam radiation is the most common approach to radiation treatment. It is produced by machines called linear accelerators. Some machines may have brand names, for example TrueBeam and CyberKnife. These machines move around the outside of your body, but they never touch you. The treatment is non-invasive.
Radiation therapy can be delivered in different ways:
This type of radiation therapy is offered only for certain gynecological and prostate cancers.
When giving internal radiation, called brachytherapy, your doctor positions small catheters or applicators in the treatment area to deliver radiation to where the cancer is. The applications are placed and removed with each treatment. You will receive sedation or anesthesia during the procedure, so the entire experience takes most of a full day. You will not be radioactive and can safely be around others when you return home. Most of the time, treatments can be done as an outpatient .
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Things To Expect And Ways To Prepare For Your Radiation Therapy
As weve previously discussed, there are many myths and misconceptions about radiation therapy, also known as radiotherapy, often leaving patients and their family members unsure about what to anticipate during their treatment course. Lets demystify some of that today.
ONE: first day of school, down in the dungeons?
- Much like first-day-of-school jitters, your first session of radiation therapy is often the most anxiety-provoking. This is only natural as its something new and unfamiliar.
- Radiation therapy often takes place below ground for reasons of shielding, and so it is likely that you will receive your therapy on the lowest floor of the building.
- Prior to therapy starting, a session called planning or simulation is performed to mimic the exact position and setup for treatment. If the brain, head or neck region is being targeted, a special customised mask may need to be created. You may wish to bring a support person with you to navigate through these sorts of new experiences.
- At treatment you will be welcomed and orientated by a team of radiation therapists who specialise in radiation therapy delivery as per the plan prescribed by your oncologist.
- This team of RTs will remain fairly constant during your therapy period and before long, as their faces become familiar, you would have formed your own school clique!
TWO: timing and punctuality
THREE: getting from point A to point B
FOUR: whos keeping an eye on me?
FIVE: special considerations
Learn Possible Side Effects Of Radiation Therapy
Just like any type of medical treatment, theres a risk of side effects that you should be aware of before you start undergoing treatment. The American Society of Clinical Oncology explains that side effects will vary depending on the type of cancer and the location being targeted, as well as your overall health.
However, signs to look out for include peeling/blistering skin, hair loss if the scalp is targeted, and unusual tiredness/fatigue. You could also experience other negative reactions including dry mouth, mouth sores, nausea, and difficulty swallowing. The source notes side effects often begin during the 2nd or 3rd-week of treatment and go away following completion. Some effects may hang around longer and second cancer from treatment is a risk as well, although low, the source adds.
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What Happens After Treatment
With internal radiation therapy, youll typically go home after a short recovery the same day. Occasionally, you may need to stay in the hospital while your body sheds trace amounts of radiation. After systemic radiation therapy, you may secrete small amounts of radiation through body fluids, like sweat, pee and blood.
If you receive IV or permanent internal radiation therapy, theres a small risk of exposing others to radiation. Follow your radiation therapy teams guidance about how much contact you should have with others after radiotherapy.
You should be able to go about your regular daily activities before and after EBRT. Theres no risk of exposing others to radiation.
Channel Your Inner Calm
Radiation therapy is a term that can cause anxiety in many patients. The disease itself can feel like its trying to take over your life. However, Relaxation is one of your best defenses, according to the Cleveland Clinic.
The source suggests just breathing, even just a minute of deep breaths, to take your body off of high alert. It also says you should keep up some activity, like a short walk, but dont push beyond what you think you can handle. Art therapy can help alleviate stress and has other benefits while pampering yourself with any massages and facials offered by the treatment center can also ease tension, the source adds.
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What Advances Have There Been In Radiation Treatment That Will Directly Impact Breast Cancer Patients
Positioning and Monitoring Technology is an important one. Technology is constantly advancing to improve the safety and accuracy of radiation. Accuracy is so important when getting radiation treatment because you want to treat cancer but protect the surrounding healthy tissue and organs. AlignRT is an advanced technology that can help ensure that you are set up precisely and constantly monitored during your treatment to ensure your cancer is treated safely and precisely.
As I mentioned earlier, Deep Inspiration Breath Hold is a technique used along with AlignRT by many top cancer centers to help protect your heart. DIBH is where you take a deep breath and hold it during treatment. By doing this you move your breast tissue away from your heart and reduce the risk of heart radiation exposure. AlignRT is an advanced technology that can help ensure you are set up precisely with sub-millimeter accuracy and has an automated safety system that can pause the radiation beam if you move out of the desired position during treatment to help ensure accurate and safe treatment.
Expert Review And References
- Canadian Cancer Society. Radiation Therapy: A Guide for People with Cancer. Toronto, ON: Canadian Cancer Society 2005.
- Radiotherapy. Cancer Research UK. CancerHelp UK. Cancer Research UK 2009.
- Haas ML. Radiation therapy. Varricchio, C., Pierce, M., Hinds, P. S., & Ades, T. B. A Cancer Source Book for Nurses. 8th ed. Sudbury, MA: Jones and Bartlett Publishers 2004: 8: pp. 131-147.
- Radiotherapy. Macmillan Cancer Support. Macmillan Cancer Support. London, UK: Macmillan Cancer Support 2009.
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Your First Radiation Therapy Appointment
The first appointment with your cancer doctor is an opportunity for you to ask any questions. In your first visit, you will:
- Discuss treatment options, including whether or not radiation treatment is recommended for you.
- Discuss the exact type, number of treatments, and potential side effects of radiation treatment, if recommended.
- Bring any paperwork and imaging done outside Stanford for your doctor to review.
- Be offered your next appointment for a simulation scan in preparation for your radiation treatment , if appropriate.
A simulation scan is done to get images of the cancer site, with you placed in the exact position you will be during all of your radiation treatments. These images are used to design a radiation plan that is customized to your specific body and anatomy. This appointment usually takes about 1-3 hours, depending on the types of scans that are recommended.
Your first visit is also an important opportunity to tell the doctor and care team about your past medical history and all of the medicines you take even occasionally. Some prescriptions, vitamins, supplements, and herbal remedies can affect how your body responds to radiation therapy, so it is important to tell your doctor about all of them.
We can help you get started with a checklist of what to expect and what to prepare.