Radiation Therapy
More than 50 percent of all cancer patients benefit from radiation therapy (also known as radiotherapy), which uses high-energy beams to pinpoint and destroy cancer cells. While similar to an X-ray, the radiation used in cancer treatments is precise and customized to each patient’s cancer, most often on an outpatient basis. You will likely be lying down comfortably to receive your treatment.
For several cancers, radiation therapy may be recommended to help shrink a relatively large, advanced tumor before surgery or chemotherapy. Or, you may benefit from radiation therapy to eliminate any residual cancer cells remaining after surgery. In other cases, radiation might be recommended for a recurrence of cancer. Some patients receive radiation therapy as the only treatment necessary to combat their cancer.
What to Expect
Fighting cancer is challenging. To help you prepare for the fight, here is a brief outline of what you can expect during treatment with radiotherapy or radiosurgery. The details of some of the steps may differ, depending on your particular case. Click on each title to expand the area and read more.
Step 1: The Consultation
First, you'll meet with Dr. Kim to discuss your treatment. Dr. Kim will tell you what type of radiation treatment he recommends, whether it will be given alone or in conjunction with other treatment methods, what the specific goals of treatment are, and what side effects you may experience.
If you have more than one treatment option from which to choose, Dr. Kim will give you the information you need to make a decision. For instance, Dr. Kim may tell you that you have a choice between prostatectomy (surgery) and radiation therapy. The consultation is an excellent opportunity for you to ask whatever questions you may have to help make such a decision.
Step 2: Imaging
The second step of the planning process is called imaging. Detailed scans are taken of the treatment area to show the location of your tumor and the normal areas around it. These scans usually include a CT scan, but they can also include an MRI, PET scan, and ultrasound scans. The scans are combined by a computer to create a detailed 3-D image of your tumor site and surrounding tissue. Dr. Kim can rotate the image on his computer screen to view the tumor from every angle.
It is very important that the position in which you are scanned is reproduced at the time of treatment. Sometimes temporary skin marks and even tiny tattoos (about the size of a freckle) are made on your body to help the radiation therapist (RT) position you correctly each day for treatment.
Step 3: Treatment Plan
After imaging is completed, Dr. Kim will meet with the medical physicist and dosimetrist to design a treatment plan that's been customized for you. After taking into account the location and type of cancer you have, your medical history, lab tests, and other factors, your treatment team will use sophisticated computer software to assist them in prescribing the exact volume to be treated, the total amount of radiation that will be delivered to the tumor, the angles for the radiation beams, how many treatments you should have, and what kind of machine to use.
Step 4: Getting Positioned for Treatment
Before each day's treatment, you may be asked to change into a gown. The radiation therapist (RT) will help you get positioned on the treatment "couch" — a platform designed to work with the radiation machine. If a facemask, mold or other device was created for you during the imaging process, it will be placed on you or under you at this time. The couch will be adjusted so a laser light shines on the mark that was put on your skin, helping to position you correctly.
Depending on the type of machine you're treated on, your treatment team may take a scan immediately prior to treatment, while you are on the couch. The purpose of this new scan is to show if the tumor has changed in size or position since the first one was created during imaging. If it reveals any changes, the RT will make the necessary adjustments to the position of the couch to ensure that you are properly aligned for treatment.
Step 5: Treatment Begins
The radiation is delivered by a machine called a linear accelerator, or linac. Most linacs have a gantry, which is the head of the machine. The gantry houses a device called a multi-leaf collimator that "shapes" the radiation beam so it conforms to the shape of the tumor from any given angle. During your treatment, the gantry will move around you to deliver the radiation. The radiation beam is not visible to the eye, so you will not see it when it leaves the gantry.
Your first two treatments may take 15 minutes or more, as your radiation therapist helps you get into position and takes images to verify that your setup on the machine is the same as the treatment plan. Subsequent treatments, however, are often shorter. In fact, some treatments — from entering the waiting room to leaving the clinic — can take as little as 12 to 30 minutes. If you are treated with radiosurgery, only one treatment session may be needed.
Step 6: Post Treatments and Follow-ups
You may experience some side effects from radiotherapy. If you do, they might not begin until after a few weeks because the effects of radiation treatment are cumulative. Talk to Dr. Kim before and during treatment if you have any questions or experience discomfort.
After your treatment has ended, Dr. Kim will want to see you for periodic checkups to monitor the results. Typically, the first checkup is given in one to three months, and subsequent checkups are scheduled at six-month intervals, but yours may be more or less frequent, depending upon your situation.
Meet your Team
Radiation treatment is administered to you by a team of highly qualified healthcare professionals. This team is comprised of specialists that among them have years of experience in treating cancer.
Dr. Kim is your radiation oncologist throughout this process—a medical doctor who specializes in the use of radiation for treating cancer. Dr. Kim will prescribe, plan and direct your treatment and is responsible for deciding what method of radiation therapy is indicated for your case.
The medical physicist works with the dosimetrist and Dr. Kim to measure the precision of your treatment plan, working with the equipment to calculate the best angles to treat your tumor, or tumor site. The medical physicist also conducts frequent safety checks and makes sure that the equipment is working properly.
The dosimetrist works closely with Dr. Kim and medical physicist in designing your treatment. The dosimetrist prescribes the length of time for each pulse of radiation, and develops strategies on how best to avoid giving radiation to healthy tissue in your body.
The radiation therapist will conduct your treatment each session. He will position you on the treatment table so that radiation can be delivered, run the equipment, and work very closely with the medical physicist during your treatment.
The radiation nurse coordinates your care, helps you learn about treatment, and tells you how to manage any side effects that you might experience.
