Radiotherapy can be done in many different ways, depending on your circumstances. If you're diagnosed with cancer, you'll be cared for by a team of specialists.
Your team will recommend radiotherapy if they think it's the best option for you, but the final decision is yours. Making this decision can be difficult. You may find it useful to write a list of questions to ask your care team. If you agree with your team's recommendation, they'll start to plan your treatment once you have given your consent to treatment. Your treatment will be carefully planned to ensure the highest possible dose is delivered to the cancer, while avoiding damage to nearby healthy cells as much as possible.
You will probably have a CT scan to work out exactly where the cancer is and how big it is. After the scan, some very small but permanent ink marks may be made on your skin to ensure the right area is targeted accurately each time. If you're having radiotherapy to your head or neck, a plastic mask will be made for you to wear during treatment. The ink marks will be made on the mask. Most people have 5 treatments each week 1 treatment a day from Monday to Friday, with a break at the weekend.
But sometimes treatment may be given more than once a day or over the weekend. Your doctor may call each dose a "fraction", although the term "attendance" is sometimes used to indicate how many hospitals visits you'll need to make during treatment. During external radiotherapy, you lie on a table and a machine directs beams of radiation at the cancer. The machine is operated from outside the room, but you'll be watched through a window or a camera. There will be an intercom if you need to speak to the person treating you.
You need to keep as still as possible throughout the treatment. Your individual treatment plan including the radiation dose and the precise area to be targeted is prescribed by your radiation oncologist. If you are having treatment to your head or neck, your specialist may decide to make a cast of your upper body. In other cases, snug-fitting supports will be placed around your body during treatment to keep you stable.
Some treatments require that you lie face down in a special cradle or on a belly-board, which allows part of your bowel to be outside the treatment area. The radiation therapist may mark the treatment areas on your body with non-permanent ink.
These marks help to line up the radiotherapy equipment correctly. After finding the ideal position for your treatment, the radiation therapist may mark certain points on your skin with a tiny, permanent skin mark to make sure any further treatments are accurately delivered. You may also be given a contrast agent, also called contrast medium or dye, to swallow or have injected into one of your veins. This helps your internal organs and structures show up during treatment.
External radiotherapy is similar to having a regular x-ray examination. There is no need for anaesthesia except for infants.
Usually, no medication is needed before treatment. However, if your treatment is likely to cause nausea or vomiting, you may be given medication to prevent this before each treatment. Traditional external radiotherapy is delivered by using multiple fields of treatment — back to front and side to side, or at oblique angles around your body.
You are not required to move to achieve the different angles as the linear accelerator can rotate right around you. This process is known as intensity-modulated radiation therapy.
It may be delivered with the beam in a fixed position, or while the beam rotates around your body. As soon as the machine is off, there is no radiation in you or the room. You may come into contact with anyone outside with no concern for their health or safety. Sometimes, your specialist will recommend both external and internal radiotherapy, depending on your cancer.
The procedure generally includes:. Brachytherapy is commonly used to treat cancer of the cervix, uterus, vagina and prostate gland. It may also be used for other types of cancer. Two types of radiation sources are available. One works slowly over a number of days low-dose rate , such as radiation seed implants. The other works very quickly and only takes minutes to give the treatment high-dose rate.
Most treatments are given using high-dose-rate sources. This may require between one and five treatments on separate occasions. Implants come in different sizes and shapes, including needles, plastic tubes, catheters, capsules and rods, depending on the type of cancer and the area of the body to be treated.
Some implants can be placed in already existing spaces inside the body called intra-cavitary implants and others are placed through the skin near the cancer interstitial implant. The implant chosen for you is inserted into your body under anaesthetic. Brachytherapy implants can be temporary or permanent.
A temporary implant is removed after treatment is given. It may need to be re-inserted each time, or may be left in place for a few days to allow treatments to be completed before removal. This will depend on the nature of the treatment. While the radiation source is inside the needles or tubing, your body will emit small traces of radioactive energy. Once the source is withdrawn, even if the implant is in place, there is no radiation left in your body. While you are being treated in the brachytherapy room or suite which may be in an operating theatre , staff will be in a shielded room observing you closely.
They can start and stop the treatment as required. Most treatments take a few minutes and there is no sensation from the actual treatment. After the implant is removed, it is unusual to have any symptoms. If needles have been used, there may be some swelling. Bleeding and infection is very rare, but may occur and require medical care. If you are being treated in a hospital using low-dose-rate radiotherapy, the source of radiation may be left inside the tubing for up to 40 hours, and you will be isolated from staff and other people.
This type of treatment is less common now. A permanent implant is usually performed using radiation seeds especially for prostate cancer. These implants stay in place. The therapy is given over days and weeks, but the seeds become weaker and eventually stop being radioactive after some months, depending on the variety of implant used.
The hospital staff will isolate you in a single room and limit the time you spend with visitors especially children and pregnant women in the first few days after the implant is inserted. The radiation fades with time, so other people will be safe to be near you once you are discharged from hospital.
Special instructions will be given about coming close to children and pregnant women while the sources are still active inside the body. Radiotherapy works by killing cells that are dividing rapidly. This is why it works on cancer cells. It also explains why radiotherapy causes side effects, as it acts on cells in the body that naturally divide rapidly, such as those in the lining of the gut, the skin, the bladder and the bone marrow.
Not everyone experiences side effects, although usually, one or two side effects occur. Side effects will depend on the type and dose of radiotherapy you receive and which part of your body is being treated.
After treatment is complete, almost all side effects will disappear. Some may return after months or years, and may affect other tissues in the treatment area.
It is important to discuss side effects with your doctor because treatments are available. You should notify your doctor at once if you experience severe or distressing side effects that do not respond to medication, such as severe vomiting, chronic diarrhoea, bleeding or some other change in your health that worries you.
As a result, although people can reach the lifetime dosage limit on one area of the body, that person may still receive radiotherapy for another tumor located elsewhere. Again, the exact length of radiation therapy depends significantly on the characteristics of the cancer.
For example, a deeper tumor may require a more-focused beam for a shorter period, but a larger, shallow tumor may be treated the same focused beam for a longer period. Moreover, the location of the tumor and its proximity to other sensitive body tissues will affect radiotherapy planning and treatment.
It is a complex question with an answer that is individualized to each patient and their specific anatomy, but most sessions last anywhere between 15 minutes and 45 minutes.
The only way to truly define the exact frequency and duration of radiotherapy treatment is with the extensive evaluation that goes into the treatment planning process. Radiation therapy can reduce the risk of metastasis and improve survival, but it is a unique treatment that depends on each tumor and individual. SERO takes the time and attention needed to craft a detailed treatment program for radiation therapy.
This can also be in conjunction with other therapies and treatments used by your oncologist and multidisciplinary care team. SERO is dedicated to reducing your time in treatment through maximized, aggressive treatments when appropriate. Learn more about the possibilities and whether radiotherapy is right for your unique needs by scheduling a consultation online today.
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