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A doctor who treats cancer is called an oncologist. There are three main kinds of oncologists:
Each of these doctors is an expert in the kind of treatment they administer. They work together to find the best treatment options that can be offered to you, and help you make choices that fit your goals, values and lifestyle. Sometimes, you may only need one kind of treatment and one kind of oncologist. Other times, you may need more than one kind of treatment and several oncologists.
If radiation therapy is a treatment option for you, it is important to talk with a radiation oncologist about it. Radiation oncologists are specially trained to explain how radiation works, what the risks and benefits are, and to answer any questions you may have about it.
No. The names may sound similar, but they play different roles in your care. Radiologists use imaging (X-rays, scans) for diagnosis. Radiation oncologists use radiation to treat cancer, as well as other non-cancer conditions.
Radiation is most often used to treat cancer, but it can also be helpful for some non-cancer conditions. For example, radiation can reduce inflammation that causes keloids (thick scars) or arthritis. It can also be used to treat a part of your body that is not working normally, such as for heart rhythm problems, abnormal blood vessels or facial nerve pain.
There are three main ways of treating a patient with radiation:
YES! Radiation is one of the main treatments used to cure many types of cancer. The role of radiation therapy depends on the type of cancer you have, and if the cancer has spread to other parts of your body. It is best to talk to a radiation oncologist to learn if radiation can be used to cure your cancer.
In many cases, radiation is used in combination with other treatments to have the best chance to achieve a cure. Sometimes radiation is used before surgery to shrink a tumor or make the tumor easier to remove. Other times, radiation is used after surgery to kill any remaining cancer cells that may not have been removed. Radiation can also be used instead of surgery so that the risks of surgery can be avoided. When radiation is used instead of surgery, chemotherapy is often given at the same time as the radiation to help make the cancer more sensitive to the radiation.
Your radiation oncologist knows from experience how much radiation is needed to treat your type of cancer safely and effectively. Most of the time, cancer cells respond slowly to radiation, so it may take weeks or months after treatment ends before we can see clear results. Because of this, we usually do not do many tests during treatment to check for changes right away. Once the treatment is complete, you will talk to your radiation oncologist about how they plan to monitor your health, and they will schedule new scans or blood tests to see how the tumor responded.
YES! Sometimes cancer spreads to different parts of the body and cannot be cured. Radiation can still be used to treat areas of cancer that cause pain or make you uncomfortable. If you ever have symptoms that you think might be caused by your cancer, ask your radiation oncologist if radiation therapy could help you feel better or improve your quality of life.
It depends on the type of cancer and symptoms that you have. For example, if your cancer is causing bleeding, it can start to decrease within a few days of starting radiation. If your cancer is causing pain or other symptoms, it usually takes 1-3 weeks before you start feeling relief.
The number of radiation treatments you were prescribed was recommended based on the best available evidence and your radiation oncologists’ best judgement. Even if a tumor is responding very well, the best outcomes are seen when the full dose of radiation is delivered. On the other hand, even if a tumor is not responding much, the radiation oncologist may not be able to give additional treatments because that may risk causing injury to normal organs nearby. For all these reasons, it is uncommon for the number of recommended treatments to change during the course of radiation therapy. You should talk to your radiation oncologist if you have questions or concerns about your treatment.
Before starting the radiation therapy, a CT scan will be done with your body in the exact position that it will be in for your treatments. This is what allows your radiation oncologist to treat your cancer accurately.
After your treatment planning session, it can take as little as an hour or as much as a few weeks before your treatments begin. The amount of time depends on your type of cancer, the technology used for your radiation therapy, and how urgent your situation is. Your care team uses this time to carefully design and check your treatment plan. A group of experts — including your radiation oncologist, dosimetrists (who figure out the safest way to aim the radiation at your tumor while protecting healthy tissue), and physicists (who make sure the machines deliver the right amount of radiation to the right place) — all review your plan. This careful process helps make sure your treatment is both safe and accurate before you begin.
A treatment plan that is made at one facility is rarely usable by another facility run by a different radiation oncology team. You would have to repeat the treatment planning at the new facility.
It is best to avoid taking breaks during a course of radiation, because this allows the cancer time to grow back in the days off. If you are having severe side effects and want to stop treatment, you should discuss this with your radiation oncologist so they can give you medications to help you feel better. Sometimes the radiation oncologist may advise taking a few days off to heal before restarting treatment, to help you complete the full course of radiation.
It is strongly recommended to complete all of the prescribed radiation therapy. Not completing all the recommended treatments makes the radiation less effective.
The experience of one person receiving radiation therapy may be totally different than your own. This is because side effects from radiation depend on the part of the body that needs to be treated, the type of cancer, the extent of spread of the cancer, the amount of radiation given, how the radiation is given and the sensitivity of other nearby organs to radiation. It is important to talk to your radiation oncologist to understand what you should expect from your specific treatment plan.
Because radiation therapy is a very precise and carefully controlled treatment, it is usually very safe. A team of highly trained doctors, nurses, medical physicists and radiation therapists work together to make sure every part of your treatment is done safely and correctly. They follow a detailed quality assurance program to check and double-check that everything is working just the way it should. For example, the machines used to administer the radiation are checked by medical physicists every day to make sure they are working correctly. Additionally, the radiation therapists operating the treatment machines have numerous safety steps to prevent mistakes. Although all cancer treatments (chemotherapy, radiation and surgery) have short- and long-term risks, the radiation team works hard to lower the risk of serious side effects while keeping the treatment safe and effective.
Other kinds of radiation, like those from cell phones or medical imaging scans, are also considered safe when used properly.
NO! Radiation passes through your body in the area of your cancer when you are in the treatment room, but does not stay in your body afterward. That means it is completely safe to be around your family and friends — you won’t expose them to radiation.
However, for brachytherapy or radiopharmaceutical therapy (see above), a small amount of radiation can stay in your body for a short time. If you receive one of these types of treatments, your radiation oncologist will give you special instructions to help keep the people around you safe.
When you receive a dose of external beam radiation therapy, you do not see or feel anything. It is like getting an X-ray or CT scan. The radiation beams are invisible and pass through your body to reach the targeted cancer cells. Over the course of multiple radiation treatments, some patients may have temporary pain, but your care team can usually help manage any discomfort with medications.
Radiation can also be used to relieve pain caused by cancer. Some people begin to feel better after just a few treatments, while others notice improvement closer to the end of their treatment course.
Most radiation treatments are aimed at tumors deep inside the body, so the skin usually gets very little radiation. This means that most people do not get skin burns.
However, some cancers, like breast cancer or head and neck cancer, are closer to the skin. In these cases, some people may notice darkening or redness of the skin, or occasional peeling or blistering of the skin. Once your radiation treatment is finished, the skin usually heals and returns to normal. Some people may notice some long-term darkening or lightening of the skin, but this usually fades over time.
Radiation only affects the part of the body where the treatment is directed. For example, if a brain tumor is treated, sometimes there can be hair loss on the scalp. If a tumor of the neck is treated, a man may lose the hair from his beard or the nape of the neck. If a tumor of the groin is treated, a patient may lose some of their pubic hair. When hair is lost due to radiation, the hair usually grows back over the next few months. Sometimes, however, the hair loss in a treated area can be permanent. Talk to your radiation oncologist about the risk of hair loss with your treatment.
As mentioned before, the side effects of radiation depend on the part of the body being treated. Most courses of radiation do NOT cause nausea or an upset stomach. Radiation can, however, cause nausea when it is directed toward the abdomen or pelvis due to irritation of the liver, stomach or bowels. In these situations, medications can be used to treat the nausea, or prevent the nausea from occurring.
