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Radiation therapy is one of the most common treatments provided to patients with cancer. This treatment uses high-energy beams or radiation “seeds” to kill cancer cells. While effective at treating many types of cancer, this method may lead to bothersome and potentially distressing side effects. If you or a loved one has been scheduled to receive radiation therapy, you may wonder what to expect.
Fortunately, while side effects can be uncomfortable, high-quality care can help you mitigate them. Regional Cancer Care Associates (RCCA) provides expert care for cancer and blood disorders at locations near you in New Jersey, Connecticut, Massachusetts, and the Washington, D.C., area. Here, our oncologists discuss the risk of common side effects of radiation therapy and how to minimize their impact.
Radiation therapy, also known as radiotherapy, uses high-energy particles or beams to damage cell DNA. Cancer cells divide rapidly, spending more time with their DNA exposed. They also frequently have flawed DNA repair systems. These two qualities make cancer cells especially vulnerable to radiotherapy. When radiation destroys their genetic code, the cancerous cells cannot fix the damage. They stop multiplying and begin to die off, gradually killing the tumor.
While radiation is more damaging to cancer cells, it can also affect nearby healthy cells. This is why radiation treatments are designed to minimize exposure to healthy tissue. Radiation oncologists use precise beams or, in some cases, implanted “seeds” that deliver radiation directly to the cancer. They also use fractionation, which splits the full dose of external radiation into multiple smaller exposures.
Radiation oncologists are oncologists, or cancer doctors, who specialize in administering radiation therapy. These professionals have subspecialty training to safely and effectively deliver radiation-based treatments. In contrast, medical oncologists use systemic treatments such as chemotherapy, immunotherapy, and hormone therapy. Medical oncologists may also serve as a patient’s overall care manager, while radiation oncologists focus on short-term treatment courses.
About 50 to 60 percent of patients with cancer will receive radiation therapy at some point during their care. This is because radiation is an effective approach for a wide variety of cancer types, including:
It is also because radiation therapy is versatile. It can be used alone or in conjunction with other types of cancer treatments, such as surgery and chemotherapy. A combined approach often is more effective than any one therapy would be alone, providing a lower risk of cancer recurrence.
While all radiation therapy is based on high-energy particles, there are several different methods for delivering these particle to the cancer. The method used depends on patients’ overall health, cancer type and stage, and whether their living situation allows them to take the required precautions. Some patients need only one type of radiation therapy, while others require more than one.
External beam radiation therapy (EBRT) uses an advanced machine called a linear accelerator (LINAC). The LINAC employs electricity to speed up particles in a straight line. Computer software and 3D imaging scans are used to shape this beam to match the exact size and shape of a tumor. This produces a precise, high-energy beam of radiation that destroys the tumor without exposing healthy tissue.
The use of a computer-guided LINAC is also called intensity-modulated radiation therapy (IMRT). This is the current standard for external radiation therapy. Recently, new ground has been broken with volumetric modulated arc therapy (VMAT). This advanced form of IMRT uses a treatment machine that rotates 360 degrees around the patient. The rotating machine “fits” the radiation more tightly to the tumor while reducing the amount of time healthy tissue is exposed.
Stereotactic body radiation therapy (SBRT) is a type of external beam radiation therapy that delivers highly concentrated doses of radiation with extreme precision. Rather than the 15 to 40 sessions associated with standard radiotherapy, patients who receive SBRT can complete treatment in less than five sessions. SBRT also spares more healthy tissue than standard external beam therapy.
Proton therapy is another advanced type of external beam radiation therapy. Instead of using the traditional X-rays, proton therapy uses a beam of positively charged particles. Protons travel a specific distance before they release their energy. This phenomenon, called the Bragg peak, allows radiation oncologists to control where the radiation is released so that more of it goes into the tumor.
Internal radiation therapy is also called brachytherapy. This approach involves placing a tiny amount of radioactive material, sometimes called a “seed,” into the body near the cancer. The seed is left in place for a duration that corresponds to its dosage:
Systemic radiation uses radioactive drugs that are given as a pill or injection. The drugs travel throughout the body to attach to cancer cells and kill them. Several types of systemic radiation drugs have been approved. They include:
Because the drugs are radioactive, patients must take precautions to avoid exposing their loved ones until the radiation subsides. These precautions vary based on the specific treatment employed.
While modern radiation therapy is designed to minimize exposure to healthy tissue, some non-cancerous cells usually will be affected. This causes side effects that can make treatment uncomfortable. The specific side effects vary depending on what part of the body is treated. Some patients have multiple symptoms, while others have none.
Most side effects of radiation therapy are acute, or short-term. These effects start during treatment and last until a few weeks or months after treatment ends.
Fatigue is the most common side effect of radiation therapy, the National Cancer Institute reports. Fatigue is described as “feeling exhausted” and can intensify as treatment progresses. Some patients may also experience insomnia or trouble sleeping. This can worsen daytime fatigue.
Patients receiving radiation therapy should try to get sufficient sleep and relax when possible during their treatment course. Oncologists may also prescribe sleep aids to alleviate fatigue.
Ongoing radiation therapy may decrease appetite. Numerous studies suggest that radiotherapy can more than double the risk of malnutrition in cancer patients. Gastrointestinal (stomach and digestive) problems such as nausea, vomiting, and diarrhea also can occur.
Patients undergoing radiotherapy should try to eat more-frequent but smaller meals with nutritious foods high in protein and fat. Anti-nausea medications and regular hydration also help to control nausea and other stomach issues.
Skin problems are also common during and after radiation therapy. These effects may include:
Patients undergoing radiotherapy can use lotions or creams to soothe dry skin. They should also wear sunscreen and other sun protection when outside to protect against sunburn.
Some short-term side effects are specific to certain areas of the body. Side effects may vary depending what part of the body radiation treatment targets:
Other side effects of radiation are long-term issues. These problems can appear months or years after treatment. If they are not detected and managed early, they can become permanent. Patients who receive radiation therapy should watch for the following complications:
Cancer research is constantly evolving with new developments and discoveries. This includes radiation therapy. More advanced machines are reducing radiation exposure to healthy tissue, minimizing side effects. Patients are experiencing less discomfort and fewer long-term complications than ever, and technologies continue to improve for even better outcomes in the future.
While radiation therapy side effects may be uncomfortable, they can be managed with the right medical support. Regional Cancer Care Associates (RCCA) provides comprehensive support at more than 20 locations near you across New Jersey, Connecticut, Massachusetts, and the Washington, D.C., area, helping patients with cancer get through treatment with minimal discomfort. Contact RCCA today to learn more or to schedule an appointment.
What is radiation therapy used to treat?
Radiation therapy is used to treat tumors, including benign tumors and cancer. It can be used to destroy cancer cells, shrink tumors before surgery, and relieve symptoms caused by large tumors in late-stage cancer.
How long does a radiation therapy session take?
A radiation therapy appointment often takes between 10 and 15 minutes. Most of this time is spent checking details and positioning correctly on the table. The actual administration of radiation treatment usually takes only one to five minutes.
How many radiation treatments will I need?
In most cases, the dose of radiation required to kill a tumor could also cause damage to nearby healthy tissues. To minimize side effects and improve the safety of treatment, radiation oncologists split the total dosage to be administered between many sessions. Many patients receive daily radiation treatments for five to eight weeks with breaks on the weekend to recover. Some people may be treated twice daily. Your cancer team will tell you how many treatments you will need.
Is radiation therapy painful?
Radiation therapy treatment sessions are totally painless. You cannot see, smell, or feel the radiation beam while the machine is on. However, after several weeks of treatment, you may develop side effects like skin irritation that cause mild to moderate discomfort.
Does radiation therapy cause cancer?
Radiation therapy can cause new cancer. Radiation damages the DNA in cells, making them more likely to mutate and become cancerous. However, this complication is rare. By splitting radiation doses between multiple treatments, oncologists can minimize healthy tissue damage and reduce the likelihood of causing new cancer.
Can radiation therapy be combined with chemotherapy?
Yes, radiation therapy can be and often is combined with chemotherapy. This approach, which is sometimes called chemoradiotherapy, weakens cancer cells with chemotherapy to make them more vulnerable to the radiation. Chemoradiotherapy shrinks tumors more effectively than radiation therapy alone and is often used to treat advanced cancers.
How long do radiation therapy side effects last?
Most radiation therapy side effects are short-term. They start during treatment and go away within a few weeks or months after the final session. However, some side effects are long-term. These can show up months or years after treatment and, depending on how they are managed, may become permanent.
Will radiation therapy make me radioactive?
External beam radiation will not make you radioactive. The radiation stops when the machine turns off, and it does not linger in your body. Internal radiation or radioactive pills or infusions may make you radioactive for a brief time. Your care team will tell you how long you will be radioactive and provide safety instructions if necessary to keep the people around you healthy.
For more information or to schedule an appointment,
call 844-346-7222. You can also schedule an appointment by calling the RCCA location nearest you.
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