Radiotherapy is the use of radiation to treat cancer. The radiotherapy is targeted at the part of your body where the cancer has been found. Your care will be adapted to meet your individual needs and may differ from what is described here. So, it's important that you follow your doctor's advice.
The aim of the treatment is to destroy the cancer cells in the area being treated. Normal cells will also be affected but they are better able to repair themselves
Why have radiotherapy?
Radiotherapy can be used to treat many different types of cancer. Radiotherapy works by attacking cells that are dividing rapidly, such as cancer cells.
It can be used for the following reasons : -
For some cancers that are diagnosed early (eg cancers of the skin, cervix, prostate, lungs, thyroid and brain), it may be the only treatment needed to cure the cancer. This is known as radical radiotherapy.
To reduce the size of some cancers before surgery. This is called neo-adjuvant treatment.
To make sure all the cancer cells are destroyed after surgery, and to treat local spread of the cancer (such as in the treatment of breast cancer). This is called adjuvant treatment.
In the emergency treatment of a cancer pressing on the spinal cord, to reduce the size of the cancer and prevent damage to the nerves.
In advanced cancer to slow down the progress of the disease and relieve pain and other symptoms.
Your radiotherapy treatment will usually be planned by an oncologist - a doctor specialising in treating cancer. In planning the radiotherapy, your doctor takes into account the size of the cancer, its sensitivity to Radiation and the sensitivity of the surrounding tissues., He or she will also take into account your general health and fitness level.
Preparing for radiotherapy
Preparation for radiotherapy can take longer than the treatment. To find the exact position of the cancer, your doctor will use X-ray scans and CT (computerised tomography) scans, which give a three-dimensional picture of your internal organs.
The area to have radiotherapy is marked, sometimes by tiny tattooed dots on your skin. If the area has to be kept very still, you may need to have a mould made. For example, if your head and neck area is to be treated, you may need to wear a see-through plastic mask to make sure you keep still during the radiotherapy. If you have anaemia, you may also need to have a blood transfusion to increase the amount of oxygen your blood can carry around your body, as this may help make some cancers more sensitive to radiotherapy.
About the procedure
There are two main types of radiotherapy treatment : -
External Radiotherapy
Internal Radiotherapy
External radiotherapy
External radiotherapy is where a machine is used to give a dose of energy, such as X-rays, to attack the cancer cells. There are different types of radiotherapy machines, which work in slightly different ways. For a session of radiotherapy you will be asked to sit or lie in a position that allows the energy beam to be directed accurately at the cancer. This may involve lying down while the machine rotates around you, or you may be asked to sit in a chair while the beam is directed at a cancer that is near the surface of your skin (also called superficial cancer).
The machine looks like an X-ray machine. It won't touch you and you won't feel any pain during the treatment. The number and duration of the radiotherapy sessions depends on the type of cancer and where it's located in your body. A superficial skin cancer may need only a few short treatments, whereas a cancer deeper in the body may need more prolonged treatment.
People usually have external radiotherapy in small doses - each dose is called a fraction - usually from Monday to Friday so your normal tissue has a chance to recover from the treatment at the weekend. Radiotherapy won't make you become radioactive during the treatment. You will be able to carry on with many of your normal daily activities. However, you may feel tired during and after your treatment so it's a good idea to ask friends and family for help if you need it.
A person having external radiotherapy
Internal radiotherapy
Internal radiotherapy is where the source of radioactivity is put inside your body so it can get closer to the cancer.
This can be done in two ways : -
Brachytherapy
This is when a solid source of radioactivity is put next to a tumour to give a high dose of radiotherapy. This means the effect on body tissue around the cancer is as little as possible. Brachytherapy can be used to treat cancers of the cervix, head and neck, womb (uterus), prostate gland and skin.
You will need to have a minor operation to put the radioactive source into your body and you will usually need to stay in hospital for a few days while it's in place. Once the treatment is over, a doctor or nurse will remove the radioactive source and you will be able to go home. Some radioactive sources need to stay in your body permanently (eg for prostate cancer), but will gradually lose their radioactivity. Hospital visiting will be restricted at this time because you will be radioactive while the source is in place.
Radioisotope therapy
This is when a liquid radioactive source is put inside your body. A radioactive liquid (usually radioactive iodine) is given either as an injection into a vein or as a liquid you can drink. Radioisotope treatment can be used for thyroid, adrenal and bone cancers.
You will need to drink plenty of water during your treatment, to flush the radioactive iodine out of your system. The amount of radiation in your body will be closely monitored, and when it drops back down to a safe level you will be able to go home.
Duration of treatment
The length of radiotherapy treatment varies. It depends on the type of cancer, if it has spread to other areas of the body, the type of radiotherapy used, the severity of your side-effects and how successful the treatment is. A course of radiotherapy can last up to eight weeks, but usually it will be shorter than this.
Recovering from radiotherapy
After your treatment, your oncologist will arrange a follow-up appointment to check how you are recovering from any side-effects and what your response has been to the radiotherapy. This is a good opportunity to ask about any long-term side-effects that you might expect to have after your treatment.
Patient support groups can give you support and advice on recovering after radiotherapy (see Further information).
What are the risks ?
Side-effects
These are the unwanted, but mostly temporary effects of a successful treatment.
Depending on which part of your body is being treated, possible side-effects immediately after radiotherapy include : -
tiredness
loss of appetite
feeling sick and vomiting
diarrhoea
skin may become red, itchy and sometimes sore, like sunburn
coughing and shortness of breath
dry mouth, causing difficulty swallowing
losing weight
hair loss - usually temporary but it can be permanent - only happens in the area of the body being treated
emotional symptoms - feeling low, depressed or anxious after treatment
stiffness of joints and muscles
Radiotherapy can also cause some long-term side-effects such as : -
tiredness
scarring of the skin in the area that has been treated (this is called fibrosis)
other tissues can also become scarred and less stretchy (eg your bladder may hold less urine)
darkening of the skin
hair may grow back a different texture and colour
hair loss is sometimes permanent
tiny red marks on the skin from broken blood vessels
swelling of the arms and legs, due to the blockage of lymph vessels (this is called lymphoedoema)
shortness of breath - if you have had radiotherapy to your chest
infertility if your ovaries or testicles have the radiotherapy
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