Frequently Asked Questions
The following is a list of frequently asked questions regarding radiation
oncology treatment. Please feel free contact us at 877-263-9127.
What is Radiation Therapy?
Radiation Therapy is the use of high energy radiation (primarily x-rays)
to kill cancer cells. Radiation Therapy can be used in combination with
surgery, chemotherapy and/or biologic therapy to cure patients with cancer,
control their disease or palliate symptoms. Radiation is also used to
treat some benign tumors and selected neurologic disorders.
How does Radiation Therapy work?
Since the discovery of radioactivity and x-rays, scientists have realized
that radiation can shrink or eliminate tumors. Radiation acts against
the genetic material in cancer cells, stopping their ability to grow and
divide. Unlike cancer cells, normal tissue tends to heal from radiation
damage and stay healthy despite some exposure. Radiation doctors use advanced
technologies and knowledge of how cells respond to focus treatments of
radiation, maximize the destruction of cancer, and minimize side effects.
What are the benefits of Radiation Therapy?
Radiation Therapy can be used to treat almost any type of cancer, anywhere
in the body. Commonly treated diseases include: tumors of the brain, breast,
lung, prostate, larynx, stomach, pancreas, cervix, uterus, and soft tissue
sarcomas. Radiation can be directed at the primary tumor site, or at sites
where cancer has spread distantly (metastatic disease). Depending on the
circumstances of each case, the goal of radiation therapy may be to cure
a patient of cancer, to control their disease, or to palliate symptoms.
About half of all patients with cancer receive some form of radiation.
When is Radiation Therapy used?
Radiation can be used alone, or in combination with other treatment modalities
such as surgery or chemotherapy. When combined with surgery, radiation
may be used preoperatively, in order to shrink a tumor and make it easier
to remove. Radiation can also be used postoperatively, in order to destroy
any potential remaining cancer cells. When combined with chemotherapy,
radiation can be used to make treatment more intense in the areas that
are at highest risk for recurrence. In addition, radiation often works
synergistically with chemotherapy of other drugs, killing more cancer
cells when given together than either treatment would otherwise kill alone.
What different kinds of Radiation Therapy exist?
All forms of radiation therapy use ionizing radiation. However, many different
delivery methods have been developed. For example, external beam radiation
therapy uses radiation generated by a machine, which is external to the
body. In contrast, brachytherapy uses radioactive sources, which are implanted
in the body.
Each of these methods uses specially named technologies, such as 3D Conformal
Radiation Therapy (3DCRT), Image-Guided Intensity-Modulated Radiation
Therapy (IG-IMRT), Tomotherapy, Volumetric Arc Therapy (VMAT), Stereotactic
Radiation Therapy (SRT) / Stereotactic Body Radiation Therapy (SBRT),
Stereotactic Radiosurgery (SRS), Gamma Knife Perfexion, Prostate Brachytherapy,
High Dose Rate Brachytherapy - (HDR), Intra-operative Radiation Therapy
(IORT), and MammositeBrachytherapy - Accelerated Partial Breast Treatment
(APBT). There are strengths and weaknesses to each technology, and no
one technology is best for every patient.
Your radiation oncologist will discuss which technology is best suited
for your needs. Learn more about each of
Hoag's innovative treatment options.
What are the risks involved with Radiation Therapy?
Radiation Therapy can cause irritation of normal tissue, resulting in acute
(short term) side effects. These side effects depend on the area of treatment
and the dose of radiation given. Potential acute side effects include:
fatigue, skin reaction, hair loss (in the treated area), nausea, diarrhea,
decrease in appetite, irritation to the esophagus, bladder or bowels,
and the blood counts. Most side effects can be lessened with medications,
and resolve within a few weeks after treatment. Many patients complete
their treatments with little or no difficulty. Long term complications
are less common, and each patient’s radiation plan is designed to
minimize these risks.
Radiation therapy patients are often concerned that they will become radioactive
from their treatment. The majority of patients are treated with techniques
that leave no radiation behind in the body. These patients will not emit
radiation, and pose no risk of exposing their family or other contacts.
However, some patients are treated with radioactive implants (most commonly
in the prostate), which emit radiation locally. These patients are counseled
about certain precautions, although the level of emission is generally
Your radiation oncologist and radiation oncology nurse will discuss all
potential side effects with you before you begin treatment.
What are the steps involved in radiation treatment?
Your treatment process begins with a consultation with a radiation oncologist,
where you will discuss treatment options and side effects. The next appointment
is called a simulation. This is a set-up appointment, where you will be
positioned for treatment, and films (fluoroscopy, x-rays, and/or a CT
scan) will be taken. To identify the treatment position, your radiation
therapist may place marks on your skin, including a few permanent dots,
In addition you may need an immobilization device, which will be made
at this time. After the simulation appointment, your radiation oncology
team will complete a planning and quality assurance process, which usually
takes several days but may take up to two weeks depending on the complexity
of your treatment plan. If needed, you may or may not return for a follow-up
simulation to confirm your treatment set-up with the treatment plan.
Once all aspects of your treatment have been reviewed and checked your
treatment will begin. Treatments are delivered daily, Monday through Friday.
After you have finished treatment, your radiation oncologist will ask
you to come in for follow-up appointments.
What are body-fix and vac-lock immobilization devices? (for the chest,
abdomen and pelvis areas)
These devices are used to assist in your daily set-up and for your comfort
in holding the position needed for your radiation treatments. The body-fix
and vac-lock devices are made of tiny beads held in a plastic coating.
The device forms to your body as air is taken out of the bag. If required,
they are made during your simulation appointment.
What is an immobilization mask and why is it used?
Plastic mesh masks (for the head area) are made from a hard plastic that
becomes very flexible in warm water. When it is wet, it conforms to the
contour of your face. It will dry very quickly. The masks are important
for accurate daily set-up. If a mask is made for you, the marks will be
placed on the mask, rather than on your skin. In the simulator and the
treatment room, laser beams are used to help confirm your precise alignment.
These laser beams are harmless.
How long will my Simulation appointment take?
Your simulation may take 45 to 120 minutes, depending upon the area being
treated, the number and types of immobilization devices required, and
the number of films or CT scans needed to create your treatment plan.
What is a treatment planning CT?What is a treatment planning CT?
Your Radiation Oncologist may request a treatment planning CT (or CAT SCAN).
It is important to note that not all patients require a treatment planning
CT. A treatment planning CT is not the same as a diagnostic CT. If an
immobilization device was made, it will be used during your CT scan. Before
or during your CT scan, you may be given an injection of a special dye
that helps us to see certain organs on the CT scan. The information from
your CT will be put into our treatment planning computer system and will
be used to determine the type of treatment field, energy and beam angle
for your radiation treatments.
What happens the first day of treatment?
On your first day, the radiation therapists on the treatment machine will
first take more x-rays called verification films. These films are very
important and are used to compare to the films taken during your simulation
to ensure the accuracy of the treatment set-up. Once these have been taken
your treatment will be delivered. During your radiation treatment you
will not see or feel anything. Although you are in the treatment room
alone, the therapists are monitoring you through the use of an intercom
and a closed circuit television system.
The time spent on the treatment table will vary depending on the treatment
technique and treatment equipment used. The time will vary between 10
minutes and 1 hour. Your therapist will tell you how long to plan daily.
Your daily appointment schedule is determined on this day. The therapists
will work with you to find a time that will satisfy your needs as well
as the current schedule on the treatment machine. In general, your treatment
time will remain the same from day to day. If, from time to time you need
this daily time to be altered, your therapist will work to reschedule you.