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What is radiotherapy?

Radiotherapy uses radiation, such as x-rays, gamma rays, electron beams or protons, to kill or damage cancer cells and stop them from growing and multiplying.

How does radiotherapy work?

Radiotherapy damages cancer cells in the area being treated. Although the radiation can also damage normal cells, they can usually repair themselves.

Why have radiotherapy?

Many people diagnosed with cancer will have radiotherapy as part of their cancer treatment. Research shows that at least one in two people recently diagnosed with cancer would benefit from radiotherapy. It can be used for several reasons:

Cure: Radiotherapy is given with the aim of curing the cancer on its own or combined with other treatments, such as surgery or chemotherapy.

Control: Radiotherapy may be used to control the cancer by making it smaller or stopping it from spreading.

Help other treatments: Radiotherapy is used before (neoadjuvant) or after (adjuvant) other treatments, such as surgery or chemotherapy. The aim is to make the main treatment more effective.

Symptom relief: Radiotherapy is often able to relieve cancer symptoms, such as pain or bleeding, to help you to feel as well as possible.

How is radiotherapy given?

It can be given in two ways:

External radiotherapy: A machine from outside the body aims radiation beams towards the cancer and surrounding tissues where the cancer may have spread.

Internal radiotherapy (brachytherapy): A radiation source is put inside the body on or near the cancer.

Depending on the type and size of the cancer, and where it is in your body, you may have one or both types of radiotherapy.

Types of radiation therapy

  • External-beam radiation therapy: This is the most common type of radiation treatment, and it involves giving radiation from a machine located outside the body. It can treat large areas of the body, if necessary. The machine typically used to create the radiation beam is called a linear accelerator or linac. Computers with special software are used to adjust the size and shape of the beam and to direct it to target the tumor while avoiding the healthy tissue that surrounds the cancer cells. External-beam radiation therapy does not make you radioactive
  • Internal radiation therapy: This type of radiation treatment, also known as brachytherapy, involves placing radioactive material into the cancer itself or into the tissue surrounding it. These radioactive implants may be permanent or temporary and may require a hospital stay.

Permanent implants are tiny steel seeds (capsules) about the size of a grain of rice that contain radioactive material and are placed inside the body at the tumor site. The seeds deliver most of the radiation around the area of the implant; however, some radiation can be emitted (released) from the patient’s body. This means the patient needs to take special precautions to protect others from radiation exposure while the seeds are still active. Over time, the implant loses its radioactivity, but the inactive seeds remain in the body.

For temporary implants, the radiation is delivered through needles, catheters (tubes that carry fluid in or out of the body), or specialized applicators and kept in the body for a specific amount of time, from a few minutes to a few days. Most temporary implant procedures deliver radiation for just a few minutes. If temporary implants are used for more time, the patient remains in a private room while the implants are in place to limit others’ exposure to the radiation

Other treatment options:

  • Intra-operative Radiation Therapy (IORT)
  • Systemic Radiation Therapy
  • Radioimmunotherapy

How do I know the treatment has worked?

In the weeks and months following your course of treatment, you’ll talk with your doctor, be examined and may have some tests. Cancer cells begin to die during a course of radiotherapy and this may continue for weeks or months after treatment ends. The examination and tests will show if the cancer has gone away, although it may be some time after treatment finishes before the full benefit can be confirmed. This is because sometimes cancer can come back (recur) at the same place or in another part of the body. If radiotherapy is given as palliative treatment, the relief of symptoms will tell you if the treatment has worked. This may take a few weeks.

Which health professionals will I see?

Health professionals who care for people having radiotherapy include:

Radiation oncologist: a specialist doctor who prescribes and coordinates the course of treatment and advises about side effects

Radiation therapist: plans and delivers the radiation treatments

Radiation oncology nurses: help you manage emotional and physical problems such as side effects that you may experience during treatment

Radiation physicist: ensures that treatment is delivered accurately and safely

Dietitian: recommends the best eating plan to follow while you’re in treatment and recovery

Social worker, psychologist, physiotherapist and occupational therapist: advise you on support services and help you get back to your usual activities

Pastoral carer: helps with religious and spiritual concerns

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