How Does Radiation Therapy Work

Will Radiation Therapy Cause My Hair To Fall Out

How Radiotherapy Works!

Only people who get radiation to the scalp or the brain may have hair loss. Others won’t. If it does happen, itâs usually sudden and comes out in clumps. In most cases, your hair will grow back after therapy stops, but it may be thinner or have a different texture.

Some people choose to cut their hair short before treatment begins to make less weight on the hair shaft. If you lose hair on top of your head, be sure to wear a hat or a scarf to protect your scalp from the sun when you go outside. If you decide to buy a wig, ask the doctor to write a prescription for one and check to see if it’s covered by your insurance or is a tax-deductible expense.

How Soon Might I Have Side Effects From Radiation Therapy

There are two kinds of radiation side effects: early and late. Early side effects, such as nausea and fatigue, usually donât last long. They may start during or right after treatment and last for several weeks after it ends, but then they get better. Late side effects, such as lung or heart problems, may take years to show up and are often permanent when they do.

The most common early side effects are fatigue and skin problems. You might get others, such as hair loss and nausea, depending on where you get radiation.

Will I Be Radioactive

Even though the effects of radiation are powerful, you will not become permanently radioactive. External radiation therapy only affects targeted cells for a moment. With brachytherapy, your body may emit a small amount of radiation for a short time. If the radiation is contained in a closed implant, the radioactive material cannot escape, but precautions, such as limitation of visitors, are taken anyway. If you receive therapeutic radiopharmaceuticals youll have a higher level of radiation in your body and will have to take more precautions.

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What To Expect Before Radiation Therapy

External beam radiation therapy and brachytherapy both start with a meeting to plan the treatment.

A doctor will examine the individual, ask about their health, and discuss the therapy. In some cases, they may request imaging.

A person who decides to have external beam radiation will typically meet with a radiation oncologist and a radiation therapist for a planning session called a simulation.

The radiation therapist may put small marks on the persons skin to show where to direct the energy beams. These marks can be either temporary or in the form of a tattoo.

In addition, healthcare professionals may create a body mold that they use to ensure that a person is in the correct position when receiving radiation therapy.

If a person is receiving radiation therapy to the head or neck, they may need to use a face mask to keep their head in place during treatment.

What to expect during radiation therapy will differ depending on which type of therapy a person receives.

Radiation Therapy Combined With Surgery

When radiation is combined with surgery, the radiation treatments may be given before or after surgery. When it is done before surgery it is used to shrink the size of a tumor to make removal easier. More commonly the radiation treatments are given after surgery to reduce the chance that the cancer will come back, among other reasons.

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In What Situations Is Radiation Therapy Used

Radiotherapy is used in several situations. For example, it can be used to remove the cancer completely. In other scenarios it is used to shrink the cancer or relieve symptoms, such as pain. When it is used in this way it is a palliative treatment to improve the quality of life for the patient.Sometimes radiation therapy is the only treatment that a patient is given, but often it is used alongside other treatments such as surgery and chemotherapy.

When it is used with other treatments it can be used first to shrink the cancer before surgery. At other times it can be used after surgery and chemotherapy to eradicate any remaining cells in the body. For my particular breast cancer treatment plan, I had radiotherapy after surgery and chemotherapy. If the treatment is given after surgery, then it is usual to wait until the wound has healed sufficiently so that the radiation does not cause further damage.

Are Some Therapies More Effective Based On Stage

The type of radiation treatment you get depends on the stage of breast cancer. People with early to stage 3 breast cancer will benefit most from radiation treatment. Radiation can also help ease side effects in people with advanced breast cancer.

External whole breast radiation works best:

for early stage to stage 3 breast cancer
for tumors that are an inch or smaller
if the cancer is in one spot
if you had breast-saving surgery or a mastectomy

External beam radiation can also help treat side effects of advanced breast cancer.

Internal radiation works best:

for early stage breast cancer
if the cancer is in one spot
if you had breast-saving surgery or a mastectomy

Sometimes, a person with advanced breast cancer will have internal radiation.

Intraoperative radiation works best:

during early stage breast cancer
when the tumor is too close to healthy tissue for external radiation to be possible

Not everyone can have intraoperative radiation or internal beam radiation. Whether you can have these procedures depends on:

size and location of the tumor
size of your breast

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Radiation Therapy Timing And Breast Reconstruction

The timing of radiation treatment in your overall breast cancer treatment plan depends on your individual situation and the characteristics of the breast cancer.

In many cases, radiation therapy is given after surgery. If chemotherapy is planned after surgery, radiation usually follows chemotherapy.

If youre having mastectomy and have decided to have breast reconstruction, its important to know that radiation can cause a reconstructed breast to lose volume and change color, texture, and appearance.

In particular, radiation therapy is known to cause complications with implant reconstruction. Research also suggests that a reconstructed breast may interfere with radiation therapy reaching the area affected by cancer, though this can vary on a case-by-case basis.

For these reasons, some surgeons advise waiting until after radiation and other treatments, such as chemotherapy, are completed before breast reconstruction surgery is done.

Other surgeons may recommend a more staged approach, which places a tissue expander after mastectomy to preserve the shape of the breast during radiation treatments. Once radiation is completed and the tissues have recovered, the expander that was used to maintain the shape of the breast is removed and replaced with tissue from another part of the body or a breast implant.

Working During Radiation Therapy

How does proton radiation therapy work?

Some people are able to work full-time during radiation therapy. Others can work only part-time or not at all. How much you are able to work depends on how you feel. Ask your doctor or nurse what you may expect from the treatment you will have.

You are likely to feel well enough to work when you first start your radiation treatments. As time goes on, do not be surprised if you are more tired, have less energy, or feel weak. Once you have finished treatment, it may take just a few weeks for you to feel betteror it could take months.

You may get to a point during your radiation therapy when you feel too sick to work. Talk with your employer to find out if you can go on medical leave. Check that your health insurance will pay for treatment while you are on medical leave.

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How Long Will Side Effects Last

In time, most side effects go away. However, some may be permanent and others may not appear until after treatment has finished.

If the side effects are severe, the radiation oncologist may change the treatment or prescribe a break. If the doctor thinks pausing treatment could affect how well the treatment is working then a break may not be possible.

To Cure Or Shrink Early

Some cancers are very sensitive to radiation. Radiation may be used by itself in these cases to make the cancer shrink or completely go away. In some cases, chemotherapy or other anti-cancer drugs may be given first. For other cancers, radiation may be used before surgery to shrink the tumor , or after surgery to help keep the cancer from coming back .

For certain cancers that can be cured either by radiation or by surgery, radiation may be the preferred treatment. This is because radiation can cause less damage and the part of the body involved may be more likely to work the way it should after treatment.

For some types of cancer, radiation and chemotherapy or other types of anti-cancer drugs might be used together. Certain drugs help radiation work better by making cancer cells more sensitive to radiation. Research has shown that when anti-cancer drugs and radiation are given together for certain types of cancer, they can help each other work even better than if they were given alone. One drawback, though, is that side effects are often worse when they are given together.

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How Does It Work

Cells in your body are always dividing and making new copies. When you have cancer, though, some cells start to divide way too fast.

That’s where radiation therapy can help. It uses high-energy particles to make tiny breaks in the DNA of cancer cells to destroy or damage them, so they can no longer make new copies.

How Proton Therapy Works

Fundamentally, all tissue cells are made up of molecules with atoms as their building blocks. In the center of every atom is the nucleus. Orbiting the nucleus of the atom are negatively charged electrons. When energized protons pass near orbiting electrons, the positive charge of the protons attracts the negatively charged electrons, pulling them out of their orbits. This is called ionization it changes the characteristics of the atom and consequentially the character of the molecule within which the atom resides. Because of ionization, the radiation damages molecules within the cells, especially the DNA. Damaging the DNA destroys specific cell functions, particularly the ability to divide or proliferate. While both normal and cancerous cells go through this repair process, a cancer cells ability to repair molecular injury is frequently inferior. As a result, cancer cells sustain more permanent damage and subsequent cell death than occurs in the normal cell population.

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Sexual And Reproductive Health

You can be sexually active during your radiation therapy unless your radiation oncologist tells you not to be. You will not be radioactive or pass radiation to anyone else.

If you or the person youre sexually active with can get pregnant, its important to use birth control during your radiation therapy. Birth control is also called contraception.

You may have concerns about how cancer and your treatment can affect your sex life. Radiation therapy can affect your sexual health physically and emotionally. Talking with your radiation oncologist or nurse about your sexual health can be hard, but its an important conversation to have. They may not bring it up unless you share your questions and concerns. You may feel uncomfortable, but most people in cancer treatment have similar questions. We work hard to make sure everyone in our care feels welcome.

Sexual health programs

We also offer sexual health programs. These programs can help you manage the ways your cancer or cancer treatment affect your sexual health or fertility. Our specialists can help you address sexual health or fertility issues before, during, or after your treatment.

For information about our Male Sexual & Reproductive Medicine Program or to make an appointment, call .
For information about our Cancer and Fertility Program, talk with your healthcare provider.

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Staying On Track With Radiation Treatments

The benefits of radiation therapy strongly depend on getting the full recommended dose without significant breaks, because:

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The full dose of radiation is needed to get rid of any cancer cells remaining after surgery.
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Radiation therapy is most effective when given continuously on schedule. In the past, it was given every day, 5 days a week, for 5 to 7 weeks. Accelerated, also called hypofractionated, radiation therapy schedules deliver about the same total dose of radiation over a shorter schedule usually 3 to 4 weeks, which can be more convenient. Partial breast radiation can be completed in 1 to 3 weeks. Also, by seeing your doctor regularly during and after treatment, you can best deal with any side effects.

Why you might have problems sticking to your radiation therapy plan:

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The treatment schedule may conflict with job demands, family needs, or the distance you live from the treatment facility. This may cause you to miss or postpone appointments, even if youre on an accelerated schedule.
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Skin irritation from radiation can cause soreness, peeling, and sometimes blisters. If you’ve also had lymph-node surgery, radiation treatment may worsen breast or underarm pain or discomfort. If you have these side effects, you might feel like stopping radiation.

Ways to overcome problems and stay on track with radiation treatment:

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What Are The Late Side Effects From Radiation Therapy

Late side effects from radiation therapy take months and sometimes years to show up and usually donât go away. But not everyone will have them.

These problems happen when radiation damages your body. For example, scar tissue can affect the way your lungs or your heart works. Bladder, bowel, fertility, and sexual problems can start after radiation to your belly or pelvis.

Another possible late effect is a second cancer. Doctors have known for a long time that radiation can cause cancer. And research has shown that radiation treatment for one cancer can raise the risk for developing a different cancer later. Factors that can affect that risk include the amount of radiation used and the area that was treated. Talk with your doctor about the potential risk and how it compares to the benefits youâll get from radiation therapy.

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What Is External Beam Radiation Therapy

How Does Radiation Therapy Work? Cancer Treatment at Allegiance Health

During external beam radiation therapy, a beam of radiation is directed through the skin to the cancer and the immediate surrounding area in order to destroy the main tumor and any nearby cancer cells. To minimize side effects, the treatments are typically given five days a week, Monday through Friday, for a number of weeks. This allows doctors to get enough radiation into the body to kill the cancer while giving healthy cells time each day to recover.

The radiation beam is usually generated by a machine called a linear accelerator. The linear accelerator, or linac, is capable of producing high-energy X-rays and electrons for the treatment of your cancer. Using high-tech treatment planning software, your treatment team controls the size and shape of the beam, as well as how it is directed at your body, to effectively treat your tumor while sparing the surrounding normal tissue. Several special types of external beam therapy are discussed in the next sections. These are used for specific types of cancer, and your radiation oncologist will recommend one of these treatments if he or she believes it will help you.

Three-Dimensional Conformal Radiation Therapy

Who Gives Radiation Therapy Treatments

During your radiation therapy, a team of highly trained medical professionals will care for you. Your team may include these people:

Radiation oncologist: This doctor is specially trained to treat cancer with radiation. This person oversees your radiation treatment plan.
Radiation physicist: This is the person who makes sure the radiation equipment is working as it should and that it gives you the exact dose prescribed by your radiation oncologist.
Dosimetrist: This person helps the radiation oncologist plan the treatment.
Radiation therapist or radiation therapy technologist: This person operates the radiation equipment and positions you for each treatment.
Radiation therapy nurse: This nurse has special training in cancer treatment and can give you information about radiation treatment and managing side effects.

You may also need the services of a dietitian, physical therapist, social worker, dentist or dental oncologist, pharmacist, or other health care providers.

Types And Characteristics Of Cell Death

Radiation therapy, like most anticancer treatments, achieves its therapeutic effect by inducing different types of cell death 37 .3). Radiation therapy does not kill cancer cells right away. It takes hours, days or weeks of treatment before cancer cells start to die after which cancer cells continue dying for weeks to months after radiation therapy ends.

Types of cell death induced by radiation. Radiation mainly kills the cells either by apoptosis or mitotic catastrophe.

Apoptosis: Programmed cell death or apoptosis is a major cell death mechanisms involved in cancer therapy and in radiation therapy in particular 38, 39, 40. Apoptosis is characterized by cell shrinkage and formation of apoptotic bodies. Mitochondria play a major role for the apoptotic cell death 41. Blebbing of cell membrane is often seen with condensed chromatin with nuclear margination and with DNA fragmentation. In general, the cellular membrane of apoptotic cells remains intact. Induction of apoptosis in cancer cells plays an important role in the efficacy of radiation therapy 37, 42.

The above two types of cell death account for the majority of ionizing radiation induced cell death.

Necrosis: Cells visibly swell with breakdown of cell membrane. Cells have an atypical nuclear shape with vacuolization, non-condensed chromatin and disintegrated cellular organelles along with mitochondrial swelling and plasma membrane rupture followed by subsequent loss of intracellular contents 46.

What Other Kind Of Cancer Treatments Are Available

Many different types of cancer treatment are used in Australia today. The type of treatment your doctor recommends will depend on the type of cancer, the stage, your treatment goals and your general health.

Types of cancer treatment available include:

surgery an operation to physically cut out a cancer
chemotherapy strong medicines used to kill cancer cells
immunotherapy medicines that use your own immune system to target and kill cancer cells
hormone therapy medicines that block the effects of certain types of the bodys hormones on cancer growth and spread
targeted therapy medicines that target specific traits of cancer cells to affect their growth and spread
ablation using chemicals, extreme temperatures or radiowaves to kill areas of cancer cells
alternative therapies using therapies outside of mainstream medical practice
clinical trials taking part in trials of new medicines designed to treat cancer

Radiotherapy may be given together with other treatments, such as surgery and/or chemotherapy. Chemotherapy and radiation given close together can make both treatments more effective.

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