You Ask, We Answer: Radiation Therapy Basics

By Jacqueline Brown, MSN, OCN, CBCN

Man Receiving Radiation Therapy for Cancer

As an oncology nurse information specialist at the American Cancer Society, part of my job is to help answer patients’ questions through our free 24-hour cancer information service. Many patients and caregivers call us with questions about treatment – including radiation therapy. When it comes to radiation, there are 4 questions in particular that seem to be the most common. As part of our new “You Ask, We Answer” series, I’ll give you answers to these 4 frequently asked questions about radiation treatment.

First, let’s go over a little background on radiation. When a doctor finds cancer, he or she may suggest several different treatments to get you healthy again. Many times, the first step may be to remove the cancer by surgery during an operation. But it is very common to use additional cancer treatments after surgery to improve the long- term success rate. These additional treatments are called “adjuvant,” meaning they are used after the primary treatment. They may be chemotherapy, radiation, hormonal, targeted or immune therapies.

Radiation is a common adjuvant therapy, so let’s dig into answering the most common questions patients and families ask our cancer team about this type of treatment.

1. Why is radiation therapy even needed if my surgery was so successful?

Cleaning Up Cells Left Behind: During surgery, a doctor will try to remove all of the cancer he or she can see, which often includes the tumor, lymph nodes, and some surrounding tissue as well.  But there is a chance that individual cancer cells that are microscopic – so too small for the doctor to see – could have been left behind and these cells could cause more cancer later. Radiation therapy can be used to treat the area where surgery took place and lower the chances that cancer returns. Many patients will have external beam radiation, which is aimed from outside the body to the target area. There are other types and uses of radiation to control cancer. The options you have will depend on your cancer.

2. If radiation is dangerous, how can it be used in a positive way to fight cancer?

Benefits Weighed Against Risks: Radiation is not always helpful in all types of cancer and there is a lifetime maximum dose that any one part of the body can receive. Importantly, doctors now use new and advanced techniques to get images of the specific area that needs to get treatment, allowing them to better control the exact amount of radiation that will pass into the healthy tissue. This helps make radiation more accurate and lessens side effects. In general, side effects that do happen will affect the part of the body where radiation is aimed. As an example, we can look at radiation given to the whole breast with expected changes in that breast and chest area only. You may notice local breast soreness and skin irritation but there is a small risk of lung irritation or thickening just underneath the treated breast. When radiation oncology doctors offer radiation, they think that the benefits of its ability to control your cancer will outweigh the risks. Still, it is OK to ask the doctor to explain all of the benefits and risks of radiation treatment prior to your consent.

3. What are the odds that radiation therapy for one type of cancer will cause another cancer?

Second Cancer Concerns: When some patients are facing radiation treatment for cancer, they may have fears about the possibility of the radiation causing a new second cancer in the future. A second cancer is a cancer that is different from the original type of cancer that was treated. The odds of a second cancer depend on many factors such as age during treatment, radiation dose, and the part of the body that was previously treated.  The small risk of a secondary cancer that could occur more than 10 to 15 years later must be weighed against the benefit of controlling the current cancer.

4. Is there a reason that I am left alone to get the radiation but the staff are protected outside? Is my family at risk because I have daily radiation treatments?

One Series for You, Lifetime Work for Staff: It can be unsettling to learn that external beam radiation treatments will be given while you are alone in the treatment room. The radiation staff will be just outside and can see and hear you via windows or cameras. The staff are not allowed inside during the treatments due to safety measures for themselves as health care workers. As a patient, you are likely only getting one series of treatments to a specific area of the body. However, health care workers see about 40 patients each day and may be working for many years in the radiation clinic. This is why they need to stay outside of the treatment room. You will not carry any radiation with you as you leave the room so there is no danger to family or caregivers. Other types of radiation treatment such as internal or systemic forms of radiation treatment can require certain precautions.

Need more answers? 1-800-227-2345

Our phone lines are open every minute of every day to help give people the answers they need about cancer. Each year, we provide free information and support to the nearly 1 million people who call us at 1-800-227-2345.

Photo of Jacqueline BrownBrown is an oncology nurse information specialist at the American Cancer Society. 

4 thoughts on “You Ask, We Answer: Radiation Therapy Basics

  1. I had always wondered how radiation was used to fight cancer when radiation itself can be dangerous, but this post explained that very clearly. It’s interesting to know that radiation therapy can be directed and used in a way to lessen the potential harm it can cause while fighting cancer. It’s also helpful to know the that soreness and irritation is a normal part of the radiation procedure. Thanks for the helpful information.

  2. It’s interesting to learn more about radiation therapy and how it compares to other cancer treatments. My Dad was just diagnosed with lung cancer and the doctor suggested that he undergo radiation treatment before trying anything else. It’s good to know that while radiation therapy is slightly dangerous, there are more benefits than risks. Thanks for sharing!

  3. Dr. Chris Duma has developped a technique of targetting the white matter pathways for patients with GBM. He boasts an 80% improvement vs. the Stupp protocol for median OS. His belief that the tumor doesn`t snowball, it moves along the white matter pathway or highway. I would just like to know if more hospitals do this, and how is this process patented, it seems like a technique, not a device or new medicine.

  4. I was diagnosed with type 2B breast cancer effecting my right breast and one sentinel node. After 6 rounds of chemo, I have been deemed as having a complete response, cancer free! I still chose to have a mastectomy. All pathology of breast and sentinel node came back with no cancer detected. Before surgery, surgeon gave me a choice: lumpectomy with radiation or mastectomy. I still am doin antibody infusions in light of HER2 positive and estrogen positive. Oncologist wants me to consider radiation therapy. In light of choices by surgeon, I thought the hard choices were done. I don’t understand why I need to do this in light of my response. I also have other health issues to contend with (diabetes, Graves’ disease, high blood pressure etc). I am so conflicted on whether I should consent to radiation or decline. I am unsure whether side effects of radiation now and future will outweigh its potential benefit. Any insight you can provide would be appreciated.

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