Radiation Therapy Frequently Asked Questions

If your cancer treatment includes radiation therapy, you likely have questions you would like answered. The oncology team at Virginia Oncology Associates put together some commonly asked questions from patients about radiation therapy treatment, how it works, and how it will affect life during and after treatment. As you go through these questions and answers, consider jotting down other questions you think of so you can ask them during your next appointment.

• What is radiation therapy, and what are the different types?

  Radiation therapy uses high-energy radiation to kill cancer cells and shrink tumors. This can be done in a few different ways: 

  • External radiation therapy comes from a machine that aims radiation at your cancer. The device does not touch you but rather moves around you, sending radiation to a part of your body from many directions. The targeted beams kill the cancer cells, so they cannot replicate. This method is often referred to as external beam radiation.
  • Internal radiation therapy is a treatment in which a solid or liquid source of radiation is put inside your body. This is also called brachytherapy. This type of radiation can be high-dose or low-dose radiation therapy.
    • Low-dose radiation therapy - Small radioactive seeds that contain a radiation source are placed in your body, in or near the tumor, and left there to break down on their own. The level of radiation does not make you radioactive. Prostate cancer is often treated in this manner.
    • High-dose radiation therapy - Radioactive material is placed in a capsule or ribbon and inserted into the body. Depending on the location of the cancer, radiation may be left in place for a few minutes or hours and then removed. These steps are repeated over several days to complete the process. You are not considered radioactive during or after treatment.
  • Systemic radiation therapy is administered as a liquid to travel throughout the entire body rather than a targeted area. You can receive systemic radiation therapy orally, through a vein via an IV line, or through an injection.
• Why was radiation therapy recommended by my oncologist, and what type will I need?

  Radiation therapy is an effective method for treating cancer and reducing cancer symptoms. It is especially effective on cancers of the breast, lung, prostate, head, and neck. There are several reasons radiation therapy is used, including:

  • Cure early-stage cancer by killing cancer cells
  • Shrink the size of a tumor before surgery
  • Ensure the area around the tumor has no cancer cells remaining after surgery
  • Stop cancer from spreading to other parts of the body (metastasize)
  • Reduce symptoms of advanced cancer like pain, problems swallowing, breathing, or bowel blockages

  Your VOA oncologist will work with you to explain which types of therapy might benefit you best. Depending on your situation, both external and internal radiation therapy may be used to ensure the cancer cells in the area are destroyed.

• How often will I receive external radiation therapy?

  Your cancer type and stage will determine the number of treatments you need and the period of time you will receive them. Traditionally, patients go to the treatment center 5 days a week for a short appointment each day over the course of 6 to 8 weeks. Each appointment for treatment is about 30 minutes to an hour. Most of the time is spent getting you into the correct position for treatment. The actual treatment takes five minutes or less.

  Hypofractionated radiation therapy is a more recent approach that gives the same dose of radiation in a shorter time frame. Rather than a 6-8 week course of radiation therapy, the same results can be achieved in 4-5 weeks by giving a higher dose of radiation at each treatment. The exact number of treatments depends on various factors, including the location of the cancer, its size, and the patient’s overall health condition. More advanced delivery methods make the shorter course of radiation treatments possible. By using the technology to precisely aim the rays of radiation, the cancerous cells are treated with a higher dose while sparing nearby organs and tissues. Currently, breast, lung, and prostate cancers are the cancers in which this method is most often used.

  External radiation therapy is usually done on an outpatient basis, meaning you will not typically require a hospital stay. Because of the frequency of your visits, finding a cancer center close to your home is ideal. Virginia Oncology Associates offers radiation therapy in Norfolk, Hampton, and Virginia Beach.

• How is radiation used, and will I be radioactive while having radiation therapy?

  Radiation therapy is used in people with cancer to shrink or stop the growth of a tumor. It may also be used in conjunction with other treatments. Radiation therapy aims to destroy cancer cells that are taking over the body while minimizing damage to healthy cells.

  During an external beam radiation treatment and most internal radiation therapy treatments, you will not be considered radioactive. Some radiopharmaceuticals will cause the patient to emit some radiation for a short period of time. If there is a chance you may emit small amounts of radiation for a period of time, any precautions that should be taken will be addressed by your radiation oncologist.

• Is radiation therapy painful?

  Overall, radiation therapy is usually painless. However, there may be some discomfort from lying in an uncomfortable position for a short period during planning and treatment. High doses of external radiation may require laying in a specific position to keep the radiation in place during treatment. Brachytherapy may require surgery to implant a source of radiation. 

• What kind of radiation therapy side effects should I expect?

  As with most other cancer treatments, radiation therapy might result in some mild side effects. This could include fatigue, sensitive skin or swelling at the treatment site, hair loss near the area of treatment, and/or headaches. Often, these side effects get better after the series of treatments are over. For some patients, the side effects can last for months or years after treatment. 

  Other side effects depend on where the radiation treatment is focused and how much radiation you receive. For example, for the treatment of head and neck cancers, patients occasionally have side effects of dry mouth, sore throat, change in the taste of foods, and potentially, teeth issues. In cases where the head is directly being treated, hair loss can be expected. Patients receiving chest treatment may have trouble swallowing, coughing, or shortness of breath.

• Can radiation therapy treatment cause cancer?

  Possibly. Unfortunately, there is no guarantee radiation therapy will not put you at risk of developing another type of cancer. The risk depends on how much radiation is needed and how long it is given. It also considers how long the patient lives after receiving radiation therapy.

  A critical part of the treatment planning process is ensuring that only the amount of needed radiation is given. The radiation oncologist aims the radiation beams at the specific body parts while trying to minimize damage to nearby cells and organs.

  If your cancer care team recommends radiation therapy as part of your treatment, the benefits outweigh the risks of developing a second cancer.

• Is radiation given before or after surgery or chemotherapy?

  The timing of when radiation therapy is given is dependent on the individual needs of the patient. Sometimes radiation is received before surgery or chemotherapy treatments to shrink a tumor, resulting in less invasive surgery or less chemotherapy. This is called neoadjuvant therapy. When radiation therapy is given after surgery or chemotherapy to kill any remaining cancer cells and lower the risk of recurrence, this is called adjuvant therapy. 

  If cancer is found at an early stage, radiation might be the only treatment option. Certain cancers that are at a more advanced stage might require radiation with additional treatments such as surgery, chemotherapy, and immunotherapy.

• Will I be able to continue working during therapy?

  Some patients feel well enough to work while receiving radiation treatments. Discussing with your oncologist before therapy can clarify what you can expect and what kind of treatment will be most effective for you. Some people feel well at the beginning of their treatment but begin to feel worn down after some time.

• How do I prepare for radiation therapy?

  You will meet your radiation oncology team before you begin treatment. At your initial appointment, they will talk about expectations, go over your medical records, and explain the process. Remember to ask any questions you may have. Once you are through discussing all the details, you will undergo a simulation before any radiation therapy is given. Watch this video to learn about what you can expect from radiation therapy cancer treatment at VOA. 

• What is a radiation therapy simulation?

  Simulation is an important step before radiation therapy treatment begins. This planning procedure helps the radiation oncology team improve the targeting of the tumor. During the simulation, you will be placed on the table where treatment will be given in the future. Your body may even be marked with a permanent marker or tattoo, so the linear accelerator will line up in the exact same spot for every treatment.

  Often, a CT scan is part of planning so the radiation oncology team can see exactly the size, shape, and location of the tumor. This determines how much radiation should be given and at which angles the beams should come from.

• Who will my radiation team consist of?

  While not exclusive, your radiation therapy team may include:

  Radiation oncologist: A specialist who watches treatments and ensures they are given correctly. They will adjust treatment or the treatment plan based on how you are responding to treatment or if they discover any new information. 

  Medical physicist: This specialist is tailored for the equipment and procedure of the treatments, monitoring the methods used, and making sure the equipment is working as it should. They work with the radiation beams and follow strict safety measures.

  Dosimetrist: This medical professional is certified in developing radiotherapy treatment plans and calculating and delivering doses of radiation to cancer patients. 

  Radiation therapists: They work closely with the rest of your cancer care team to provide the treatments under a doctor's supervision. Radiation therapists do the documentation and ensure the machinery is working correctly.

• Will I see my medical oncologist while I’m going through radiation therapy?

  The VOA radiation team works closely with your medical oncologist and surgeons to ensure treatments are working as planned and discuss the next steps. This means the medical oncologist will know how you are progressing through the radiation treatments.

  Most patients continue to be seen by the medical oncologist on a regular basis, even while receiving radiation therapy and regularly seeing the radiation oncology team. Talk to your oncologists about needed appointments and any blood work required before meeting with the physician.

How to Make an Appointment with Virginia Oncology Associates

If you need radiation therapy as part of your cancer treatment, Virginia Oncology Associates has multiple cancer centers offering this type of treatment, making it more convenient and less of an intrusion in your schedule. Find a radiation oncologist at one of our locations in Norfolk, Hampton, and Virginia Beach to request an appointment.