Radiation therapy, also called radiotherapy, is a type of treatment that:
- Uses high energy X-rays to kill cancer cells.
- Is a local therapy because it only destroys cancer cells in the area it treats.
Radiotherapy can be used to treat single areas of disease, and sometimes the whole body. This is called total body irradiation (TBI). It is mainly used before an allogeneic stem cell transplant. Radiotherapy is sometimes used after chemo-immunotherapy to improve treatment response, especially in areas where the cancer was large.
If you have blood cancer that is affecting your central nervous system, you may have radiation therapy to your brain and spine. Usually, intrathecal chemo is tried first.
Before you start
- You will meet with the radiation oncologist (specialist doctor).
- Treatment options and goals will be discussed, and you may have a physical examination.
- You will have a radiotherapy simulation session.
Radiotherapy simulation
At this appointment you will have scans to:
- Calculate your dose of radiation.
- Position your body for radiotherapy treatments. This position will be the same at each treatment to make sure the area is treated accurately.
You may have a dot tattooed on your skin to help guide treatment.
During treatment
Treatment is usually 15-30 minutes long. Most of this time the treatment team will be setting you up for treatment. Once set up you will be alone in the treatment room. Your treatment team will be able to hear and see you. If you feel nervous you might like to bring along some music.
During treatment:
- Any important structures like your heart and lungs will be shielded, so they are not affected by the treatment.
- You will be positioned like you were at simulation.
- The radiation machine moves around you to deliver the treatment and makes a buzzing sound.
- The radiation beam is only on for a couple of minutes.
- It is important to stay still throughout the treatment.
- You do not see or feel anything during the treatment.
You may have one or two treatments, but most courses of radiotherapy are over several weeks. Longer courses are usually given in small doses, called fractions. Treatments are usually weekdays, Monday to Friday.
Side effects
Radiation therapy side effects vary from person to person and are dependent on the area treated. Some are short term, and some can last beyond treatment.
Skin changes
It is very common to experience skin changes following radiotherapy. Radiotherapy can make the skin feel dry, itchy and flakey. Your skin may also change colour.
These changes normally happen 10-14 days after your first dose of radiotherapy and improve around 4 weeks after you have completed treatment. You may need creams and dressings to help the area heal and avoid infection.
If you are experiencing skin changes due to radiotherapy, seek support from your treatment team.
Your treatment team will tell you how to take care of your skin, this may include:
- Protecting the affected area from the sun.
- Keeping any protective dressings in place.
- Using an unscented lotion to clean the skin.
- Patting skin dry with a soft towel.
- Moisturising with lotions recommended by your treatment team.
- Avoiding razors, hair dryers, hot water bottles or heat packs.
- Avoiding certain deodorants or lotions.
- Wearing loose soft clothing.
Other side effects include:
- Fatigue – extreme tiredness not relieved by rest.
- Mouth pain or soreness.
- Feeling sick (nausea and/or vomiting).
- Bowel changes – wind, diarrhoea, bloating, cramping.
- Hair loss – only in the area where you’re having radiation.
Radiotherapy follow up
After your course of radiotherapy finishes, you may have scans. Then you’ll see your radiation oncologist to discuss how your treatment went.
