17637 Radiation Therapy

Overview

Radiation therapy (also called radiotherapy) is a treatment that uses high-energy beams or tiny radioactive sources to damage cells in a targeted area. It is used mostly to treat cancer, because cancer cells are less able to repair this damage than healthy cells. It can be given to cure a cancer, to shrink a tumour before surgery, to lower the chance of cancer coming back after surgery, or to ease pain and other problems when a cure is not possible. It is also sometimes used for a few non-cancer problems, such as painful joint or skin conditions. The treatment itself is painless — you do not feel the beams — and it does not make you radioactive, apart from some special internal treatments where your care team will explain any temporary precautions.

Yes. It is one of the main cancer treatments, and roughly half of people with cancer have radiation therapy at some point as part of their care.

It can be used for people of any age, from young children to older adults. Children are treated at specialist centres with extra support, and doses are carefully adjusted for a growing body. Older adults may need extra help with tiredness, skin care and keeping well hydrated during treatment.

Symptoms

Common symptoms

• Tiredness that builds up over the course of treatment and improves afterwards
• Red, dry, itchy or sore skin in the area being treated, like mild sunburn
• Hair loss, but only in the area the beams pass through
• A sore mouth, dry mouth or changed taste when the head or neck is treated
• Feeling sick, or loose stools, when the tummy or pelvic area is treated
• Needing to pass urine more often, or discomfort when passing urine, with pelvic treatment
• Low blood cell counts, which can make you more open to infection or bruising
• Swelling or stiffness in the treated area, or difficulty swallowing

Symptoms in children

• More tiredness than usual, and needing more sleep or quiet time
• Being clingy, tearful or cross, especially during planning visits
• Sore skin or a sore mouth that makes eating and drinking harder
• Feeling sick, or changes in appetite
• Later effects on growth, learning or hormone levels, which the specialist team watches for over the years

Symptoms in older adults

• Stronger tiredness, sometimes lasting longer after treatment ends
• Thin or fragile skin that reacts more easily and needs gentle care
• Dehydration or weight loss if eating and drinking become harder
• More flare-ups of other health conditions, such as heart or lung problems
• Confusion or dizziness, which should always be reported to the team

Causes

Main causes

• Cancer or a tumour that can be targeted with radiation, either to cure it or to control it
• Shrinking a tumour before surgery, or lowering the risk of the cancer returning after surgery
• Easing symptoms such as pain, bleeding or pressure when a cure is not possible
• A small number of non-cancer conditions, such as some painful skin, joint or eye problems

Risk factors

• A larger area of the body being treated, or a higher total dose, which can mean stronger side effects
• Having chemotherapy at the same time, which can add to tiredness and soreness
• Smoking, which slows healing and can make side effects worse
• Poor diet or low weight before treatment starts
• Diabetes or a weakened immune system, which can affect skin healing
• Skin conditions or previous radiation to the same area
• Pregnancy — always tell your team, as extra checks and precautions are needed

When to see a doctor

See a doctor urgently if:

• A temperature that is higher than the level your team asked you to watch for
• Shivering, or feeling very unwell or floppy, especially after chemotherapy
• Severe diarrhoea, vomiting or inability to drink
• Sore, broken or weeping skin, or a wound that looks infected
• New shortness of breath, chest pain or a racing heart
• Sudden severe pain, or a limb that swells up quickly

Book a routine appointment if:

• Skin redness, dryness or itching that is getting worse
• Tiredness that is affecting your daily life
• A sore mouth, changed taste, or trouble eating
• Changes in bowel or bladder habits
• Swelling, stiffness or a change in how the treated area feels
• Any worry about your treatment plan or side effects

Diagnosis

Radiation therapy is not a diagnosis in itself — it is a treatment. Before it is offered, a specialist team reviews your test results and agrees whether radiation is likely to help, and how. If it is, you have a planning session where scans are used to map the exact area to be treated and to protect the healthy parts nearby. A physicist and doctor then design a plan just for you, and you may be given small ink marks or tiny dots on your skin to help line everything up each day.

Tests that may be done

• A CT scan of the area being treated, used to plan the treatment
• MRI, PET or other scans to see the tumour more clearly
• Blood tests to check your general health and blood counts
• A pregnancy test where relevant, before treatment starts
• A dental check if the head or neck is being treated
• A check of your skin and general fitness before starting

What to expect at your appointment

Planning usually takes one visit, and treatment may start a week or two later. Each treatment session is short — often 10 to 30 minutes in total, with only a few minutes of actual treatment. You lie still on a couch while the machine moves around you. You can breathe normally and you will not feel anything. The radiographers stay nearby and can see and hear you the whole time. Most people go home the same day, and many carry on with work or normal routines, at least at first.

Treatment

Radiation therapy is given in several ways. The most common is external beam therapy, where a machine outside the body aims beams at the area. Internal therapy (brachytherapy) places a small radioactive source inside or very close to the tumour for a short time. Some treatments are given as a drink or injection that travels through the body to certain tissues. Your team will explain which type suits you, how many sessions you need, and what to expect. Supportive care — such as creams, pain relief, anti-sickness medicines and advice on rest and fluids — is a normal part of the plan and is arranged by your team.

Self-care at home

• Wash the treated skin gently with lukewarm water and a mild, unperfumed product — pat dry, do not rub
• Use only creams or products your team has approved, and tell them about anything you buy yourself
• Keep treated skin out of strong sun and avoid hot water bottles, saunas and tight clothing on that area
• Rest when you feel tired, and plan your day around short breaks rather than pushing through
• Drink plenty of fluids unless your team has asked you to limit them
• Eat small, frequent, soft meals if your mouth or throat is sore
• Keep a simple diary of side effects so you can tell your team clearly at each review
• Ask before shaving or using hair products on treated skin

Medical treatments

Your radiation plan is designed by a specialist team and adjusted to your body, your condition and your goals. Treatment is usually given in short daily sessions over several weeks, sometimes with breaks. Alongside it, your team may offer medicines to control sickness, pain, diarrhoea or infection, plus creams for skin reactions and mouthwashes for a sore mouth — they will choose what suits you and explain how to use it. Some people also have chemotherapy, hormone treatment, targeted treatment or immunotherapy around the same time. Never start or stop any medicine, supplement or herbal product without checking with your team, because some can affect treatment.

When is surgery considered?

Radiation therapy and surgery are often used together. Sometimes radiation is given first to shrink a tumour and make an operation easier or safer. Sometimes it is given after surgery to lower the chance of the cancer coming back. For some cancers, radiation can be used instead of surgery when surgery is not suitable or not wanted. Your team will discuss the pros and cons of each order of treatment with you.

Living with this condition

Many people manage to keep up most of their normal routine, especially in the first weeks. Tiredness tends to build up and may be strongest near the end of treatment, then improve over a few weeks. Plan rest into your days, accept offers of help with shopping, cooking and lifts, and keep your treatment team's contact details somewhere you can find them quickly. Ask about parking, travel help, wig or headwear services, and free or discounted transport schemes — these exist in many areas and the team can point you to them.

Lifestyle tips

• Keep moving gently — short walks help with tiredness and mood
• Avoid smoking and limit alcohol, which can slow healing
• Use a gentle, unperfumed moisturiser on treated skin as advised
• Protect treated skin with loose cotton clothing and a high-factor sunscreen once healed
• Keep up your usual social contact, even if visits are shorter
• Ask about help with money, work and travel if treatment is affecting your income

Diet and exercise

Eat regularly and aim for a balanced mix of protein, vegetables, fruit and starchy foods to help your body repair. If your appetite is poor, small meals every few hours often work better than three large ones, and a dietitian can give practical advice. Keep drinks handy and sip through the day. Gentle exercise — walking, stretching, light housework — is usually encouraged because it helps with tiredness, sleep and low mood. Build up slowly and stop if you feel unwell, and check with your team before starting anything strenuous.

Mental health and emotional wellbeing

It is very common to feel anxious, low, irritable or worn out during and after radiation therapy. You may worry about the machine, the side effects, your appearance, or what happens next. These feelings are understandable and they usually ease as treatment finishes and side effects settle. Talking helps — with family, friends, your treatment team, or a counsellor. If you feel hopeless, cannot sleep, or have thoughts of harming yourself, please reach out for crisis support straight away: contact your local emergency number, your doctor, or a crisis line in your country. You do not have to cope alone, and help is available.

Prevention

You cannot prevent the need for radiation therapy in every case, but you can lower the chance of some cancers that are treated with it by not smoking, limiting alcohol, staying active, keeping to a healthy weight, and taking up screening invitations. You can also reduce the impact of treatment by eating well, stopping smoking before treatment starts, and telling your team early about any side effects.

Vaccines

Some vaccines lower the risk of cancers that may need radiation therapy. The HPV vaccine helps protect against cervical and some head and neck cancers, and the hepatitis B vaccine helps protect against liver cancer. Ask your doctor whether these are recommended for you or your family.

Screening programmes

Screening programmes can find some cancers early, when treatment is simpler and more likely to succeed. Depending on your age and where you live, this may include breast, cervical, bowel or lung screening. Your doctor or local health service can tell you what you are eligible for and how to book.

Complications

If left untreated

• A cancer may keep growing and cause pain, bleeding, blockage or pressure on nearby organs
• Symptoms such as breathlessness, difficulty swallowing or bowel problems may get worse
• Some cancers become harder to treat if left for a long time
• There may be more limited options later if the cancer spreads

Long-term outlook

Radiation therapy helps many people live longer and feel better, and for some cancers it offers a cure. Side effects are usually at their worst near the end of treatment and then improve over a few weeks to months, though some effects can be longer lasting. Your team will follow you up regularly, adjust your plan if needed, and help you manage anything that comes up. Many people return to their usual activities and quality of life after treatment.

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