When you undergo external beam radiation therapy treatment, each session is painless, just like getting an X-ray. The radiation is directed at your tumor from a machine located away from your body, usually a linear accelerator. External beam radiation is noninvasive. One of the benefits of radiation therapy is that it is usually given as a series of outpatient treatments so you don’t have to stay in the hospital. You may not need to miss work or experience the type of recuperation period that may follow more invasive treatments.
The radiation therapist will deliver your external beam treatment following your radiation oncologist’s instructions. If an immobilization device was made during simulation, it will be used during every treatment to make sure that you are in the exact same position every day. Radiation therapists position you for treatment and set up the equipment. Time spent in the treatment room will vary depending on the type of radiation.
Once you are positioned correctly, the therapist will leave the treatment room and enter the control room next door to begin your treatment. During your treatment, your therapist will closely monitor you on a television screen. There is a microphone in the treatment room so you can always speak with the therapist if you have any concerns. The machine can be stopped at any time if you are feeling sick or uncomfortable.
The radiation therapist may move the treatment machine and treatment table to target the radiation beam to the exact area of the tumor. The machine might make noises during treatment that sound like clicking, knocking or whirring, but the radiation therapist is in complete control of the machine at all times.
Your radiation oncologist monitors your daily treatment and may alter your radiation dose based on these observations. Also, your doctor may obtain other tests such as blood tests and imaging to see how your body is responding to treatment. If the tumor shrinks or if your body changes significantly, another simulation may be required. This allows your radiation oncologist to change the treatment to target the remaining tumor with more precision and spare even more normal tissue.
Treatments are usually scheduled five days a week, Monday through Friday, and continue for multiple weeks. These treatments are typically given at the same time each day throughout the duration of your treatment, though your time may be updated/altered based on your needs or those of the radiation clinic. The number of radiation treatments you will need depends on the size, location and type of cancer you have, the goal of treatment, your general health and other medical treatments you may be receiving. Radiation oncologists will take all of this into account when determining your treatment course. If you have questions about your treatment length, please ask your radiation oncologist.
In some cases, you may receive other treatments directed at your cancer at the same time you are receiving radiation therapy. Typically, this includes form of hormonal therapy treatment, which can be delivered under the skin, such as Eligard (Leuprolide Acetate), into the muscle, such as Lupron (Leuprolide Acetate), or by mouth, such as Orgovyx (Relugolix) and Casodex (Bicaludamide). This hormone treatment works together with your radiation to treat your cancer to maximize the outcome of your treatment.
Hormone therapy can be delivered monthly, every 3 months, every 6 months, daily (oral treatments), or at an alternate schedule determined by your medical oncologist and/or urologist together with the radiation oncologist. Your treatment team will help coordinate these therapies and care for potential side effects.
Radiation therapy is most effective when it is delivered as prescribed, and for this reason, it is best to arrive on time and not miss any of your appointments. We realize that sometimes a course of treatment may need to be interrupted for a day or more. This may happen if you develop side effects that require a break in treatment. Other reasons include uUnscheduled machine maintenance or issues with transportation or other personal obligations. These missed treatments may be made up by adding treatments at the end. Please discuss this potential issue with your physician.
A portion of your external radiation therapy may be directed at the tumor and surrounding tissues at risk for harboring microscopic cancer cells. This might be followed by shrinkage of the volume of tissue treated to the tumor area itself, since this area may require a higher dose to eliminate the cancer cells. This is called a boost.
During radiation therapy, your radiation oncologist and nurse will see you regularly (typically weekly) to follow your progress, evaluate whether you are having any side effects, recommend treatments for those side effects (such as medication) and address any concerns you may have. Your doctor may also make changes in the schedule or treatment plan depending on your response or reaction to the therapy.
Your radiation oncology team will also gather on a regular basis with other health care professionals to review your case andto ensure your treatment is proceeding as planned. During these sessions, all the members of the team discuss your progress and any concerns.
During your course of treatment, correct positions of the treatment beams will be regularly verified with images made using the treatment machine. These images can be 2-dimensional (called port films, beam films or portal verification) or 3-dimensional (including ultrasound, cone beam CT, or MRI). These images represent an important quality assurance check to verify the radiation is being delivered as prescribed, but often do not give any information about the cancer itself. Depending upon what kind of treatment you receive and what your doctor thinks will work best, the type of images used may vary. These images are reviewed during or after each treatment, after which further adjustments are made, if necessary.
The information on this site was created by our medical advisory board made up of physicians and other members of the radiation oncology team with expertise in radiation therapy and on the topics presented. However, this material is informational only and should not be used in place of advice from a medical professional. If you have questions about a specific treatment, please ask your radiation oncologist.