• What Is Radiation Therapy?
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|What Is Radiation Therapy?
It is one of main types of therapies used in cancer treatments. Radiation therapy is the use of radiation to destroy local nests of cancer cells. Radiation can be used to shrink or destroy a cancer tumor. It can also be used to 'sterilize' an area where a tumor was removed by cancer surgery but which may still contain some cancer cells (for example after the removal of a lump in breast cancer, or lumpectomy). High doses of radiation applied to cancer cells or a tumor prevents cells from growing and dividing into more cells. It may also affect healthy normal cells in the area but they can repair themselves, cancer cells cannot. Radiation can come from a machine outside the body which is known as external radiation therapy or it can also be delivered from a source implanted inside the body known as internal radiation therapy. Radiation is different to chemotherapy. Radiation is a local treatment which just treats the tumor. Chemotherapy is the use of drugs which treat cancer throughout the body.
Once you have been given a cancer diagnosis, and you have been recommended radiation therapy by your doctor or team of healthcare experts, you should ask about:
1. The purpose of the radiation therapy: Is it to destroy or shrink the tumor?
Radiation therapy is very expensive, this is because a lot of doctors and nurses are involved and the machines are complex. The exact cost will depend on what type of treatment is carried out and how many treatments are necessary. Most health insurance plans cover radiation therapy, including Medicare Part B. Do be sure to check the costs before beginning treatment. In some states Medicaid will help pay for treatments. If you do not have insurance or Medicaid talk to your hospital's social service office or call the American Cancer Society at 1-800-227-2345 for more options.
This is the use of a machine to send high beams of energy rays to the tumor or area around the tumor. The frequency and intensity of the beam is selected by the radiation therapist. The beam is aimed to hit the cancer area while avoiding any vital organs nearby. For example radiating a breast straight on could cause significant damage to nearby lungs and hearts, so the radiation is aimed at a different angle.
How Long Do Treatments Take?
Treatments are given 5 days a week for between 1 to 10 weeks, depending on the size and type of cancer. Patients are usually allowed to rest at weekends. The total amount of radiation is divided into daily doses. The amount of radiation is expressed in interchangeable units called rads or CentiGrays (cGy). For example a woman scheduled for a total of 4,500 rads will receive doses of 150 rads every week day for 6 weeks. For those seeking alternatives read about cancer clinical studies.
What Happens Before a Treatment?
Before external radiation begins the woman meets with a radiation oncologist at the hospital to learn about the therapy and to undergo a physical examination. She often has to undergo other imaging tests such as a CT scan or MRI scan so that the oncologist has all the information he needs about the tumor and its exact location. The oncologist may speak to a radiation physicist or dosimetrist to discuss dosages and most effective angles. Together they will agree a dosage.
Before the first treatment is given, the woman comes to the hospital for a dry run known as 'stimulation'. During a stimulation no actual radiation is given, but the machines are put through the motions. The unfamiliar noise of the machines can be unnerving the first time. Stimulation can take some time as the oncologist and technologists mark the skin to show the proposed targeted area, assess angles and construct shields to protect nearby organs. Regular X-rays will be taken to see if the process is right. The woman will have markings made with a felt-tip pen on her body after the procedure and she will be told not to wipe them off. They will need to be touched up regularly. Occasionally tattooing is used, but this is permanent.
What Happens During a Treatment?
The actual treatment itself only takes a few minutes and is like getting an X-ray. The time involved is usually in the set up, so a session can last up to 30 minutes. The technologist helps the woman into the right position, laying her flat on a treatment table underneath the radiation machine. Sometimes pads are placed under the head and knees and any shields are put in place. Once the set up is completed the technologist will go into a nearby room where he can see the woman through a window. Alone in the room, the woman lies still for a few minutes while the radiation is given. There is no pain involved although some women claim to feel a hot or cold sensation in the area being zapped. After completion of the dose the technologist will reappear to readjust the woman if radiation needs to be given from another angle. And that's it! Treatment completed for one day. It is important to remember at no time is the woman radioactive when she is undergoing radiation from an external machine.
The other way to receive radiation is from a radioactive source which is implanted into the body. The implant continues to emit energy for a specific time, continuing to decay until the supply is exhausted. If you have implants that are inserted physically into the body this is known as brachytherapy. This is a common treatment for a gynecological cancer such as uterus cancer. An empty applicator is placed into the body cavity (such as the uterus) in an operating room. Later, in a hospital room, a sealed source of radioactive material, bought in a lead-lined box, is inserted into the applicator with a special tongs. The applicator is left to emit rays for a set number of days before being removed again. During this time the woman is considered radioactive and a sign will be placed on her door stating 'Danger: Radioactive' so that no one else is unnecessarily exposed. Visitors and health care workers have to follow strict guidelines about how close they can go and for how long. They may need to wear protective clothing. Typically a woman going through brachytherapy will feel isolated and bored.
Other types of internal radiation are less restrictive. Implants can be put inside the body with needle like tubes. This may be carried out in the operating theater. Implants are inserted through the tubes and emit energy for a specific time. After a few weeks or months, once the radiation is depleted, the implants stay in place and cause no harm. They need not be removed. Most patients resume normal activates right away after an implant is inserted, although they may be told to avoid pregnant women for a certain time.
Fatigue: Severe but temporary fatigue or extreme tiredness is very common. Fatigue normally sets in a few weeks after treatment begins. The body is using extra energy resources to repair damaged cells and the trips to and from the hospital take their toll.
Skin Damage: Temporary damage to the skin which looks like sunburn is also common. This normally only occurs a few weeks into treatment once damaged cells have risen to the surface. The 'sunburn' turns to a tan which gradually fades, although some women report permanent pigmentation changes. Fair and sensitive skin is more likely to show signs of damage.
How Can I Protect Myself During Therapy?
1. Ensure you get plenty of rest. Fatigue can last up to 6 weeks after treatment has ended.
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