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What is radiation therapy?

Radiation therapy is well-established as a treatment for cancer. High-energy radiation is used to destroy cancer cells. It can be done with external beam radiation therapy or internal radiation therapy, also called brachytherapy. Usually, no numbing medication (anaesthesia) is needed for radiation therapy.

External beam radiation therapy is a treatment option in:

Brachytherapy is a treatment option in:

  • Prostate cancer

The procedure

External beam radiation

The radiation oncologist will position you on the treatment table and make sure that you cannot move during the treatment (Fig 1.). You will be given pads or cushions to make it as comfortable as possible for you to keep still. While radiation therapy is given, the radiation oncologist will leave the room and monitor you from outside, but you will be able to talk the whole time. Beams from one or more directions may be used.

The amount of time that each beam is focused on a certain point is calculated before treatment starts.

The standard course of external radiation therapy usually lasts around 8 weeks, 5 days a week. You receive one dose of radiation per day. The treatment takes about 20 minutes each day, and you do not have to be admitted to the hospital.

Before the start of a course of radiation therapy you may get a CT scan. This is done to map the area that will be radiated as well as the surrounding tissue that should not be treated. In recent years, image-guided radiation therapy has become more widely available. For this type of therapy the radiation oncologist locates the affected organ very precisely with the help of an x-ray or CT scan to make sure that the radiation dose is delivered to that organ.

Brachytherapy

In prostate cancer another form of radiation therapy is possible, also called brachytherapy. For this type of treatment, a source of radiation is inserted directly into the prostate (Fig. 2).

Fig. 1: External beam radiation therapy damages and kills cancer cells.
Fig. 1: External beam radiation therapy damages and kills cancer cells.
Fig. 2: In brachytherapy a radiation source (seeds) is inserted directly into the prostate.
Fig. 2: In brachytherapy a radiation source (seeds) is inserted directly into the prostate.

How do I prepare for the procedure?

Your doctor will advise you in detail about how to prepare for the procedure. You will receive a schedule for eating and drinking before each session to make sure that your bladder is comfortably full and the rectum is empty before the procedure. If you are taking any medication, discuss it with your doctor. Generally, you do not need to stop taking it during radiation therapy.

Side effects

Radiation can also damage healthy cells in other organs, so the radiation beam must target the cancer cells to limit damage. Side effects are usually mild.

Common side effects of radiation therapy include:

  • Stomach or GI symptoms, including peptic ulcer
  • Tiredness
  • Sore skin
  • Upset stomach (nausea)
  • Diarrhoea