What to Expect When Having Radiation Therapy

Approved by the Cancer.Net Editorial Board, 08/2020

It is normal to feel worried or overwhelmed when you learn that you will need radiation therapy. However, learning more about this type of cancer treatment may help you feel more prepared and comfortable. The information in this article can help you prepare for your first treatment.

Who is on my radiation therapy team?

A highly trained medical team will work together to provide you with the best possible care. This team may include the following health care professionals:

Radiation oncologist. This type of doctor specializes in giving radiation therapy to treat cancer. A radiation oncologist oversees radiation therapy treatments. They work closely with other team members to develop the treatment plan.

Radiation oncology nurse. This nurse specializes in caring for people receiving radiation therapy. A radiation oncology nurse plays many roles, including:

Answering questions about treatments
Monitoring your health during treatment
Helping you manage side effects of treatment

Medical radiation physicist. This professional helps design treatment plans. They are experts at using radiation equipment.

Dosimetrist. The dosimetrist helps your radiation oncologist calculate the right dose of radiation.

Radiation therapist or radiation therapy technologist. This professional operates the treatment machines and gives people their scheduled treatments.

Other health care professionals. Additional team members may help care for physical, emotional, and social needs during radiation therapy. These professionals include:

Social workers
Nutritionists or dietitians
Rehabilitation therapists, such as physical therapists or speech therapists
Dentists

Learn more about the oncology team.

What happens before radiation therapy treatment?

Each treatment plan is created to meet a patient's individual needs, but there are some general steps. You can expect these steps before beginning treatment:

Meeting with your radiation oncologist. The doctor will review your medical records, perform a physical exam, and recommend tests. You will also learn about the potential risks and benefits of radiation therapy. This is a great time to ask any questions or share concerns you may have.

Giving permission for radiation therapy. If you choose to receive radiation therapy, your health care team will ask you to sign an "informed consent" form. Signing the document means:

Your team gave you information about your treatment options.
You choose to have radiation therapy.
You give permission for the health care professionals to deliver the treatment.
You understand the treatment is not guaranteed to give the intended results.

Simulating and planning treatment. Your first radiation therapy session is a simulation. This means it is a practice run without giving radiation therapy. Your team will use imaging scans to identify the tumor location. These may include:

Depending on the area being treated, you may receive a small mark on your skin. This will help your team aim the radiation beam at the tumor.

You may also be fitted for an immobilization device. This could include using:

Tape
Foam sponges
Headrests
Molds
Plaster casts

These items help you stay in the same position throughout treatment.

For radiation therapy to the head or neck, you may receive a thermoplastic mask. This is a mesh mask that is molded to your face and secured to the table. It gently holds your head in place.

It is important for your body to be in the same position for each treatment. Your radiation oncology team cares about your comfort. Talk with the team to find a comfortable position that you can be in every time you come in for radiation therapy. Tell them if you experience anxiety lying still in an immobilization device. Your doctor can prescribe medication to help you relax.

After the simulation at your first session, your radiation therapy team will review your information and design a treatment plan. Computer software helps the team develop the plan.

What happens during radiation therapy treatment?

What happens during your radiation therapy treatment depends on the kind of radiation therapy you receive.

External-beam radiation therapy

External-beam radiation therapy delivers radiation from a machine outside the body. It is the most common radiation therapy treatment for cancer.

Each session is quick, lasting about 15 minutes. Radiation does not hurt, sting, or burn when it enters the body. You will hear clicking or buzzing throughout the treatment and there may be a smell from the machine. Typically, people have treatment sessions 5 times per week, Monday through Friday. This schedule usually continues for 3 to 9 weeks, depending on your personal treatment plan.

This type of radiation therapy targets only the tumor. But it will affect some healthy tissue surrounding the tumor. While most people feel no pain when each treatment is being delivered, effects of treatment slowly build up over time and may include discomfort, skin changes, or other side effects, depending on where in the body treatment is being delivered. The 2-day break in treatment each week allows your body some time to repair this damage. Some of the effects may not go away until the treatment period is completed. Let the health care professionals if you are experiencing side effects. Read more about the side effects of radiation therapy.

Internal radiation therapy

Internal radiation therapy is also called brachytherapy. This includes both temporary and permanent placement of radioactive sources at the site of the tumor.

Typically, you will have repeated treatments across a number of days and weeks. These treatments may require a brief hospital stay. You may need anesthesia to block the awareness of pain while the radioactive sources are placed in the body. Most people feel little to no discomfort during this treatment. But some may experience weakness or nausea from the anesthesia.

You will need to take precautions to protect others from radiation exposure. Your radiation therapy team will provide these instructions. The need for such precautions ends when:

The permanent implant loses it radioactivity
The temporary implant is removed

Weekly reports

During your treatment, your radiation oncologist will check how well it is working. Typically, this will happen at least once a week. If needed, they may adjust your treatment plan.

Personal care

Many people experience fatigue, sensitive skin at the site of radiation exposure, and emotional distress during radiation therapy. It is important to rest and take care of yourself during radiation therapy. Consider these ways to care of yourself:

Learn more about coping during treatment. And, be sure to talk with your health care team about how you are feeling throughout your treatment period.

What happens after radiation therapy treatment ends?

Once treatment ends, you will have follow-up appointments with the radiation oncologist. It's important to continue your follow-up care, which includes:

Checking on your recovery
Watching for treatment side effects, which may not happen right away

As your body heals, you will need fewer follow-up visits. Ask your doctor for a written record of your treatment. This is a helpful resource as you manage your long-term health care.

Questions to ask the health care team

Who is creating my radiation therapy treatment plan? How often will the plan be reviewed?
Which health care professionals will I see at every treatment session?
Can you describe what my first session, or simulation, will be like?
Will I need any tests or scans before treatment begins?
Will my skin be marked as part of treatment planning?
Who can I talk with if I'm feeling anxious or upset about having this treatment?
How long will each treatment session take? How often will I have radiation therapy?
Can I bring someone with me to each session?
Are there special services for patients receiving radiation therapy, such as certain parking spaces or parking rates?
Who should I talk with about any side effects I experience?
Which lotions do you recommend for skin-related side effects? When should I apply it?
How else can I take care of myself during the treatment period?
Will special precautions be needed to protect my family and others from radiation exposure during my treatment period?
What will my follow-up care schedule be?