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Radiation therapy is a localized treatment, using laser technology to target a particular area with pinpoint accuracy. Patients don't actually feel the radiation as it's administered, and most side effects afterward can be minimized or controlled. Patients undergoing radiation therapy can often continue their daily activities without much interruption.
Radiation treatment must be individualized for each patient depending on the size and location of their cancer. The process involves consultation, simulation, treatment planning, and finally, the actual treatment.
Consultation: During the consultation, the radiation oncologist will obtain a medical history and perform a physical examination. You may want to bring X-rays, medical records, a list of medications, insurance information, and referral forms. After the initial consultation, the radiation oncologist communicates with the rest of your care team to determine the appropriate course of treatment.
CT Simulation: Simulation is used to determine the radiation treatment fields and most of the treatment planning. Images are obtained and transferred to the planning system where a virtual 3-dimensional image of the patient is created and the treatment delivery plan is developed.
Treatment planning: During treatment planning, the technologists perform special calculations so that the proper radiation dose will be delivered. Computers have become extremely sophisticated in planning radiation therapy delivery, even creating three-dimensional representation of the treatment area and surrounding normal tissues. If such computerized planning is necessary, the patient may be asked to have a special CT scan (a special type of X-ray device with a donut shaped opening). After all treatment planning is complete, radiation therapy treatments are ready to begin.
Radiation treatment: Radiation treatment is usually given using a linear accelerator focused on a patient table. During radiation treatment, you must lie very still on the treatment table while the radiation beam is targeted to the exact area of the tumor. The machine and treatment table may rotate up to 360 degrees if the treatment requires the radiation to hit the tumor from all angles. You will not feel the radiation as it is being delivered.
Radiation therapy is generally given as outpatient treatments once a day, five days a week, usually at the same time each day. The number of treatments depends on multiple factors and varies from 5-10 to 40 or more, which means that treatment may last anywhere from one to eight weeks or longer. While the first few visits might last for an hour or more, typically a daily radiation treatment will take about 15-30 minutes in the treatment room and the actual treatment only lasts a few minutes.
Although patients do not feel anything during a radiation treatment, the effects of radiation gradually build up over time. Most patients complete radiation therapy without significant problems, though many experience fatigue at some point.
Other side effects are typically limited to areas receiving radiation. If side effects occur, let your care team know, because treatment is almost always available and effective. Side effects generally resolve upon completion of treatment.
The most common side effects of radiation are:
Side effects that commonly occur with radiation to the head and neck are:
Other less common side effects are:
While not as common with the advent of modern radiation delivery techniques, side effects that may occur with radiation to the chest are:
In addition to the above temporary side effects, in certain cases, patients may develop long-term side effects, also called "late complications", such as:
These long-term side effects are also less common with the advent of modern radiation techniques.
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