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R ADIATION T HERAPY
Welcome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
What Is Radiation Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 - 3
Types of Radiation Therapy
External Radiation Therapy
Types of External Radiation Therapy
Internal Radiation — Brachytherapy
Radiation Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Your Radiation Treatment Team
Safety and Quality Assurance
What to Expect . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Your Radiation Consultation Visit
Planning Your Treatment — Simulation
Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6- 7
Your Treatment Schedule
The Treatment Process
How Will I Feel During Radiation Therapy?
After Your Treatment Program Ends
Managing Side Effects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 - 9
Recommended Skin Care During Radiation Treatment
Nutrition
Fatigue
Hair Loss
Sexual Activity
Fertility — During & After Treatment
Feelings and Concerns
Support Services and Programs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Clinical Services
Support and Education Programs
Glossary of Commonly Used Terms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Helpful Hints . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Jay S. Loeffler, MD
Chief, Radiation Oncology, Massachusetts General Hospital
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W HAT I S R ADIATION T HERAPY ?
Radiation therapy uses high energy X-rays or particles to kill cancer cells. The
radiation source may be external (from outside the body) and come from
beams and X-rays aimed at the cancer; or, the radiation source may be
internal (from inside the body) and come from radioactive implants. The goal
of both external and internal radiation therapy is to kill the cancer cells while
limiting the damage to healthy normal cells around the tumor. Most healthy
cells that are damaged by the radiation can quickly repair themselves.
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External Radiation Therapy External radiation treatments do not make you
External radiation therapy uses a machine called a radioactive. You may go about your normal daily
linear accelerator to direct beams of high energy activities. You may have close physical contact
X-rays at your tumor. The machine can change with people without worrying that you might
positions so the beams may enter your body from expose them to radiation.
any angle. By changing the angle of the beams your
RADIATION
radiation doctor is able to match the shape of your
tumor and spare as many healthy cells as possible.
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RADIATION THERAPY
4
WHAT TO EXPECT
W
WHAT
have any allergies or if you are pregnant. tiny ink dot marker injected under the skin that
HAT TO
(Please see “Fertility — During & After Treatment” helps line up the treatment area. These marks or
on page 9.) tattoos are very important because they allow the
radiation therapist to position you the exact same
TO E
Your treatment team wants you to be their
way for each treatment. Do not remove the marks
partner in your care. Helping you understand
EXPECT
during treatment. However, do not worry, if the
your diagnosis and the treatments available to
XPECT
marks happen to come off, they can be reapplied.
you is the first step. During this first visit your
doctor and nurse will go over information about Part of the simulation or planning session is finding
your type of cancer, the radiation treatment and recording the best body position for you
choices, and any possible side effects. during your treatment. Special devices, such as
molds and masks, can help to keep your body in
Your radiation doctor will go over your treatment
the correct position. The molds and masks are
plan. This includes:
made to fit your body at the time of the simulation.
• Why the treatment plan is best for you
After your simulation, our radiation physicists
• What it can and cannot do develop a treatment plan based on your radiation
• The type and amount of radiation therapy doctor’s design. Once a plan has been made, your
you will receive treatment can begin.
• How the treatment is done
• What the side effects of treatment might be
When you understand your treatment plan, you
will be asked to sign a consent form before your
first treatment.
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TREATMENT
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How Will I Feel During Radiation Therapy?
Radiation therapy does not hurt. You will not even feel the radiation.
However, there can be side effects from radiation therapy. Your doctor will
discuss these with you before your treatment. A section on side effects is
covered later in this brochure.
Checking Your Treatment Progress
Your radiation oncologist will see you throughout your radiation treatment
to monitor the effect the radiation therapy has on your cancer. During these
appointments the doctor may:
• Give you a physical exam
• Order blood tests
• Make changes in your treatment plan
• Prescribe medications
These appointments are a good time to ask your doctor and nurse questions
and discuss any problems or concerns you may have. Write a list of concerns
and questions ahead of time. Having a family member or friend come with
you to the visits can also help. They can listen and take notes or ask questions
about your care.
You must talk with your doctor or nurse before you start taking any new
prescription medicines, over-the-counter drugs, herbal remedies, or
vitamins during your radiation treatment.
TREATMENT
After Your Treatment Program Ends
When your treatment program ends, your radiation doctor will send a
complete report to your referring physician. You should contact the referring
physician to schedule follow-up exams.
Your radiation doctor will also schedule follow-up appointments with you to
monitor your progress. It is important to keep these appointments. The effects
of radiation may continue for several weeks or months after the completion of
your treatment. It is important to notify both your referring physician and your
radiation doctor if any symptoms or concerns develop after your treatment ends.
Side effects from radiation may continue for weeks or months after your
treatment has ended. It is important to notify both your referring doctor
and your radiation doctor if any symptoms or concerns develop after your
treatment ends.
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MANAGING SIDE EFFECTS
The goal of radiation therapy is to destroy cancer cells, but radiation therapy
can also injure or destroy normal cells. This can cause some side effects.
Your radiation doctor will explain any possible side effects before your
treatment begins.
Early or acute side effects from radiation therapy can be treated and usually go
away a few weeks after your treatment ends. Fatigue, loss of appetite and skin
irritation are examples of acute side effects.
Late or long-term side effects may take months or years to develop and can be
permanent. For example, high doses of radiation can cause permanent hair loss
and damage to the skin in the treatment area.
You should always tell your treatment team about any symptoms or side effects
you have. Your radiation nurse will give you specific information on how to
manage those side effects.
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Nutrition Fertility – During & After Treatment
You may notice changes in your appetite during For women of child bearing years
your radiation treatment. It is very important that If you are already pregnant or think you might be
you eat well to help lessen the side effects of pregnant, tell your radiation doctor before treatment
cancer therapy. Eat foods that are high in protein begins. You should not become pregnant during your
and calories to maintain your weight and treatments because the radiation therapy could injure
strength. You should always check with your your developing fetus. Talk with your radiation
doctor or nurse before taking vitamins or other doctor about reliable methods of birth control.
supplements. A consult with a nutritionist is
Radiation therapy may affect your future fertility. If
available and in some cases required.
you plan to have a child in the future, talk with your
doctor about the options for preserving your eggs.
Fatigue For men
It is normal for you to feel tired during your Receiving radiation therapy in the area of your
treatment. Low energy can be a side effect of testes can reduce both the number and function
your treatments. Your body is working very hard of your sperm. This does not mean that conception
to heal and repair itself. Be sure to get plenty of cannot occur. Talk with your radiation doctor
sleep at night. Talk to your nurse or doctor if you about reliable methods of birth control.
are fatigued.
Radiation therapy may affect your future fertility.
If you are working full-time, you may have to If you are concerned about fertility, you should
adjust your schedule to part-time or do some work discuss sperm banking with your radiation doctor
from home. Let family members and friends help before your treatments begin.
you with daily chores.
Sometimes, light exercise, like walking, can help
you feel less tired. Ask your doctor or nurse about
Feelings and Concerns
starting an exercise program. It is normal for a person with cancer and their
family to have worries or concerns. Each person
may react differently to the stress cancer treatment
Hair Loss has on their daily life. You may also have concerns
Radiation therapy can cause hair loss (also called about your job, parenting or finances. Sometimes
alopecia) in the area of the body that is being just talking about these
treated. Many patients find that their hair grows issues can be helpful. Please
back several months after treatments stop. The new tell your radiation
SIDE EFFECTS
hair may be different in color and texture. Whether treatment team about any
or not your hair grows back depends on the type concerns you may have.
and dose of radiation you receive and the area of They can find the right
your body that was treated. people and resources to
help you. There is a list of
Cancer Center services and
Sexual Activity programs on the following
You can be sexually active during radiation pages.
treatment but you must use a reliable method
of birth control to prevent pregnancy. If you
are a man in treatment you should not get your
mate pregnant.
Feeling tired can reduce your interest and desire.
This is temporary and should go away after you
complete your therapy.
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SUPPORT SERVICES AND PROGRAMS
Clinical Services
Oncology Social Workers provide support, counseling and resources for
radiation oncology patients and their families. Social workers help with
emotional issues and other concerns that may come up during cancer care.
There are also support groups you may join where you can share your feelings
with others going through the same experience.
The Oncology Chaplain can offer spiritual guidance during treatment.
The oncology chaplain also works closely with other hospital chaplains of all
faiths to meet the spiritual and religious needs of patients and families.
Dietitians can help you with eating and nutrition during your cancer treatment
and recovery.
Ask your team if there are special instructions you need to follow.
Get tips from your doctor and nurse about managing side effects.
You can relax in the Radiation Oncology Patient Lounge on Cox 1st floor
in between radiation treatments.
We have found that information reduces patients’ fears and helps patients
and families care for themselves. You can get information about radiation
therapy by:
Talk with an oncology social worker about any concerns you may have.
They provide counseling and access to hospital and community resources.
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