Radiotherapy

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Radiation therapy is a common treatment for many different forms of cancer. The treatment can be used to remove a cancerous tumor, to slow down the disease or relieve symptoms. It does not hurt to get radiotherapy but it can cause side effects.

Preparations

It is important that you lie well and in exactly the same way at every treatment if you are to receive external radiation treatment, which is the most common type of radiation treatment.

Therefore, you may need to try out some type of equipment. It can be, for example, a headrest, armrests, pillows or a plastic mask for the head and shoulders.

You will be examined and marked

Once you get the equipment you need, you are examined with computed tomography. Sometimes other investigations are also needed, such as PET examination or magnetic camera examination.

The doctor uses the images from the examination to determine exactly which area of ​​the body to treat.

You can get some small tattoo dots or markings with ink so that the radiator can easily be set in the same way every time you receive treatment. You can shower the area with markings, but avoid rubbing with soap. The tattoo dots are not washable. 

It takes one to two hours to be examined and get the markings. Then your treatment is planned.

They plan your treatment 

Specialist trained nurses, doctors, and radiation physicists plan your treatment. They determine, among other things, how much radiation you need and from which direction it should come.

It is common for treatment to begin approximately one week after planning is complete.

You can bring someone with you

At the first visit, it may be good to bring someone close, if possible. That person can help you remember all the information by listening and asking questions.

The person who comes with must leave the room during the examination or treatment itself, but maybe involved when talking to the healthcare staff.

Children may come along, but it may be good to wait a few times until you feel safe in the environment.

Stop smoking if you smoke

If you smoke, try to quit smoking before starting treatment. Then the treatment becomes more effective. You have less oxygen in your blood if you smoke. Tell your doctor if you need help to quit smoking.

Then the treatment goes on

You receive treatment at a radiotherapy department in a hospital. Most people can stay home between treatment sessions.

Usually, there are patient hotels that you can stay at if you have a long way to the treatment department. Your contact nurse will help you with the practical. You may be entitled to reimbursement for the costs you incurred in going to the hospital for treatment.

External radiation therapy

External radiation treatment means that the radiation comes from an apparatus that is a distance away from you.

You undress the part of the body to be treated and put on a bun. 
The nurses will help you stay as you should with the equipment you have tried out. Then they set the radiation device so that the treatment is given to the right area of ​​the body.

You are alone in the room while you get radiation. The staff enters a room next to the treatment room. They see you and everything that happens on a television screen. You can signal to them if something feels weird. Then treatment is interrupted and the staff enters the room again.

You can get radiation from several directions

You get radiation from one direction or several directions. It depends on where the cancer tumor is located and what is most beneficial for the healthy tissue around cancer.

The directions are called beam fields. When a beam field is ready, the device moves so that it becomes a new beam field. In some treatments, the radiation device moves around you while receiving the radiation.

The device usually emits a buzzing sound, but the radiation is neither felt nor visible.

It is important that you lie still while the treatment is in progress so that the radiation hits where it should. You can listen to music in the meantime if you like. You can usually bring your own music.

The treatment takes a few minutes

The radiation itself goes fast. The total radiation time is usually two to five minutes. The entire visit takes between 10 and 20 minutes.

When the appliance is switched off, the radiation is also gone. No radiation remains in the body afterward.

Internal radiation therapy – brachytherapy

Internal radiation means you get the treatment inside your body. A radioactive substance is introduced into the cancer tumor or placed near it. Then the cancerous tumor can be given a high dose of radiation while the tissue outside is spared.

Internal radiation therapy is also called brachytherapy. Sometimes external and internal radiation therapy can be combined.

When is brachytherapy used?

Brachytherapy is mainly used in gynecological cancers, such as cervical and uterine cancer, in prostate cancer and cancerous tumors of the mouth or throat.

You get anesthetized before the treatments. It can be, for example, local anesthesia, back anesthesia or being anesthetized.

Gynecological cancer

You get the radiation treatment through a narrow instrument that is inserted into the vagina.

The staff is left in the room when you receive treatment, or they are in a room next door where they constantly see you and everything that happens on a TV screen. You can contact the staff at any time with an alarm clock that you have in your hand.

The instrument is removed from the vagina when the treatment is complete.

Here you can read more about cervical and uterine cancer.

Prostate cancer

You receive radiation treatment through needles that the doctor inserts into the prostate and take out when the treatment is complete.

You can also get radiation from radioactive iodine grains that are brought into the prostate and left there. Treatment with iodine grains is also called seed therapy.

You can read more in the text about prostate cancer.

Cancer of the mouth or throat

You get the radiation treatment through a few thin tubes in the mouth.

The staff is in a room next door when you get the radiation treatment, but they see you all the time and everything that happens on a TV screen. You can contact the staff at any time with an alarm clock that you have in your hand.

The hoses are removed when the treatment is complete.

Here you can read more about cancer of the mouth or throat.

Other radiation therapy

You receive radiation treatment as a syringe in the blood or as a solution that you drink. The treatment is sometimes given for example thyroid cancer.

Then you do afterward

You do not know the radiation itself but it can cause side effects after you have been treated for a while. The side effects depend on which part of the body has been irradiated and how much radiation you have received.

Some have no side effects at all.

Many side effects diminish after a while and disappear completely. Sometimes it takes a long time.

Sometimes you can get side effects that do not go away. It may depend on how much radiation you have received and how sensitive you are to radiation.

Most side effects can be alleviated in various ways.

Side effects are usually divided into early side effects and late side effects.

Early side effects

Early side effects come after a few weeks of treatment. They may be clearest a week after treatment is completed. They usually disappear after a few weeks. Here are examples of common side effects that may come early.

Fatigue is common but usually disappears

Many people feel tired during the treatment period. Some just get a little tired, others get so tired that it affects existence. Fatigue usually decreases a few weeks after the treatment is complete and then disappears completely.

Sometimes a physical activity can make you feel less tired. Touch it as you see fit. It can also be easier to take several short rest breaks during the day rather than a single, longer rest break.

Nausea can be prevented and relieved

Some feel bad. You may feel ill early in the treatment or towards the end of treatment. You can get medicines that make you feel unwell. What you eat can affect how you feel. You can get advice from a dietician. Read more in the text food for cancer.

Temporary skin problems

It is common for the skin to become red or dry and itch where you receive radiation treatment. The trouble may come after a few weeks of treatment. Sometimes it can be sore. The armpits, groin and other areas with skin folds are extra sensitive.

  • Avoid strong perfumed soap and deodorant where the skin is affected.
  • Lubricate the skin every day after receiving treatment.
  • Eat as good and versatile as you can. The body needs a lot of energy and nutrition to heal the skin.

Healthcare professionals can provide more advice on how to care for the skin.

The hair usually grows out if you lose it

You may get thinner hair or lose your hair after a few weeks of treatment if you receive radiation treatment to the head.

The hair usually grows out again a few months after the end of treatment. The new hair may have a slightly different color and texture than before. Even eyelashes, beards and pubic hair can fall off if you receive treatment against those parts of the body.

At higher radiation doses you can lose your hair without growing out again.

You can get a wig or false eyelashes if you lose hair.

Discomfort with the stomach and bladder

You can get diarrhea and a lot of gases in the gut if you receive radiation therapy to your stomach. Radiation treatment against the bladder may cause you to urinate frequently and it may fade when you urinate. There are drugs that can relieve the hassle.

You can get help against reduced appetite and dry mouth

Radiation treatment to the mouth or throat can cause the mucous membranes there to become irritated or sore. It can hurt. You can get dry in your mouth. Then you can more easily get holes in your teeth. The taste buds can be affected so that the food tastes differently.

The trouble can make eating and drinking difficult.

You will receive painkillers if you need them. There are lozenges that allow you to get more saliva. A dietitian can advise on how to adjust the food so that you can eat as well and varied as possible. It helps the body heal the mucous membranes and the skin.

Here you can read more about food in cancer and what you can do yourself to relieve dry mouth.

Be careful about oral hygiene. Use a soft toothbrush. You may be entitled to special dental care.

Help with lymphedema

Radiation therapy can cause lymphedema. This means that a lot of lymph fluid is collected in, for example, a leg or arm. It can become swollen, numb or feel heavy where the lymph fluid has collected.

The problems are greatly reduced if they are detected early and you receive treatment.

Late side effects

Late side effects may come several months or years after cessation of radiation therapy. Many people get no late side effects at all.

Skin changes

The skin in the radiation area can become stiff and hard with visible blood vessels. It’s called fibrosis.

Help if you find it more difficult to keep tight

The bladder can be affected so that it licks the kiss. The intestines can also be affected so that you get diarrhea.

  • You can train your muscles so that you can pinch them if needed. You can get help from a physiotherapist or physiotherapist.
  • There are different types of incontinence protection. You can get free incontinence protection through the district nurse.
  • There are drugs that relieve the hassle.

It can hurt

You may get a sore, tingle, or become weak in a part of your body if you have been treated for an area with a lot of nerves. An example is if you have received radiotherapy to the clavicle or above the clavicle. Then you may have symptoms in your arm.

Sexuality can be affected

Cancer and cancer treatment can change both the body and how you perceive yourself. Sex appetite can be affected if cancer treatment makes you feel anxious or depressed.

If you have a partner it can be good if you talk to each other about how you think and feel. In this way, you can avoid unnecessary misunderstandings, such as a feeling of being rejected.

Body contact and closeness without sex can strengthen the relationship – and make the desire come back. Here you can read more about cancer and sexuality.

Vaginal disorders can be relieved and prevented

Radiation treatment to the pelvis and abdomen can make the mucous membranes fragile. It can bleed and hurt, for example during intercourse. Lubricants can help.

The slit opening can become narrow because it has formed scar tissue after the treatment. Then it can be more difficult to have intercourse or during a gynecological examination.

You can prevent the inconvenience by using a dilator. It is a rod that you insert into the vagina. You get it at the clinic where you have been treated. You may need to resize after a while.

It may also work to use a massage stick but it is important that it is the right size for you. You can also get help with that. 

More difficult to get a hold

It can be more difficult to get a hold and to keep it if you have received radiation treatment for, for example, the prostate. The difficulties can come after a while and increase with time. There are medicines and aids. Here you can read more about having difficulty getting up and running.

Good to be able to talk to someone

Nurses and doctors where you receive treatment are used to the side effects you can get. It may feel good to talk to them if you need to. They can provide help and support.

Many clinics arrange information meetings in groups or individually. There are also several patient associations. They may have question columns or discussion forums, both for those who have received treatment and for those who are related.

Respect your own needs

It is different how you handle the period of treatment. Some continue with life as usual, for example with work or studies. Others need to be at home in peace and quiet. The most important thing is that you do what feels best for you.

Why Do You Get Radiation Treatment?

Radiation is a common way of treating many cancers. The purpose of the treatment varies, among other things depending on cancer you have and how you feel:

  • You can get radiotherapy that shrinks a cancerous tumor to make it easier to operate.
  • You can receive radiotherapy after an operation to remove cancer cells that may have remained.
  • Sometimes just radiation therapy is enough to remove a cancerous tumor.
  • You may receive palliative radiotherapy that can cure cancer and relieve symptoms of the disease that cannot be removed. Here you can read more about palliative care.

How does radiotherapy work?

The radiation damages the cancer cells so that they cannot become more. Radiation also damages healthy cells, but healthy cells are better at repairing their damage than cancer cells are.

It is common for the treatment to be divided into several occasions. Then the healthy cells can repair their damage a little between the radiation doses while the cancer cells are increasingly damaged and destroyed.

Almost all external radiation treatment is provided with ionizing electromagnetic radiation.

There are also external radiation treatments given with protons. Proton radiation can be controlled in a different way and considered when it is extra important to reduce the dose to the surrounding healthy tissue. It is used, among other things, in the radiation treatment of children and adolescents and in some tumors in the brain. Ask your cancer doctor for more information.

Different doses of radiation

A high total dose of radiation is often required to remove cancer with radiation therapy. The dose can be divided into several treatment sessions.

For external radiation treatment, you can receive radiation therapy five days each week for up to seven weeks.

It is common to receive the treatment once a day but it can be different. Some need treatment twice a day, others have treatment-free days during the week.

It is common with fewer treatment sessions if you are to receive radiotherapy to relieve symptoms. The total radiation dose is lower. Often, a single treatment may be sufficient to reduce pain.

One of several cancer treatments

Radiation therapy can be combined with other treatments, such as surgery, cytostatic therapy, targeted therapy, or hormone therapy.

Sometimes you have to wait a while between each treatment method so that the body can rest and heal. Sometimes you can get different treatments at the same time.

How does cancer occur?

The body consists of many billions of cells. The cells divide to form new cells so that the body can function. Sometimes it gets wrong when a cell divides. Usually, it does nothing or the cell can stop the error from spreading to more cells at the next cell division. But sometimes it doesn’t work. Then more and more altered cells can be formed for each cell division. Eventually, cancer cells can form and become a cancerous tumor. The cancer cells divide uncontrollably and do not die when they should. You can read more in the article What is Cancer?

When is treatment inappropriate?

Radiation therapy can affect fertility if given to, for example, the ovaries or testes. Talk to your doctor before treatment if you want to discuss the possibilities of having a pregnancy after treatment for cancer. 

Read more in the article Fertility after cancer treatment.

Also, consult your doctor if you are breast-feeding and should receive radiotherapy.

Radiation therapy is inappropriate if you are pregnant.

Related and radiation

You can spend time with your loved ones as usual when you receive radiation therapy. The radiation disappears directly from the body after every treatment and does not affect people with whom you interact.

In seed therapy, the iodine grains are left in the body where they continue to radiate. But the radiation only reaches a very short distance and eventually diminishes. You can live as usual again after a few days.

Influence and participate in your care

In order for you to be involved in your care, it is important that you understand the information you receive from the healthcare staff. Ask questions if you don’t understand.

You are involved in making a care plan

The contact nurse is responsible for you being able to join and make a care plan. The care plan should answer questions that are important to you. For many people, for example, what is the purpose of the treatment and how you can get help with side effects or complications.

When treatment is completed

It may take a long time before you are called to an initial post-check if you are finished after the radiation treatment. Before you are finished, you can ask the staff when you will be able to get a post-check. Also, ask who you can contact if needed.

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