Medically Reviewed by Virginia L. Clyburn-Ipock, MD
From an interview with Virginia Clyburn-Ipock, MD McLeod Radiation Therapy
Today’s radiation technology can improve cancer treatments and limit side effects. Radiation Therapist Dr. Virginia Clyburn-Ipock discusses:
Here are key points from Dr. Clyburn-Ipock’s comments:
Radiation, in general, uses high-energy x-ray beams to target malignancies within the body. Radiation is generally delivered once a day, five days a week, with anywhere from four to seven weeks of treatment, depending on the area we’re treating and our intent for the treatments.
Sometimes we treat in the “definitive” setting, meaning with head neck cancers we are treating to cure the patient. We’ll give radiation and chemotherapy together at the same time and the patient will receive about seven weeks a radiation.
Other times we treat in the palliative setting, which means if someone has a metastases (cancer spread) to a bone, we can treat them with radiation for two to three weeks to try to alleviate the pain that’s in that area.
Radiation treatments themselves don’t hurt. It’s just like getting an X-ray. You don’t see the beams. You don’t feel the beams. Patients come in every day and lay on the treatment machine. We position them. A machine rotates around them delivering the radiation. And patients go about their day.
Treatments are anywhere from five to 20 minutes, depending on the area that we’re treating and the complexity of the treatment. Patients are usually in a treatment center about 40 minutes. But the treatment themselves are usually quite short.
Patients tolerate radiation fairly well. The side effects all have to do with the area that we’re treating.
Side effects from treating something in the pelvis like a prostate or cervical cancer are quite different from when we treat a woman with breast cancer. Women treated for breast cancer will have side effects in the short term, which would include skin changes, redness of the skin. Sometimes the skin can actually break down and become painful. But we watch them closely during the course of radiation. We give them ointments, creams and a lot of encouragement to get them through treatment.
Radiation can also cause patients to feel a bit tired. So, they can get generalized fatigue and that’s usually not specific to a certain area of the body that we’re treating. This usually will happen regardless of where we’re treating. Often by the time the patient gets into the fourth or fifth week of treatment, they start to feel tired.
Often, patients will continue to work full time when they receive radiation. We try to work with their work schedule. If they want come in early in the morning or late at night for radiation therapy, we try to accommodate that and usually it’s done. Patients often do quite well continuing to work through radiation.
The side effects to radiation all have to do with the area that we’re treating, which sometimes is a hard concept for patients to understand. Frequently, they are being treated with chemotherapy which goes to the whole body and can affect multiple systems. With radiation, we are treating a certain area. We target that area with a radiation beams. The beams don’t go to other places throughout the body. They just focus on the area that we’re treating. Side effects from radiation all have to do with the area that we’re treating. For example, if we’re treating the breast, we don’t expect somebody to lose their hair. We don’t expect them to get sick to their stomach. All the side effects have to do with the area being treated and are related to the breast and immediately surrounding tissues.
If we are treating someone for prostate cancer, our beams are only going in the pelvis. The side effects when we treat prostate cancer all have to do with the organs that are in the pelvis. Men that are going to receive prostate cancer treatment might notice an increase in urination. They might urinate more during the day, more at night. They may have some burning when urinating. They could have trouble starting their stream. Usually, these side effects resolve when radiation ends. But about 20 percent of men will require a medication like Flomax to help them with their urination long-term.
Patients that receive radiation for prostate cancer can also experience changes in their bowel movements. This is because of where the prostate sits in the body. The rectum is right behind the prostate. When we deliver radiation to the prostate gland the rectum will get some radiation dose, resulting in loose bowel movements during the course of treatment. Some people will develop diarrhea. Usually this is very well controlled with over-the-counter Imodium.