Radiotherapy Radiotherapy uses carefully handled doses of radiation to destroy cancer cells. Recent advances in the technology mean that success rates are rising and the treatment is less likely than it once was to cause damage to nearby normal cells.
How does it work? In radiotherapy, the area of your body that’s affected by cancer is treated with radiation to destroy cancer cells. The radiation also has an impact on neighbouring normal cells, but they should recover when your treatment is over.
Your treatment could be external or internal. The treatment plan depends on the kind of cancer you have, if you’re having (or have had) other treatments like chemotherapy or surgery, and how fit you are. For that reason, your treatment plan could be very different from another person who has the same cancer as you.
What will it be like? External radiotherapy is delivered in short doses in a machine similar to an x-ray machine. Sessions last just a few minutes, but it might take up to half an hour to position you correctly in the machine. It’s common to have a session on each weekday, with weekends off so your normal cells have some time to recover. Radiotherapy may continue for several weeks.
During external radiotherapy, the aim is to direct radiation at the affected area as precisely as possible. To make that happen, the team looking after you will spend a lot of time scanning and measuring your body. You may have some semi-permanent marks made on your skin to help the radiographers position you accurately. You might also be given a custom-made mould to hold part of your body still.
Sometimes these planning exercises can be uncomfortable, and the process of sitting inside a large and sometimes noisy machine for treatment can be intimidating, but radiotherapy itself is pain-free.
Staff will stand outside the treatment room during the session to avoid radiation exposure. Once the session is over, the radiation levels in your body will go back to normal.
Although radiotherapy itself is pain-free, some people develop a skin irritation after three to four weeks of treatment. Tell your care team if this happens as they can suggest creams to soothe your skin.
Internal radiotherapy is mainly used for cancers of the head and neck, the cervix and womb, the prostate gland and the skin. Sometimes the treatment involves putting a piece of solid radioactive material in or close to the tumour for a period of time: that’s called brachytherapy. Alternatively, it can involve taking radioactive material as a drink, a pill or as an injection straight into your bloodstream: that’s called radioisotope treatment.
When you’re having internal radiotherapy, the radiation being used on your cancer cells can be dangerous to your family and friends. That’s why you’ll have to put up with some restrictions like short, limited visits or even complete isolation for a few days. Even after treatment finishes, you may have to keep your distance from small children and pregnant women until your radiation levels return to normal.
Why would I do it? Radiotherapy can be used to cure your cancer or to help you control symptoms for a better quality of life during palliative care.
Words to know
Brachytherapy internal radiotherapy treatment that involves placing radioactive material in or near a tumour
Palliative care treatment to relieve symptoms without trying to cure the cancer
Radioisotope treatment radiotherapy treatment that involves taking radioactive material as a drink, a pill, or an injection straight into the bloodstream
Things to ask
How will this affect my fertility? Having radiotherapy in areas near your reproductive organs can affect your ability to have children. Ask your team if your fertility is likely to be affected and what you can do to plan for the future. To read more about fertility issues, take a look at Planning for a family.
What side effects am I likely to experience? You could experience fatigue and you could notice that the skin in the target area is dry, itchy and red. You could also lose some hair, have a sore mouth or throat, have some dental problems or go through stretches of nausea or diarrhoea. Your care team can give you some idea of what to expect, based on what kind of radiotherapy you’re having and what part of your body is affected by cancer. Side effects can be very different depending on what part of your body is being treated. To read more about side effects and how to handle them, take a look at Getting through.
Expert's insight: Keith Cox Keith Cox, a nurse practitioner at the Sydney Cancer Centre, explains that the best way to approach radiotherapy is with a healthy body and a positive outlook.
“Radiotherapy is accumulative so when it starts off you may not have any side effects, but as the time goes on, the side effects become more pronounced.
“Generally, people don’t lose their hair when they have radiotherapy, unless they’re having radiation to their head.
“Your skin may get red or peel. It’s like getting a bad case of sunburn. It’s good to use moisturiser, although sometimes you have to be careful about what you’re applying because the skin may react. Check with your oncologist first. Similarly, you should check with your team before you take any vitamins or if you’re planning complementary therapy.
“It’s important to look after your body in the lead-up to and during radiotherapy. Gentle exercise is important, as is a good diet and drinking plenty of fluids. Try to get some rest and avoid getting too exhausted.”
More help
Cancer Council Helpline 13 11 20 Cancer Council Helpline is a free, confidential telephone information and support service run by Cancer Councils in each state and territory. Specially trained staff are available to answer your questions about cancer and offer emotional or practical support. You can call from anywhere in Australia for the cost of a local call. The Helpline is open between 9am and 5pm, Monday to Friday (some states have extended hours).
Photo by Randy Larcombe
VINCE RIVIERE A fit man in his 20s, Vince Riviere found two months of radiotherapy to be a hard slog.
Vince, 25, was very active, playing soccer and cycling on weekends. He found a lump on his neck in 2007, but thought he’d picked up a parasite on a recent trip to South America. It wasn’t affecting his health, so he ignored the lump. But after 12 months of nagging from his mum, Vince relented. It turned out to be advanced stage 4 thyroid cancer. He underwent surgery, radiotherapy and radioactive iodine treatment.
“The doctor told me before my radiotherapy treatment it would feel like I was getting pounded by a sledgehammer to the throat. For the first week or so, I thought he must have been kidding me. I rode a bike for 80 kilometres after the first week, but a few days later I was eating a pizza and it just wouldn’t go down. I struggled from then on.
“They aimed three laser beams to parts of my neck and upper chest. The procedure only lasts 30 to 40 seconds. I was being treated five days a week for seven weeks.
“I stopped eating from the second week onwards and I didn’t eat for three months. You can’t swallow saliva, that’s how bad the pain got. You can’t swallow, you can feel pieces of your throat coming off. After the six-week mark, I lost the ability to talk as well.
“Before the treatment I weighed 80 kilos, but I was hovering around the 45-kilo mark. Food is the last thing you want. I had no energy because I was losing so much weight.
“I made mistakes. A nasogastric tube was offered to me beforehand as well as a feeding tube for my stomach. I just thought it wouldn’t be that hard. I should’ve put on weight beforehand as well.
“Make sure you do research that’s specific to your cancer. I read up on radiotherapy and prostate cancer. With that cancer, you’re still able to eat because the radiation doesn’t go to an area that affects eating.
“I was out of action for a good 10 months. I was able to eat two months after the last radiotherapy treatment. The radiotherapy only lasted two months, but it took me another three months to recover.”