Common questions about radiation therapy

Where will I have treatment?

Radiation therapy is usually given in the radiation oncology department of a hospital or in a treatment centre. This may be in the public or private health system.

Most people have radiation therapy as an outpatient. This means you do not stay in hospital, but travel to the hospital or treatment centre for each session. It’s a good idea to think about how you will get to each session. For some types of internal radiation therapy, you may need to stay in hospital overnight or for a few days.

What are the steps in radiation therapy?

1. Consultation session

You will meet with a radiation oncologist. They will check your test results, assess your fitness for treatment, explain the process and expected results, and discuss possible side effects and risks. You will be asked to agree (consent) to have treatment.

2. Planning (simulation) session

You will meet with a radiation therapist. They will work out how to best position your body during EBRT or where to place the applicators for brachytherapy.

Learn about planning for:

• EBRT
• Brachytherapy.

3. Treatment plan

Based on the planning session and the treatment guidelines for the cancer type, the radiation oncologist, radiation therapist and medical physicist will work out the radiation dose, what area needs to be treated and how to deliver the right dose of radiation.

4. Treatment sessions

Radiation therapists will deliver the course of radiation therapy as set out in the treatment plan. How long each treatment session takes will depend on the type of radiation therapy.

• EBRT treatment
• Brachytherapy treatment

5. Review and follow-up

You will have regular reviews with the treatment team to discuss how to manage any side effects and assess how you have responded to treatment.

How many treatment sessions will I have?

Radiation therapy is tailored to your situation. The number of treatment sessions recommended by your radiation oncologist will depend on the type of cancer you have.

Based on treatment guidelines, your radiation oncologist will work out the total dose of radiation needed to treat the cancer. In most cases, the total dose is broken up into a number of smaller doses called fractions. Each fraction of radiation is given in one treatment session.

The whole course of radiation therapy may be given over a number of days or weeks. Some people have one treatment session, other people may have treatment once a day, Monday to Friday, for several weeks. Some people have radiation therapy twice a day and others have treatment sessions a week apart. Your radiation oncologist will talk to you about your treatment schedule.

Treatment schedules will continue to change as research shows what works best to kill cancer cells and lessen side effects.

How much does radiation therapy cost?

It is your choice whether you have treatment in the public or private health system. If you have radiation therapy as an outpatient in a public hospital, Medicare pays for your treatment.

Medicare also covers some of the cost of radiation therapy in private treatment centres, but you may have to pay the difference between the cost of treatment and the Medicare rebate (gap payment). Private health insurance does not usually cover radiation therapy because it’s considered an outpatient treatment.

Before treatment starts, ask your provider for a written quote that shows what you will have to pay. If you are concerned about the cost, you may want to ask for a referral to a public centre for treatment.

Will I be able to work?

During radiation therapy, you are likely to feel well enough to continue working and doing your usual activities. As you have more sessions, you may feel more tired or lack energy.

Whether you will be able to work depends on:

• the type of radiation therapy you have
• whether you are having chemotherapy at the same time
• how you feel
• the type of work you do.

Ask your treatment team if they offer very early or late appointments so that you can fit your treatment sessions around your work.

Let your employer know how much time you are likely to need off work. Explain that it is hard to predict how radiation therapy will affect you, and discuss the options of flexible hours, modified duties or taking leave.

Can I have radiation therapy if I’m pregnant?

You probably won’t be able to have radiation therapy if you are pregnant, as radiation can harm a developing baby. It’s also important that you don’t become pregnant during the course of treatment.

If at any time you suspect you may be pregnant, it is important to tell your doctor. If you are breastfeeding, ask your doctor whether it is safe to keep breastfeeding while you’re having radiation therapy.

It is recommended that people who have radiation therapy to the pelvic area use contraception to avoid pregnancy during treatment and for about 6 months afterwards, as radiation therapy can damage sperm. Your doctor will be able to give you more information about radiation therapy and pregnancy.

How will I know the treatment has worked?

Because cancer cells continue to die for weeks or months after treatment ends, your radiation oncologist most likely won’t be able to tell you straightaway how the cancer is responding. You may not know the full benefit of having radiation therapy for some months. See also Follow-up appointments.

If radiation therapy is given as palliative treatment, the relief of symptoms is a good sign that the treatment has worked. This may take a few days or weeks. Until then, you may need other treatments for your symptoms, such as pain medicine.

What imaging scans will I need?

X-ray

• low‑energy beams of radiation pass through the body and create an image on x‑ray film
• you hold still while a machine takes images

Ultrasound

• uses soundwaves to create pictures of internal organs
• a small device called a transducer sends out the soundwaves as it is moved over an area of your body

CT scan (computerised tomography)

• uses x‑ray beams and a computer to create detailed pictures of the inside of the body
• before the scan, you may have an injection of dye into one of your veins to make the pictures clearer
• you lie on a table that moves in and out of the scanner

PET scan (positron emission tomography)

• uses a low‑dose radioactive solution to measure cell activity in different parts of the body
• before a PET scan, you will be injected with a solution containing a small amount of radioactive material
• cancer cells absorb more of the solution and show up brighter on the scan

PET–CT scan

• combines a PET scan and a CT scan in one machine to provide more detailed information about the cancer

MRI scan (magnetic resonance imaging)

• uses a magnet and radio waves to build up detailed pictures of an area of the body
• before the scan, a dye may be injected into a vein to make the pictures clearer
• you will lie on a table that slides into a large metal tube