Not so Risky Business: The Truth About Radiation Oncology
While a cancer diagnosis can be a very confronting time, many patients also worry whether the treatment will bring additional health issues down the track.
Radiotherapy is one of the most important cancer treatments available, along with surgery, chemotherapy, biological therapy and hormonal therapy.
According to Dr Bronwyn King, Radiation Oncologist at Epworth HealthCare, modern radiation therapy is a highly focused treatment which targets very specific areas of concern and minimises radiation dose to all other areas in order to protect the rest of the body.
“It is always important to balance the benefits with the risks, however, in general, radiation therapy is safe and well tolerated and associated risks are very small,” Bronwyn says.
Here we explore some of the common queries about radiation treatment and ask her advice.
Will I lose my hair during radiotherapy?
Bronwyn: Patients will experience hair loss only in the treatment area. When the skull or brain requires treatment, the hair on the head will fall out, usually a few weeks after treatment begins. Hair grows back most of the time after a few months.
Will I be radioactive, and will I be able to interact with others during treatment?
Bronwyn: The vast majority of radiation therapy is called external beam radiation therapy. This treatment does not make patients radioactive, and patients carry no risk at all to other people in the community, including family members who they touch, kiss or hug.
To treat some patients with prostate cancer, radioactive seeds are implanted internally and radioactive isotopes are occasionally used to treat thyroid cancer. The treating doctor will advise the patient of some special precautions that need to taken in the first few weeks and months following these treatments.
How long does radiotherapy take?
Bronwyn: The length of the treatment course is tailored for each individual patient. It can be as long as seven to eight weeks of daily treatments, which is the typical duration for prostate cancer. Most breast cancer patients will undergo three to six weeks of radiation therapy. Patients receive treatment every weekday during that time, with weekends off. Most treatments take 30 minutes from the time the patient walks through the door to the time the patient leaves the department. The actual treatment takes only three or four minutes to deliver.
Can the family come into the room when I am having treatment?
Bronwyn: Family members or close friends are welcome throughout the entire visit except for the three or four minutes when the treatment is being delivered. For safety reasons, no one else is allowed in the room during the procedure but the patient can see family members immediately after treatment. Expert staff monitor patients at all times with video and audio equipment to ensure they remain comfortable throughout the procedure.
Will radiotherapy hurt?
Bronwyn: Patients receiving external beam radiation therapy lie very still in front of a machine that delivers radiation to the specific treatment area. During the procedure the patient is awake and breathing normally. Nothing touches the patient during the treatment and there is no pain during or after the procedure.
Will I become infertile as a result of my radiotherapy?
Bronwyn: It is especially important to discuss radiation therapy side effects before undergoing treatment to the pelvic area, which may involve radiation dose to the ovaries in women or the testicles in men. Radiation therapy can lead to infertility so for younger patients in whom this is a concern, it’s essential for fertility options to be discussed and explored in advance. This will be a usual part of the preparation process before any radiation therapy begins.
What are the short and long-term side effects of radiotherapy?
Bronwyn: The short term side effects of radiotherapy are usually mimimal and can be managed with medications and creams. Patients receiving radiation therapy for breast cancer can expect to develop pinkness or redness of the skin in the treatment zone, some mild swelling of the breast and a feeling of mild generalised fatigue. These effects resolve within one to two months of treatment.
At Epworth Radiation Oncology, patients with left sided breast cancer now receive radiation therapy delivered using a special breath-holding technique. This reduces the dose of radiation to the heart and minimises the risk of long-term side effects.
Long term side effects of radiation therapy are uncommon, but they may occur months or even years after treatment. If they do occur, these side effects can be minimised or controlled, so it’s important to have ongoing follow up with a radiation oncologist. There is a very rare risk of developing a second cancer as a result of radiation therapy (around 1 in 400 patients). If this does occur, it is usually many years after completion of treatment.
Overall, the most important advice is to have a clear and detailed conversation with a radiation oncologist, who can give a full account of both the expected benefits and the likely side effects of individually tailored radiation therapy.
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