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Frequently Asked Questions About Radiation Therapy | Side Effects | Your Follow-up Care | About Billing

Frequently Asked Questions About Radiation Therapy

What is radiation therapy?
Radiation therapy is a treatment for cancer, used in more than half of all cancer cases. In radiation therapy, high-energy rays are used to destroy cancer cells in your body. The radiation is delivered by a special machine called a linear accelerator or by radioactive substances that are implanted or injected. We use the most advanced computer planning and treatment delivery systems to precisely deliver the radiation. Your safety is of paramount importance to us. Follow-up care is aimed at assessing the disease status and managing side effects.

What is a Radiation Oncologist?
The Radiation Oncologist is a physician who specializes in using radiation to treat cancer and some benign diseases. During your consultation the Radiation Oncologist discusses treatment options and advises on the best treatment for you. The Radiation Oncologist works closely with other cancer specialists and healthcare professionals involved in your care and meets with you on a regular basis to check on the status of your treatment.

How does radiation therapy work?
Radiation therapy works by damaging the DNA in the cancer cell, thereby disabling the cancer cell from reproducing and growing. The cancer cells then die and the cancer shrinks. The most common form of radiation therapy uses multiple beams of high energy x-rays focused on the tumor from several directions. A machine called a linear accelerator is used to generate the x-ray beams.

Will I feel the radiation or will it hurt?
No, external beam radiation treatments are painless, like having an x-ray taken.  Most likely, you will not feel anything during the daily radiation session.

Will I become radioactive?
External beam radiation does not cause you to become radioactive, and you pose no risk of radiation exposure to people near you. If you have a radioactive implant in place, some visitors, such as pregnant women and small children, will not be allowed to get too close and visiting time may be limited or restricted until the implant is removed. Your doctor or nurse will tell you when these precautions are necessary.

Are there risks involved with radiation therapy?
The radiation used to damage or destroy cancer cells can also damage normal cells.  When this happens, you may experience side effects. However, the risk of side effects is usually outweighed by the benefits of killing cancer cells. The Radiation Oncologist will carefully monitor any side effects.

What are the typical side effects of radiation therapy?
The most common side effects of radiation therapy reported by patients are fatigue and skin irritation at the site of treatment.  Other side effects depend on the area of the body being treated and the dosage being given. Dry or sore mouth or throat may occur when treatment is being given in the mouth, throat or neck area. Some coughing and excess mucus production may occur if treatment is given to the lung area. Mild nausea and/or diarrhea may occur if treatment involves the abdominal area.

Most of these side effects will subside within 4 to 6 weeks after treatment is completed.  Some long-term effects may include changes in the color and elasticity of skin in the treatment area.  Discuss any concerns you may have about side effects with the radiation oncologist and ask about medications to counteract them.

 

Will the radiation therapy make me sick?
You will not experience any nausea with radiation therapy, unless the area being treated with radiation is around the intestines/stomach.  If you experience nausea, report this and any other symptoms to your doctor.  Effective medications exist to reduce and/or prevent your symptoms.

Will I lose my hair?
Hair loss only occurs in the area that is being treated with radiation therapy.  For instance, if the area being treated is your arm, you can expect to lose the hair on that arm during treatment.  You will not lose the hair on your head unless that is the area being treated.

How long will my radiation treatment take?
Most of the time, external beam radiation is delivered in daily treatments, or fractions, over a period of 1 to 7 weeks. You will generally receive these treatments Monday through Friday, and then have the weekend off. Your daily appointment will take about 15-30 minutes.

Who will administer my radiation treatments?
A doctor who specializes in radiation therapy is called a Radiation Oncologist. The Radiation Oncologist will prescribe the type and amount of radiation treatment that is appropriate and work closely with a team of healthcare professionals in determining the best way to deliver that treatment. Those healthcare professionals may include the following: Radiation Physicists are experts who make sure the machines are working properly and that they deliver accurate radiation doses. The Physicist also works closely with the doctor in planning your treatment. Dosimetrists are specialists who work with the doctor and Physicist to create the treatment plan and calculate the radiation dose delivered to the tumor and the surrounding normal tissues. Radiation Therapists are professionals who position you and operate the machines to deliver the radiation treatment on the linear accelerator. Radiation Oncology Nurses are caregivers who will help coordinate your care, manage side effects, and help you and your family learn about your disease.

Can someone come to my treatments with me?
Friends or family are welcome to accompany you to your treatments.  However, federal regulations prohibit anyone who is not a patient or a person wearing a film badge monitor to be in the radiation controlled area during the time radiation equipment is being operated. Those accompanying you will likely be asked to wait in the reception area during the treatment.  This also serves to protect the privacy of other patients.  Only patients and staff are allowed in the treatment area during treatment hours. 

Can I continue my regular routine while undergoing radiation treatments?
You should continue with your normal routines.  Most patients continue full-time occupations or leisure activities through the course of treatments.  When you feel tired, do not over exert yourself; take time to rest when needed.  Try to get plenty of sleep and maintain a healthy diet.

Will I be alone during my treatments?
Because radiation effects are accumulated and radiation therapists treat many patients each day, it would be a long-term health risk for them to be in the room during the radiation treatments.  To ensure that you are okay and your treatment delivery is going well, you will be in voice contact with your radiation therapists and constantly monitored by a video camera.  If you should need assistance, simply tell the therapists and they will terminate the treatment and immediately tend to your needs.

What cancers are treated with brachytherapy?
Brachytherapy is used predominantly to treat early-stage prostate cancer; however, it may also be used in breast, cervical, head and neck, and other cancers. With this type of therapy, a radioactive substance or source is sealed in small containers, such as thin wires or tubes, called implants. These implants are placed directly into a tumor or inserted into a body cavity.

What is involved in the implantation of a radioactive seed into the prostate (brachytherapy)?
For most patients, radioactive seed implantation into the prostate is a one-time, non-surgical, low-impact procedure. Radioactive seed implantation into the prostate is typically performed in an outpatient hospital setting by a team of physicians consisting of a Urologist, Radiation Oncologist, and a Radiation Physicist. Spinal anesthesia is typically performed, but general anesthesia may occasionally be utilized. Some centers perform this procedure in their hospital operating rooms. Both outpatient and inpatient settings are acceptable. Most patients can return to normal activity, including work, within one to three days, with little or no pain.

Will radioactive seeds be painful?
After the implantation of radioactive seeds into the prostate, there typically is some soreness underneath the scrotum. Occasionally patients describe feeling like they are "sitting on a golf ball." This is due to the slight swelling and bleeding associated with the surgery and gradually resolves. Most patients require only mild analgesics like acetaminophen (Tylenol®). Narcotic pain medications are rarely required.

How soon after implantation of radioactive seeds into the prostate can I resume exercise or other vigorous activities?
The insertion of the needles causes some trauma to the vessels surrounding the prostate. Therefore, immediately after the implant, any exercise or activity that puts pressure on the prostate should be avoided. You should avoid lifting heavy objects or doing vigorous exercise for at least three to four days after the implant. Very vigorous exercise after this period may cause minor bleeding in the bladder. This is not harmful, but you should limit your exercise until the bleeding stops. Activities such as bike riding, horseback riding, and motorcycle riding in which there is pressure on the prostate should be avoided for at least six months. The repetitious jarring of the prostate with these activities can cause some swelling and impair urination.

Will I be radioactive after the seed implantation?
No. Although the seeds are radioactive, patients are not. Because the radioactivity is so low and the placement is so precise, virtually all the radioactivity is absorbed into the prostate. However, special precautions should be taken when a patient is in contact with small children and pregnant women in the first two months after treatment. Your nurse or doctor will advise you what precautions are necessary and when.

Does the radiation from seed implants pose any danger to my sexual partner?
No, the seeds are of low energy and pose little risk to your partner. The semen is not radioactive. You may resume sexual activity very soon after the procedure. Occasionally, there may be blood in the semen or slight pain at climax.

What is conventional radiation therapy?
External beam radiation therapy is an effective way to treat many kinds of cancers in almost any part of the body. In external therapy, a machine referred to as a linear accelerator directs high-energy rays or particles at the cancer.

What is 3D conformal radiation therapy?
It is a relatively new treatment technique developed to improve the precision with which radiation is delivered to tumors, thus maximizing radiation dose to tumors while minimizing dose to healthy tissues. Conformal treatments are designed so that the range of high-dose irradiation conforms, as closely as possible, to the three-dimensional shape of the tumor. This is achieved by applying multiple conformal-shaped beams, focused on the tumor from several different directions.

What is Intensity Modulated Radiation Therapy (IMRT)?
This is the newest form of 3D conformal radiation therapy. IMRT’s unique approach is to use real-time computer control of the linear accelerator, not only to shape beams, but also to vary the intensity of radiation within each beam. We can now treat patients with greater precision and speed than previously available.

Side Effects

Are There Any Side Effects?
Patients often experience few or no side affects from radiation therapy and are able to continue their normal routines. Be sure to talk to your treatment team about any problems you experience managing side effects.

Nausea & Vomiting | Diarrhea | Constipation | Difficulty Swallowing | Loss of Appetite | Change in Taste

NAUSEA

• Try small, frequent feedings instead of three large meals. Eat and drink slowly.
• Eat dry foods (toast, crackers) before rising in the morning.
• Avoid fatty, greasy, or fried foods. Avoid overly sweet or spicy foods.
• Clear, cool beverages are recommended. Sip liquids slowly through a straw.
• Avoid liquids at meal times. Take them 30 to 60 minutes before or after eating.
• Don’t lie flat for at least two hours after eating.
• If smells make you nauseated, have someone else do the cooking or use foods that don’t have to be cooked. Avoid foods with strong odors.
• Eat foods cold or at room temperature.
• Avoid eating in a room that is stuffy or too warm.
• Don’t force yourself to eat a favorite food when you feel nauseated.
• Wear loose-fitting clothes.

DIARRHEA

• Use refined-grain products (white bread and rice) in place of whole-grain products (oat, whole wheat, bran).
• Avoid vegetables or fruits with skins, hulls, or seeds. All vegetables should be cooked and without seeds. Avoid gas-forming foods like broccoli, cauliflower, and cabbage.
• Include foods high in potassium such as bananas, potatoes, orange juice, or meat.
• Drink lots of uncaffeinated liquids to replenish lost fluids. Liquids should be at room temperature.
• Use low-lactose products if milk causes diarrhea.
• Avoid caffeine.
• Avoid highly spiced, greasy, fatty, or fried foods.
• Tell your doctor if diarrhea persists.

CONSTIPATION

• Add more fiber and fluid to your diet. Use whole-grain breads and cereals (whole-wheat bread, oatmeal) in place of refined-grain products (white bread, pasta, and rice).
• Eat a variety of fresh fruits and vegetables. You should strive for five to eight servings a day.
• Try adding bran to cooked cereals and casseroles. Bran can also be eaten as a cereal.
• Snack on dried fruits.
• Drink plenty of uncaffeinated fluids (8 to 10 full glasses each day). Prune juice is a good choice since it has a laxative effect.
• Hot liquids often stimulate bowel activity and may be helpful.

DIFFICULTY SWALLOWING OR SORE MOUTH

• Foods that are liquid or soft are the best choice when soreness develops in the mouth or throat.
• Very cold foods are often soothing. Add ice to milk and milkshakes.
• Fruit drinks and nectars can be substituted for acidic fruit juices (orange, grapefruit, tomato) to avoid burning.
• Drink small amounts of high-calorie supplements frequently. Try double-strength milk (8 oz. whole milk and 5 tbsp non-fat dry milk), eggnogs, milkshakes, and powered instant breakfast mixed with whole milk.
• Use a blender or food processor to puree your foods.
• Cut food into small pieces and moisten with soups, thin gravies, butter, or sauces.

LOSS OF APPETITE

• Eat small, frequent meals and keep snacks handy for nibbling.
• Make the foods you eat count by using high-calorie, high-protein items. Try high-calorie milkshakes and supplements or eggnog instead of noncaloric beverages (water, diet soda, coffee, tea). Make your meals attractive. Eat in a calm, pleasant atmosphere, with others if possible. Listen to relaxing music while eating. Add variety to your meals.
• Avoid foods that will cause feelings of fullness (carbonated beverages and fatty foods).
• Engage in light or moderate exercise two hours before meals. Check with your doctor first.

CHANGE IN TASTE

• Use herbs and spices to make food more flavorful (basil, oregano, rosemary, arragon, lemon).
• Try adding bacon or ham to vegetables.
• Try cooked chicken, turkey, or fish if red meat tastes strange. Use eggs and dairy products as substitutes.
• Marinate meat, chicken, or fish in sweet fruit juices, flavorful salad dressings, or sweet-and-sour sauce.
• Tart foods (oranges and lemons) may enhance flavor (if you have no mouth or throat problems).
• Serve foods cold or at room temperature for improved taste.
• Try eating foods that leave their own taste in your mouth, such as fresh fruit orhard candies.
• Ask your dentist about special mouthwashes and good mouth care.
• Avoid smells from cooking if possible.
• Maximize other food characteristics such as color and texture.
• Avoid cooking in metal pots.
• Chew sugar-free mints to disguise unpleasant tastes.

Most side effects are related to the area being treated. For example a breast cancer patient may notice skin irritation, like a mild to moderate sunburn. Patients with cancer in the mouth may have soreness when swallowing. These side effects are usually temporary.

Side effects usually begin during the second or third week of treatment and may last for several weeks after your final treatment.

Fatigue, which is usually mild to moderate, is the most often reported side effect. During the course of Radiation Therapy it is important that you eat a well-balanced diet and plan for adequate rest. In many cases, level of daily activity does not have to be restricted, and many patients continue to work full time during radiation therapy.

Your follow-up care

After my treatments are completed, will I see the radiation oncologist again?
You will see the radiation oncologist 1-2 months after treatments are completed and periodically thereafter, depending on your situation.  Follow-up care is aimed at assessing disease status and managing side effects.

About Billing

Does the clinic accept Medicare assignment?
Yes, we accept assignment.

Whom do I call if I have questions about my insurance paying for cancer treatments prior to your first appointment?
Questions regarding your insurance coverage should be directed to our Billing Office at 608-259-4372. Hours are 7:00 am to 3:30 pm.

Whom do I call if I have questions about my account?
If you are a current patient, call and speak to the Billing Office at 608-259-4372. Hours are 7:00 am to 3:30 pm.

Frequently Asked Questions About Radiation Therapy | Side Effects | Your Follow-up Care | About Billing

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