Radiation Oncology

What is radiotherapy?

Radiotherapy is applied by radiation oncologists. Radiotherapy uses rays that consist of high energy waves delivered to the specific part of the body.

  • Radiotherapy is painless.
  • Each session may take several minutes to half an hour. This duration is reduced to 2 to 3 minutes with TrueBeam STX technology that is applied in our center.
  • Radiotherapy may cause tenderness and irritation of the skin.
  • The side effects of radiotherapy are temporary and may vary depending on the area being treated.

In Department of Radiation Oncology, ionizing radiation is used to take malignant tumors under control as a part of cancer treatment. Devices, such as TrueBeam that are developed to deliver the radiation to the diseased organ in the most accurate and appropriate way, also known as Linear Accelerator, are required for this purpose. “Radiotherapy” or “radiation therapy” implies using those devices to deliver high-dose radiation in order to destruct cancerous tissue or to ensure palliation.

In our department of Radiation Oncology, our services are rendered by radiation oncologist, medical physicist, radiotherapy technician, nurse, dosimetrist, psychologist, social services expert, dietician, radiation protection expert and patient consultant. Moreover, multidisciplinary approach is adopted for basic steps of treatment planning, such as investigating spread of the tumor and staging the tumor, since patient is jointly evaluated by multiple clinics, such as Nuclear Medicine, Radiology and Pathology.

Modalities used in treatment processes in the Department of Radiation Oncology are as follows:

With our TrueBeam STX devices;

  • IMRT, VMAT, SRS, SBRT
  • Total Body Irradiation- TBI
  • Total Skin Electron Irradiation – TSEI

SRS, SBRT with Trilogy Robotic Radiosurgery System

How does Radiotherapy Exert Effects?

High-dose radiation prevents the growth of cells or kills them. Since cancerous cells grow and divide faster than many normal cells, radiotherapy results in success in treatment for numerous cancers. Meanwhile, normal cells can also be affected by radiation, but most recover. To protect healthy cells, doctors limit the dose of radiation delivered and extend the time period of treatment. In addition, while radiation is delivered to the cancerous area, various methods are applied to protect intact cells as far as possible.

Radyasyon Onkolojisi

What are the aims and benefits of radiotherapy?

The aim of radiotherapy is to kill cancer cells with as little harm as possible to healthy cells.

Radiotherapy is a local treatment method similar to surgical methods that targets cancer cells in any part of the body. Sometimes, radiation oncologists choose to use radiotherapy together with systemic treatments like chemotherapy that can be delivered to the entire body.

Why it’s done?

More than half of all people with cancer are given radiotherapy as a part of cancer treatment. Doctors apply radiotherapy to eliminate just about every type of cancer.  Radiotherapy is also useful in treating some benign tumors.

Your doctor may recommend radiotherapy as an option at different times during your cancer treatment and for different reasons, including:

  • As the only (primary) treatment for cancer
  • In preoperative period, to shrink a cancerous tumor (neoadjuvant therapy)
  • In postoperative period, to stop the growth of any remaining cancer cells (adjuvant therapy)
  • In combination with other treatments, like chemotherapy, to kill cancer cells
  • In advanced stage cancer to relieve symptoms secondary to the cancer

What are the risks of radiotherapy?

A shorter course of higher dose radiotherapy that damages or destroys cancer cells may also damage healthy cells or even kill them. Most of side effects of radiotherapy are well-known. These side effect can be easily eliminated with the help of your radiation oncologist and nurse. The risk of side effects is generally milder than the benefits of killing cancer cell.

Side effects of radiotherapy depend on which part of the body is being exposed to radiation and how much radiation is used. You may not face with any side effect or you may experience several side effects. Most side effects are temporary, can be managed and generally disappear over time after treatment is completed.

Part of body being treated Common side effects
Any part Hair loss at treatment site (sometimes permanent), skin irritation at treatment site, fatigue
Head and neck Dry mouth, thickened saliva, difficulty swallowing, sore throat, changes in the way food tastes, nausea, mouth sores, tooth decay
Chest Difficulty swallowing, cough, shortness of breath
Abdomen Nausea, vomiting, diarrhea
Pelvis Diarrhea, bladder irritation, frequent urination, sexual dysfunction

Source: National Cancer Institute, 2007

Some side effects may emerge later. For instance, another cancer (second primary cancer) that’s different from the first one treated with radiation may occur years later, albeit rare. Ask your doctor about possible side effects, both short and long term, that may occur after your treatment.

Please click to get detailed information about the risks of radiotherapy

What are the methods of radiotherapy?

Two methods, external or internal, are used when radiotherapy is applied.

In external radiotherapy, a machine that directs high-energy beams of radiation into the cancerous area and healthy tissue that encircles this area is used.

In internal radiotherapy, a source of radiation is directly put inside the tumor or targeted tissue.

For some patients, both of treatment methods are concurrently applied. External radiotherapy is applied for most of patients who receive radiotherapy against cancer. This type of treatment is generally applied in hospitals and medical centers as an outpatient or day treatment.

How is radiotherapy planned?

CT-Stimulation is the first stage of radiotherapy. CT scan generally lasts less than 5 minutes and it is completely painless. During this appointment, fixation materials for treatment, such as mask (immobilization), are supplied for appropriate position and fixation.

Before the next session, radiation oncologist and medical physicist organize a treatment plan that contains radiotherapy parameters considering CT results. Radiotherapy technician run sessions by applying this plan.

What are the side effects of radiotherapy?

External radiotherapy does not lead your body to be radioactive. Therefore, staying together with other people is not contraindicated during your treatment. Most of side effects of radiotherapy are related to the area being treated. Many patients experience almost no side effects. Your doctor and nurse will inform you about possible side effects and what you should do.

You can visit our page titled “side effects of radiotherapy” to get detailed information about side effects of radiotherapy.

What can you do to take care of yourself during radiotherapy?

Almost each patient who is given radiotherapy needs to take extra care to protect their health and contribute treatment.

Some rules that should be kept in mind are as follows:

  • Before treatment, inform your doctor about all medications you take and about allergies, if present
  • Good nutrition is highly important.
  • Consult your doctor before using vitamin supplements and  herbal products.
  • Avoid wearing tight clothes for the area being treated.
  • Be gentle for your skin on the area being treated.

How you prepare?

Before you receive external beam radiotherapy, your health care team guides you through a planning process to ensure that radiation reaches the precise spot in your body where it’s needed. Planning typically includes:

Radiation simulation:

During simulation, your radiation therapy team helps you to get a comfortable position for you during treatment.

It’s necessary that you lie still during treatment, so finding a comfortable position is very important. For this purpose, you’ll lie on the same type of table that’s used during radiotherapy. Cushions and restraints are used to position you in the right way and to help you hold still.

Your radiotherapy team will mark the area of your body that will be given radiation.  Depending on your situation, temporary marking can be done with a marker or small permanent tattoos may be performed.

Planning scans:

Your radiotherapy team will provide you with computerized tomography (CT) scans to determine the area of your body to be treated.

After the planning process, your radiotherapy team will decide what type of radiation and what dose you will receive based on your type and stage of cancer, your overall status, and the aims regarding your treatment.

The exact dose and focus of radiation beams used in your treatment are carefully planned to maximize the radiation to your cancer cells and minimize the harm to surrounding healthy tissue

What you can expect

External beam radiation therapy is typically given using a linear accelerator — a machine that directs high-energy beams of radiation into your body.

As you lie on a table, the linear accelerator moves around you to deliver radiation from several angles. The linear accelerator can be adjusted for your particular situation so that it delivers the exact dose of radiation your doctor has ordered.

You are typically given external beam radiation on an outpatient basis five days a week over a certain period of time. In most instances, treatments are usually spread out over several weeks to allow your healthy cells to recover in between radiotherapy sessions.

Expect each treatment session to take approximately 10 to 30 minutes. In some cases, a single treatment may be applied to help relieve pain or other symptoms secondary to more-advanced cancers.

During a treatment session, you will lie down in the position determined during your radiation simulation session. To hold you in place, you might be positioned with molds.

The linear accelerator machine may rotate around your body to reach the target from different directions. The machine makes a buzzing sound.

You will lie still and breathe normally during the treatment, which takes only a few minutes.  For some patients with lung or breast cancer, you might be asked to hold your breath while the machine delivers the treatment.

Your radiotherapy team stays nearby in a room with video and audio connections so that you can talk to each other.  You should speak up if you feel uncomfortable, but you shouldn’t feel any pain during your radiation therapy session.

You can read my article “How cancer is treated?” to receive information about Types of Cancer Treatment.

What to do after radiotherapy?

Your doctor may have you undergo periodic scans after your treatment to see how your cancer has responded to radiotherapy, If you receive radiotherapy for tumor.

In some cases, your cancer may respond to treatment quickly. In other cases, it may take weeks or months for your cancer to respond.