Answers to Questions about Radiation Treatment for Cancer
Below are answers to common questions asked about radiation therapy and the overall treatment process.
Your questions are many and cancer information is everywhere. We’d like to start you off with the basics, as well as a simple word of advice:
Every cancer patient’s journey is unique.
Fighting cancer can be as personal as anything you’ve ever experienced. Other patients may share your diagnosis and treatment options. But you may have vastly different perceptions, discomforts, supports and outcomes.
There are a number of cancer organizations that do a great job of accurately representing the facts. So, in addition to exploring the basics here, you may wish to visit the following sites for in-depth information:
General Questions about Radiation Therapies
Q. How do I prepare for radiation treatments?
A. Most patients do not need to make any changes to their lifestyle before beginning radiation therapy.
Q. How long will my treatment take?
A. The time required for the treatment depends on the treatment plan for your type of cancer. The average time is generally 20 minutes from the time you arrive until you leave the center. However, some treatments may take a little longer. Your first treatment will take longer in order to review the set up with the physician prior to starting. You may ask your radiation therapist on the first day how long to expect your treatment to last.
Q. Can I drive myself to my treatment?
A. In many cases, yes, but check with your physician prior to your appointment.
Q. Can I eat or drink before my treatments?
A. Your physician will give you dietary instructions based on your specific course of treatment.
Q. What side effects should I expect?
A. Side effects will vary from patient to patient. The most common side effects include tiredness and a skin reaction that is specific to the area targeted for radiation therapy. Our radiation oncologists meet with each patient to discuss the side effects of the radiation therapy and to arrange treatment and/or medication to eliminate any side effects.
Q. Will my skin burn during radiation therapy?
A. At times, a patient may experience a sunburn-like reaction to the radiation. A patient’s treatment team will help address what to do in case such a reaction occurs.
Q. How is radiation therapy different from chemotherapy?
A. Radiation is a local or regional form of cancer therapy that is applied to the specific area of the body containing a tumor. By contrast, chemotherapy is given by injection or by mouth and travels throughout the entire body. Both radiation and chemotherapy inhibit cell growth and both therapies can be used together effectively to treat cancer.
Radiation Treatment for Brain Cancer
Q. What are common types of brain tumors?
A. The majority of brain tumors are actually metastases from a primary tumor outside the brain. Malignant cancer cells can spread to the brain from a tumor in the lung, colon, or stomach, for example. Tumors that originate in the brain are called primary brain tumors. Common primary brain tumors arise from the cells that surround and support nerve cells, called glial cells. These tumors are called gliomas. Another common type of primary brain tumor arises from cells that form the meninges, the protective membrane surrounding the brain, and is called meningioma. Other types of primary brain tumors include pituitary tumors and lymphomas.
Q. What causes brain tumors?
A. Most brain tumors are metastases from cancers in other parts of the body. The cause of primary brain tumors is not well understood in most cases. Some individuals are at higher risk of developing primary brain tumors. For example, patients with weakened immune systems are at increased risk of developing lymphoma of the brain. Certain hereditary conditions such as neurofibromatosis are associated with increased risk of brain tumors. Children treated with brain radiation for leukemia have been found to have a higher than average risk of developing brain tumors later on as adults.
Q. Do cell phones cause brain tumors?
A. Cell phone use has been extensively studied as a risk factor for developing brain tumors. The literature is not conclusive, with some studies showing no increase in risk, and other reports showing an association with cumulative lifetime cell phone use. While cell phones do not give off high-energy ionizing radiation that can directly damage brain cells, there continues to be concern given the many hours of exposure and the increasingly young age of users. In light of this unresolved question, some experts advocate using an earpiece to keep the transmitting antenna housed in phone away from the head.
Q. How are brain tumors evaluated?
A. Important parts of the evaluation of brain tumors include the patient history (including specific symptoms involved, duration of symptoms, and the presence of seizures), and neurologic examination. Imaging studies are obtained to show the location of the lesion and its relationship to critical areas of the brain. Often, a team of specialists including neurologists, neurosurgeons, neuroradiologists, radiation oncologists and medical oncologists will discuss a case and jointly determine an appropriate treatment plan.
Q. How are brain tumors treated?
A. Most primary brain tumors are initially considered for surgical resection. Depending on both tumor factors such as location, and patient factors such as general medical condition, surgery may or may not be feasible. Radiation and chemotherapy can be used after surgery to treat tumor cells in the surgical site, or in cases where surgery is not performed. Metastatic tumors can also be treated with surgery, radiation therapy, and chemotherapy, often in combination.
Q. How is radiation used to treat brain tumors?
A. There are two basic types of radiation treatment: conventional external-beam radiation treats larger regions of the brain or even the whole brain, whereas radiosurgery focuses radiation to small specific targets in the brain. The newest type of conventional treatment uses a technique called intensity-modulated radiation therapy (IMRT), which allows shaping of radiation dose to avoid critical structures while covering the target lesion. Radiosurgery techniques include Gamma Knife treatments. Malignant primary brain tumors are usually treated with conventional radiation to cover areas of the brain adjacent to the visible tumor that may harbor cancer cells. Depending on the type and number of brain metastases, patients may undergo surgery, radiosurgery, or whole brain irradiation, or some combination of these treatments. Benign tumors are often treated surgically or with radiosurgery.
Q. What is Gamma Knife treatment?
A. Basically, this is a very complex machine that can perform radiosurgery (the precise, targeted delivery of high dose radiation to a small lesion in the brain). The Gamma Knife system focuses a minimum of 201 fixed radiation beams onto the target tumor through a fixed head frame.
Additional resources about Brain Cancer Treatments include:
Radiation Treatment for Breast Cancer
Q. Why is radiation recommended after the tumor is surgically removed?
A. Surgery to remove the tumor and preserve the remaining breast tissue is called a lumpectomy. Radiation treatment is given to destroy any remaining microscopic deposits of cancer in and around the site of surgery. The combination of lumpectomy followed by radiation therapy is considered equal to mastectomy, or removal of the entire breast. If radiation is omitted following lumpectomy alone, there is a high likelihood of cancer recurrence in the breast.
Q. What are the common side effects of radiation therapy to the breast?
A. Side effects can include fatigue, skin irritation similar to a moderate sunburn, and mild to moderate breast swelling. These changes are temporary and can be treated by skin creams and/or medications. Tell your radiation oncologist or nurse about any discomfort you may feel.
Q. What is Accelerated Partial Breast Irradiation (APBI)?
A. Accelerated partial breast irradiation (or APBI) is the delivery of radiation to only part of the breast over four to five days. By treating a smaller area of the breast, treatment can be completed in just one week. While it is not yet considered standard practice, there is reason to believe that APBI may be equivalent to 5 to 7 weeks of external beam radiation therapy. Thousands of patients are being actively evaluated in national clinical trials—data on these patients must be collected over 10 to 20 years to see if APBI is as effective as the standard external beam treatment. Currently, it is used most often for patients who find it impossible to travel to and from the clinic for a standard radiation therapy course.
Q. How is APBI performed?
A. APBI may be performed by placing flexible plastic tubes called catheters or a balloon into the breast or with external beam radiation using a linear accelerator. During treatment, the catheters or the balloon are connected to a machine which sends out a small radioactive seed directly into the catheter which is placed where the tumor was removed. The radiation is left in place for several minutes, twice a day. After the end of the five days, the catheters or balloon are removed.
Q. Who is a candidate for APBI?
A. Not everyone is a candidate for APBI. Patients must qualify based on the current guidelines of the American Brachytherapy Society and American Society of Breast Surgeons. The current recommendations include:
- Older than age 45
- Invasive ductal carcinoma
- Tumor size < 3cm
- Negative surgical margins, and
- Sentinel or auxiliary nodes negative.
In addition, there are several technical factors which must be determined based upon a planning CT scan and the patient’s individual characteristics. Patients who are not considered candidates for APBI can still be candidates for standard external beam radiation.
Q. Does choosing to have a mastectomy guarantee I will not need radiation?
A. Whether or not radiation therapy should be used after removal of the breast depends on several factors. These factors include lymph node involvement, tumor size, and whether or not cancer cells were found near the edge of the tissue that was removed. You should see a radiation oncologist to discuss these possibilities before you decide which type of surgery to undergo.
Radiation Treatment Clinical Trials
Q. What is a clinical trial?
A. A clinical trial is a study that is looking for better ways to treat and cure cancer. Every cancer treatment that we offer patients today comes from the results of clinical trials done in the past. It is the safest and most thorough way to look for improvements in the way we treat patients.
A trial is created when investigators ask a scientific question looking for an improved way to treat cancer. They are looking for volunteers to agree to participate and it is their (and our) goal that the treatment will not only be beneficial to you, but also help us gain knowledge in order to better treat patients in the future.
Q. What are the different types of trials?
A. There are Phase I, II, and III trials.
Phase I trial is the first step. It is looking to answer how a new treatment should be given and what dose is safe. Usually, a small number of people are entered into a Phase I trial.
Next, a Phase II trial builds on the knowledge we have gained and looks at how well the new treatment works for treating a particular cancer. Typically, Phase II trials enroll more patients than a Phase I trial.
Finally, a Phase III trial seeks to compare this new treatment to the current standard approach. The goal is to determine whether this new type of treatment is an improvement from the way we treat a certain cancer currently. A Phase III trial seeks to enroll hundreds of patients. When a patient is enrolled, they are assigned either to be treated with the new treatment or with the standard treatment.
Q. What are the risks and benefits of being in a trial?
A. This is one of the most commonly asked questions and is one that you should discuss with your doctor so that you get answers that are related to the trial you are being asked to consider.
In general, the benefits include:
- Being closely monitored not only by your doctor, but by some of the national leaders in the field
- A chance to provide a valuable contribution to the care of patients with cancer
- A chance to be one of the first people to benefit from a new approach to treatment
In general, the risks include:
- The new treatment may be less effective than the current approach
- The new approach may have side effects that are still being investigated
- Even if the treatment has shown a benefit in others, it may not for you
Q. If I choose not to be on the trial, can I get the same treatment?
A. In general, yes. The main difference is that the results of your treatment will not be collected and submitted to the trial.
Q. Does being on a trial affect the quality of the care I will receive?
A. Not at all. Whether or not you participate in a trial, we are dedicated to giving you the same quality care.
Q. If I agree to be on a trial, can I change my mind at a later date?
A. Yes and we will respect your wishes. We would talk to you to make sure that there is not any confusion about the trial and follow your decision.
Q. If I choose not to be on a trial, but then want to enter it later, is it too late?
A. Once a treatment has begun, it is difficult to enroll you in that trial. Usually, the investigators need to review your information before treatment begins and complete the enrollment process. After you start treatment, it is harder to get into the trial. However, we can still plan to treat you as if you were enrolled.
Q. Where can I get more information?
A. Each trial has a website that gives patients more information about the trial. In addition, your doctor will provide you with printed information about the trial and commonly asked questions.
To learn more about clinical trials in general as well as what it means to be in a trial, you can visit:
Radiation Treatment for Gynecologic Cancers
Q. What does a typical course of radiation for treatment of gynecologic cancer consist of?
A. A typical course of radiation for endometrial or cervical cancer consists of external pelvic radiation and internal radiation. External radiation is usually 5 weeks of daily treatments. It takes approximately 1/2 hour for each daily treatment. There can be 3-5 additional internal treatments. The internal treatments are delivered with a brachytherapy implant. They are given 1-2 times per week. The exact prescription of external and internal radiation is customized for each patient.
Q. What side effects should I expect?
A. Side effects of radiation treatment vary from patient to patient. You may have no side effects, a few mild side effects, or more serious side effects. The side effects that you experience depend mostly on the treatment dose and the part of the body treated.
There are two main types of side effects: acute and chronic. Acute, or short-term, side effects occur during the treatment and are usually gone completely within a few weeks of finishing treatment. Chronic, or long-term, side effects may take months or years to develop and may be permanent.
For pelvic radiation, side effects may include diarrhea, frequent urination, decreased blood counts, skin irritation and fatigue. Chronic side effects may include diarrhea (especially related to certain foods), frequent or uncomfortable urination, and vaginal narrowing.
Q. What should I do if I develop diarrhea and cramping?
A. Diarrhea and cramping can occur as a result of radiation therapy. Radiation can cause changes to the lining of the intestine, causing an increased movement of stool through the intestine. This prevents proper absorption of fat, carbohydrates and proteins, which then causes cramping, gas, diarrhea and mucousy stool. These side effects usually do not develop until approximately the second or third week of treatments, and may or may not be a problem, depending on factors such as the dose of radiation being given, the number of treatments, and individual sensitivity.
If you currently take a laxative or stool softener, stop the use of this as soon as you notice that the stool is softer or there is an increased frequency of bowel movements. A change in the type of foods that you eat, including lowering the roughage in your diet, will help minimize bowel irritation. Roughage (also called fiber) is the material in foods that is undigested and passed in bowel movements. When your intestines are irritated, normal levels of roughage may be too much. Bulking agents may be used to absorb excess fluid in the intestine. These medications will slow the passage of stool in the intestine, decrease the frequency of bowel movements, and relieve spasms. If you have diarrhea or frequent bowel movements, the anal area may become irritated. Sitz baths will help relieve discomfort. Keep the area clean and pat dry; do not rub.
If you develop problem diarrhea, it may be helpful to have frequent small feedings (1-2 ounces) of clear liquids, such as mild carbonated beverages including 7-UP®, ginger ale, non-acid juices including apple and cranberry juice, Hawaiian Punch, Kool-Aid®, Gatorade®, artificially flavored fruit drinks and punches, plain gelatin and Popsicles®.
Avoid coffee, milk and milk products, colas, chocolate, orange and grapefruit juice, prune and grape juice.
Progress slowly to solid food. Plain starchy foods are usually well tolerated, such as crackers, dry toast, plain boiled white rice, plain boiled white potatoes, cooked cereals such as cream of rice, cream of wheat, and oatmeal.
Gradually add protein foods such as cheese, chicken and turkey (baked or roasted). Progress to bland fruits and vegetables including carrots, squash, beets, applesauce and bananas. If tolerating well, follow general guidelines for the Low Roughage Diet.
LOW ROUGHAGE DIET – GENERAL RECOMMENDATIONS
- Eat smaller amounts at frequent intervals, rather than 2 or 3 larger meals.
- Avoid eating or drinking very hot or ice-cold beverages or foods, since they stimulate bowel activity
- Drink an adequate amount of liquids, but include them between meals, rather than with meals, to help prevent fullness.
- Avoid spicy, greasy and fried foods
- Include potassium-rich foods in your daily diet. Potassium is an important mineral in the body, and is lost when diarrhea occurs. Good potassium sources include: canned apricots and apricot nectar, bananas, oranges and grapefruit and their juices (if tolerated). Other good sources include cooked asparagus, carrots, mushrooms, winter squash, white and sweet potatoes, spinach, pumpkin and Swiss chard.
- If you have cramps, stay away from foods that encourage gas or cramps, such as carbonated drinks, beer, beans, cabbage, broccoli, cauliflower, onions and highly spiced foods.
- Use less roughage in your diet by eating only cooked vegetables, and omitting foods with seeds, tough skins, or whole grain.
FOODS THAT MAY CAUSE DISTRESS
- High protein
- Baked or broiled beef, pork, chicken, liver, turkey
- Dried peas and beans such as lentils, kidney beans, white beans, nuts, seeds, peanut butter, and very spicy, fatty meats.
- Breads, cereals, rice, and pasta
- Bread and rolls made from refined, white flour; pasta; converted or instant rice. Refined cereals such as farina, cream of wheat, cream of rice, oatmeal, cornflakes. Pancakes, waffles, cornbread, muffins, graham crackers.
- Whole-grain breads and cereals such as whole wheat and rye bread, bran, shredded wheat, granola, wild rice.
- Fruits and vegetables
- Soups made with allowed cooked vegetables: asparagus tips, beets, carrots, peeled zucchini, mushrooms, celery, tomato paste, tomato puree, tomato sauce, green beans, acorn squash, baked potato without skin. Canned, frozen or fresh fruit.
- Fresh, unpeeled fruit, pears, melon. All other vegetables.
- Beverages, desserts, and miscellaneous
- Butter, margarine, mayonnaise, salad dressing, vegetable oil, cake, cookies, flavored gelatin desserts, sherbet, fruit pie made with allowed fruit, decaffeinated beverages.
- Desserts with nuts, coconut, dried fruit, chocolate, licorice, pickles, popcorn; foods with a lot of pepper, chili seasoning, taco seasoning, hot sauces.
Q. What can I do for urinary problems?
A. Radiation therapy may cause irritation to the lining of the bladder causing pain with urination, urgency, hesitancy, and/or an increase in frequency both during the day and at night. Drink three liters of fluid a day. Avoid caffeine found in coffee, tea and soda, and alcohol. Limit the amount of fluid you drink in the evening to prevent having to urinate frequently during the night. Your doctor may prescribe medications to help with these symptoms. Report cloudy, foul smelling urine, backache, fever, chills, or blood in the urine, which could indicate infection.
Q. Will I continue to have my period during pelvic radiation?
A. Depending on the radiation dose, women having radiation therapy in the pelvic area may stop menstruating and may have other symptoms of menopause. Treatment also can result in vaginal itching, burning, and dryness. You should report these symptoms to your doctor or nurse, who can suggest treatment.
Q. Can I continue to have intercourse during pelvic radiation?
A. As long as you are not bleeding heavily from a tumor in your bladder, rectum, uterus, cervix, or vagina, you can usually have intercourse while you’re being treated with pelvic radiation therapy. The outer genitals and vagina are just as sensitive as usual. (Unless intercourse or touching is painful, you should still be able to reach orgasm.)
Some shrinking of vaginal tissues occurs during radiation therapy. After your therapy is finished, your doctor will advise you about sexual intercourse and how to use a dilator, a device that gently stretches the tissues of the vagina.
Q. Can I become pregnant while receiving radiation?
A. Scientists are still studying how radiation treatment affects fertility. If you are a woman in your childbearing years, you should discuss birth control measures with your doctor. It is not a good idea to become pregnant during radiation therapy.
Radiation may injure the fetus. In addition, pregnancy, childbirth, and caring for a very young child can add to the physical and emotional stress of having cancer. If you are pregnant before beginning radiation therapy, special steps should be taken to protect the fetus from radiation.
Radiation Treatment for Lung Cancer
Q. When is radiation therapy recommended for lung cancer?
A. Radiation therapy delivers high-energy x-rays that can destroy rapidly dividing cancer cells. It has many uses in lung cancer:
- As primary treatment
- Before surgery to shrink the tumor
- After surgery to eliminate any cancer cells that remain in the treated area
- To treat lung cancer that has spread to the brain or other areas of the body
Q. What are the most common types of lung cancer?
A. There are two major types of lung cancer. Non-small cell lung cancer (NSCLC) is the most common, accounting for 75 to 80% of those seen in the United States. Small cell lung cancer (SCLC) is less common, tends to grow more rapidly, and has a greater likelihood to have spread at diagnosis. SCLC is considered to be either limited (confined to the chest) or extensive stage (beyond the chest) at diagnosis.
For limited stage SCLC, radiation is targeted to the lung cancer and given concurrently with chemotherapy. For extensive stage SCLC, radiation therapy may be given to the lung for palliation of pain, shortness of breath, or hemoptysis (coughing up blood).
If initial treatment for SCLC results in a good response, radiation therapy may be directed to the brain to prevent the development of brain metastases as well.
For early stage NSCLC (Stage I and II) radiation alone may be used for patients who are unable to tolerate or who are not interested in surgery. Radiation therapy is also sometimes recommended in patients with early stage NSCLC who have undergone surgery to remove the tumor. When radiation is used after surgery, it is called “adjuvant” radiation therapy. Adjuvant RT decreases the chance that a tumor will return or recur following surgery, and is usually used if small amounts of tumor are thought to remain in the surgical bed, or for those patients who have lymph node involvement. For patients with known mediastinal involvement (N2 or N3 disease) who are considered unresectable (Stage IIIA or Stage IIIB) at diagnosis, chemotherapy and radiation are recommended to be used together. Using these two treatments concurrently may lead to a “synergistic” or “one plus one equals three” effect on the tumor.
Q. What are the common side effects of radiation therapy to the lung?
A. The most common side effects of radiation therapy for lung cancer are:
- Esophagitis (difficulty swallowing due to inflammation of the esophagus, the muscular tube between the mouth and stomach)
- Pneumonitis (inflammation of the normal lung surrounding the tumor)
Both of these conditions are usually self-limited and improve after treatment is completed. Other side effects that may occur include fatigue, cough, and mild to moderate redness of the skin in the treatment area (similar to sunburn). Tell your radiation oncologist or nurse about any discomfort you may feel.
Q. What kind of radiation do you give to treat lung cancer?
A. There are two main methods by which the radiation therapy treatments can be given: External beam radiation or sterotactic ablative body radiotherapy (SABR).
External beam radiation therapy involves a series of noninvasive daily (Monday through Friday) outpatient treatments delivered over several weeks. It works by focusing a beam of ionizing radiation to the tumor while sparing the surrounding tissue. The two main techniques for delivering external beam radiation therapy are: a) 3-dimensional conformal therapy (3-D conformal) which refers to a method of treatment delivery that incorporates 3-dimensional computer planning and treatment systems to produce a high-dose area of radiation that conforms to the shape of the area to be treated. This technique allows the delivery of precise doses of radiation to the targeted area through multiple treatment fields while sparing surrounding tissues, and b) Intensity modulated radiation therapy (IMRT)which utilizes a more sophisticated system of shields within the machine allowing a higher dose of radiation to be delivered to the tumor from multiple angles while minimizing effects on surrounding tissue. This form of 3-D conformal radiotherapy allows a precise adjustment of radiation beams to the tissue within the target area. It continues to be studied for lung cancer especially in our clinics where respiratory gating (synchronizing the delivery of radiation to the individual’s own breathing cycle) is possible.
Q. When is radiation to the brain also given for lung cancer?
A. Radiation directed to the whole brain to prevent brain metastasis is typically given for patients with SCLC whose disease has responded to initial therapy. The brain is a common site of tumor spread (termed metastasis) in people with SCLC. Having radiation treatment of the brain after chemotherapy and before evidence of metastases develops, substantially reduces the chances of ever developing brain metastases and prolongs survival. This type of radiation therapy is called prophylactic cranial irradiation, or PCI. PCI has been so successful in SCLC patients that research trials are now underway to see if similar benefits can be seen in patients with NSCLC, too.
In patients who have spread of lung cancer to the brain at diagnosis or down the road, radiation therapy to the brain is often recommended to control symptoms and shrink those tumor deposits. Standard radiation machines can bathe the whole brain with radiation treatment, and the specialized Gamma Knife machine at our North Oaks Center can give highly focused doses to critical spots in the brain as well.
Q. Why is PET/CT useful in the diagnosis and treatment of lung cancer?
A. PET/CT scanning improves the detection rate of malignancy compared to conventional diagnostic studies such as CT or radionuclide bone scans. This enhanced detection accuracy frequently alters diagnostic management and treatment decisions. Better targeting of the tumor can significantly impact on radiotherapy treatment planning volumes, and can help us avoid treating normal tissues unnecessarily.
Q. What is respiratory gating?
A. Several of our clinics are incorporating breakthrough technologies of PET/CT, respiratory gating, and IMRT to treat lung cancer.
When you breathe, internal organs move by as much as several centimeters. As the lungs expand and contract while inhaling and exhaling, lung tumors move and even change shape, making precise targeting of radiation beams difficult. Respiratory gating is the process of turning the radiation beam on and off based on your breathing cycle. High doses of radiation ensure the best outcomes (greater control, tumor reduction, and potential cure), but higher radiation doses can only be delivered if the dose to normal tissues can be kept to safe levels. When the radiation beam is activated in synchronization with a patient’s respiratory pattern, it targets the tumor only when it is in the optimal position and prevents the radiation beam from treating healthy tissues.
Radiation Treatment for Prostate Cancer
Q. Are all men with prostate cancer eligible for radiation treatment?
A. Many men without evidence of metastasis (cancer spread to other organs) have a chance to be cured of their cancer by either a prostate seed implant and/or IMRT. Men diagnosed with prostate cancer should consult with both a urologist and a radiation oncologist. They will review your past medical history and current physical condition and discuss the pros and cons of surgery, external radiation, and seed implants. There are treatment protocols for men with both early and advanced stage disease.
Q. How does radiation kill cancer cells?
A. Radiation, in this case, X-ray or Gamma-ray radiation can damage a cancer cell’s ability to multiply, ultimately leading to its death. Cancer cells are much more sensitive to radiation damage than normal cells and are less likely to repair any damage done.
Q. Is it all right to give hormone blockers and radiation together?
A. Yes. Not only is it all right, research has shown that the combination can improve results in men with more advanced or aggressive prostate cancers.
Q. How long will I be out of work with a prostate seed implant?
A. Most men can return to work and their normal activities in 24-48 hours.
Q. Since I have radioactive seeds in my prostate, am I at risk to other people?
A. The amount of radiation given off outside the body is minimal. However, we do not recommend that you hold pregnant women or young children in your lap for a few months following your implant.
Q. Will I need a urinary catheter after a seed implant?
A. Most men go home without a catheter, but some may need one for up to 24 hours.
Q. Can I have surgery if the cancer re-grows in the prostate after radiation?
A. Ordinarily surgery is not used for a recurrence of prostate cancer. We use other effective treatment modalities.
Q. How do I know if I was cured by a radical prostatectomy?
A. The answer is quite simple. A PSA blood test done two months after surgery should reflect a PSA of less than 0.1. If this is not the case, you may have some cancer cells left behind that should be irradiated. In this circumstance, we may recommend IMRT external radiation, as there is no longer a prostate in which to accurately implant the seeds.
Q. Is there any hope if I am diagnosed with late/advanced stage prostate cancer that has already spread?
A. Yes. There are many promising hormonal and chemotherapeutic treatments. Our physicians will discuss these options with you and refer you to the relevant specialists.
Radiation Treatment for Skin Cancer
Q. Is skin cancer common? Is it curable?
A. Skin cancer is by far the most common type of cancer diagnosed (especially in California), and fortunately it is readily treatable and rarely fatal.
Q. What are the options for treatment?
A. Patients often have a variety of choices for treating skin cancers. Countless small skin cancers are frozen, burned, shaved, excised, and treated every year by primary care doctors and dermatologists. Sometimes, skin cancers become larger, or involve the face or parts of the body where simple treatments may be inappropriate.
Q. If my skin cancer is not small, what are my options for treatment?
A. For many decades, superficial radiation therapy has been favored for these types of skin cancers, for several reasons:
- control rates with modern radiation therapy are similar to what is achievable with aggressive surgery
- organ function is usually not affected (for example, an eyelid skin cancer can be treated without removal of the eyelid)
- and most patients heal without scarring
Due to the excellent cosmetic results radiotherapy offers, many patients prefer radiation therapy over surgery for treatment of skin cancers on the face. This is a personal decision, and your Coastal radiation oncologist will discuss your options with you.
For a wealth of in-depth information on skin cancer, visit the National Cancer Institute.
Radiation Treatment for Head and Neck Cancers
Q. What are head and neck cancers?
A. Head and neck cancer is the term given to a variety of tumors located in the head and neck region including the:
- sinuses and nasal cavity
- salivary glands
Also included in this classification are lesions of the skin on the face and neck and the cervical lymph nodes. Tumors of the brain are usually excluded from this definition because they are treated using different approaches.
Q. Are head and neck cancers common? And, are they treatable?
A. According to the American Cancer Society over 60,000 Americans are diagnosed with head and neck cancer each year. Currently, more than 400,000 survivors of oral and head and neck cancer are living in the United States.
Q. What are the side effects of radiation treatment of head and neck cancers?
A. Long term side effects from treatment of head and neck cancers can greatly affect quality of life. Through state-of-the-art treatment planning and radiation delivery, Coastal doctors can often limit the radiation exposure to sensitive normal tissues, such as the salivary glands. We also employ the use of radio-protective agents during treatment to decrease normal tissue reactions and preserve salivary function. These techniques lead to quicker recovery from treatment, improved healing, and better quality-of-life for our patients.
Nutritional and oral care are very important to successful treatment, and you will discuss this with your physician.