RADIOTHERAPY

( By JASCAP )

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General information on radiotherapy

This section has been written to give you information about radiotherapy. We hope that it will answer some of the questions that you may have about this treatment.

If you have any further questions relating to your treatment, please don't hesitate to ask the doctor, nurse or radiographer looking after you. It is important to talk to someone who is familiar with your treatment, as radiotherapy differs from one person to another. Other people you meet may be having different treatments, even if they have a similar type of cancer.

What is radiotherapy?

Radiotherapy is the use of high energy x-rays and similar rays (such as electrons) to treat disease. Since the discovery of x-rays over one hundred years ago, radiation has been used more and more in medicine, both to help with diagnosis (by taking pictures with x-rays), and as a treatment (radiotherapy). While radiation obviously has to be used very carefully, doctors and radiographers have a lot of experience in its use in medicine.

Many people with cancer will have radiotherapy as part of their treatment. This can be given either as external radiotherapy from outside the body using x-rays or from within the body as internal radiotherapy.

Radiotherapy works by destroying the cancer cells in the treated area. Although normal cells can also be damaged by the radiotherapy, they can usually repair themselves.

Radiotherapy treatment can cure some cancers and can also reduce the chance of a cancer coming back after surgery. It may be used to reduce cancer symptoms.

Some people find that the side effects are very mild and that they just feel tired during their course of radiotherapy treatment.

Why radiotherapy is given?

Curative treatment

Radiotherapy is often given with the aim of destroying a tumour and curing the cancer. When radiotherapy is given in this way it is described as radical radiotherapy.

Radiotherapy may be used on its own or may be given before or after surgery or chemotherapy. Chemotherapy is the use of anti-cancer drugs to destroy cancer cells. If radiotherapy and chemotherapy are given at the same time, this treatment is known as chemoradiotherapy.

For some types of curative radiotherapy treatment, you may need to go to the hospital each weekday for between two and seven weeks. In this situation, a small dose of radiotherapy is given each time. This is because as well as damaging cancer cells, radiotherapy can also cause damage to healthy cells in the treatment area. If a very high dose of treatment was given all in one go, it could cause too much damage to the healthy cells, so small doses are given to allow them to recover in between.

Palliative treatment

Sometimes, when it is not possible to cure a cancer, radiotherapy may be given to relieve symptoms – for example, to lessen pain. This is called palliative treatment. Lower doses of radiotherapy are given than for curative treatment, usually over a shorter period of time (sometimes just a single treatment).

Research - clinical trials for radiotherapy treatments

Cancer research trials are carried out to try to find new and better treatments for cancer. Trials that are carried out on patients are known as clinical trials.

Clinical trials may be carried out to:

  • test new treatments, such as new chemotherapy drugs, gene therapy or cancer vaccines
  • look at new combinations of existing treatments, or change the way they are given, to make them more effective or to reduce side effects
  • compare the effectiveness of drugs used to control symptoms
  • find out how cancer treatments work
  • see which treatments are the most cost-effective.

Trials are the only reliable way to find out if a different operation, type of chemotherapy, radiotherapy, or other treatment is better than what is already available.

Taking part in a trial

You may be asked to take part in a treatment research trial. There can be many benefits in doing this. Trials help to improve knowledge about cancer and develop new treatments. You will also be carefully monitored during and after the study. Usually, several hospitals around the country take part in these trials. It is important to bear in mind that some treatments that look promising at first are often later found not to be as good as existing treatments, or to have side effects that outweigh the benefits.

If you decide not to take part in a trial your decision will be respected and you do not have to give a reason. There will be no change in the way that you are treated by the hospital staff and you will be offered the standard treatment for your situation.

The process of clinical trials is described in more detail in our booklet on cancer research trials.

Blood and tumour samples

Many blood samples and bone marrow or tumour biopsies may be taken to help make the right diagnosis. You may be asked for your permission to use some of your samples for research into cancer. If you are taking part in a trial you may also be asked to give other samples which will be frozen and stored for future use, when new research techniques become available. These samples will have your name removed from them so you can’t be identified.

The research may be carried out at the hospital where you are treated, or it may take place at another hospital. This type of research takes a long time, so you are unlikely to hear the results. The samples will, however, be used to increase knowledge about the causes of cancer and its treatment. This research will, hopefully, improve the outlook for future patients.

Work and radiotherapy

Sometimes people can carry on working part-time during their treatment, but many people feel very tired and may feel unwell. In this case you may need to make changes to your usual routines. Most employers will be sympathetic if you explain why you need time off work. It is helpful to talk to your employer or personnel officer to explain how much time off you may need and what you will

be able to do. It can be hard to predict exactly what you will be able to do, but your employer will appreciate being given some idea of what to expect.

Children and radiotherapy

Radiotherapy can be a frightening experience for both children and their parents, but once everyone understands what is involved this fear can be reduced. The radiotherapy staff are used to treating children and they can offer help and support.

Young children, especially if they are aged three or younger, may have their treatment under a mild general anaesthetic. As your child can't eat or drink for at least four hours before his or her treatment, you will probably have a morning appointment. The anaesthetic is usually given in the radiotherapy department by an anaesthetist. You can stay with your child until they are asleep.

Although you won't be able to stay in the radiotherapy room during your child's treatment, you can watch through the window or on the TV screen. The nurses will look after the child until he or she wakes up, usually after 20 minutes to an hour. You will then both be able to go home, unless your child is an in-patient, in which case a nurse will take him or her back to the ward.

Older children may take a while to get used to the size and sound of the machines, but this should get easier once they get to know the staff and the surroundings. If you are finding it difficult to cope with your child's illness, you may find it helpful to contact one of the children's cancer groups.

Sharing your experiences with other parents can help you to cope with your own problems and fears. Our booklet on children's cancers gives more information.

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