External Radiation

You will go through a process called simulation. This takes between 30 minutes and two hours.

• You will lie on an exam table. A radiation therapist uses a CT scan to define the exact place(s) where radiation will be directed. They may mark the exact area on your skin with colored ink. You may also have a small tattoo (or several) placed on your skin. This is as a permanent mark to help aim the radiation beam.
• Depending on the type of treatment required, you may also be measured for devices like braces that will help you stay still during treatment.

Internal Radiation

You will be given general or local anesthesia so you do not feel pain during the procedure.

External Radiation

None

Internal Radiation

You may need local anesthesia, which will numb a small area, or general anesthesia, which keeps you asleep during the procedure. This depends on the type of radiation and the area of your body that is being treated.

External Radiation

You will be positioned on the treatment table or chair. The radiation therapist will leave the room and enter a control room. The machine will deliver radiation to certain areas of your body. The most common sources of radiation are x-rays, electron beams, and cobalt-60 gamma rays.

You must be very still during treatment. The therapist can see you on a screen. You can talk with them if you feel uncomfortable or sick.

Internal Radiation

The radiation source will be placed inside your body on or near the affected area. This provides higher doses of radiation in a shorter time. The radioactive sources (such as cesium, iridium, palladium, or iodine) are in the form of wires, seeds, or rods. This treatment is mostly used for cancers of the head and neck, breast, uterus, thyroid, cervix, and prostate. The two main types of internal radiation are:

• Interstitial radiation—Rods, ribbons, or wires placed inside the affected tissue on a short term or permanent basis
• Intracavitary radiation—A container of radioactive material placed inside a body cavity, such as the uterus, vagina, or windpipe (This is always temporary.)

Rods for Internal Radiation

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External Radiation

The treatment takes 1-5 minutes. You should allow at least 30 minutes for each session. Most treatments last 2-8 weeks. They are given once a day, five days per week. In some cases, you may be treated twice daily or only three times a week. Treatment schedules will depend on different factors. Talk to your radiation oncologist about the schedule planned for you.

Internal Radiation

This depends on the type of cancer treated and the method of internal radiation used.

External Radiation

No

Internal Radiation

Anesthesia prevents pain during the procedure. You may be sore when recovering from the procedure depending on where the radioactive material was placed.

External Radiation

None. External radiation is typically done at an office visit.

Internal Radiation

You will stay in the hospital until the implant is removed, or in the case of a permanent implant, when the radioactivity has decreased. Doctors usually remove high-dosage implants within a matter of minutes. Low-dosage implants may stay in for a few days. Permanent implants lose their radioactivity within a few days.

External Radiation

You will leave and resume your normal activities. You are not radioactive. You are not a threat to anyone else around you, in terms of radiation exposure.

Internal Radiation

You will return to a hospital room while the implant is in place. While the radiation is implanted, you will follow these precautions to prevent transmitting radiation to others:

• Limited visitation: Many hospitals do not allow children under 18 years old or pregnant women to visit a patient having implant radiation. They may visit once the implant is removed. If visitors are allowed, they will need to sit at least six feet from the bed. Visits will be limited to a short time (10-30 minutes). Staff may place a shield beside the bed to protect visitors and staff from radiation exposure.
• Limited contact with the staff: The staff will be available to you at all times. They may speak to you from the doorway. They may also come and go very quickly to avoid excessive radiation exposure.

External Radiation and Internal Radiation

During treatment, your doctor will want to see you at least once a week. You may have routine blood tests to check for the effects of radiation on your blood cells.

After treatment is completed, you will have regular visits to monitor healing and to make sure the treatment affected the disease as planned. Follow-up care will vary for each person. Care may include further testing, medicine, or rehabilitative treatment.

Tell your doctor if you experience side effects. Many side effects can be controlled with medicine or diet. Your doctor may change or delay the course of your treatment if the side effects are too much. Most side effects will gradually go away after treatment.