Radiotherapy: questions and answers

11 December 2018

What happens in the body during irradiation?

Like a human body, tumors also consist of cells. Tumor growth is regulated by cell division. Irradiation is a “growth brake” for living tissue. One of the key effects of irradiation is the derangement or prevention of cell division. In particular, irradiation affects the genetic material in the cell nucleus. Such cell loses its ability to divide and, as a result, dies.

However, every cell has a regeneration system to reverse such damages. Ability to regenerate is much more pronounced in healthy, normal cells than in tumor cells, so irradiation affects the tumor much more than healthy tissue. From this difference concerning the ability to regenerate and benefit within radiation therapy. However, the process of regeneration in the surrounding irradiated tissue takes some time, so the total dose of irradiation is divided into several separate sessions (fractions).

Experience shows that in many cases daily exposure gives the best results. After successful irradiation, tumor cells die, are degraded by the body’s own cells and are excreted from it.

How long does radiation therapy last?

Every individual session of radiation therapy lasts only a few minutes. In order to cure cancer successfully, it is often necessary to have the multi-week treatment 5 days a week. In this case, the weekend remains free.

What rays are actually used?

Our apparatus for treatment regenerates the so-called electron and photon radiation with different energies that affect the human body from the outside.

Will I spread radiation after irradiation?

No. When irradiation by a linear accelerator, you do not in any way spread the radiation.

Will I feel radiation? Will I feel pain?

No. As in case of radiological diagnostics, you will not notice the irradiation.

What adverse effects does radiation therapy have?

In general, irradiation is well tolerated. However, adverse effects may occur, which mainly depend on which area of the body you will be exposed to. Our doctors will explain to you the likelihood of occurrence of adverse effects and kind of adverse effects that you can expect within the first consultation talk in our outpatient clinic or in the department. We will also tell you about how we, together with you, can mitigate adverse effects and which ones.

What should I do if adverse effects occur?

Please inform your medical technical assistant or to your attending doctor on any possible adverse effects that may have occurred. There are many activities and medications to alleviate these adverse effects.

Can the irradiation cause a skin burn?

In most cases of radiation therapy, skin reactions are practically absent. If the skin is purposefully incidentally irradiated or should be irradiated, reddening of the skin may occur, as well as partial superficial peeling and sunburn, as in sun-tan. These reactions disappear within a few weeks after the completion of radiation therapy.

How should I care for my skin during a series of exposures?

As part of the first consultation, you will receive information on skin care. During our weekly medical consultations, possible skin reactions will be monitored and, if necessary, recommendations for their treatment will be discussed.

May I wash?

Yes, however, this opportunity is limited. Due to irradiation, the skin in the area of irradiation can become sensitive and therefore will require soft and gentle care. Your attending doctor will give you information concerning skin care.

If your skin has markings for irradiation, you must ensure that they do not disappear while taking a shower or bath. If this happens, please inform the medical practitioner and in no case try to apply the markings by yourself.

Should I be accompanied by an accompanying person for daily irradiation?

In most cases, the accompanying person does not need help, but their presence facilitates the process of treatment and helps to overcome fear, at least in the first days of irradiation. It is true for the geriatric patients who feel more confident in the presence of the accompanying person, especially in the first days of irradiation, they remember the way better and understand the process of treatment faster.

Why is another computed tomography (CT) examination conducted?

Computed tomography for irradiation planning, which is performed with the help of special devices for placing the patient on the table, allows you to create exactly the same conditions as later when carrying out irradiation. This is the only way to plan and conduct therapy precisely. Therefore, previously taken computed tomography images are not suitable for irradiation planning.

Should I follow a special diet?

There is no need in diet following, however, when irradiating the face and neck areas and when irradiating the chest area (for example, in lung or esophagus cancer), food with high content of acid and spices should be avoided. It also concerns beverages that contain fruit acid or alcohol.

When irradiating the abdominal and pelvic areas (for example, irradiation of colon and prostate gland or gynecological abdominal irradiation), you should abandon the consumption of products that cause flatulence, and very fatty food. As a rule, a balanced diet and carefully prepared meals are recommended.

When irradiating the prostate gland, it is also necessary to ensure that the bladder is sufficiently filled with each treatment session (both on the day of planning and on the day of irradiation). Therefore, approximately 30-60 minutes before each dose, drink the sufficient amount of fluid and no longer empty the bladder immediately before irradiation.

How appropriate is intake of vitamins and nutritional supplements?

There is no urgent need for taking vitamins and nutritional supplements during radiation therapy. However, there is nothing wrong with taking the multivitamin preparation. Intake of individual vitamins, such as vitamins A, C, or E, is not recommended, as they may have a negative effect on the results of irradiation. The effects of nutritional supplements such as enzymes or selenium are unproven.

Can I play sports and continue to engage in professional activities?

It is possible that during treatment, you will not have to give up sports activities, and you will be able to have normal life. Moderate mobility, such as walking, is particularly favorable. Easy do everything that brings you pleasure, and give up what is connected with mental or physical overload.

Visiting the solarium and sunbathing during or after radiotherapy.

In principle, irradiated areas should not be subjected to additional ultraviolet radiation during treatment and for 6 months after it. This means that these areas of skin, for example, during beach vacations, must be protected from light or covered.

Visiting a hairdresser.

You can safely visit your hairdresser. However, when irradiating the head and neck areas, please refrain from dyeing your hair or rubbing substances containing alcohol. It is possible to wash your hair, for example, once a week. Please use a mild shampoo (for example, baby shampoo).

Can I interrupt a series of irradiation for important events?

To avoid the regeneration of tumor cells and their repeated growth, your radiation therapy should not be interrupted.

In rare cases, it may be necessary to interrupt treatment to allow time for weakening of pronounced adverse effects.

Is the first irradiation conducted immediately after the outpatient admission?

No. First, it is usually necessary to perform the CT examination for careful planning of irradiation, so that the first irradiation can be performed only a few days after the CT examination for planning.

Does hair fall out during radiation therapy?

Hair on the head falls out only if the head area is irradiated. As a rule, hair loss is only temporary. We will be happy to assist you if you need a wig for this period.

Can I drink alcohol or smoke during a series of irradiation?

There are no objections to the infrequent enjoyment of a glass of wine or beer, unless irradiation is carried out in the area of the oral cavity or esophagus. The use of strong alcoholic beverages should be completely abandoned, as this may increase possible adverse effects.

Smoking damages your health. In addition, it increases the risk of development of cancer (especially lung, larynx and esophagus cancer). We strongly advise you not to smoke.

What can be seen on the control images taken during treatment?

Control images show whether the irradiation covers the entire necessary area completely, and whether there is perhaps a need for a small correction relative to the patient’s position (on the irradiation table). In the images you can see the bones and lungs, however, on the basis of these images it cannot be said whether the tumor has diminished or disappeared.

Can irradiation be repeated?

Usually repeated exposure is possible, but only in another area. Whether the same area can be irradiated depends, inter alia, on the dose of the previous irradiation and the surrounding organs. If you have already been exposed to irradiation, you should discuss this with your attending doctor anyway.