Chemotherapy | Radiation | Surgery | Bone Marrow Transplants | Supportive Care

Your Treatment Plan: Radiation

What is Radiation therapy anyway?
Radiation therapy is the use of high-energy rays or particles to kill cancer cells. Don't worry, the levels you will be exposed to will be safe and will not make you glow in the dark!

Radiation therapy may be used alone or in combination with chemotherapy and surgery to help cure your cancer. The most common teen cancers treated with radiation are brain tumors, leukemia, lymphoma, neuroblastoma and certain sarcomas.

Radiation is also part of the treatment plan for bone marrow transplants.

How does radiation work?
Cancer is the overgrowth of abnormal cells. One way to stop the cancer from growing is to interfere with the cell's ability to multiply. Radiation, used at high doses, causes cellular changes that stop its ability to multiply and eventually kills the cancer cell.

The most common form of radiation therapy for teens is external beam irradiation. If radiation is given to the entire body, it is called Total Body Irradiation or TBI (this is the procedure prior to bone marrow transplants).

Getting Started
Your radiation therapy must be planned very carefully because both cancer cells and normal cells are damaged by the radiation. The goal is to wipe out the cancer while doing as little damage as possible to your healthy cells.

First, a radiation oncologist reviews all of your records and examines you. Then treatment recommendations are discussed with you and your parents and a plan is developed that includes one or two sessions called simulations (basically getting everything set up).

During the simulation, you lie on a flat x-ray table in what is called the treatment position. To help you keep the same position during each treatment, an immobilization device (like a mask or a mold) may be used. These are not necessary for everyone and are never used for TBI.

A CT scan or X-rays are done so the radiation oncologist can design the exact area to be radiated. Several small marks or tattoos are marked on your skin to help identify the area to be treated. These marks are permanent, so you don't have to worry about them washing off. They are very small and over time will hardly be noticeable.

Special shielding "blocks" are designed to shape the radiation beam and help shield normal tissues. Special computer plans are developed that give the best radiation dose to the selected treatment field.

In a second set-up simulation, the shielding blocks are placed in the machine and an x-ray is taken. The radiation oncologist compares this x-ray with the simulation x-ray to ensure accuracy.

The Actual Treatment…
Everything is now ready. During treatment, you lie on a table, in the treatment position, and the radiation machine (called a linear accelerator) moves itself over and around you to aim the radiation beam directly at your tattoos.

The treatments are very short, usually lasting less than 30 minutes each. Most of this time is spent getting the treatment fields accurately positioned. You will not feel anything during the treatment but must lie very still.

No one is allowed to stay in the room with you during the actual irradiation. You are observed on monitors and can speak to the therapists if necessary. You can also bring a tape or CD to listen to, if you want.

Radiation is usually given once or twice a day for a number of weeks, but your medical team will tell you your exact schedule.

What about side effects?
Side effects are related to the treatment dose and the area that is being treated. Most side effects of radiation - although sometimes unpleasant - are not serious and can often be controlled.

The most common side effects are:

• Nausea/vomiting
• Diarrhea/constipation
• Fatigue or weakness
• Skin redness or irritation
• Loss of appetite (mouth sores; food may taste weird)
• Hair loss (if you had radiation to your head).

Radiation often has a cumulative effect- you might not notice many side effects right away but over time they build up. Be sure to talk with your medical team about which side effects you can expect and how best to deal with them.

What Can I Do About This?
To help overcome any worry about your radiation treatment, make sure you know the plan - your treatment schedule, possible side effects and how to deal with them. It's important that you understand the role radiation therapy plays in your overall treatment plan.

Understanding your treatment is one way to stay in control of your mental and emotional well-being.

Talking with other teens might also be helpful (you can use the TLC Discussion Boards). Just remember - every person is different. One teen's experience might be very different from yours.

Go to Weird Body Issues to learn more about how to manage the side effects of radiation.