Common questions about radiation therapy

Radiation therapy (also known as radiotherapy) is one of the main treatments for cancer.

Learn more about:

• How does radiation therapy work?
• Why have radiation therapy?
• How is radiation therapy given?
• Where will I have treatment?
• How many treatments will you have?
• How much does treatment cost?
• Will I be able to work during radiation therapy?
• Can I have radiation therapy if I’m pregnant?
• What is chemoradiation?
• What are the steps in radiation therapy?
• How do I prepare for radiation therapy?
• How will I know the treatment has worked?

How does radiation therapy work?

Radiation therapy aims to kill or damage cancer cells in the area being treated. Cancer cells begin to die days or weeks after treatment starts, and continue to die for weeks or months after it finishes. Although the radiation can also damage healthy cells, most of these cells tend to receive a lower dose and can usually repair themselves. You should not feel any pain or heat during radiation therapy.

Many people will develop temporary side effects during or shortly after treatment that may cause pain or discomfort. Learn more about how to prevent or manage the side effects of radiation therapy.

Why have radiation therapy?

Research shows that about one in two people with cancer would benefit from radiation therapy.

It can be used in three main ways:

As the main treatment to achieve remission or cure – Radiation therapy may be given as the main treatment with the aim of causing the cancer to disappear. This is called curative or definitive radiation therapy. Sometimes definitive radiation therapy is given with chemotherapy to increase its effectiveness. This is called chemoradiation or chemoradiotherapy.

To help other treatments achieve remission or cure – Radiation therapy is often used before (neoadjuvant) or after (adjuvant) other treatments to make the treatment more effective.

For symptom relief – Radiation therapy can help to relieve pain and other symptoms by making the cancer smaller or stopping it from spreading. This is known as palliative treatment.

How is radiation therapy given?

There are two main ways of giving radiation therapy, outside the body or inside the body. You may have one or both types of radiation therapy, depending on the cancer type and other factors.

External beam radiation therapy (EBRT)

Radiation beams from a large machine called a linear accelerator are precisely aimed at the area of the body where the cancer is located. The process is similar to having an x-ray. You will lie on a treatment table underneath a machine that moves around your body. You won’t see or feel the radiation, although the machine can make noise as it moves. Learn more about EBRT.

Internal radiation therapy

A radiation source is placed inside the body or, more rarely, injected into a vein or swallowed. The most common form of internal radiation therapy is brachytherapy, where temporary or permanent radiation sources are placed inside the body next to or inside the cancer.

Where will I have treatment?

Radiation therapy is usually given in the radiation oncology department of a hospital or in a treatment centre. This may be in the public or private health system. The large machines used for EBRT are kept in a separate treatment room.

While treatment courses vary, most people have radiation therapy as an outpatient. This means you do not stay in hospital, but travel to the treatment centre for each session. For some types of internal radiation therapy, you may need to stay in hospital overnight or for a few days.

How many treatments will you have?

You may have treatment once a day, Monday to Friday, for several weeks, but shorter courses of one to five treatments are also common.

How much does treatment cost?

If you receive radiation therapy as an outpatient in a public hospital, Medicare pays for your treatment. Medicare also covers some of the cost of radiation therapy in private clinics. How much Medicare pays depends on your treatment plan. Private health insurance does not usually cover outpatient treatments. Ask your provider for a written quote that shows what you will have to pay.

Will I be able to work during radiation therapy?

Many people can continue to work during their treatment and feel well enough to do all their usual activities. Others may need to reduce their hours or take time off. How much you will be able to work depends on the type of radiation therapy you have, how the treatment makes you feel and the type of work you do. Ask your treatment team if they offer very early or late appointments so that you can fit your treatment appointments around your work.

Talk to your employer about your working arrangements. Explain that it is hard to predict how radiation therapy will affect you, and discuss the options of flexible hours, modified duties or taking leave.

Your treatment team will encourage you to be as active as possible, and they can answer your questions about working during treatment. Ask your social worker about any practical or financial assistance available to you.

For more on this, see Cancer, work and you.

Can I have radiation therapy if I’m pregnant?

You probably won’t be able to have radiation therapy if you are pregnant, as radiation can harm a developing baby. It’s important that you don’t become pregnant during the course of treatment. If you suspect you may be pregnant at any stage, it is important to tell your doctor. If you are breastfeeding, talk with your doctor about whether it is safe to continue during your treatment course.

Men who have radiation therapy should avoid getting their partner pregnant during treatment and for about six months afterwards, as radiation can damage sperm. Your doctor will be able to give you more information about radiation therapy and pregnancy.