Understanding Radiation Therapy

What is Radiation Oncology?

Radiation Oncology focuses on studying, diagnosing, and treating cancer using various types of radiation like X-rays, gamma rays and electrons. These are used to destroy abnormal cells while protecting surrounding healthy tissue.

At Stony Brook, most treatments use X-rays and electron beams from linear accelerators housed in shielded areas for safety. Radiation therapy is often the best treatment for cancers and may also be combined with surgery or chemotherapy.

A specialized team of radiation oncologists, nurses, physicists, therapists, dosimetrists, nutritionists and social workers collaborates to provide care. All team members are licensed or certified experts.

How does radiation work?
Radiation damages cancer cells by breaking their DNA, preventing growth and causing them to die. Healthy cells also absorb radiation, but they recover more effectively compared to cancer cells. Modern technology helps reduce unnecessary damage to healthy tissues while targeting cancer cells effectively.

Will I become radioactive during my treatment?
No, you will not become radioactive during radiation therapy. You can safely interact with friends and family after leaving the department. For certain treatments like brachytherapy or radioisotope therapy, specific guidelines will be provided.

What are the side effects?
Radiation can relieve cancer symptoms, but side effects may occur. These depend on the area treated, dosage, and individual response. Common side effects include fatigue, which may last for a few weeks post-treatment, and other effects specific to the treatment area.

Most side effects can be managed with medication, diet, or other measures. Your radiation oncologist and nurse will discuss potential side effects and strategies to manage them before treatment starts. They will also be available daily to address any concerns or questions.

What is the usual routine for radiation therapy treatments?

• Check-in at the reception desk. The receptionist will notify your therapist of your arrival and assist with parking validation.
   
• Changing rooms are available with gowns and storage cubbies. Not all patients need to change; your therapist will advise. Leave valuables with a companion when possible.
   
• Treatment rooms: Stony Brook has six radiation therapy rooms. During each visit, advanced techniques like image-guided radiotherapy (IGRT) ensure precision.

Your first treatment session is longer, as therapists set up and validate all information. Once a week or after every five treatments, you will meet with your oncologist and nurse to review progress and address questions. For urgent questions, inform staff or call the office anytime.

Radiation Therapy Process

Radiation therapy is customized for each patient based on the form of treatment selected. Typically, the process includes five steps: consultation, simulation, treatment planning, treatment delivery, and follow-up.

Initial Consultation
The process begins with a consultation with a radiation oncologist who reviews medical records, pathology reports, and radiology images, and performs a physical exam. If radiation therapy is chosen, a simulation appointment will be scheduled.

Simulation
Simulation determines the exact treatment area. X-rays or CT scans, sometimes with contrast agents, are used. Patients may be positioned with customized immobilization devices like mesh masks or body molds to ensure consistent positioning. Tiny tattoo dots may mark the treatment area to guide daily therapy. Patients are advised to protect and not remove these marks.

Treatment Planning
The radiation oncologist, physicist, and dosimetrist develop a tailored treatment plan using imaging and advanced software. The goal is to target the tumor with high doses of radiation while minimizing exposure to nearby healthy tissue. This process may take several days to complete.

Treatment Delivery
Patients are positioned using immobilization devices, and radiation therapists deliver the prescribed dose. Images are taken as needed to confirm accurate targeting. Treatment sessions are typically quick, with most lasting about 20 minutes, including setup time.
Patients meet weekly with their doctor and team members to monitor progress, address concerns, and provide guidance on skin care and nutrition. The team is available daily for questions or issues at the patient’s request.

Post-Treatment Follow-up
After therapy, follow-up appointments monitor recovery and health. Tests may be ordered, and reports are sent to all involved physicians. Over time, visit frequency decreases, but the team remains available to address any concerns.