5 questions patients might be reluctant to ask about radiation therapy
January 22, 2020
Getting a recommendation for radiation therapy as part of cancer treatment comes with a learning curve – and a lot of questions. More than half of all patients with cancer receive radiation therapy at some point in their care, and patients and their families want to know how radiation works and how it might affect their lives during and after treatment.
Still, we know some patients feel nervous asking questions about their cancer therapy. In a word: Don’t. Asking questions helps your doctors provide the best care.
Radiation oncologists at the UT Southwestern Harold C. Simmons Cancer Center are leaders in the field, conducting research studies and pioneering advanced radiation techniques such as stereotactic ablative radiotherapy (SAbR), brachytherapy, and novel combinations of radiotherapy with chemotherapy.
We’re always happy to share the most current radiation knowledge with our patients. So, here are answers to five of the most common questions patients have said they were nervous to ask – but were glad they did.
Top radiation therapy questions and answers
1. Will I be radioactive during or after treatment?
Some patients worry that undergoing radiation therapy can be harmful to others because they are radioactive. For example, patients sometimes think they can't cuddle with their partner or hold a grandchild on their lap until after treatment. However, most patients don’t need to worry about being radioactive.
External beam radiation therapy is the most common type of treatment, and true to its name, it delivers radiation from a source outside the body. With this approach, you don’t need to worry about contact with family members or other people you encounter. Once you’re finished in the treatment room, there is no more radiation being delivered and you are not radioactive.
With internal radiation therapy (brachytherapy), your radiation oncologist will place a small radiation source inside the body. One example is the use of radioactive beads placed inside the prostate to deliver radiation therapy for prostate cancer.
Related reading: Treating prostate cancer with radiation
For some types of treatments termed high-dose rate (HDR) brachytherapy, the source remains in place for a few minutes at a time and is removed once you leave the procedure room – you are not radioactive in these scenarios.
For other types of treatments termed low dose rate (LDR) brachytherapy, the source remains permanently. These sources remain active in the body for many weeks (and longer in some cases), but the radiation emitted is so low that there is a negligible risk to others. However, to be extra cautious, patients are advised to avoid close contact with children and pregnant women for up to two months.
2. Will radiation treatment harm my immune system?
Radiation therapy can potentially affect your immune system, especially if a significant amount of bone marrow is being irradiated because of its role in creating white blood cells. However, this doesn’t typically suppress the immune system enough to make you more susceptible to infections.
Certain types of chemotherapy have a higher likelihood of causing immunosuppression. If your treatment plan includes chemotherapy and radiation therapy, talk with your doctor about whether you need to take special precautions or have additional lab work to monitor your immune system during treatment.
3. Should I take any supplements or vitamins during treatment?
In most cases, no. Radiation therapy generates molecules called free radicals that kill cancer cells, and oxygen is required in this process. Because many vitamins and supplements include antioxidants, which limit the amount of oxygen in tissue and organs, they could potentially decrease radiation’s effectiveness.
Targeting cancer cells with advanced radiation therapy
Advances in stereotactic radiation therapy and technology are helping the Radiation Oncology team at UT Southwestern's Harold C. Simmons Cancer Center deliver more effective and less invasive treatments to patients. Nina Sanford, M.D., provides a behind-the-scenes look at the life-changing options.
In general, dietary supplements are not regulated by the U.S. Food and Drug Administration. They are not tested for effectiveness or safety in the same way as medications or prescribed treatments. So, we can't fully predict how supplements and vitamins will interact with or reduce the effectiveness of prescribed treatments, including radiation therapy.
A recently published study showed that women with breast cancer who took supplements in addition to treatment had higher risk of their cancer coming back. I also published a study in 2019 showing that nearly a third of patients with cancer who were using complementary and alternative therapies such as dietary supplements did not discuss it with their doctors.
No matter how beneficial a supplement might seem, it’s important to let your provider know about it, so we can best advise you on weighing potential risks and benefits.
4. Will radiation change the way I look?
This depends on where you are getting treated. For radiation treatments aimed at the skin or shallow areas, mild, temporary skin reactions are common, affecting up to 85% of patients, and typically resolve within a couple of weeks. If you are worried about this, talk with your doctor about ointments or salves that can minimize risk.
Most patients don’t need to worry about long-term dermatological issues after radiation treatment, but we generally advise them to use good sun protection and to keep their skin moisturized to minimize risk.
Unlike some types of chemotherapy, radiation is unlikely to cause hair loss unless the radiated area includes your brain or scalp.
Typically, high-dose radiation therapies – such as stereotactic ablative radiotherapy (SAbR) and stereotactic body radiation therapy (SBRT) – are targeted to minimize damage to healthy surrounding tissue and limit side effects, including cosmetic changes.
Related reading: How we’re using high-dose radiation therapy to treat kidney cancer
5. Can I continue to work and exercise during treatment?
Your ability to continue to work will depend on your specific treatment, your overall health, and whether you’re also receiving other cancer treatments, but most patients who are working when they begin radiation are able to continue working during much of their treatment.
The same is generally true of exercise and staying active – in fact, we encourage our patients to stay active and continue to exercise (within their abilities) during treatment.
Related reading: Introducing a new, faster treatment for early-stage breast cancer
Emerging radiation advancements at UT Southwestern
At UT Southwestern’s Radiation Oncology Clinics, we’ve pioneered hypofractionated radiation therapy which delivers high doses of radiation in fewer treatments to more targeted areas. This is also called Stereotactic Ablative Radiation Therapy (SAbR).
Robert Timmerman, M.D., spearheaded the use of SAbR with SBRT for early stage lung cancer at UT Southwestern. Now we’re working to apply the treatment to nearly every location in the body where cancer can grow, including previously difficult-to-reach areas such as the head and neck or gastrointestinal tract.
SAbR or SBRT offer two major benefits for patients:
- Convenience: Instead of coming to appointments every day for six or seven weeks, patients come three to five times total, which is more convenient and cost-effective.
- Smaller treatment zones: Advanced targeting technology allows us to deliver higher doses to smaller areas with the goal of improving treatment effectiveness and reducing damage to healthy tissue.
Related reading: Radiation Reimagined
Additionally, we’re pioneering strategies to combine radiation therapy with immunotherapy, which is geared toward revving up the patient’s own immune system to fight the cancer, and further improve clinical responses.
The questions we've noted are only a small sample of queries patients typically have. Ask your doctor anytime you're unsure or want more information. Remember, there are no foolish questions, and we're happy to give you the resources you need to make the best choices regarding your cancer care.
Get to know Dr. Nina Sanford
Inspired by her mother, who was a primary care physician, Nina Sanford, M.D., has created a career path that includes treating cancer patients as a radiation oncologist, and also doing research that can help the next generation of physicians and patients.