Frequently Asked Questions

Around 50% of cancer patients receive some type of radiation therapy (also known as radiotherapy) during their cancer treatment. Radiation can be used on its own or in combination with chemotherapy, surgery, or hormone therapy. It is completely painless and is usually given once a day for between one day and eight weeks.

How does cancer radiation work?

Normal cells grow and divide to form new cells. Cancer cells grow and divide faster than most normal cells. Radiation works by making small breaks in the DNA inside cells as they are dividing. This makes cancer cells a lot more vulnerable to radiation than normal cells, as they divide more often. These breaks in the DNA keep cancer cells from growing and dividing, causing them to die.

The goal of radiation therapy is to destroy cancer cells and/or slow tumor growth without harming nearby healthy tissue.

What are the types of radiation?

The most common type of radiation is called external-beam radiation therapy, which is given from a machine located outside the body. Words you may hear to describe your treatment include proton therapy, 3-dimensional conformal radiation therapy (3D-CRT), intensity-modulated radiation therapy (IMRT), and stereotactic radiation therapy (SRS or SBRT). Radiation can also be given using implants – this is called internal radiation therapy or brachytherapy.

When is radiation used?

Your doctor may recommend external beam radiation for prostate cancer as an option at different times during your cancer treatment and for different reasons, including:

• As the only (primary) treatment for cancer, usually for early-stage cancer that is confined to your prostate
• In combination with other treatments, such as hormone therapy, cancer that’s still confined to your prostate
• After surgery, to reduce the risk of cancer returning (adjuvant therapy)
• After surgery, when there is indication that your cancer has recurred either in the form of increased levels of prostate-specific antigen (PSA) in your blood or signs of cancer in your pelvis
• To alleviate symptoms, such as bone pain, caused by advanced cancer that has spread beyond the prostate

Who delivers radiation therapy treatments?

• Radiation oncologist: This doctor is specially trained to treat cancer with radiation. This person oversees your radiation treatment plan.
• Dosimetrist: This person plans where the radiation beams go to ensure your radiation is delivered effectively and safely.
• Radiation therapist or radiation therapy technologist:This person operates the radiation equipment and positions you for each treatment.
• Radiation physicist: This is a person who makes sure the radiation equipment is working as it should and that it gives you the exact dose prescribed by your radiation oncologist.
• Radiation therapy nurse: This nurse has special training in cancer treatment and can give you information about radiation and managing side effects.

How long is radiation treatment?

Treatment is usually given once a day for between one day and eight weeks. Treatments typically take less than 1 hour. This depends on your individual treatment plan. Most of the time in the treatment room will be spent making sure you are in the correct position for treatment. The beam-on time is usually less than a minute each visit. You will most likely have radiation delivered from multiple different machine angles. Many clinics now use AlignRT to assist them in ensuring you are in the right position.

What is hypofractionation?

Hypofractionation is an advanced treatment technique that is becoming a standard of care for lung, breast, and prostate cancer patients. Using hypofractionation, or hypofractionated radiation therapy, higher doses of radiation are delivered over a shorter timeframe, so patients can complete their course of radiation therapy much faster than conventional treatments.

Some patients are eligible for extreme hypofractionation or SBRT (stereotactic body radiation therapy), which, when appropriate, can shave weeks off the traditional treatment length. Because each cancer type requires a different approach, each patient’s treatment plan is customized to their unique needs and treatment goals.

Why is it important to have an empty rectum and full bladder?

Your bladder and rectum are very close to your prostate, so they can change the position of your prostate. By keeping these organs the same size for your setup and planning appointment and daily radiation treatments, your radiation therapy will be more accurate. This will also help to reduce some of the side effects from your radiation therapy.

How do I need to prepare for treatment?

Most hospital protocols require an empty rectum and comfortably full bladder for treatment. Your individual cancer center will inform you of the exact protocol as these vary depending on the treatment plan and equipment used.

What are the potential radiation side effects?

The side effects of prostate radiation therapy will vary based on your recommended treatment and your overall health. Side effects may include fatigue, urinary changes, and possible sexual dysfunction. These often begin during the second or third week of treatment. Most side effects will be temporary but be sure to let your doctor know about any issues. To learn more.