Frequently Asked Questions

Why is Radiotherapy Used in Conjunction With Other Treatments?

Once a cancer diagnosis has been made you may be referred for a radiation oncology opinion. Best cancer outcomes occur where patient care plans are determined through discussions between multi-disciplinary cancer medical specialists. For example, if you have breast cancer, you are likely to have breast cancer surgery to remove the tumour, radiotherapy to destroy any remaining cancer cells and possibly receive chemotherapy or hormone therapy to destroy cancer cells that may have travelled to other parts of the body.

How Does Radiotherapy Work?

Radiotherapy is the use of radiation to safely and effectively treat cancer and other diseases. It may be used to cure cancer, control the growth of the cancer or relieve symptoms caused by cancer such as pain. Radiotherapy works by damaging cells. Normal cells are able to repair themselves, whereas cancer cells are less capable of repair; this repair differential in itself provides a biological advantage which is used in planning radiotherapy treatments for different cancer types. To best harness this biological advantage radiotherapy is delivered usually in daily intervals, (Monday to Friday) called fractions. This allows time between daily treatments for the healthy cells to repair much of the radiation effect, while cancer cells are not as likely to survive the changes.

Radiation Oncologists optimise the radiation dose to treat the cancer using a tumoricidal dose , while simultaneously avoiding healthy organs and tissues surrounding the cancer. Sometimes radiotherapy is the only treatment a patient needs, at other times, it forms one part of a patient's multifaceted treatment regimen. For example, prostate and larynx cancers are often treated with radiotherapy alone, whereas a breast cancer may be treated with surgery, radiotherapy and chemotherapy. Radiotherapy can increase the effectiveness of other treatments. For example, you can be treated with radiotherapy before surgery to help shrink a cancer and allow less extensive surgery than would otherwise have been needed. Or, you may be treated with radiation after surgery to destroy small amounts of microscopic cancer cells that may have been left behind.

Adelaide Radiotherapy Centre treatment discussion

Are There Different Kinds of Radiation Used?

Radiotherapy can be delivered in two ways: externally and internally. During external beam radiotherapy, the radiation oncology team uses a machine called a linear accelerator ( Linac) to direct high-energy X-rays at the cancer. Internal radiotherapy or brachytherapy involves placing radioactive sources (radioactive seeds) inside your body. 

  • EXTERNAL BEAM RADIOTHERAPY
    During external beam radiotherapy radiation is directed using an individualised number of radiation beams through the skin to the cancer and the immediate surrounding area in order to destroy the tumour and any nearby cancer cells.
  • BRACHYTHERAPY
    Brachytherapy involves placing radioactive material into a tumour and its surrounding tissue. At Adelaide Radiotherapy Centre patients referred to our care with prostate cancer may be able to have their treatment delivered using this approach. The radioactive sources used in prostate brachytherapy, come as implantable “seeds”. These are implanted permanently into the prostate gland remaining in the body after the sources are no longer radioactive. Click here to download 'PDF'- 'Treatment options for localised prostate cancer: an introduction to prostate brachytherapy' for Nurses and Patients.

How is Radiation Generated?

The radiation is generated by a machine called a linear accelerator—also known as a linac. The linac is capable of producing high-energy X-rays and electrons for the treatment of your cancer. Using advanced treatment planning software for your treatment plan, we are able to control the size and shape of the radiation beams and direct them at your body to effectively treat your tumour whilst sparing the surrounding normal tissue.

Is Radiotherapy Safe?

Radiation has been used successfully to treat patients for more than 110 years. In that time, many advances have been made to ensure that radiotherapy is both safe and effective. Adelaide Radiotherapy Centre aligns its treatment schedules and practices with current evidence based approaches. Your radiation oncologist will be able to explain the measures taken to ensure a safe reliable radiation dose delivery schedule for your situation.

Will I Become Radioactive After External Beam Radiotherapy?

No. All radiation stays within the treatment room. No radiation is left inside your body after the treatment; you will not be radioactive.

Hair Loss

Temporary or permanent hair loss in the treated areas may occur. Treatment that interferes with the division of cancer cells is also likely to affect hair growth. When deciding about treatment with chemotherapy or radiotherapy there is a trade-off between the potential for cure or control of your cancer and the possibility of side effects including hair loss. Hair will only fall out in the area of the body being treated. For example, if you are having radiotherapy to your head you will probably lose some hair from your scalp. If the area being treated includes an armpit or your chest, then it is only hair in these regions which is likely to fall out.

When you finish radiotherapy your hair will usually grow back but it may not be as thick as before. The time it takes and the way it grows back depends on the dose of radiotherapy you have received and the duration of treatment. Your hair will usually have grown back within six to twelve months of completing your treatment. Occasionally after a large dose of radiotherapy the hair may not recover completely and new growth can be rather patchy. Read more about hair loss.

Will the Radiotherapy Hurt?

No. Radiation therapy is painless. During treatment, you won't see or feel anything and the only thing you will hear is the sound of the treatment machine buzzing.

Will Radiotherapy Burn Me?

After some weeks into your treatment, the skin and other tissues in the body react to the radiation, by becoming irritated and unpleasant. This is not a burn, but the body’s inflammatory response to the radiation, the severity of which is dependent on the area of the body being treated, your general health and wellbeing, any medications or medical treatments you maybe undergoing at the same time and the radiation dose prescribed. The effect radiotherapy has on your skin varies on the area being treated and the dose prescribed by the radiation oncologist. Your radiation oncologist will explain the likely severity of side effects in your case and ensure you are best prepared to manage them if they eventuate. Our nursing staff and radiation therapists are able to give you practical advice on how to manage.

Will I be Sick and Sore From Day One?

Not usually. Radiotherapy has a cumulative effect. As a general rule it will take some time for any side effects to develop. Similarly it takes some weeks after the completion of treatment before they start to subside.

Will Radiotherapy Make Me Sick?

Radiotherapy treatment only causes nausea and vomiting when the stomach or areas of liver, pancreas , sensitive abdominal organs or gastrointestinal tract is being treated. Medications called antiemetics are prescribed in thiese circumstances and are very effective in controlling nausea caused by radiotherapy. The nursing staff can also advise on simple dietary and lifestyle adaptations that can help manage nausea alongside taking prescribed medication.

What is Cancer?

Cancer is known medically as a malignant neoplasm. It represents a broad group of various diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the body through the lymphatic system or bloodstream. Not all tumors are cancerous. Benign tumors do not grow uncontrollably, do not invade neighboring tissues, and do not spread throughout the body. There are over 200 different known cancers that affect humans

Can Radiotherapy be Used to Treat Skin Cancer?

Skin cancers are the most common form of cancer affecting all Australians. Radiotherapy is an effective treatment used to treat superficial skin cancers that are not melanomas.

In some circumstances, following surgery, radiotherapy can be used to reduce the risk of skin cancers, including melanomas, recurring.

Skin cancers that are not melanomas are basal cell carcinomas (BCC), the most common and Squamous cell carcinomas (SCC) the next most common and are generally more aggressive than BCCs as they have a tendency to spread through the bloodstream and lymphatics.

How do Skin Cancers Start?

Exposure to the sun is considered the primary risk factor. A genetic pre-disposition, fair skin and northern European descent are also considered risk factors.

It is important not to neglect skin spots that appear irregular, grow in size, ulcerate or that bleed. You should always check with your local doctor if you are concerned about your skin. If your Doctor is unsure about a spot or skin marking, they can refer you to Specialist Radiation Oncologist or a Dermatologist.

Diagnosis

Clinicians with experience can often tell whether a skin spot is cancerous or not by simply examining it. In order to confirm the diagnosis, your doctor may perform a punch biopsy, which is when a small circle (2 to 5mm) of the superficial skin is cut out under local anaesthetic and sent to a pathologist for microscopic evaluation. If the lesion is not too large, your doctor may perform an excisional biopsy, which is when the whole lesion is cut out.

Treating BCCs and SCCs

BCCs and SCCs can be cured in most instances if treated early.

Surgery is usually the most common form of treatment in younger patients. However, if the lesion is not cut out entirely (close or positive surgical margins) or the risk of it recurring is high because it is aggressive (grade 3) or exhibits invasion of nerve tissue (perineural invasion), then radiotherapy is recommended as well.

Superficial radiotherapy is of benefit also to patients who cannot have surgery or patients with very large skin cancers that would otherwise require extensive surgery and grafting or if the cancer is in an awkward position, such as the face, where surgery would be deforming. You can always request an opinion from a Radiation Oncologist.

Radiotherapy for BCCs and SCCs

Superficial radiotherapy provides excellent cure rates for superficial BCCs and SCCs as well as pre-cancerous conditions such as Bowen's disease or sun spots that could turn into cancer.

The outcomes are equal to that of surgery with proven cure rates of 95% and higher, and often the cosmetic result is much better than surgery which may require skin grafts or leave deformities.

Treatment is quick, invisible and pain-free and usually conducted once – twice or up to 5 times per week over 4 to 6 weeks.

The advantage of superficial radiotherapy is that can be used for a number of different patients, who can't have other treatments, such as patients who:

  • Are medically unfit for surgery or too frail for a general anaesthetic.
  • Have multiple or widespread skin cancers, which would require major reconstructive surgery involving skin grafting.
  • Have reasons why they can't have surgery, including medications such as warfarin, which thins the blood, making surgery dangerous.
  • Require treatments to difficult areas, such as the head and neck region, where the risks of incomplete excision, damage to normal, important structures and poor cosmetic outcomes are extremely high.
  • Are at a very high risk of recurrence of the cancer following surgery alone, with risk factors for recurrence such as incomplete excision, tumours that are poorly differentiated (grade 3) or that invade nerve tissue (perineural invasion).

Who are the Members of the Radiotherapy Team?

  • Radiation Oncologists
    Radiation oncologists are the doctors who will oversee your radiotherapy treatments. These oncologists will work with you and the other members of the radiotherapy team to develop and prescribe a personalised treatment plan. Your radiation oncologist will also track your progress through weekly face to face review sessions where they assess your progress, manage any treatment or disease side effects, and will adjust the treatment as necessary to make sure you receive the best care possible. Radiation oncologists assisted by the nursing staff will help identify and treat any side effects that may occur due to radiotherapy. They also work very closely with other cancer doctors, including medical oncologists and surgeons, and all members of the radiotherapy team.

  • Radiation Therapists
    Radiation therapists are allied health care professionals who work with radiation oncologists to plan and deliver daily radiotherapy. The therapists are responsible for both the calculation and delivery of each patient’s personal radiotherapy dose prescription, calculated precisely to ensure the tumour gets the planned targeted radiotherapy dose. Using dedicated computers and sophisticated treatment planning software, therapists develop a treatment plan under the guidance of the radiation oncologist that aims to best destroy the tumour while sparing the healthy tissue.

  • Medical Physicists
    Radiation Oncology medical physicists are specially trained hospital clinical scientists who work directly with the radiation therapists and radiation oncologists during treatment planning and delivery.They assist in ensuring that complex treatments are properly tailored for each patient. Medical physicists develop and direct quality control programs for the radiotherapy equipment and procedures. They also enable comprehensive quality assurance programs to best ensure all equipment works precisely and reliably

  • Radiation Oncology Nurses
    Radiation oncology nurses are registered nurses who work with every member of the treatment team to care for you and your family before, during and after treatment. They will explain the possible side-effects you may experience and will describe how you can manage them. They will assess how you are doing throughout treatment and will help you cope with the changes you are experiencing. The nurses are wonderful advocates for you and your family and are available on site Monday to Friday for any questions you may have.

  • Reception and Administration Staff
    Reception and administration staff greet all patients and their families/friends when they first come to the centre. They assist in helping to streamline your initial and subsequent appointments through liaisons with your referring doctors and other specialists’ rooms like pathology and radiology providers. They are also responsible for notifying the clinical staff when you have arrived for your daily treatment, and are responsible for all enquiries regarding Medicare and your accounts. Our friendly administration staff are happy to answer any concerns and direct your enquires to the right people.

Follow us on Facebook

Genesis Logo Small.pngGenesisCare is Australia’s leading provider of radiation oncology, cardiology and sleep treatments. We exist to fill the treatment gap for the biggest disease burdens in Australia - cancer and heart care - in an environment of substantial unmet demand from an ageing population. Click here to learn more