Cancer Treatment: Radiation Therapy

Also Called: Radiotherapy, Irradiation, X-Ray Therapy

What Is Radiation Therapy?

Radiation therapy is a treatment for cancer and some tumors. It works by preventing cancer cells from growing and by destroying them.

The high-energy radiation used comes from:

• X-rays
• gamma rays
• fast-moving tiny particles (called particle or proton therapy)

How Does Radiation Therapy Work?

Two Kinds of Radiation Therapy

External radiation therapy uses an external beam (the radiation source is outside the body). A large machine and special equipment carefully aim the right amount of radiation at cancerous tumors.

With internal radiation therapy, the radiation source is inside the body. Doctors inject or implant a radioactive pellet or seed into the area with the tumor or cancer cells. In some cases, the patient swallows the material.

Some kids may need both external and internal radiation therapy.

Targeting Certain Cells

Besides killing cancer cells and shrinking tumors, radiation therapy also can harm normal cells. Normal cells are more likely to recover from the harmful effects of radiation therapy than cancer cells. The radiation oncologist will carefully check a child's radiation therapy plan and doses before starting treatment to maximize tumor kill and minimize damage to healthy tissue.

What Happens During External Beam Radiation Therapy?

A Little Treatment at a Time

For external beam radiation therapy, kids usually go to the hospital or treatment center four or five days a week for several weeks. They'll get small daily doses (fractions) of radiation therapy, which helps to maximize tumor kill and minimize damage to normal tissues. The weekend breaks help the cells recover from the radiation.

Targeting the Right Spot

Before the treatments begin, the radiation therapist will mark an area on the skin with ink. This "tattoo" helps ensure that the radiation therapy is given precisely to the correct areas.

Most of the time that a child spends on the radiation treatment table involves positioning. The treatment itself takes only minutes. When the child is in the right position, the:

• radiation therapist leaves the room
• machine delivers the right amount of radiation to kill the cancer cells

Parents aren't allowed in the treatment room, but can wait nearby for their child during therapy.

What Happens During Internal Radiation Therapy?

Most children who get internal radiation treatment stay in the hospital for several days. The radioactive material may be given in any of these ways:

• surgically placed into the tumor
• swallowed
• injected into the bloodstream

Doctors might do a minor surgery using anesthesia to place the material (for example, when treatment is in the uterus or esophagus, or in an airway).

Internal radiation therapy is also called brachytherapy, interstitial therapy, or implant therapy.

Can Children Be Around Other People After Getting Radiation?

Parents may wonder whether they can touch, hug, and care for their child during and after therapy.

Kids and teens who get external radiation therapy have no restrictions on contact with family members. 

Those who get internal radiation therapy may have some restrictions. Radiation in the implant can send high-energy rays outside the patient's body. To protect others from exposure, the patient will be in a private room. Healthcare team members enter for short periods and work quickly to provide care. Visiting times might be brief, and young kids, pregnant women, and others might not be allowed into the room.

Does Radiation Therapy Cause Side Effects?

Radiation can damage healthy cells. This damage can cause side effects such as skin problems, tiredness, and anemia. The type of side effects someone might get depends on the dose of radiation, whether it was internal or external, and the area treated.

Many patients have no side effects. When problems do happen:

• Most will go away after radiation therapy ends.
• They usually aren't serious.
• Treatment can help control them.

Radiation therapy can also cause long-term side effects on the normal cells surrounding the tumor. They can include problems with muscles or bone growth, second cancers, infertility, hormone deficiencies, learning issues, vision problems, hearing loss, and other problems.

How Can Parents Help?

It may help for you and your child to take a tour of the radiation department to see the radiation technologists and equipment so your child can get familiar with them.

When your child asks questions about cancer or treatment, be honest. Use age-appropriate terms and encourage your child to share their feelings.

And you don't have to go it alone. The doctors, nurses, social workers, Child Life specialists, and other members of the cancer treatment team are there to help you and your child. Many resources are available to help your family before, during, and after cancer treatment.

You also can find information and support online at:

• CureSearch
• The American Society for Radiation Oncology