About radiotherapy treatment

Radiotherapy or ‘radiation therapy’ is a treatment that uses X-rays to kill cancer cells.

You may not know anything about radiotherapy, and this can make the treatment seem frightening.

Many people say that their fears before radiotherapy were wrong. Once they have treatment, they think they would have felt less afraid if they’d known more from the start.

We explain the different types of radiotherapy, when it might be used, and what to expect during treatment.

When doctors may recommend radiotherapy

Not everyone will need radiotherapy as part of their cancer treatment.

It depends on several factors such as:

• what type of surgery (if any) you have as part of your treatment
• the location of the cancer.

If your treatment plan includes chemotherapy and radiotherapy, you usually have chemotherapy first.

To understand how radiotherapy may be relevant to you, go to:

• Radiotherapy for early breast cancer
• Radiotherapy for metastatic breast cancer
• Radiotherapy for DCIS.

How radiotherapy works

Radiotherapy uses forms of radiation such as X-rays to kill or damage the cancer cells. 

Radiation damages the DNA of the cancer cells, so they can't repair themselves like normal cells. This does not happen immediately. The process starts days or weeks after your first treatment. It continues for weeks or months after you finish all radiotherapy treatment.

Your body naturally breaks down and removes the cells when they die.  

Radiotherapy treats one area at a time and is given externally, with a beam of radiation.

Radiotherapy is a ‘localised’ treatment. This means it only treats the area of the body it is aimed at. You may still have some side effects.

Planning your radiotherapy treatment

A lot of planning is involved with radiotherapy. Doctors will customise the treatment for you.

Meet your radiation oncologist

If your treating team is thinking about radiotherapy, they will refer you to a radiation oncologist.

You will meet with the radiation oncologist to plan your treatment. At the planning appointment, they will talk about:

• why your treating team has recommended radiotherapy
• how they will plan and deliver the treatment
• when radiotherapy will happen, around any other treatment
• the possible side effects and how to reduce them
• the cost of treatment.

This is a good time to ask the radiation oncologist any questions that you have.

CT scans before radiotherapy

You may have a CT scan during the planning visit. This is to work out which areas the radiotherapy needs to target.

The therapist puts small marks on your skin to make sure you’re in the right position for each treatment.

These marks may be temporary or more permanent tattoos. Some centres now do radiotherapy without tattoos.

Timing of radiotherapy treatments

Radiotherapy usually begins within a few weeks of your planning visit.

You usually have radiotherapy every day for 3 to 6 weeks (except weekends and public holidays).

The timing of your radiotherapy depends on:

• when services are available
• how quickly you recover from surgery, if you had it
• what other treatments you are having (radiotherapy usually happens after chemotherapy).

Shorter treatment: hypofractionated radiotherapy

Standard radiotherapy is delivered in smaller doses over several weeks. Some people can have higher doses of radiation in a shorter time period, such as 3 weeks, or even 5 days. This is called ‘hypofractionated radiotherapy’.

There are fewer treatments, with the advantages of:

• less travel time
• less time off work
• less interruption to your life
• less cost.

It is just as effective as standard radiotherapy for reducing the risk of cancer coming back.

Ask your radiation oncologist if the shorter option is possible for you.

What to expect in a treatment

Each treatment takes only a few minutes, but you may have to wait for a radiotherapy machine.

You also need time to change into a gown, so you could be at the hospital for up to an hour each day.

The treatment doesn't make any noise, and you won't feel anything. 

Some hospitals have special parking or cheaper fees for people having daily radiotherapy. Before your first visit, ask if they provide free or reduced-fee parking.

‘Deep inspiration breath hold’ radiotherapy

Deep inspiration breath hold (DIBH) radiotherapy is designed to reduce radiation to the heart. DIBH requires special technology so not all radiation centres offer it.

This technique is most often used when the cancer is in the left breast.

During the treatment, you take a deep breath in and hold it for about 20 seconds. Then the machine delivers the radiation.

By taking a deep breath in, your lungs fill with air and your heart moves away from your chest.

Ask your radiation oncologist if this technique is available for you. 

Radiotherapy in rural and remote areas

Not all hospitals have radiotherapy departments. It is usually available in hospitals or specialised clinics in capital cities or major regional towns.

Some people need to spend up to 6 weeks away from home to have radiotherapy. If you need to travel long distances or pay for accommodation, financial help may be available.

Find out about financial and practical help at Support in rural and regional Australia.