Radiation therapy (also called radiotherapy) uses either high-energy x-rays (photons) or protons to shrink tumors and kill cancer cells. Radiation damages cancer cells so that they stop growing and dividing.
Sometimes radiation may be the only treatment your child needs. Or radiation may be used with other treatments, such as surgery and chemotherapy.
Radiation targets cancer, but it may affect nearby healthy tissue and cause side effects. Your care team plans treatments for effectiveness and safety.
Radiation therapy usually treats a small area of the body, such as part of the brain, spine, soft tissue, or bone.
Types of radiation therapy
Radiation therapy can be given in different ways. Types include:
External beam radiation therapy: A machine outside the body sends high-energy beams to an area of the body. Proton beam therapy is a type of external radiation therapy.
Internal radiation therapy: Radiation may be given or placed inside the body. Examples include brachytherapy and MIBG Therapy.
Radiation therapy can have different goals depending on your child’s diagnosis and treatment plan. It may be used to:
Target, shrink, and destroy cancer cells
Make surgery easier or help your child avoid surgery
Prevent cancer from coming back after other treatments
Relieve symptoms such as pain, bleeding, or shortness of breath (called palliative radiation therapy)
Work along with other treatments, like chemotherapy
Before radiation therapy
Consultation
You will meet members of the radiation therapy team. They will explain the treatment process and side effects. They will also answer your questions. It may be helpful to bring someone with you to take notes. If you have more questions after the appointment, you can contact your care team.
Radiation simulation
Radiation simulation is the first step in planning your child's radiation treatment. Your child will have imaging tests done, such as a CT scan or an MRI. This helps your team see where the tumor is (or was) so they know how to position your child for treatment.
The care team will make small marks or tattoos to help position your child for the radiation. They may also make a mask or body mold to help your child lie still in the correct position during treatment.
Treatment planning
The radiation oncologist is the doctor in charge of radiation therapy. They work with the radiation therapy team to develop a treatment plan for your child. The treatment plan will include:
The total amount of radiation your child will get
How often your child will get radiation therapy
Where the radiation will be aimed
Discussing the treatment plan
The radiation oncologist will explain:
How long each session takes
How many treatments are needed (often 5 days a week for 1–7 weeks)
Breaks between treatments
Why staying still is important
What side effects to watch for
A personalized plan for keeping your child safe and comfortable during radiation, which may include:
A child life specialist may help explain radiation therapy to your child in a way they will understand.
What to expect during radiation therapy
Radiation is usually given as an outpatient visit, so your child will not have to stay in the hospital overnight. If anesthesia is needed, your child will have a separate appointment for getting the anesthesia medicine.
Follow your care center’s steps for registration and check-in. During registration you may:
Check in at the registration desk.
Go with a staff member to the treatment room.
Meet the anesthesia team if anesthesia is needed.
Once your child is in the treatment room:
The team will position your child on the table using the marks, mask, or body mold made during simulation. Positioning usually takes longer than the actual radiation treatment.
The therapist will leave the room to start treatment. They can see and talk to your child the whole time.
The radiation therapy machine will line up to target the treatment spot. Your child may see lasers that help with positioning. They will not feel them.
Your child will not feel or see the radiation. It does not hurt. They may hear a noise from the machine.
Tips to prepare for radiation treatments
Arrive on time or a few minutes early for appointments. Being late may mean waiting longer.
If a mask is used during radiation treatment, your child’s hairstyle needs to be the same as it was when the mask was made.
Have your child wear loose, comfortable clothing such as T-shirts with sweatpants, pajama bottoms, or other elastic waist pants.
Care centers have different rules about observing therapy sessions. Some let caregivers watch from a nearby room, or you may need to wait in the waiting area. Siblings usually need to stay in a waiting area with an adult, so plan ahead for their care.
After radiation therapy
If no anesthesia was used, your child can usually return to their usual activities as soon as treatment ends. If anesthesia was used, your child will need time to wake up and recover.
For most types of radiation therapy, there are no restrictions on contact (hugging, touching, caring for a child) after treatment. Your child may return to school and regular activities right after radiation therapy if the care team says it is OK.
If your child gets internal radiation therapy such as MIBG therapy, there will be rules for avoiding close contact with others after treatment. This is especially true for contact with young children and pregnant women. Ask your care team about specific guidelines for your child.
Caring for your child after radiation therapy
Skin care: Skin changes might get worse for 7–10 days after your child’s last radiation treatment. It is important to take good care of the skin during this time.
Eating and drinking: After radiation, your child may not feel as hungry as usual for a few weeks. It is important for your child to eat healthy foods and drink plenty of water. If they have nausea or vomiting, give them their prescribed anti-nausea medicine. Call the care team if the medicine does not help.
Rest and activities: Your child may have low energy for weeks or even months after therapy ends. Their body is working hard to repair itself, so they need plenty of rest.
Follow-up visits
Your child will have regular follow-up visits with the radiation oncologist. This may include diagnostic imaging tests such as CT, PET scans, or MRIs to monitor how well the cancer responds to treatment.
Possible risks of radiation therapy
Radiation therapy can cause side effects, including:
These side effects depend on where the radiation is given. Some can last for weeks or, rarely, months. Most go away with time.
Location
Possible Side Effects
Head/Neck
Fatigue
Hair loss
Nausea and vomiting
Headache
Blurry vision
Mouth changes
Taste changes
Throat changes, such as trouble swallowing
Less active thyroid gland
Chest
Fatigue
Hair loss
Sking changes
Throat changes, such as trouble swallowing
Cough
Shortness of breath
Stomach/Abdomen
Diarrhea
Fatigue
Hair loss
Nausea and vomiting
Sking changes
Urinary and bladder changes
Pelvis/Rectum
Diarrhea
Fatigue
Hair loss
Nausea and vomiting
Sexual problems
Fertility problems
Skin changes
Urinary and bladder changes
Proton beam radiation therapy is a type of radiation therapy using protons as its energy source. This therapy allows doctors to aim high doses of radiation at tumors and minimize damage to nearby healthy cells.
Childhood cancer treatments may impact a patient's fertility. Read about Thanaydi Sandoval's decision to have fertility preservation before starting treatment.
Surface Guided Radiation Therapy (SGRT) uses special cameras and lights to help position your child for radiation treatment. Learn what to expect during SGRT.
