Radiation Therapy FAQ and Patient Stories

Radiation therapy, also known as radiotherapy, uses high doses of radiation to destroy cancer cells and to shrink tumors.

Below, find answers to popular radiation therapy questions and experiences of radiation therapy shared by The Patient Story community.

How does radiation therapy work?

Radiation therapy in high doses destroys or slows down the growth of cancer cells through damaging the cells’ DNA. When the DNA is damaged enough, the cells will stop dividing and die. The body then breaks down and removes those damaged cells.

This process usually takes days or weeks of radiation therapy treatment before the cancer cells suffer enough damage. They continue to die for weeks, sometimes months, after the radiation therapy ends.

The actual process of radiation is pretty short. For the radiation therapy treatment, most of the appointment is usually spent positioning the body correctly.

Types of radiation therapy

Your medical team will decide what kind of radiation therapy to give you based on multiple factors, including:

• Cancer type
• Tumor size and location
• How close the tumor is to normal cells and tissue
• Other cancer treatments you’ll be undergoing
• General health history
• Age
• Other medical conditions

You can break radiation therapy down into two main types:

• External beam:
  • 3-dimensional conformal radiation therapy (3D-CRT)
  • Intensity-modulated radiation therapy (IMRT)
  • Stereotactic body radiation therapy (SBRT) or stereotactic ablative radiation therapy (SABR)
    
• Internal radiation

External beam radiation therapy (EBRT)

• Commonly treated cancers: Many types
• Process: Most common type of radiation therapy. It’s delivered with machines (linear accelerators) that move around the outside of the body without touching it, which means you should not feel anything or any pain during the treatment.
• Post-therapy: You will be able to be around other people safely after the radiation therapy, as it does not make the patient radioactive.
• Types of EBRT
  • 3-dimensional conformal radiation therapy (3D-CRT): 3D images created by either computed tomography (CT) or magnetic resonance imaging (MRI) provide physicians a better picture of targeting the tumor
  • Intensity-modulated radiation therapy (IMRT): This is similar to the 3D method but with IMRT, the doctor can adjust levels of radiation in each beam. This is meant to help reduce side effects by targeting cancer cells and avoiding normal cells.
  • Stereotactic body radiation therapy (SBRT) or stereotactic ablative radiation therapy (SABR): This treatment is thought to be more powerful in destroying cancer cells. If you get this radiation method, you should get it in five or fever treatments.

Internal radiation (Brachytherapy)

• Commonly treated cancers: Head and neck, breast, cervix, prostate, and eye
• Process: Less common type of radiation therapy, usually done outpatient. The physician will likely put small applicators or catheters directly into the treatment area to target the radiation right at the cancer. This can help limit the radiation exposure to normal cells. You will get anesthesia or sedation during the procedure, so the appointment will take some hours.
• Post-therapy:The radiation source is either solid or liquid and may emit radiation for a while.
• Types:
  • Systemic therapy: Internal radiation therapy that uses a liquid source, allowing treatment to travel in the blood throughout tissues in your body to destroy cancer cells. This can be done through oral pill, IV, or injection. Body fluids like sweat, saliva, and urine will emit radiation for a while.
    • Common types are radioactive iodine pill for thyroid cancer and targeted radionuclide therapy, to treat advanced prostate cancer or gastroenteropancreatic neuroendocrine tumor (GEP-NET).

How does radiation work alongside other treatments?

Radiation therapy is sometimes given alone, but mor often than not, there will be other treatments given before, during, or after the radiation.

• Radiation before surgery: Radiation can shrink the size of the tumors and cancer to improve the chances of success for surgical removal.
• Radiation during surgery: Known as “intraoperative radiation,” this radiation is applied directly to the cancer without having to go through the skin.
• Radiation after surgery: To destroy any cancer cells that might remain.

Hear from a radiation oncologist

Hear from radiation oncologist, Dr. Kenneth Biehl.

Radiation therapy stories and experiences

Here are different experiences with radiation therapy, as told by our TPS community members.

External beam radiation therapy (EBRT)

April D., Metastatic Triple Negative, BRCA1+



Symptoms: Four lumps on the side of the left breast
Treatment: Chemotherapy (carboplatin, paclitaxel doxorubicin, surgery (double mastectomy), radiation (proton therapy), PARP inhibitors
...

Susan S., Recurrent Breast Cancer Diagnosis: Breast Cancer Symptoms: Lump, twisted and caved-in nipple Treatment: Double mastectomy, radiation, lumpectomy, chemo...

Kelly T., Stage 3C, Triple Negative



Symptoms: Swollen lymph nodes on the neck, high white blood count
Treatment: Chemotherapy (doxorubicin, cyclophosphamide, paclitaxel, carboplatin, capecitabine), surgery (nipple-sparing, skin-sparing double mastectomy), radiation, hormone therapy (tamoxifen)
...

Chris W., Stage 4 Mucosal Melanoma Diagnosis: Stage 4 Mucosal Melanoma Symptoms: Sweaty rectum, zit-sized lump in rectum that grew, lump that developed in right-groinTreatment: Surgery, Chemo, Radiation, Immunotherapy, Tumor-infiltrating lymphocytes (TILs)...

Brittney B., Metastatic Breast Cancer Diagnosis: Stage 4 Breast Cancer Symptoms: Lump in the right breast, inverted nippleTreatment: Surgery, chemo, immunotherapy, radiation...

<a href="
thepatientstory.com/patient-stories/ashley-b/"> Ashley B., Stage 2 Brain Cancer Diagnosis: Brain Cancer Symptoms: Grand mal seizureTreatment: Surgery, chemotherapy, radiation...

Michelle C.



Symptoms: Felt like either a UTI or yeast infection
Treatment: Chemotherapy (carboplatin and paclitaxel), surgery (hysterectomy), and radiation
...

Ellen P.



Symptoms: Felt like either a UTI or yeast infection
Treatment: Chemotherapy (carboplatin and paclitaxel), surgery (hysterectomy), and radiation
...

Cynthia J., IDC, Stage 2B Breast Cancer Diagnosis: Stage 2B Breast Cancer Symptoms: Architectural distortion on mammogram Treatment: Double mastectomy, radiation...

Terri Ann D., Recurring Lung Cancer, Stage 1



Initial Symptoms: None; incidental lung nodule finding
Treatment: Lobectomy, stereotactic body radiation therapy (SBRT), wedge resection
...

Christine E., Stage 3 Triple-Positive



Initial Symptom: Lump in left breast
Treatment: Chemotherapy (AC-T), lumpectomy, radiation
...

Amy H., Rectal Cancer, Stage 3B, Lynch Syndrome



Symptoms: Feeling off, abdominal pain, bloating, weight loss, blood in stool, thin stool, massive shift in bathroom habits, exhaustion
Treatment: Radiation, chemotherapy (Xeloda & oxaliplatin), surgery (total proctocolectomy with ileostomy, APR reconstruction, and radical hysterectomy)
...

Tatijane W.



Symptoms: Bone pain in ribs, trouble breathing, fast heart rate, painful lymph nodes in the neck, lump in between breasts
Treatment: Chemotherapy, double CAR T-cell therapy (clinical trial), bone marrow transplant
...

Renée F., Stage 2 Metastatic



Symptoms: Breast shaped differently, dimple in breast, flat nipple
Treatment: Chemotherapy, mastectomy
...

Renée F.



Symptoms: Bruising
Treatment: Chemotherapy, radiation, allogeneic bone marrow transplant
...

Lainie J., Stage 2 Breast Cancer



Symptoms: Lump in breast
Treatment: Chemotherapy, double mastectomy, radiation
...

Bethany W., Stage 4 Metastatic



Symptoms: Lower back pain
Treatment: Chemotherapy, radiation, maintenance treatment
...

Bethany W., Stage 2, ER+



Symptoms: Lump in breast and armpit
Treatment: Chemotherapy, double mastectomy, radiation
...

Manda M., Relapsed Hodgkin’s, Stage 2B



Symptoms: Loss of menstrual cycles, iron deficiency, itching, night sweats, tiredness, night terrors, trouble breathing, difficulty concentrating, enlarged lymph nodes
Treatment: ABVD chemotherapy, radiation, ICE chemotherapy, bone marrow transplant
...

Dan W., Non-Small Cell, ALK+, Stage 4



1st Symptoms: Cold-like symptoms, shortness of breath, chest pains
Treatment: Radiation, targeted therapy (Alectinib)
...

Pete D., Waldenstrom Macroglobulinemia



1st Symptom: Irregular blood test results during a regular workup for Crohn’s
Treatment: Chemotherapy, surgery, radiation, monthly IVIG
...

Robyn S., Stage 2E Relapsed Diffuse Large B-Cell Lymphoma (DLBCL)



Symptoms: Enlarged lymph nodes
Treatments: Chemotherapy: R-CHOP, R-ICE, intrathecal, BEAM; autologous stem cell transplant, head and neck radiation, CAR T-cell therapy
...

Amy G., Non-Small Cell Squamous, MET, Stage 4



1st symptoms: Lump in neck, fatigued
Treatment: Pembrolizumab (Keytruda), SBRT, cryoablation, Crizotinib (Xalkori)
...

Heidi N., Non-Small Cell, Stage 3A



Cancer details: Non-small cell lung cancer (NSCLC)
1st Symptoms: None, unrelated chest CT scan revealed lung mass & enlarged mediastinal lymph nodes
Treatment: Chemoradiation
...

Terri C., Non-Small Cell, KRAS+, Stage 3A



Cancer details: KRAS-positive, 3 recurrences → NED
1st Symptoms: Respiratory problems
Treatment: Chemo (Cisplatin & Alimta), surgery (lobectomy), chemo, microwave ablation, 15 rounds of SBRT radiation (twice)
...

Stephen H., Non-Small Cell, ALK+, Stage 4 (Metastatic)



Cancer details: ALK+ occurs in 1 out of 25 non-small cell lung cancer patients
1st Symptoms: Shortness of breath, jabbing pain while talking, wheezing at night
Treatment: Targeted therapy (alectinib), stereotactic body radiation therapy (SBRT)
...

Dennis G., Gleason 9 (Contained)



Cancer Details: Staged Gleason score 9
1st Symptoms: Urinating more frequently middle of night, slower urine flow
Treatment: Radical prostatectomy (surgery), salvage radiation, hormone therapy (Lupron)
...

Mara T., Stage 2BX (Bulky)



1st Symptoms: Shortness of breath, back pains, daily migraines
Treatment: 3 rounds of ABVD, 3 rounds AVD, Radiation
Topics: Self-advocacy, mental health
...

Allison R., Colorectal Cancer, Stage 2C



Age at Diagnosis: 32
1st Symptoms: Extreme fatigue, unexplained weight loss, blood in stool, "blockage" feeling after eating
Treatment: Concurrent adjuvant (oral) chemotherapy + radiation, colectomy, oral chemotherapy
...

Kara L., Synovial Sarcoma, Stage 1B



1st Symptoms: Pain behind left knee, needle-like sensation in left foot
Treatment: Surgery to remove what was thought to be benign tumor, chemotherapy, final surgery, radiation (36 sessions)
...

Laura F., Renal Cell Carcinoma (Clear Cell), Stage 4



1st Symptoms: Severe headaches



Treatment: Partial nefrectomy (surgical removal of one kidney), Gamma Knife brain radiation, stereotactic body radiation therapy (SBRT), nivolumab (Opdivo), Avastin, cabozantinib
...

Mikael H., Non-Seminoma, Stage 1



Age at Diagnosis: 32
1st Symptoms: Fatigue, one swollen testicle
Treatment: Surgery (removal and reconstruction), radiation, hormone therapy
...

Demi D., Desmoid Tumor



Cancer details: Rare, <3% of all soft tissue tumors, more common in women
1st Symptoms: fatigue, lump in hip
Treatment: Surgery, radiation, chemo
...

Steve R., Stage 2



Cancer Details: Started at stage 2 and gradually progressed to stage 3, and then to stage 4 with metastasis to lymph nodes
1st Symptoms: Rising PSA score
Treatment: IMRT (radiation therapy), brachytherapy, surgery, and lutetium-177
...

Casey H., Acute Lymphoblastic Leukemia (ALL)




1st symptoms: Lump on throat, extreme fatigue, shortness of breath, bruising easily
Treatment: Chemo, immunotherapy, radiation, stem cell transplant
...

Kayla T., Hodgkin's, Stage 3A



Cancer details: Possibly misdiagnosed the first time; later diagnosed as grey zone lymphoma
1st Symptoms: Pulled muscle in chest
Treatment: ABVD chemo, radiation, high-dose chemo, stem cell transplant
...

Lauren C., Hodgkin's, Stage 2A



Cancer details: Diagnosed at 23 years old with nodular sclerosis, relapsed after 6 months of 1st-line treatment
1st Symptoms: Itchy body, enlarged lymph node over collar bone
Treatment: ABVD chemotherapy and ICE, radiation, and stem cell transplant for relapse
...

Helicon K., Hodgkin's, Stage 2A



Cancer details: Found lymphoma cells in adenoid tissue
1st Symptoms: Difficulty breathing with blockage in nose, surgery to remove tissue resulted in discovery of Hodgkin lymphoma cells
Treatment: ABVD chemotherapy (4 cycles), radiation (20 sessions)
...

Jelena T., Rectal Cancer, Stage 3A



Cancer Details: 7cm mass found
1st Symptoms: Gas changes, rectal bleeding
Treatment: Chemo, radiation, surgery for tumor removal, ileostomy reversal
...

Jackie S., Rectal Adenocarcinoma, Stage 3B, Lynch Syndrome



Cancer Details: Rectal adenocarcinoma; 98% of rectal and colon cancers are adenocarcinomas
1st Symptoms: Blood in stool, constipation
Treatment: Chemo, radiation, surgery, immunotherapy
...

Catherine P., Rectal Cancer, Stage 3



Cancer Details: Rectal adenocarcinoma; 98% of rectal and colon cancers are adenocarcinomas
1st Symptoms: Rectal bleeding, constipation, bloating
Treatment: Fertility treatments, chemo, radiation, tumor resection surgery
...

Brittany W., Squamous Cell, Stage 4B



1st Symptoms: Spotting after sex, eventual significant bleeding at random
Treatment: Chemotherapy (Cisplatin) concurrent with radiation, 6 rounds adjuvant chemo, 2nd round radiation, immunotherapy trial, targeted therapy
...

Marissa, Squamous, Stage 3B



1st Symptoms: Excessive and prolonged vaginal bleeding
Treatment: Chemotherapy (Cisplatin), radiation, brachytherapy
...

Mila L., Squamous, Stage 1B



1st Symptoms: Abnormal lump in cervix area, bleeding after sex
Treatment: Chemotherapy (Cisplatin), radiation, adjuvant chemotherapy (Carboplatin + Paclitaxel
...

Tina C., Ductal & Lobular Carcinoma in Situ, Stage 3A, ER+



Cancer details: Both ductal and lobular, estrogen receptor positive. Different than breast cancer Tina’s mom was diagnosed w/ twice.
1st Symptoms: Sunken in nipple of right breast
Treatment: Double mastectomy, chemotherapy, radiation, hormone therapy
...

Margaret A., IDC & DCIS, Stage 2B



Cancer details: IDC is most common kind of breast cancer. DCIS means cancer has not spread into surrounding breast tissue
1st Symptoms: Pain in left breast, left nipple inverting
Treatment: Double mastectomy, chemo (AC-T), Radiation
...

Alison R., Partially Differentiated DCIS, Stage 4 Metastatic



Cancer details: Triple positive = positive for HER2, estrogen receptor (ER), progesterone receptor (PR)
1st Symptoms: Lump in underarm/breast
Treatment: Chemotherapy, surgery, radiation, targeted therapy
...

Erin C., IDC, Triple Negative, Stage 2B/4 Metastatic



Cancer details: Triple negative doesn’t have any receptors commonly found in breast cancer making it harder to treat
1st Symptoms: Pain in breast
Treatment: Surgery, chemotherapy, radiation
...

Shari S., Stage 4, Metastatic, Triple Positive



Cancer details: Triple positive = positive for HER2, estrogen receptor (ER), progesterone receptor (PR)
1st Symptoms: Lump in breast
Treatment: Surgery, chemotherapy, radiation
...

Renee N., IDC, Stage 3, HER2+



Cancer details: IDC is most common kind of breast cancer.
1st Symptoms: Lump in breast
Treatment: chemotherapy, bilateral mastectomy, radiation
...

Andrea A., IDC, Stage 2B/3, ER+



Cancer details: Found cancer while pregnant
1st Symptoms: Divot in breast
Treatment: Chemotherapy, radiation, surgery
...

Genoa M., Stage 2, HER2-Positive



Cancer details: HER2-positive tends to be more aggressive than HER2-negative cases
1st Symptoms: Nausea
Treatment: Chemotherapy, radiation
...

Doreen D., IDC, Stage 2A, Triple Positive



Cancer details: IDC is most common kind of breast cancer. Triple positive = positive for HER2, estrogen receptor (ER), progesterone receptor (PR)
1st Symptoms: Lump in left breast
Treatment: Neoadjuvant chemotherapy (TCHP), lumpectomy, radiation
...

Monica H., IDC, Stage 2B



Cancer details: IDC is most common kind of breast cancer.
1st Symptoms: Tightness and lump in left breast
Treatment: Chemotherapy, radiation, surgery
...

Caitlin J., IDC, Stage 2B, ER/PR Positive



Cancer Details: ER/PR positive = estrogen and progesterone receptor positive
1st Symptoms: Lump found on breast
Treatment: Lumpectomy, AC/T chemotherapy, radiation, and hormone therapy (Lupron and Anastrozole)
...

Brianna B., Anaplastic Large Cell Lymphoma (ALCL)



1st Symptoms: Infections, inflammation, high fever, swelling, abdominal pain
Treatment: Chemo, radiation
...

Intensity Modulated Radiation Therapy (IMRT)

Heidi N., Non-Small Cell, Stage 3A



Cancer details: Non-small cell lung cancer (NSCLC)
1st Symptoms: None, unrelated chest CT scan revealed lung mass & enlarged mediastinal lymph nodes
Treatment: Chemoradiation
...

Steve R., Stage 2



Cancer Details: Started at stage 2 and gradually progressed to stage 3, and then to stage 4 with metastasis to lymph nodes
1st Symptoms: Rising PSA score
Treatment: IMRT (radiation therapy), brachytherapy, surgery, and lutetium-177
...

Brachytherapy

Steve R., Stage 2



Cancer Details: Started at stage 2 and gradually progressed to stage 3, and then to stage 4 with metastasis to lymph nodes
1st Symptoms: Rising PSA score
Treatment: IMRT (radiation therapy), brachytherapy, surgery, and lutetium-177
...

Marissa, Squamous, Stage 3B



1st Symptoms: Excessive and prolonged vaginal bleeding
Treatment: Chemotherapy (Cisplatin), radiation, brachytherapy
...

Lutetium-177

Steve R., Stage 2



Cancer Details: Started at stage 2 and gradually progressed to stage 3, and then to stage 4 with metastasis to lymph nodes
1st Symptoms: Rising PSA score
Treatment: IMRT (radiation therapy), brachytherapy, surgery, and lutetium-177
...

References:

1. www.cancer.gov/about-cancer/treatment/types/radiation-therapy
2. www.stanfordhealthcare.org/medical-treatments/r/radiation-therapy/about-this-treatment/types.html