Radiation Oncology FAQs

If you have any other questions that aren’t answered here, please ask our radiation oncologist or anyone on our staff.  You may find it helpful to keep a journal of questions.  Our goal is to help you and your child to feel informed about and comfortable with the treatment plan at all times.

What is Radiation Therapy?

Radiation therapy involves the use of photons (or X-rays), electrons, or radioactive sources to destroy cancer cells.  Although radiation therapy may be given in several different ways, external beam radiation from a linear accelerator machine is used most often in cancers of childhood.

When is Radiation Therapy Used?

Radiation therapy is useful in a variety of situations, including:

• Before surgery, with or without chemotherapy, to shrink a tumor and make it easier and safer to remove
• After surgery to eliminate residual cancer cells
• Alone or together with chemotherapy to destroy a tumor without surgery
• To relieve symptoms of a tumor and make a child feel more comfortable
• To eliminate both cancerous and normal bone marrow cells throughout the body, in preparation for bone marrow or stem cell transplantation
• To prevent abnormal growth of connective tissues
• To destroy leukemia cells present in the lining of the brain or testes, where most chemotherapy can’t penetrate

How Does Radiation Therapy Work?

Radiation (either photons or X-rays or electrons) travels from the linear accelerator machine to the part of your child's body that needs treatment.  As with diagnostic X-rays, our radiation cannot be seen or felt and does not hurt.

• Radiation works by damaging cells, much like chemotherapy
• Unlike chemotherapy, radiation therapy's affects are localized, only affecting the tumor and normal cells that are within the part of the body covered by the radiation beams
• The radiation treatment course is divided into multiple small doses given once daily to allow the patient’s healthy cells to repair the damage between doses

Who is on the Radiation Oncology Team?

• Our physicians are board-certified in radiation therapy with special expertise in treating children
• Also involved in planning treatments for your child is the radiation physicist, a scientist who is board-certified in medical physics, with a specialty in radiation oncology physics
• Another team member is the radiation dosimetrist, who is trained to measure and generate the radiation dose distributions and calculations, under supervision of the radiation physicist and radiation oncologist
• Daily radiation treatments are administered by radiation therapists under the supervision of the radiation oncologist
• Radiation therapists have specialty training in all aspects of radiation therapy treatments
• The therapists follow the orders of the physician and the approved  treatment plan of the physicist

Other team members include a social worker, child life specialist, psychologist and language interpreter.

How Will You Prepare My Child for Radiation Therapy?

You and your child will meet with the pediatric radiation oncologist, who will explain and answer all your questions about the recommended course of treatment, anticipated results, potential side effects, and the alternatives to radiation therapy. At that time, you also may be introduced to other members of the Radiation Oncology team.

• Before any radiation treatments are given, most patients come in for one or two preparatory sessions in the Simulation Room
• During these sessions, we custom make the positioning devices and molds to help ensure that your child will be lying down in the same position each day for radiation therapy and that he/she will not move from the correct position while therapy is being delivered

Are Other Tests Done in Preparation for Radiation Therapy?

A CT scan and/or fluoroscopic X-rays may then be done with your child in the positioning or immobilization devices to define the location of the tumor and all the normal tissues in that part of the body.  The radiation oncologist, physicist and dosimetrist then use our treatment planning computer systems to design the optimal set of radiation beam sizes, shapes, and entry angles to destroy the tumor with minimal side effects.

• During the simulation procedure, we will make ink marks on your child's skin to indicate the proper position he/she should lie in during radiation treatments. 
• We may place transparent tape over some of these marks
• The tape and marks must remain on your child's skin throughout the entire course of radiation therapy
• When the treatment course is complete, we will be able to peel off the tape and wash off the ink marks
• There will be no permanent marks left on your child's skin

How is Radiation Therapy Given?

Most children receive one radiation treatment every weekday, Monday through Friday, over a period of one to seven weeks. 

• The number of weeks depends primarily on the type of tumor your child has and the objective of the treatment. Most treatments take 30 minutes or less each day. 
• Your child will have a specific appointment each day
• We try not to keep patients waiting past their appointment time
• The pediatric radiation oncologist is available in the clinic every day to evaluate your child's progress and answer your questions

What if My Child isn’t Cooperative for Radiation Therapy?

We understand that radiation treatments may cause anxiety for anyone, particularly children. We have created a child-friendly environment, which has been designed to help minimize our patients' anxieties. We work only with children, and will be with your child to comfort him/her at all times, except when the radiation beam is on. At that time, federal regulations require that we step out of the treatment room. However, we will be able to talk to and see your child even when the radiation beam is on.

• Some children, especially those under five years old, require sedation to remain calm and still during treatments
• We’ve found that it’s often best to give the sedation medicine intravenously
• We have an anesthesiologist and certified sedation nurses present daily to administer intravenous sedation safely, a special feature of our clinic
• Children generally wake up about half an hour after their radiation treatment and are able to eat and engage in their usual activities the rest of the day

What Can I Do to Help Prepare My Child for Radiation Therapy?

If your child has a favorite CD or digital media player, please bring it during your session. He or she may listen to it throughout the treatment procedure. You also may want to bring a favorite book or toy with you. We have children’s books, games, toys, videos and stuffed animals in our waiting area.

What are the Side Effects of Radiation Therapy?

We make special efforts to minimize the radiation dose that the normal tissues in the vicinity of your child's tumor receive, however, they will be exposed to some radiation. The potential side effects depend on your child's age, the area of his/her body that is receiving radiation, the radiation dose and whether your child also is receiving or has received chemotherapy. The pediatric radiation oncologist, therapists, and nurses will monitor your child closely during and after his/her radiation therapy course and recommend medications and strategies to prevent and manage side effects.

Is Radiation Therapy Dangerous to Others?

No, radiation therapy is not dangerous to others.

• Your child will not become radioactive or have any radioactivity in him/her when they are outside the radiation treatment room
• You don’t need to take any special precautions for handling his/her clothing, dressings or diapers
• Your child will not give radiation to anyone else and will not be a hazard to pregnant women, children or other living things