Radiation Therapy: What You Need to Know

Radiation Therapy: What You Need to Know

Approximately 50% of cancer patients need radiation treatment. It is important to be informed before this stage of your treatment.  Please see some commonly asked questions and responses from a radiation therapist who has treated hundreds of patients over the past 6 years. 

Please tell us a little about you?

My name is Raizy Streicher, I’ve been a Radiation Therapist for a little over six years now. I have four children and live in Spring Valley, NY.  

How did you choose to become a Radiation Therapist? 

I always planned on pursuing a career in the medical field but was particularly interested in Cancer Care. I volunteered for an organization who helped children diagnosed with cancer and their families cope with this new reality. More specifically, my great grandmother, who is also my namesake was diagnosed with breast cancer at a young age, had undergone radiation therapy and unfortunately died of treatment complications. Upon completion of my bachelor’s in biology, I wanted to work directly with cancer patients and make a difference every day throughout their treatments. I researched multiple cancer care modalities and career opportunities and came across radiation therapy. From the moment I started school I knew I found my calling. Being able to be there for my patient’s day in and day out while working with the latest and greatest technology in cancer care is my passion and I am grateful every day for the career path that I have chosen, but in many ways has chosen me.

What types of cancers are treated with radiation therapy? 

Radiation therapy is used to treat multiple cancers including breast, prostate, lung, upper GI, colon, brain, bone, and many other areas.

What is Radiation Therapy? 

  • Are there different types of radiation therapy? 

There are many types of radiation therapy including EBRT, IORT, BRACHY, PROTON THERAPY, PHOTON THERAPY AND ELECTRON THERAPY.

  • How does external radiation (Proton, Photon, Electron) work and when it is used? 

High energy beams of radiation are targeted directly at the tumor or tumor bed with the goal of destroying tumors and cancerous cells.

  • Is it painful? 

Radiation therapy is not painful but can lead to side effects that can be uncomfortable for patients overall. 

  • How long is the typical treatment?

A typical radiation therapy appointment is about 20-30 min, sometimes more, sometimes less depending on what/ how many areas we are treating.

What are some of the latest advancements in radiation therapy technology?

Align RT is one of the most cutting-edge technologies that I have had the pleasure of working with. It gives you real time information on the patient position in relation to the planning scan that was done on the very first day. This gives therapist the ability to match patient positioning daily and reference them to the original first day scan, while also accurately monitoring patient movement and respiratory motion in real time throughout the treatment. This technology helps reassure the therapist and patient that their radiation is delivered as planned. 

How should someone prepare for their treatment? 

Prior to the radiation therapy treatment, patients will meet with the MD to go over the individual case and decide on a customized treatment plan. During this visit, the MD will explain side effects and what to expect during treatment. A simulation or mapping appointment is then scheduled during which a customized mold or immobilization device is made for the patient to be used for treatment positioning daily. A CT scan is done at this time while the patient is positioned in the device and is used by the doctor and physics to plan the radiation treatment individualized for each patient. Each patient should follow the specific instructions given to them by the nurse or MD to ensure they are prepared for treatment. This may include, eating/ drinking restrictions, skin care routine or full bladder etc… As always, the team is here for support and are available at any time for questions or concerns at any point during this process.

Can a person work during treatment?

If a patient is not taking medications that affect their daily functioning, most patients can drive themselves to treatment and continue to work at a level they feel comfortable with. Patients are given information packets explaining exactly what to expect as far as side effects during treatment and how to manage them. Patients typically see an MD and nurse once a week during their treatment and are monitored by the team from beginning to end in case there is a situation that needs to be addressed.

Can you walk through what a typically treatment day looks like? 

A typical day starts at 6:30am, we run about an hour of QA testing on the machines daily. Once all is clear, we’ll set the room with the specific mold or immobilization device designated for each individual patient. When the patient arrives, they’ll change into a gown and are escorted into the treatment room where they will lay in their device set for them. Using tattoo marks or Align RT, depending on the case, we carefully position the patient to ensure they are perfectly setup for treatment. Once the patient is set and comfortable the therapists leave the room and proceed to take images of the patient position to ensure accurate delivery of treatment. Once the tumor is within target and the patient position is satisfactory to the team, the therapist will beam on and direct the radiation at the planned target. Upon the completion of treatment, the patient is helped down and off the table and escorted back to the changing area. An MD and nurse will see each patient weekly to monitor them and assess any side effects the patient may be experiencing. 

Can you explain some of the potential side effects? 

Radiation therapy is a localized treatment, meaning patients will usually only experience side effects to the area we are treating. For specific side effects and how to manage them, patients are encouraged to speak with their provider who is available before during and after a patient’s treatment has been complete. 

Why is patient positioning so important?

On the very first day a patient comes in for their simulation, a mold or immobilization device is fabricated to ensure the patient is comfortable and can lay still in a tolerable position. A CT scan is performed and is used by the MD and physics staff to plan and specifically target the tumor or area of interest. Radiation is highly localized and is specifically directed to avoid surrounding healthy tissue and organs at risk. Due to the specificity of the treatment plan, reproducibility of the patient position for each and every treatment is extremely important. 

Are there techniques or technologies that can help prevent side effects? 

Align RT is a technology system that tracks patient position and motion in real time, ensuring the highest level of accuracy when directing radiation therapy to a target. A technique often used is DIBH, deep inspiration breath hold, this is particularly useful when treating left sided breast cancer patients. When a patient holds their breath, the chest wall is pushed further away from the heart and lungs, allowing less healthy tissue to be included in the treatment field thus resulting in less long-term side effects to the patient.

Can you tell us about radiation tattoos and marks, when are they used and is it possible to avoid them?

 Tattoos have been given to patients for years to help therapist align and position the patients accurately for treatment. This can be upsetting for patients for several reasons including cosmetic, religious or other concerns the patient may have. Using Align RT has been a game changer for these patients. Due to its accuracy in patient positioning and real time monitoring, tattoos are becoming less and less necessary and is a wonderful option for patients who feel uncomfortable with the idea of getting tattoos.

Do you have some tips for people planning for or going through treatment to help them manage it effectively? 

Learn as much as you can about radiation therapy and the different treatment options, be your own advocate and listen to your body, take the time to rest and take things slow. 

Are there some helpful resources that you recommend to patients?

Some helpful resources a patient can research are:





Information provided by Sharsheret is not a substitute for medical advice or treatment and should not be used to diagnose or treat a health problem.  Always seek the advice of your physician or qualified health provider.


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