What to Expect When Having Radiation Therapy

Approved by the Cancer.Net Editorial Board, 06/2022

It is normal to feel worried or even overwhelmed when you learn that you will need radiation therapy. However, learning more about this type of cancer treatment may help you feel more prepared and comfortable.

This article will help you prepare for your first treatment. It will cover who is on your radiation therapy team and what will happen before, during, and after your radiation therapy treatment. Learn more about the basics of radiation therapy and the side effects of radiation therapy.

Who is on my radiation therapy team?

A highly trained medical team specialized in giving radiation therapy will work together to provide you with the best possible care. This team may include the following professionals:

Radiation oncologist. This type of doctor specializes in giving radiation therapy to treat cancer. A radiation oncologist oversees radiation therapy treatments. They work closely with other team members to develop the treatment plan.

Radiation oncology advanced practitioners. Nurse practitioners and physician assistants are also called advanced practitioners. This type of provider meets with patients and will collaborate with the radiation oncology team, including a supervising radiation oncologist.

Radiation oncology nurse. This type of nurse specializes in caring for people receiving radiation therapy. A radiation oncology nurse plays many roles in your treatment, including:

  • Answering questions about treatment

  • Monitoring your health during treatment

  • Helping you manage side effects of treatment

Medical radiation physicist. This professional helps design treatment plans. They are experts at using radiation equipment.

Dosimetrist. The dosimetrist helps your radiation oncologist calculate the right dose of radiation.

Radiation therapist or radiation therapy technologist. This professional operates the treatment machines and gives people their scheduled treatments.

Other health care professionals. Additional team members may help care for physical, emotional, and social needs during radiation therapy. These professionals include:

  • Social workers

  • Dietitian nutritionists

  • Rehabilitation therapists, such as physical therapists or speech therapists

  • Dentists

Learn more about the oncology team.

What happens before radiation therapy treatment?

Each treatment plan is created to meet a patient's individual needs, but there are some general steps. You can expect these steps before beginning treatment:

Meeting with your radiation oncologist. During this meeting, the doctor will review your medical records, perform a physical exam, and recommend tests. You will also learn about the potential risks and benefits of radiation therapy. This is a great time to ask any questions or share concerns you may have.

Informed consent. If you and your doctor decide that radiation therapy is the best treatment option for you, your health care team will ask you to sign an "informed consent" form. Signing this legal document means:

  • Your health care team gave you information about your treatment options

  • You chose to have radiation therapy

  • You give permission for the health care professionals to deliver the treatment

  • You understand the treatment is not guaranteed to give the intended results

Simulating and planning treatment. Your first radiation therapy session is called a simulation. This means it is a practice run without giving radiation therapy. Your team will use imaging scans to confirm the tumor location. These may include:

Depending on the area of your body being treated, you may receive a small mark(s) on your skin. This will help your team aim the radiation beam at the tumor.

Sometimes, you may need an immobilization device. This device will help you stay in the same position during each radiation therapy session. Immobilization devices can include:

  • Tape

  • Foam sponges

  • Headrests

  • Molds

  • Plaster casts

For radiation therapy to the head or neck, you may receive a thermoplastic mask. This is a mesh mask that is molded to your face and secured to the table. It gently holds your head in place during each session. Ask your health care team how your mask will be made and what to expect during that process.

It is important for your body to be in the same position for each treatment and for you to be as comfortable as possible during your treatments. Your radiation oncology team cares about your comfort. Talk with the team to find a comfortable position that you can be in every time you come in for radiation therapy. Tell them if you experience any anxiety lying still in an immobilization device. To help you relax, your health care team may offer relaxation techniques and/or your doctor can prescribe medication.

After the simulation run-through at your first session, your radiation therapy team will review your information and finalize your radiation therapy treatment plan. Computer software helps the team develop the plan.

What happens during external-beam radiation therapy?

What happens during your radiation therapy treatment depends on the kind of radiation therapy you receive. External-beam radiation therapy delivers radiation from a machine outside the body. It is the most common radiation therapy treatment for cancer.

Each session is generally quick, lasting about 15 minutes. Radiation does not hurt, sting, or burn when it enters the body. You will hear clicking or buzzing throughout the treatment and there may be a smell from the machine.

Typically, people have treatment sessions 5 times per week, Monday through Friday. This schedule usually continues for 3 to 9 weeks, depending on your personal treatment plan.

This type of radiation therapy only targets the tumor. But it will affect some healthy tissue surrounding the tumor. While most people feel no pain when each treatment is being delivered, effects of treatment slowly build up over time and may include discomfort, skin changes, or other side effects, depending on where in the body treatment is being delivered. The 2-day break in treatment each week allows your body some time to repair this damage. Some of the effects may not go away until after the treatment period is complete. Let your health care team know if you are experiencing any side effects so they can help relieve them. Read more about the side effects of radiation therapy.

What happens during internal radiation therapy?

Internal radiation therapy is also called brachytherapy. This includes both temporary and permanent placement of radioactive sources at the site of the tumor.

Typically with this treatment approach, you will have repeated treatments across a number of days and weeks. These treatments may require a brief hospital stay. You may need anesthesia to block the awareness of pain while the radioactive sources are placed in the body. Most people feel little to no discomfort during this treatment. But some may experience weakness or nausea from the anesthesia.

You will need to take precautions to protect others from radiation exposure. Your radiation therapy team will provide these instructions. The need for such precautions ends when:

  • The permanent implant loses its radioactivity

  • The temporary implant is removed.

What else do I need to know about radiation therapy treatment appointments?

During your treatment period, your radiation oncologist will check how well radiation therapy is working. Typically, this will happen at least once a week. If needed, they may adjust your treatment plan.

While being treated, many people experience fatigue and sensitive skin at the site of radiation therapy. You may also experience emotional distress during radiation therapy. It is important to rest and take care of yourself during radiation therapy. Consider these ways to take care of yourself:

What happens after radiation therapy treatment ends?

Once your treatment plan is completed, you will have follow-up appointments with the radiation oncologist. It's important to continue your follow-up care. Your health care team will want to check on your recovery and watch for treatment-related side effects, which may not happen right away.

As your body heals, you will need fewer follow-up visits. Ask your doctor for a written record of your treatment. This is a helpful resource as you manage your long-term health care.

Questions to ask the health care team

Consider asking the health care team these questions about your radiation therapy appointments:

  • Who is creating my radiation therapy treatment plan? How often will the plan be reviewed?

  • Which health care professionals will I see at every treatment session?

  • Can you describe what my first session, or simulation, will be like?

  • Will I need any tests or scans before treatment begins?

  • Will my skin be marked as part of treatment planning?

  • Will I need an immobilization device during radiation therapy? If so, can you describe that to me?

  • Who can I talk with if I'm feeling anxious or upset about having this type of treatment?

  • How long will each treatment session take? How often will I have radiation therapy?

  • Can I bring someone with me to each session?

  • Are there special services for patients receiving daily radiation therapy, such as certain parking spaces or parking rates?

  • Who should I talk with about any side effects I experience?

  • Which lotions do you recommend for skin-related side effects? When should I apply it?

  • How else can I take care of myself during the treatment period?

  • Will special precautions be needed to protect my family and others from radiation exposure during my treatment period?

  • What will my follow-up care schedule be?

Related Resources

Understanding Radiation Therapy

Side Effects of Radiation Therapy

ASCO Cancer Treatment and Survivorship Care Plans

More Information

RTAnswers.org: What to Expect

ASCO answers; Radiation TherapyDownload ASCO's free Radiation Therapy fact sheet. This 1-page printable PDF gives an introduction to radiation therapy, including an overview of the different types of radiation, what to expect during treatment, possible side effects, terms to know, and questions to ask the health care team. Order printed copies of this fact sheet from the ASCO Store.