8. What I need to Ask: Radiotherapy

Radiation therapy, also called radiotherapy, is often used in conjunction with surgery and chemotherapy to treat cancers of the rectum and colon.

The primary treatment for bowel cancer is surgery.  However, your doctor may also recommend radiation therapy and/or chemotherapy depending on the location and stage of the cancer.

For some rectal cancers, radiation therapy is given with chemotherapy to make the tumour smaller so it can be removed more easily during surgery.  Other times, radiation is given at surgery to keep the cancer from returning.

Radiation therapy is the careful use of radiation to treat cancer safely and effectively.  Radiation oncologists use radiation therapy to try to cure cancer, control cancer growth or relieve symptoms, such as pain.

Radiation therapy works within cancer cells by damaging their ability to multiply.  When these cells die, the body naturally eliminates them.  Healthy cells are also affected by radiation, but they can repair themselves in ways cancer cells cannot.

The following list of questions may assist you with your discussions with your radiation oncologist should you be a candidate for radiotherapy.
 


Questions to ask before radiotherapy

  • What type and stage of bowel cancer do I have?
  • What is the purpose of radiation treatment for my type of bowel cancer?
  • What areas of my body will be treated with radiation?
  • How will the radiation therapy be given?  Will it be external beam or brachytherapy (the placement of radioactive sources in or just next to a tumour)?  What do the treatments feel like?
  • Can you explain the terms 3D-CRT (3 dimensional conformal radiation therapy), IMRT (intensity modulated radiation therapy), IGRT (image guided radiation therapy) and indicate which of these technical terms would apply to me?
  • Can you explain the term SIRT (Selective Internal Radiation Therapy) and indicate if this treatment option is available to me?
  • If so, can SIRT be given in conjunction with chemotherapy?
  • For how many weeks will I receive radiation?  How many treatments will I receive per week?
  • What are the chances that radiation therapy will work?
  • Can I participate in a clinical trial?  If so, what is the trial testing?  What are my benefits and risks?
  • What is the chance that the cancer will spread or come back if I do not have radiation therapy?
  • How will I feel after the treatments?
  • Will I be able to work?
  • Will I be able to take care of my spouse and children?
  • Will I be able to drive my car?
  • What are the side effects of radiation?
  • Is there anything I can do to lessen the side effects?
  • Can I eat or drink anything I want during the weeks I have radiation?
  • Can I drink alcohol?
  • Will I need chemotherapy, surgery, or any other treatments in conjunction with radiotherapy?  If so, in what order will I receive these treatments?
  • How soon after radiation therapy can I start receiving other treatments?  Can I receive several treatments at the same time?
  • What are some of the support groups I can turn to during treatment?
  • If I have questions after I leave here, who can I call?  Telephone numbers to call?
  • Will radiation therapy affect my ability to have children?
  • What is the cost of radiotherapy?  Is it covered by Medicare?

 


Questions to ask during radiotherapy

  • How can I expect to feel during treatment and in the weeks following radiation therapy?
  • Can I drive myself to and from the treatment facility?
  • Will I be able to continue my normal activities?
  • What side effects may occur from the radiation and how are they managed?
  • Do I need a special diet during or after my treatment?
  • Can I exercise?
  • Can I engage in sexual activity?
  • Can I drink alcohol?
  • Will side effects change my appearance?  If so, will the changes be permanent or temporary?  If temporary, how long will they last?
  • Is it safe to take vitamins during treatment?
  • Who should I call and what are the reasons that I should call at night or on a weekend if necessary?

 


Questions to ask after radiotherapy  

  • How and when will you know if I am cured of cancer?
  • What are the reasons that I should call you after my treatment ends?
  • What are the chances that the cancer will come back?
  • How soon can I go back to my regular activities?  Work?  Sexual activity?  Aerobic exercise?
  • How often do I need to return for check-ups?
  • Are there any additional side effects I should look for?  How should I manage them?

 


Questions to ask about radiotherapy-related side effects

  • Is there any way I can anticipate what my radiation therapy side effects will be?
  • Will the side effects be debilitating?
  • Will I be able to take multi-vitamins during radiotherapy?
  • How will the side effects affect my bowel movements?
  • Will I experience any pain?
  • Will I experience any nausea/vomiting?
  • Can we safeguard against the onset of the nausea/vomiting?
  • Will I lose my appetite?  How can this be remedied?
  • Will I experience any skin irritations?  Will they be permanent or temporary?  If temporary, for how long?
  • Can I control the side effects with any medications?
  • Can I control the side effects with a change in my diet?
  • How should I care for the skin that is exposed to radiation?  May I bathe?