Cancer patients and their families often have many questions regarding their feelings, finances,

treatment, physical appearance, and how that will affect their families and friends. Below is a list

of frequently asked questions that we have adapted and referenced from our helpful links on our

Resouces page. Please consult your physician and team here at South Florida Radiation

Oncology for any help you need.

How do I choose an oncologist?

What is radiation therapy? 

 Why do patients receive radiation therapy?

How does nutrition affect cancer care?

 How does radiation therapy kill cancer cells?

Does radiation therapy only kill cancer cells?

How is radiation therapy administered to patients?

How may a diagnosis of cancer affect me psychologically and emotionally?

Why are some types of radiation therapy given in many small doses?

When will a patient receive radiation therapy?

Does radiation therapy make a patient radioactive?

What are the potential side effects of radiation therapy? 

How to choose an oncologist: 

When choosing your oncologists and specialist physician team after your diagnosis, it can be confusing. There is very good reason so many experts are required. Cancer treatments are most effective when provided by experienced specialists with particular areas of expertise. Here’s an overview of the types of cancer specialists you may be working with, separately or as part of a team:

Oncologists are physicians who study, diagnose, and treat cancer. Each oncologist trains initially as a specialist in a particular area, such as surgery or gynecology, and then narrows his or her focus to cancers within that specialty. So, for example, a medical oncologist is an internist who treats cancer of the internal organs with chemotherapy, hormone therapy, and other medications, and a hematologic oncologist is an oncologist who treats cancers of the blood. Other specialties include gynecological, surgical, radiation, and pediatric oncology.

Your relationship with oncologists has several phases, including diagnosis, treatment, and aftercare. You may work with the same doctors throughout or select a new team at some point. For example, if a second opinion differs from the original diagnosis and treatment approach, you’ll have to decide which doctor’s views you’re more comfortable with — or seek a third perspective.

It's ok to change oncologists if you don’t seem to click. People have different personalities and communication styles. Maybe your doctor doesn’t provide the encouragement you’re seeking, for example, or perhaps his or her treatment philosophy is to watch and wait while you’d rather take action, or the other way around. There’s nothing wrong with seeking a more compatible bond.

What is radiation therapy?

Radiation therapy uses high-energy radiation to shrink tumors and kill cancer cells. X-rays, gamma rays and charged particles are types of radiation used for cancer treatment.

The radiation may be delivered by a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy, also called brachytherapy).

Systemic radiation therapy uses radioactive substances, such as radioactive iodine, that travel in the blood to kill cancer cells. Almost 60% of all cancer patients receive some type of radiation therapy sometime during the course of their treatment.

Why do patients receive radiation therapy?

Radiation therapy is usually given with curative intent (that is, with the hope that the treatment will cure a cancer, either by eliminating a tumor, preventing cancer recurrence or both) In such cases, radiation therapy may be used alone or in combination with surgery, chemotherapy or both.

Radiation therapy may also be given with palliative intent. Palliative treatments are not intended to cure. Instead, they relieve symptoms and reduce the suffering caused by cancer.

How does nutrition affect cancer care?

Cancer and cancer treatments may cause nutrition-related side effects.

An important part of cancer treatment is a patient’s proper nutrition and diet. Eating the right kinds of foods before, during, and after treatment can help the patient feel better and stay stronger. To ensure proper nutrition, a person has to eat and drink enough of the foods that contain key nutrients (vitamins, minerals, protein, carbohydrates, fat, and water). For many patients, however, some side effects of cancer and cancer treatments make it difficult to eat well.

Symptoms that interfere with eating include:

• anorexia
• nausea
• vomiting
• diarrhea
• constipation
• mouth sores
• trouble with swallowing
• pain
• depression
• anxiety

Good eating habits during cancer care help the patient cope with the effects of the cancer and its treatment.

"Nutrition therapy can help cancer patients get the nutrients needed to maintain body weight and strength, prevent body tissue from breaking down, rebuild tissue, and fight infection. Eating guidelines for cancer patients can be very different from the usual suggestions for healthful eating. Nutrition recommendations for cancer patients are designed to help the patient cope with the effects of the cancer and its treatment. Some cancer treatments are more effective if the patient is well nourished and getting enough calories and protein in the diet. People who eat well during cancer treatment may even be able to handle higher doses of certain treatments. Being well-nourished has been linked to a better chance of recovery."

"A lack of key nutrients or malnutrition can result from lack of appetite, taste, smell, and the ability to eat enough food or absorb the nutrients from food. These factors may also result in patient weakness, tiredness and an inability to resist infections or withstand cancer therapies. Eating too little protein and calories is the most common nutrition problem facing many cancer patients. Protein and calories are important for healing, fighting infection, and providing energy. "See our Facebook page for patient support coordinator info about nutrition by Dr. Cindy Collins, PhD- Health Psychology, R.D.- Registered Dietician.

https://www.facebook.com/pages/South-Florida-Radiation-Oncology/108559549169534

How does radiation therapy kill cancer cells?

Radiation therapy kills cancer cells by damaging their DNA (the molecules inside cells that carry genetic information and pass it from one generation to the next). Radiation therapy can either damage DNA directly or create charged particles (free radicals) within the cells that can, in turn, damage the DNA.

Cancer cells whose DNA is damaged beyond repair stop dividing or die. When the damaged cells die, they are broken down and eliminated by the body’s natural processes.

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Does radiation therapy kill only cancer cells?

No, radiation therapy can also damage normal cells, leading to side effects. However, advanced technologies (link to Our Technologies page) offered by SFRO precisely target cancer cells and minimize damage to surrounding healthy tissue.

Doctors take potential damage to normal cells into account when planning a course of radiation therapy. The amount of radiation that normal tissue can safely receive is known for all parts of the body. Doctors use this information to help them decide where to aim radiation during treatment.

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Why do patients receive radiation therapy?

Radiation therapy is usually given with curative intent (that is, with the hope that the treatment will cure a cancer, either by eliminating a tumor, preventing cancer recurrence or both) In such cases, radiation therapy may be used alone or in combination with surgery, chemotherapy or both.

Radiation therapy may also be given with palliative intent. Palliative treatments are not intended to cure. Instead, they relieve symptoms and reduce the suffering caused by cancer.

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How is radiation therapy administered to patients?

Radiation can come from a machine outside the body (external-beam radiation therapy) or from radioactive material placed in the body near cancer cells (internal radiation therapy, more commonly called brachytherapy). Systemic radiation therapy uses a radioactive substance, given by mouth or into a vein, that travels in the blood to tissues throughout the body.

The type of radiation therapy prescribed by a radiation oncologist depends on many factors, including:

· The type of cancer.
· The size of the cancer.
· The cancer’s location in the body.
· How close the cancer is to normal tissues that are sensitive to radiation.
· How far into the body the radiation needs to travel.
· The patient’s general health and medical history.
· Whether the patient will have other types of cancer treatment.
· Other factors, such as the patient’s age and other medical conditions.

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Patients diagnosed with cancer may

feel many different emotions, including anxiety and distress.

These complex emotiona may have an affect on a patient's ability to cope with treatment.

Patients may also have anxiety while being screened for a possible cancer, waiting for the results of tests for cancer, receiving a cancer diagnosis, being treated for cancer, or worrying that cancer will come back. It may cause patients to miss check-ups or delay treatment.

Patients living with cancer can feel different levels of distress.

Some patients living with cancer have a low level of distress and others have higher levels of distress. The level of distress ranges from being able to adjust to living with cancer to having a serious mental health problem, such as major depression. However, most patients with cancer do not have signs or symptoms of any specific mental health problem. This summary describes the less severe levels of distress in patients living with cancer, including:

• Normal adjustment—A condition in which a person makes changes in his or her life to manage a stressful event such as a cancer diagnosis. In normal adjustment, a person learns to cope well with emotional distress and solve problems related to cancer.
• Psychological and social distress—A condition in which a person has some trouble making changes in their life to manage a stressful event such as a cancer diagnosis. Help from a professional to learn new coping skills may be needed.
• Adjustment disorder—A condition in which a person has a lot of trouble making changes in his or her life to manage a stressful event such as a cancer diagnosis. Symptoms such as depression, anxiety, or other emotional, social, or behavioral problems occur and worsen the person's quality of life.
• Anxiety disorder—A condition in which a person has a lot of anxiety from a stressful event such as a cancer diagnosis. The anxiety affects his or her ability to manage their emotions, social relationships, and work life. Medicine and help from a professional to manage the anxiety may be needed.

For the most immediate professional help, speak with your physician and team with South Florida Radiation Oncology, including our Patient Support Coordinator, Dr. Cindy Collins, PhD Health Psychology, and R.D. - Registered Dietician. She is located at the SFRO offices on Tuesdays and Thursdays and may be reached at 561-512-0065.

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When will a patient receive radiation therapy during the course of treatment?

A patient may receive radiation therapy before, during or after the course of treatment along with surgery, chemotherapy or alone. Radiation is used sometimes to shrink the size of the cancer before surgery, or it is used after surgery to kill any cancer cells that remain. Sometimes, radiation therapy is given during surgery so that it goes straight to the cancer without passing through the skin. This is called intraoperative radiation.The same occurs with chemotherapy treatment and radiation. Oftentimes, chemotherapy is given to help radiation work more effectively.

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Does radiation therapy make a patient radioactive?

External-beam radiation does not make a patient radioactive.

During temporary brachytherapy treatments, while the radioactive material is inside the body, the patient is radioactive; however, as soon as the material is removed, the patient is no longer radioactive. For temporary brachytherapy, the patient will usually stay in the hospital in a special room that shields other people from the radiation.

During permanent brachytherapy, the implanted material will be radioactive for several days, weeks or months after the radiation source is put in place. During this time, the patient is radioactive. However, the amount of radiation reaching the surface of the skin is usually very low. Nonetheless, this radiation can be detected by radiation monitors and contact with pregnant woman and young children may be restricted for a few days or weeks.

Some types of systemic radiation therapy may temporarily make a patient’s bodily fluids (such as saliva, urine, sweat, or stool) emit a low level of radiation. Patients receiving systemic radiation therapy may need to limit their contact with other people during this time, and especially avoid contact with children younger than 18 and pregnant women.

A patient’s doctor or nurse will provide more information to family members and caretakers if any of these special precautions are needed. Over time (usually days or weeks), the radioactive material retained within the body will break down so that no radiation can be measured outside the patient’s body.

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What are the potential side effects of radiation therapy?

Radiation therapy can cause both early (acute) and late (chronic) side effects. Acute side effects occur during treatment, and chronic side effects occur months or even years after treatment ends. The side effects that develop depend on the area of the body being treated, the dose given per day, the total dose given, the patient’s general medical condition and other treatments given at the same time.

Acute radiation side effects are caused by damage to rapidly dividing normal cells in the area being treated. These effects include skin irritation or damage at regions exposed to the radiation beams. Examples include damage to the salivary glands or hair loss when the head or neck area is treated, or urinary problems when the lower abdomen is treated.

Most acute effects disappear after treatment ends, though some can be permanent. Fatigue is a common side effect of radiation therapy regardless of which part of the body is treated. Nausea with or without vomiting is common when the abdomen is treated and occurs sometimes when the brain is treated. Medications are available to help prevent or treat nausea and vomiting during treatment.
Late side effects of radiation therapy may or may not occur. Whether or not a patient experiences late side effects depends on other aspects of their cancer treatment in addition to radiation therapy, as well as their individual risk factors. Some chemotherapy drugs, genetic risk factors and lifestyle factors (such as smoking) can also increase the risk of late side effects.

When suggesting radiation therapy as part of a patient’s cancer treatment, the radiation oncologist will carefully weigh the known risks of treatment against the potential benefits for each patient (including relief of symptoms, shrinking a tumor or potential cure). The results of hundreds of clinical trials and doctors’ individual experiences help radiation oncologists decide which patients are likely to benefit from radiation therapy.

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For these and other questions about your diagnosis, and subsequent treatments, please consult your physician and team at South Florida Radiation Oncology. Our Resources page offers a blog where you can interact with our Patient Support Coordinator, Dr. Cindy Collins, as well as many helpful links to other cancer information and reference materials. Please visit our Facebook page to see our latest updates on ways to help our patients and their families cope with cancer and it's effects.

Get Back to Living Your Life. Call 877-930-SFRO (7376) today to find the right advanced cancer treatment option for you.