Angelina Radiation Oncology Associates

Radiation Therapy FAQs

What is radiation therapy?

AROA PictureRadiation therapy is one of the three major ways to treat cancer; the other two are surgery and chemotherapy. Everyone knows what surgery is: something gets cut out or cut off. What most people don't understand is the difference between chemotherapy and radiation therapy. Chemotherapy - or chemo, for short - is basically a treatment procedure that circulates anti-cancer medicine throughout the entire body. This is most often given as an intravenous (IV) infusion or by pill form.

Radiation therapy is the use of x-rays or gamma rays to treat cancer. X-rays and gamma rays are basically the same, although they come from different sources. When a radioactive source such as cobalt or radium is used, as was common in the past, the ray produced was a gamma ray. In modern radiotherapy, AROA Picturex-rays are produced in a machine called a linear accelerator. The only time radioactive sources are used today is with radioactive implants. Your physician will tell you if this is indicated for your cancer. Most patients are treated on a linear accelerator with x-rays.

X-rays are a focused type of treatment; the beam is aimed very precisely to only certain areas where the cancer is believed to be present. The radiation beam can be shaped and focused so that areas that don't need to be treated can be protected, thus limiting side effects to just the area that is in the treatment field.

How does radiation work?

Radiation therapy works by targeting the strands of genetic material inside cells called DNA, rendering those cells incapable of dividing and spreading. Cancer cells are, for a variety of reasons, more sensitive to the effects of radiation than normal tissues, so normal tissues can recover more easily. This differential effect allows us, over time, to preferentially kill cancer cells rather than normal cells.

Will I feel the radiation, or will it hurt?

No. Just like getting an x-ray of the chest, you don't see or feel anything during the radiation treatment. Over time, you may notice certain side effects (see question below), depending on the area being treated. Your nurse and doctor will go over these with you.

Will I become radioactive?

AROA PictureNo. With linear accelerator-based x-ray treatment, no radioactive material is being used, and therefore no radioactive material can be left behind. Radiation does not stay with you when you leave the treatment room. Only certain patients who have permanent radioactive implants, such as seeds for prostate cancer, will potentially expose others to radiation for a period of time. You will be instructed on precautions if this is the case. Patients simply coming for daily external beam radiation treatment do not pose any risk to others.

Are there risks involved with radiation therapy?

Radiation often has to pass through normal tissue in order to get to where the cancer is. Side effects (see listing below) can occur when the normal tissue is irritated. These side effects depend on the area being treated. Some areas have very few noticeable side effects. However, combining treatments such as surgery and chemotherapy may be necessary for your cancer, and that may increase your risk of side effects. Most side effects are quite manageable. Your nurse and doctor will go over these issues with you.

Will the radiation therapy make me sick?

It is unusual for radiation patients to be nauseated unless the abdomen is being treated directly. Let your doctor know if you experience these symptoms, as there may be medication that can help alleviate nausea.

Will I lose my hair?

Only patients whose head and skull regions are being treated will lose the hair on their head, unless they are also getting certain chemotherapy agents along with the radiation treatment. Hair in other areas may be lost in those areas of treatment.

How long will my radiation treatment take?

AROA PictureMost of the time external beam radiation is given Monday through Friday, five days a week, for usually five to eight and a half weeks, depending on the type of cancer and the area being treated. Most patients are on the treatment table for 10-15 minutes for each treatment session, although some more complicated treatments may take as long as 30-45 minutes to deliver.

What are the typical side effects of radiation therapy?

Typically side effects of radiation treatment are localized to the area which is being treated. Of course, any patient can experience fatigue while going through a course of radiation therapy, but this side effect is usually mild. Many patients who work can continue to do so during their courses of treatment and simply schedule their treatments into their work schedule. (Most employers will accommodate our patients' needs.)

Site-specific side effects will be discussed in detail with you during your consultation, but some things you may want to ask about are the following (not meant to be an inclusive list):

  • Head and neck cancers: dry mouth, sore mouth and throat, altered taste, skin reaction.
  • Lung cancer: sore throat and "lumpy" swallowing, skin reaction on chest and back, indigestion, and the possibility of a change in breathing ability or more shortness of breath long term, depending on the amount of lung and heart being treated.
  • Breast cancer: skin reaction, mild fatigue, small possibility of swelling of the arm - lymphedema - often depending on how many lymph nodes were removed at the time of surgery. Rare risks of heart or lung problems.
  • Rectal, cervical, endometrial cancers: diarrhea, cramping, small increased risk of adhesions or obstruction
  • Abdominal cancers (such as pancreas and stomach): nausea, bloating, indigestion, small increased risk of adhesions or obstruction
  • Brain tumors: hair loss in the area(s) being targeted

Side effects also depend on the total dose being given and on the amount given each day, as well as whether or not chemotherapy is being given simultaneously and whether or not surgery has been part of the treatment. Most of the "acute" side effects that develop during a course of radiation treatment go away about a month or two after radiation is complete. Some side effects don't develop for months or years after treatment. A detailed list of side effects particular to your site of treatment will be discussed with you before any treatment can begin. Always let your doctor or nurse know if you are experiencing any side effects or if you need anything.

What consent forms do I need to sign before AROA begins treatment?

Before beginning treatment, you will be asked to sign a consent form that is mandated by state law. This document informs you, the patient, or a person authorized to consent for you, of possible risks and hazards involved in your treatment. A list of disclosures (possible side effects) specific to your area of treatment will be attached to the consent form.

Click this link if you would like to preview the standardized consent form prior to coming in for your appointment.

A form similar to this one will be given to you when you arrive at either the Temple Cancer Center. At that time, we will go over the form and give you an opportunity to ask any questions you may have about the treatment. After you have your questions answered to your satisfaction, you will be asked to sign the form indicating your consent to treatment. If you have questions about any of the disclosures, please ask!

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Who will administer my radiation treatments?

Radiation therapists work with radiation oncologists to administer the daily radiation treatment under the doctor's prescription and supervision. They maintain daily records and regularly check the treatment machines to ensure they are working properly.

Can someone come to my treatments with me? Will I be alone during my treatments?

AROA PictureYou do not necessarily need anyone to accompany you to your treatments. No one can be in the treatment room with you, so friends and family that do come with you will need to wait for you in the waiting room until you are done each day. Most patients, even if they are normally claustrophobic, do not have trouble with radiation treatment. In fact, most patients comment that treatment is a lot easier and simpler than they thought it would be.

May I continue my regular routine / activities while undergoing radiation treatments?

We do not necessarily place any particular restrictions on diet or activity during radiation treatment. If particular side effects develop that might be lessened with certain dietary or activity restrictions, we will talk to you about these.

How will I be billed for treatment?

Radiation therapy is covered by Medicare, Medicaid and virtually all insurance plans to some extent. You will receive bills from the hospital (Memorial Health System of East Texas for patients treated at the Arthur Temple, Sr. Regional Cancer Center in Lufkin) which will cover the cost of the machines, equipment and personnel involved in your care. You will also receive a bill from Angelina Radiation Oncology Associates (AROA) for the services of the physician and other AROA employees. These two bills do not represent double billing but represent bills for two different components of your care. Billing questions may be directed to the following:

  • Memorial Health System of East Texas –
    For all billing questions or inquiries, call:
    Customer Service: (936) 639-7931
  • Nacogdoches Medical Center –
    For billing questions, call:
    Customer Call Center: (866) 904-6871, or locally, (936) 558-3724 and ask for Cindi Rogers.

For uninsured or co-pay concerns, call Perry Upshaw at (936) 462-4416.

AROA (Dr. Sid Roberts) Billing Services Provided by:

3304 S. Broadway, Suite 200
Tyler, Texas 75701
(877) 839-9517

Payments may be made to:
Angelina Radiation Oncology Associates
PO Box 95350
Grapevine, Texas 76099-9733