Page last updated: April 2024
The information on this webpage was adapted from Understanding Radiation Therapy - A guide for people with cancer, their families and friends (2024 edition). This webpage was last updated in April 2024.
Expert content reviewers:
This information was developed with help from a range of health professionals and people affected by cancer who have had radiation therapy:
- A/Prof Susan Carroll, Senior Staff Specialist, Radiation Oncology, Royal North Shore Hospital, and The University of Sydney, NSW
- Katie Benton, Advanced Dietitian Oncology, Sunshine Coast Hospital and Health Service, QLD
- Adrian Gibbs, Director of Physics, Radiation Oncology, Princess Alexandra Hospital Raymond Terrace, QLD
- Sinead Hanley, Consumer
- Dr Annie Ho, Radiation Oncologist, GenesisCare, Macquarie University Hospital and St Vincent’s Hospital, NSW
- Angelo Katsilis, Clinical Manager Radiation Therapist, Department of Radiation Oncology, Royal Adelaide Hospital, SA
- Candice Kwet-On, 13 11 20 Consultant, Cancer Council Victoria
- Jasmine Nguyen, Radiation Therapist, GenesisCare Hollywood, WA
- Graham Rees, Consumer
- Nicole Shackleton, Radiation Therapist, GenesisCare Murdoch, WA
- Dr Tom Shakespeare, Director, Cancer Services, Mid North Coast Local Health District, NSW
- Gabrielle Vigar, Nurse Lead, Cancer Program, Royal Adelaide Hospital and Queen Elizabeth Hospital, SA
What is radiation therapy?
Radiation therapy uses a controlled dose of radiation to kill cancer cells or damage them so they cannot grow, multiply or spread. Most forms of radiation therapy use focused, high-energy x-ray beams.
Radiation can also be electron beams, proton beams, or gamma rays from radioactive sources. Radiation therapy is a localised treatment, which means it generally affects only the area being treated.
When and why is radiation therapy used?
It’s estimated that radiation therapy would be a suitable part of treatment for 50% of people with cancer. It can be used for different reasons:
- To achieve remission or cure – given as the main treatment to cause the cancer to reduce or disappear (curative or definitive radiation therapy). Sometimes definitive radiation therapy is given together with chemotherapy to make it work better (chemoradiation).
- To help other treatments – often used before other treatments (neoadjuvant) to shrink the tumour or after other treatments (adjuvant) to kill any remaining cancer cells.
- To relieve symptoms – can help to relieve pain and other symptoms by making the cancer smaller or stopping it from spreading ( palliative treatment).
Your guide to best cancer care
The Guides to Best Cancer Care set out the recommended treatment pathways in Australia for many types of cancer.
For some cancers, radiation therapy is recommended as the most effective approach, either on its own or in combination with other treatments. For other cancers, other treatments may be more effective.
Explore the guides
Can I have radiation therapy if I’m pregnant?
You probably won’t be able to have radiation therapy if you are pregnant, as radiation can harm a developing baby. It’s also important that you don’t become pregnant during the course of treatment.
If at any time you suspect you may be pregnant, it is important to tell your doctor. If you are breastfeeding, ask your doctor whether it is safe to keep breastfeeding while you’re having radiation therapy.
It is recommended that people who have radiation therapy to the pelvic area use contraception to avoid getting their partner pregnant during treatment and for about 6 months afterwards, as radiation therapy can damage sperm.
Your doctor will be able to give you more information about radiation therapy and pregnancy.
Radiation therapy for children
This page is for adults having radiation therapy, but much of it will also be relevant for children.
Talk to your treatment team for specific information about radiation therapy for children, and check out:
- Cancer Hub – Provided by Canteen, Redkite and Camp Quality, this website helps families affected by cancer (with children aged up to 25 years) get support.
- Cancer Australia Children’s Cancer – For information about children’s cancers and how they are treated.
- Talking to Kids About Cancer – Explaining a cancer diagnosis to kids can feel overwhelming. This booklet provides a starting point for these often challenging conversations.
How does radiation therapy work?
Radiation therapy aims to kill or damage cancer cells in the area being treated. Cancer cells begin to die days or weeks after treatment starts, and continue to die for weeks or months after it finishes.
There are two main ways of giving radiation therapy, from outside the body or inside the body. You may have one or both types of radiation therapy, depending on the cancer type and other factors.
- External beam radiation therapy (EBRT) – radiation beams from a large machine are precisely aimed at the area of the body where the cancer is located. The process is similar to having an x-ray, operates for a few minutes only and can't be felt.
- Internal radiation therapy – a radiation source is placed inside the body or, more rarely, injected into a vein or swallowed. The most common form of internal radiation therapy is brachytherapy, where temporary or permanent radiation sources are placed inside the body next to or inside the cancer.
Treatment is carefully planned to do as little harm as possible to healthy cells near the cancer. Most of these cells tend to receive a lower dose and can usually repair themselves.
Treatment locations
Radiation therapy is usually given in the radiation oncology department of a hospital or in a treatment centre. This may be in the public or private health system.
Most people have radiation therapy as an outpatient. This means you do not stay in hospital, but travel to the hospital or treatment centre for each session.
For some types of internal radiation therapy, you may need to stay in hospital overnight or for a few days
Frequency of treatment sessions
Radiation therapy is tailored to your situation. The number of treatment sessions recommended by your radiation oncologist will depend on the type of cancer you have.
Based on treatment guidelines, your radiation oncologist will work out the total dose of radiation needed to treat the cancer.
In most cases, the total dose is broken up into a number of smaller doses called fractions. Each fraction of radiation is given in one treatment session. The whole course of radiation therapy may be given over a number of days or weeks.
Some people have one treatment session, other people may have treatment once a day, Monday to Friday, for several weeks. Some people have radiation therapy twice a day and others have treatment sessions a week apart.
Your radiation oncologist will talk to you about your treatment schedule. Treatment schedules will continue to change as research shows what works best to kill cancer cells and lessen side effects.
Possible side effects
If radiation therapy injures healthy cells near the treatment area, side effects may occur. The side effects you have will vary depending on the part of the body treated, the dose of radiation and the length of treatment.
Most side effects are temporary and tend to improve gradually in the weeks after treatment ends.
Knowing if the treatment has worked
Because cancer cells continue to die for weeks or months after treatment ends, your radiation oncologist most likely won’t be able to tell you straightaway how the cancer is responding.
You may not know the full benefit of having radiation therapy for some months.
If radiation therapy is given as palliative treatment, the relief of symptoms is a good sign that the treatment has worked.
This may take a few days or weeks. Until then, you may need other treatments for your symptoms, such as pain medicine.
Life after treatment
For most people, the cancer experience doesn’t end on the last day of radiation therapy. Radiation therapy usually does not have an immediate effect, and it could take days, weeks or months to see any change in the cancer.
After radiation therapy has finished, your treatment team will tell you how to look after the treatment area and recommend ways to manage side effects.
You will have regular check-ups with the radiation oncologist at the treatment centre. These will become less frequent over time. You will receive continued support from allied health professionals, such as a dietitian, physiotherapist or speech pathologist, if you need it.
Let your treatment team know immediately if you have any health problems between follow-up appointments. Many of the long-term or late effects of radiation therapy can be managed better if identified early.
“I read a lot about all the negative side effects you might get from radiation therapy, but I’ve had no long-term side effects.” Derek
How much does radiation therapy cost?
It is your choice whether you have treatment in the public or private health system. If you have radiation therapy as an outpatient in a public hospital, Medicare pays for your treatment.
Medicare also covers some of the cost of radiation therapy in private treatment centres, but you may have to pay the difference between the cost of treatment and the Medicare rebate (gap payment).
Private health insurance does not usually cover radiation therapy because it’s considered an outpatient treatment. Before treatment starts, ask your provider for a written quote that shows what you will have to pay.
If you are concerned about the cost, you may want to ask for a referral to a public centre for treatment.
What is chemoradiation?
Chemoradiation means having radiation therapy at the same time as chemotherapy. It is also known as chemoradiotherapy.
The chemotherapy drugs make the cancer cells more sensitive to the radiation. Having radiation therapy and chemotherapy together is more effective for some cancers.
Chemoradiation is only helpful for some cancer types. If you have chemoradiation, your treatment team will talk to you about your treatment plan.
You may have chemotherapy and radiation therapy at different times on the same day or on separate days.
The side effects of chemoradiation will vary depending on the:
- chemotherapy drugs you have
- dose of radiation
- part of the body being treated
- length of treatment.
Your treatment team will talk to you about what to expect and how to manage any side effects.
Learn about common side effects
Health professionals
During and after treatment, you will see a range of health professionals who specialise in different aspects of your cancer care. The main specialist doctor for radiation therapy is a radiation oncologist.
You may be referred to a radiation oncologist by your general practitioner (GP) or by another specialist such as a surgeon or medical oncologist.
Treatment options will often be discussed with other health professionals at what is known as a multidisciplinary team (MDT) meeting.
You may also see some allied health professionals, such as a speech pathologist, occupational therapist and exercise physiologist, to help you manage any treatment side effects.
Question checklist
Asking your doctor questions will help you make an informed choice. You may want to include some of the questions below in your own list:
Treatment
- Why do I need radiation therapy?
- What are the advantages and disadvantages of radiation therapy for me?
- How successful is radiation therapy for the type of cancer I have? Are there other treatments I could have instead?
- What kind of radiation therapy will I have?
- Will it be my only treatment, or will I have other treatments?
- How long will treatment take? How will it be given?
- Where can I have this treatment? Will I have to travel away from home?
- Will I have radiation therapy as an inpatient or outpatient?
- How will I know if the treatment is working?
- Are there any out-of-pocket expenses? Can the cost be reduced if I can’t afford it? Can I be referred to a public treatment centre?
- Are there clinical guidelines you are following?
- Are there any clinical trials or research studies I could join?
Side effects
- What are the risks and possible side effects of radiation therapy?
- Will any side effects be long-term or short-term?
- Will I be radioactive? Will my partner be affected?
- Is it safe to have sex during the course of radiation therapy?
- Will radiation therapy interact with any other medicines or vitamins I take?
- Can I work, drive and do my normal activities while having treatment?
- Are there any complementary therapies that might help me?
- Should I change my diet or physical activity during or after treatment?
- Who should I contact if I have a problem during treatment? Who is my after-hours contact?
After treatment
- How often will I need check-ups after treatment?
- If the cancer returns, how will I know? What treatments could I have?
Steps in radiation therapy
- Consultation session – you will meet with a radiation oncologist. They will check your test results, assess your fitness for treatment, explain the process and expected results, and discuss possible side effects and risks. You will be asked to agree (consent) to have treatment.
- Planning (simulation) session – you will meet with a radiation therapist. They will work out how to best position your body during EBRT or where to place the applicators for brachytherapy.
- Treatment plan – based on the planning session and the treatment guidelines for your cancer type, the radiation oncologist, radiation therapist and medical physicist will work out the radiation dose, what area needs to be treated and how to deliver the right dose of radiation.
- Treatment sessions – radiation therapists will deliver the course of radiation therapy as set out in the treatment plan. How long each treatment session takes will depend on the type of radiation therapy.
- Review and follow-up – you will have regular reviews with the treatment team to discuss how to manage any side effects and assess how you have responded to treatment.
How do I prepare for radiation therapy?
Radiation therapy affects everyone differently, so it can be hard to know how to prepare for treatment. The suggestions below may help you cope with radiation therapy.
You can also talk to the social worker at the treatment centre to find out what support is available
Ask about fertility
Some types of radiation therapy affect fertility. If you think you may want to have children in the future, talk to your treatment team about your options before radiation therapy begins.
Explore ways to relax
Read a book or listen to music while you wait, ask a friend or family member to keep you company, or try chatting to other people waiting for treatment.
To help you relax during the session, try breathing exercises or meditation, or ask the radiation therapists if you can listen to music.
Organise help at home
Support with housework and cooking can ease the load. If you have young children, arrange for someone to look after them during radiation therapy sessions.
Older children may need someone to drive them to and from school and activities. Ask a friend or family member to coordinate offers of help, or use an online tool such as Gather My Crew.
Consider quitting
If you smoke or vape, it is important to stop before starting treatment. Smoking or vaping may affect how well the treatment works and may make side effects worse.
If you need support to quit, talk to your doctor or call the Quitline on 13 7848.
Arrange transport and accommodation
Plan how you will get to radiation therapy sessions. If travelling by car, ask about parking.
If you feel tired as the treatment goes on, you may want to arrange for someone to drive you.
If you have to travel a long way for treatment, you may be eligible for financial assistance to help cover the cost of travel or accommodation.
A social worker can help you apply or you can call Cancer Council 13 11 20 for more information.
Look after yourself
Try to eat nourishing food, drink lots of water, limit the amount of alcohol you drink, get enough sleep, and balance rest and physical activity.
Regular exercise and good nutrition can help reduce some of the side effects of radiation therapy.
Discuss your concerns
Keep a list of questions and add to it whenever you think of a new question. If you are feeling anxious about having radiation therapy, talk to the treatment team, your GP, a family member or friend, or call Cancer Council 13 11 20.
Check other medicines
Some over-the-counter medicines, alternative and home remedies, herbs, vitamins and creams can affect how radiation therapy works and increase skin reactions.
Ask your radiation oncologist whether you need to stop taking or using any herbs, creams or supplements before treatment.
Check your teeth
If you are having radiation therapy for a cancer in the head and neck area, you may need a dental check‑up before treatment starts.
The dentist can check for any decaying teeth and advise if they need to be removed before you start treatment.
Mention medical implants
Let your treatment team know if you have any medical devices in your body. This may be a pacemaker, cochlear implant, or a hip or knee replacement.
Radiation therapy can affect these devices or be affected by them.
Working during radiation therapy
During radiation therapy, you are likely to feel well enough to continue working and doing your usual activities. As you have more sessions, you may feel more tired or lack energy.
Whether you will be able to work depends on:
- the type of radiation therapy you have
- whether you are having chemotherapy at the same time
- how you feel
- the type of work you do.
Ask your treatment team if they offer very early or late appointments so that you can fit your treatment sessions around your work.
Let your employer know how much time you are likely to need off work. Explain that it is hard to predict how radiation therapy will affect you, and discuss the options of flexible hours, modified duties or taking leave.
Learn more about cancer and work
