WHAT RADIATION ONCOLOGY IS NOT
Radiation oncology is not always well known or well understood. That is why we made this website. When talking to non-specialists, we found that some confusion seems to exist: some people confound ‘radiation oncology’ (or ‘radiotherapy’) with other systems or treatments that have little in common with what we are discussing here.
We also found that there are a number of misconceptions about radiation oncology that some people seem to have, probably based on how radiation treatments were done 20 or 30 years ago.
Radiation oncology is NOT:
… NOT nuclear medicine
Nuclear medicine is a different medical specialty. It obtains images of the body (like the radiologists), but not just images showing that there is a structure, organ, … in the body, but also what it is doing.
Many patients with cancer are referred to the department of nuclear medicine to get a PET-CT scan. Images obtained from this scan allow the physician to see if any tumour is active in the body, where it is expected to be, but also to check if no lesions are located elsewhere in the body.
For more information (in Dutch) please go here.
… NOT radiology
The department of radiology in many hospitals is now referred to as the ‘medical imaging department’. Radiologists obtain images of the body, including of cancer regions, but they do no treat them. The most common exams you can have in the department of medical imaging are CT scans and MRI scans.
… NOT nuclear industry
Radiation is also used outside hospitals. For instance to kill bacteria on food. Nuclear energy is also used to obtain electricity in nuclear power plants. The techniques and systems there have nothing to do with what is done in a radiation-oncology department in a hospital.
… NOT ‘making people radio-active’
Standard radiation treatments do not make the human body radioactive, so there is absolutely no risk for family, friends, pets or members of the general public. Also, children will not be harmed in any way when in contact with a patient who has received radiation therapy. A person can only be 'radioactive' after a specific radiotherapy treatment that involves placing a radioactive source inside the human body. This is referred to as brachytherapy. Such a treatment can be performed using temporarily inserted radioactive sources, or, in some situations, using permanently implanted low-radioactive sources. The latter is referred to as brachytherapy with 'seeds'. This approach is best known for prostate cancer brachytherapy. Outside the world of radiation oncology, other medical specialists like the nuclear medicine team can apply radioactive sources. We will not discuss these
treatments in detail.
Strict regulations are in place for using implanted radioactive sources in the human body: patients are only discharged from the hospital when the radioactive sources have been removed, or when very mild radioactive sources have been used. These seeds will gradually lose their radioactivity. This is the case for the seeds used in the prostate. In conclusion: only after prostate seed implants are patients likely to be very lightly radioactive when leaving the hospital. In that case, a number of guidelines will be given to the patient to assure safety of himself and his surroundings. The radiation oncologist will give all the required details and explanations. If you wish to read a detailed report on this topic by the Belgian High Commission on Healthcare, please click for a Dutch or French version (report will download as a PDF).
Please remember that radiotherapy can be an important component of a medical treatment. Only in comic books will radiation give superpowers or make people fluorescent green ...
… NOT a treatment just for palliative situations
Radiation oncology plays an important role in treating a very wide variety of cancers, and this includes some ‘early stage’ cancers and cancer in younger people. It is absolutely not correct that radiation treatments are given only to ‘patients who are dying to obtain some symptom relief. It is true however that radiation therapy is a very effective way of treating metastasis in the body, for instance for pain relief.
…NOT a treatment that ‘burns’
All radiation that is sent to the body from an external machine (so not brachytherapy), needs to cross the skin first before arriving at the correct place in the body. Because the irradiation is sent from many angles, and because it is of high energy, it will ‘fly through’ the skin without hurting it. There are some exceptions: if a higher radiation dose is needed, and the area to be treated is really close to the skin, there can be some skin irritation. Usually, this is limited to some redness, and should absolutely not be called ‘burning the skin’. In some treatments in the neck area, the redness can be more pronounced, and also women treated on the breast can sometimes be bothered more, mainly if the breasts are rather large. But even then: the skin irritation is a mild and temporary problem for the vast majority of patients.
... NOT a treatment dangerous for the heart
High doses of irradiation on large volumes of the heart can indeed, many many years after the irradiation, cause cardiac problems. But during modern radiotherapy treatments doses given to the heart are often kept small, and even if a slightly higher dose is given somewhere, it will be on a small volume. So contrary to what some people claim about radiotherapy for breast cancer, cardiac risks induced by radiotherapy are very low nowadays.