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What Happens During Radiation Treatment?

What Happens During Radiation Treatment? | UPMC Italy

Receiving a recommendation to undergo radiotherapy can raise doubts and concerns. However, it is a widely used therapy in the treatment of cancer and, in some cases, other conditions as well.

When a doctor prescribes it to you or a loved one, the goal is to improve the clinical condition, after carefully weighing the risks and benefits and identifying the most appropriate care pathway.

Understanding what radiotherapy involves and what to expect during treatment can help you face it with greater awareness and peace of mind.

What Is Radiation?

Radiation is a form of energy that travels as waves or particles. In the medical field, when we talk about radiotherapy, we specifically refer to electromagnetic radiation, such as X-rays and gamma rays.

Radiotherapy is a targeted treatment: it acts selectively on the affected area of the body, limiting exposure to surrounding healthy tissues.

In oncology, radiation damages the DNA of cancer cells, preventing their growth and spread. At the same time, it activates biological mechanisms that gradually lead to their elimination.

Types of Radiotherapy

There are different ways of delivering radiotherapy, chosen based on the condition and the patient’s characteristics.

The main types are:

  • External Beam Radiotherapy (EBRT) — uses high-energy radiation beams precisely directed at specific target areas of the body. The treatment is delivered by external equipment (linear accelerators), without direct contact with the body.
  • Internal Radiotherapy (brachytherapy) — involves placing radioactive material directly inside the body, close to or within the tumor. This allows higher doses of radiation to be concentrated in localized areas, reducing exposure to healthy tissues compared to external radiotherapy.

Why Is Radiotherapy Needed?

Radiotherapy can be prescribed alone or in combination with other cancer treatments, with the goal of destroying cancer cells and reducing tumor size. This can make surgery easier and improve the overall effectiveness of treatment.

Beyond oncology, radiotherapy is also used today in the management of certain non-cancerous conditions, thanks to its ability to act precisely on specific tissues.

Which Cancers Is Radiotherapy Used For?

Radiotherapy is one of the main treatment options in oncology and is used for many types of cancer.

However, this does not mean it is always necessary: the indication varies from case to case. The specialist will carefully assess whether and when to include it in the treatment plan, based on the type of tumor, its location, and the patient’s characteristics.

Among the cancers most commonly treated with external beam radiotherapy (EBRT) are:

Internal radiotherapy (brachytherapy) is commonly used in the treatment of gynecological cancers (cervix, uterus, vagina) and prostate cancer. In selected cases, it may also be used for lung, rectal, head and neck, breast, and skin cancers, thanks to its ability to concentrate the therapeutic dose in highly localized areas.

What Other Conditions Can Radiotherapy Treat?

External beam radiotherapy can also be used for non-oncological conditions.

Osteoarthritis

Osteoarthritis is a degenerative condition that affects the joints, causing pain, stiffness, and reduced mobility. When lifestyle changes and drug therapies are not sufficient, corticosteroid injections may provide relief, but they can be difficult to perform in smaller joints, such as those in the hand.

In these cases, low-dose radiotherapy (LDRT) may be used as a targeted, non-invasive treatment option.

LDRT can help:

  • Reduce pain.
  • Improve mobility.

To access this treatment, a diagnosis of osteoarthritis is required, along with unsuccessful use of standard conservative therapies such as medications and injections. It is not indicated for other forms of arthritis, such as rheumatoid or psoriatic arthritis, nor in more advanced stages of the disease.

Keloid Scars

Keloid scars are an excessive response of the skin tissue to trauma or injury. They can develop after surgery, wounds, or even minor procedures such as piercings.

After surgical removal of a keloid, external radiotherapy can be used to reduce the risk of recurrence by preventing the formation of new scar tissue. However, it is not effective in treating already fully formed keloids.

What Happens During Radiotherapy Treatment

Radiotherapy is performed on an outpatient basis. Before the session, you will be asked to wear a gown and enter the treatment room, where you will lie on a dedicated table. Radiotherapy technicians will guide you into the correct position, which is essential to ensure the precision and effectiveness of the treatment.

During the session, you may receive instructions via an audio system, for example to hold your breath for a few seconds or remain still. Sessions are generally short and, in most cases, last less than 20 minutes, including preparation and positioning time.

Radiotherapy is a non-invasive and painless procedure, like an X-ray: the radiation cannot be seen or felt, while the machine moves around the body to precisely target the affected area.

How Often Are Sessions Performed?

The frequency depends on the type of tumor or condition; sessions are generally scheduled daily or on alternate days.

What Happens During Brachytherapy (Internal Radiotherapy)?

Internal radiotherapy, or brachytherapy, usually involves a minimally invasive procedure. Radioactive material is placed directly inside the tumor or in its immediate vicinity, allowing precise targeting of the treatment area.

It can be of two types:

  • Temporary, when the radioactive material is removed at the end of treatment
  • Permanent, when it remains in place and gradually becomes inactive over time.

Side Effects of Radiotherapy

During the course of treatment, most people continue their normal daily activities, such as working or studying, without major limitations.

However, a feeling of fatigue may occur at certain stages of the treatment. The doctor will assess the situation and recommend any necessary precautions or restrictions.

Radiotherapy side effects may vary depending on the type of treatment and the area of the body involved. The most common include:

  • Fatigue — a progressive feeling of tiredness, especially after a few weeks of therapy.
  • Diarrhea or bowel changes — more common in treatments involving the pelvic area (rectal or gynecological), generally manageable with dietary adjustments or medication.
  • Nausea — may occur in treatments involving the upper abdomen and can be controlled with antiemetic drugs.
  • Lymphedema — risk increases when lymph nodes are irradiated, leading to persistent swelling due to lymphatic fluid buildup.
  • Skin reactions — redness, dryness, or irritation similar to sunburn, which can be treated with specific products.

Depending on the treated area, other side effects may also occur: the medical team will provide personalized information on what to expect and how to manage them during the treatment journey.

At our UPMC Hillman Cancer Center locations in Italy, we provide advanced external beam radiotherapy treatments using state-of-the-art technologies and highly qualified specialists. Contact the center closest to you for more information: