Pediatric Radiation

Radiation therapy is given through different methods, depending on the type of cancer, the location of the cancer, and the patient's health. Sometimes, radiation therapy is used in combination with other treatments. The following are some of the different types of radiation therapy with brief explanations of their goals:

• External radiation (external beam therapy). With external radiation (external beam therapy), radiation is administered by a large machine that points the energy waves directly at the tumor. The radiation therapist controls the machine. Since radiation is used to kill cancer cells, special shields may be made to protect the tissue surrounding the treatment area. Radiation treatments are painless and usually last a few minutes.
• Internal radiation (brachytherapy, implant radiation). With internal radiation (brachytherapy, implant radiation), a high dose of radiation is given inside the body as close to the cancer as possible. The radiation treatment may be swallowed, injected or implanted directly into the tumor. Some of the radioactive implants are called seeds or capsules. Internal radiation involves administering a higher dose of radiation in a shorter time span when compared with external radiation. Some internal radiation treatments stay in the body temporarily; other internal treatments stay in the body permanently, although the radioactive substance loses its radiation within a short period of time. In some cases, both internal and external radiation therapies are used.

The side effects of radiation depend on the dose and location, and if it is internal or external. Before receiving radiation for treatment of cancer, many tests may be performed to evaluate the baseline (pretreatment) function of heart, kidneys, lungs, eyes, ears and reproductive organs. Some radiation may affect the function of these organs either during treatment or months to years after treatment. Some treatment may affect fertility. The side effects usually relate to the area of the body that is receiving the radiation treatments. Potential side effects may include, but are not limited to, the following:

• Hair loss (also called alopecia). Hair loss may occur if radiation therapy of the head is given. After treatment is completed, most children's hair will grow back.
• Bone growth. Bone growth may also be affected, especially with young children who are still having significant bone growth. Height stature and/or limbs may be shortened because of the effect of radiation.
• Skin changes. The skin may be more sensitive, reddened or irritated after having radiation. Skin care is an important part of radiation treatment. Skin changes are short-term effects of radiation. Your child's doctor will explain the necessary prevention and treatment of any skin problems related to radiation.
• Diarrhea, nausea and vomiting. If radiation therapy of the pelvis or abdomen is given, a child may experience diarrhea, nausea and/or vomiting.
• Fatigue. Extreme tiredness called fatigue is common with radiation therapy. It may get worse as treatment goes on and can last for months after treatment ends.