Radiotherapy for children's cancers
Radiotherapy treats cancer by using high-energy rays to destroy cancer cells in a particular part of the body, while doing as little harm as possible to normal cells.
The treatment is usually given in the hospital radiotherapy department as a series of short daily sessions over a few weeks.
The treatments are usually given from Monday-Friday with a rest at the weekend. Each treatment takes about 10-15 minutes. Your child’s doctor will discuss the treatment and possible side effects with you. The length of treatment will depend on the type of cancer your child has.
Radiotherapy has to be planned carefully and this may take a few visits. On your child’s first visit to the radiotherapy department, they may have a CT scan or lie under a machine called a simulator. The CT scanner or simulator takes x-rays of the area to be treated.
The treatment is planned by a cancer specialist (clinical oncologist). Marks may be drawn on your child’s skin to help the radiographer, who gives the treatment, to position them accurately. This makes sure that the treatment is given to the right place each time.
Sometimes a mould or mask is made to keep the affected part of the body still each time the treatment is given. The doctors or specialist nurse will explain more about this if your child needs a mould or mask.
At the start of each radiotherapy session, the radiographer will position your child carefully on the couch and make sure they’re comfortable. During the treatment, your child will be left alone in the room, but they will be able to talk to the radiographer who will be watching from the next room. You can be with the radiographer so you can see your child and talk to them. In some hospitals, story tapes can be played or you can read stories over the communication system while your child has their treatment.
Radiotherapy is not painful, but your child has to lie completely still for a few minutes while the treatment is being given. Younger children or children who aren’t able to keep still may be given a sedative. Occasionally, they may need to have a general anaesthetic so the treatment can be given.
Remember, radiotherapy will not make your child radioactive and it is safe for them to be with other people.
Proton therapy is a specialised type of radiotherapy that can be used to treat some types of cancer. Proton beams are thought to cause fewer side effects, particularly long-term effects.
Currently, there are no high-energy proton machines in the UK. However, if the doctors feel this is the best treatment for your child, it may be possible for you to travel abroad for treatment. Your child’s doctor can tell you more about this treatment.
Side effects of radiotherapy
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The immediate side effects of radiotherapy are usually very mild. We discuss some of the general side effects here. Your child might have other side effects depending on the area of the body being treated. Your doctor or nurse will be able to explain these to you.
Your child may feel very tired while they are having radiotherapy and for a few weeks afterwards. Their energy levels may take a few months to return to normal once the treatment is finished.
Effects on the digestive system
You may find that your child loses their appetite. It may help for them to eat small snacks and meals frequently throughout the day, rather than large meals. Some children feel sick (nauseous) or may be sick (vomit). Your child's doctor can prescribe drugs to help with this.
Effects on the bone marrow
Radiotherapy to some parts of the body can sometimes affect the bone marrow, which produces the different types of blood cells. If this is likely to be a problem, your child will have regular blood tests during their treatment to check their blood cell levels. If these become low, they may feel very tired and lethargic. Let your child’s doctor know if this becomes a problem. Some children may need to have a blood transfusion – your child's doctor can give you more information about this.
Effects on the skin
Some children develop a skin reaction similar to sunburn while having radiotherapy. This can happen after 3-4 weeks of treatment. In children with pale skin, the skin in the treatment area can become red and sore or itchy. In those with dark skin, it becomes darker. The extent of the reaction depends on the area being treated and your child’s skin type. Some children have no skin problems at all. Your child’s radiographers will be looking out for these reactions and will advise you about skin care.
Long-term side effects
Radiotherapy can sometimes cause other long-term side effects, which can develop gradually, months or sometimes years after the treatment. As time goes by, the effect of radiotherapy on any growing tissues may become more noticeable. In particular, radiotherapy to the brain can affect a child’s growth and development. Your doctor will be able to discuss this with you in more detail when planning treatment.
The information about children’s cancer was written by the Children’s Cancer and Leukaemia Group (CCLG). It has been reviewed and edited by their publications committee, which includes medical experts from all fields of children’s cancer and care.