If your oncologist has referred you for radiotherapy, it is natural to have questions and concerns. Radiotherapy is a type of cancer treatment that uses high-energy radiation to kill cancer cells and shrink tumours. You may be referred for radiotherapy as the primary treatment for your cancer, or as an additional therapy to surgery or chemotherapy. The aim is to destroy as many cancer cells as possible, while minimising harm to the healthy cells in your body. Radiotherapy can be an effective treatment for many types of cancer, and can offer benefits such as pain relief, improved quality of life, and a reduced risk of cancer recurrence. However, like all cancer treatments, radiotherapy can have side effects. Your medical team will work with you to manage any side affects you may experience during and after treatment and will provide you with guidance on how to mitigate them.
At Blackrock Health, our three hospitals have a history of providing fast and easy access to extensive diagnostic facilities and expert medical or surgical care for patients with cancer. We have invested heavily, both in technology, and in an expert oncology team. This ensures that we can deliver cancer care, tailored to the needs of each individual patient. Our expert consultants and dedicated multidisciplinary teams are here for you. We aim to provide the most comprehensive and compassionate treatment possible in your cancer journey. We are committed to the highest standards of care and have earned a reputation as one of the leaders in the field of private oncology care in Ireland.
What is Radiotherapy?
Radiotherapy is the use of exact, carefully measured doses of radiation to damage the DNA within abnormal cells and destroy their ability to reproduce. These cells are then naturally eliminated by the body. It is a complex process involving many steps, personnel, and equipment. Radiation
therapy is prescribed by a consultant Radiation Oncologist and given by highly skilled Radiation Therapists, who use special machines called Linear Accelerators (LinAc) which produce different types of radiation. The accuracy with which each step of the process is carried out has a major impact on both the prospect of tumour control/cure and the attendant risk of normal tissue complication/patient side effects.
Our expert team includes:
Consultant radiation oncologists
The team regularly works with dieticians, physiotherapists and social workers as your treatment requires.
Why is this treatment used?
Radiation therapy is a very useful and effective way to treat cancer. Depending on the patient's diagnosis it may be used as the primary treatment or in conjunction with other treatments modalities such as surgery, chemotherapy, hormone therapy and immunotherapy.
Who we treat
The aim of radiotherapy depends on the patient. We can use radiotherapy with the intent to cure a patient of cancer, or to lower the risk of cancer coming back. We also treat palliative care patients to help minimise uncomfortable side effects caused by cancer.
The goal of treatment is to cause as much damage as possible to cancer cells and as little damage as possible to healthy cells.
Our Radiotherapy department offers a full range of radiotherapy treatments for a variety of reasons. Your oncologist may recommend radical radiotherapy - which aims to treat a tumour with the hope of reducing it completely. Alternatively, you may be offered palliative radiotherapy - which aims to reduce the side effects of your cancer.
The benefits of radiotherapy include shrinking or eliminating tumours and improving cancer symptoms. While radiotherapy can have side effects, such as fatigue, skin changes, or nausea, your healthcare team will work with you to manage or mitigate them as best they can.
Not every treatment is available in all our hospitals. Please check with your preferred location to confirm that the treatment you seek is carried out there.
Terms you might hear used:
If you are undergoing radiotherapy, you might hear terms used like photons, protons, and electrons. These refer to the different types of beams used in radiation treatment, each with its own advantages and disadvantages. Understanding the differences between them can help you better understand your treatment and what to expect.
Photons are the most used type of radiation in external beam radiotherapy and are similar to X-rays.
Electrons are also commonly used in external beam radiotherapy and are best suited for treating superficial tumours.
Protons are another type of radiation that are more precise than photons and electrons and are often used for tumours near sensitive areas such as the brain, spinal cord, or eyes.
Heavy ions, such as carbon ions, are another type of radiation used in some specialised centres for certain types of cancer, particularly those that are resistant to other forms of treatment.
Radiotherapy at Blackrock Health:
Radiotherapy can be given in different ways - here is an overview of some of them that Blackrock Health can provide:
External Beam Radiotherapy: This is the most common type of radiotherapy, where high-energy X-rays are directed at the cancer from outside the body to kill cancer cells. You might be referred for this treatment if your cancer is large or has spread to nearby tissues or organs.
IMRT (Intensity Modulated Radiation Therapy): This is a type of external beam radiotherapy that uses advanced computer technology to deliver more precise radiation to the cancer while minimising the dose to surrounding healthy tissue. You might be referred for this treatment if your cancer is close to critical organs, such as the spinal cord or brain.
Stereotactic Radiotherapy: This is a type of external beam radiotherapy that delivers high doses of radiation to the cancer in one or a few treatments. It is often used to treat small tumours, such as those in the brain or lungs.
CyberKnife: This is a type of stereotactic radiotherapy that uses a robotic arm to deliver radiation from many different angles, which allows for even more precise targeting of the cancer. It is often used to treat tumours in the brain, spine, and other areas that are difficult
to reach with traditional radiotherapy.
Brachytherapy: This is a type of internal radiotherapy where radioactive material is placed inside the body, either temporarily or permanently, to kill cancer cells. It is often used to treat cancers of the cervix, prostate, and breast.
Your healthcare team will discuss the most appropriate type of radiotherapy for your individual situation and will help you manage any side effects you may experience. Side effects can include fatigue, skin irritation, and changes in bowel or bladder function, but these can often be managed with medication or lifestyle adjustments.
What to expect
Radiotherapy can be given in one treatment or daily over a number of weeks. The length of your treatment will depend on your individual condition. Your consultant will advise you of your treatment schedule.
On your first visit, you will have a CT (Computed Tomography) scan. This will allow our experts to plan your radiotherapy treatment.
After your scan, your radiation therapist will ask for your permission to place permanent, freckle-sized ink marks on your skin. They will then use these marks during your treatment to position the lasers. 3 marks are usually enough.
Your consultant will see you regularly during your radiotherapy treatment to monitor your progress and discuss any side effects.
Most radiotherapy side effects are temporary, but some may last a few months after you have completed treatment.
Radiotherapy will only cause hair loss in the area of the body being treated. If you lose hair anywhere on the body, it should start to grow back a few weeks after your treatment ends.
Your consultant radiation oncologist will discuss all possible side effects ahead of your treatment. Always let your consultant know if you have any questions or concerns at any stage of the process.
During your treatment
You might feel tired while you are having radiotherapy. You are also likely to feel dehydrated and your treatment area will be more sensitive to the sun.
As such, we suggest you avoid:
over-scheduling your diary
sitting in the sun for long periods of time
exposing the treatment area to the sun or extreme temperatures
smoking or drinking alcohol as much as possible
There are two stages to radiotherapy - treatment planning, and treatment. At the treatment planning stages, our radiotherapy team work how best to tailor treatment to suit your particular needs.
Planning, Dosimetry and Quality Assurance Checks
Our team of radiation dosimetrists develop the most optimal plan to determine the intensity, duration and position of the radiation beams for your tumour. They do this using a comprehensive 3-Dimensional computer planning system. Beam shaping devices and multi leaf collimators (MLC’s) are used to shield critical body organs surrounding the target to produce a homogenous tumour dose. All data is transferred via DICOM to the linear accelerator including Digitally Reconstructed Radiographs produced from the CT scan which are used for treatment verification. Radiation Dosimetry and Physics Quality assurance is maintained at each phase of the treatment process.
Radiotherapy is a complex treatment and it requires precise planning in advance. Simulation often called “marking” is done to decide on the exact location for treatment. It is necessary to localise the treatment site and surrounding critical organs. This information is obtained via a CT scan referred to as a planning CT scan. This differs from a diagnostic CT scan in that the patient is scanned in the optimum treatment position, which can then be reproduced on a daily basis. This information is then sent to a comprehensive 3 Dimensional planning system. This is known as virtual simulation where an entire treatment plan can be produced using the one CT scan.
Research has shown that PET/CT scans are very useful to localise the position of some tumours. This procedure has been introduced recently as part of our ongoing technological advances within the department.
Once these radiotherapy planning stages are complete, we can them move onto delivering your treatment. Below are some of the treatments we can deliver at Blackrock Health.
At the Hermitage Clinic, we offer a specialist form of radiotherapy called CyberKnife. This is a form of stereotactic radiation therapy also sometimes known as stereotactic body surgery, even though no actual surgery is involved. Stereotactic radiation is given from many different angles around the body, with these beams all focusing on the tumour. It offers a quick and painless non-invasive radiation treatment to target certain cancerous and non-cancerous tumours.
How CyberKnife works
CyberKnife is a quick and painless treatment. It is a radiotherapy machine that produces high energy X-rays. The treatment unit is supported on a robotic arm which allows the treatment to be delivered from any angle. High doses of radiation are then delivered to the affected area with extreme accuracy.
This level of accuracy means that tumours in difficult to reach areas may be able to be treated by CyberKnife instead of surgery.
Who we treat
Our specialists at the Hermitage can treat a range of conditions using CyberKnife. We commonly treat patients with the following cancers:
- brain tumours and metastases
- prostate cancer
- spine tumours and metastases
- lung tumours
We also use Cyberknife to treat the following benign conditions:
- acoustic neuroma (growth in the inner ear)
- meningioma (tumour of the central nervous system)
- arteriovenous malformations (AVM)
- pituitary adenoma (growth on the pituitary)
If you want to know whether you can be treated with CyberKnife, talk to your consultant. They may then refer you to our CyberKnife team to discuss further.
What to expect with CyberKnife
Before you go in for your treatment, a radiation therapist will explain the treatment process to you. At this point you can ask any questions you may have.
When you are brought into the treatment room you'll lie down on the treatment couch. Your radiation therapists will on the other side of a window partition, watching at all times. If you need to stop treatment at any point, you can simply raise your hand.
During your treatment, the CyberKnife robot will move around you and stop at multiple positions to deliver treatment to the affected area. It will never touch you. The CyberKnife treatment is completely painless and you will not see or feel anything while this happens. The robot simply moves around.
You may see the machine moving up and down slightly. This is the robot following the tumour position, which changes as you breathe.
A radiation therapist outside the room may also move your treatment couch remotely. This is part of the process to make sure the treatment is accurate.
Your treatment will take about 1-1.5 hours.
CyberKnife Treatment does not make you radioactive and it's perfectly safe for you to be around young people, children and pregnant women after your treatment.
Once you've had your treatment, you're free to go home. After about 2 weeks, we follow up with you to check how you are.
Conformal radiotherapy is a type of external beam radiotherapy that uses advanced technology to deliver radiation directly to the tumour, while reducing the amount of radiation to surrounding healthy tissue. During treatment, the beams of radiation are shaped to match the shape of the tumour, which helps to avoid damaging nearby healthy tissue. This can help to reduce side effects and improve the effectiveness of the treatment. You will need to undergo a planning scan to help the team create a treatment plan specifically tailored to you. The treatment itself usually takes a few minutes, and you may need to have several sessions over a period of weeks.
Galway Clinic recently introduced the delivery of Intensity Modulated Radiation Therapy (IMRT). IMRT is an advance in conformal radiotherapy. It uses many smaller beams, and the strength of some beams can be changed to target certain parts of the tumour with higher doses.
Volumetric Arc Therapy
Volumetric Arc Therapy (VMAT) is a type of external beam radiation therapy used to treat cancer. During treatment, the machine moves around you in a circular motion, delivering radiation to the cancerous area from many different angles. The machine's intensity and position change constantly, so the radiation conforms more closely to the shape of the tumour and spares surrounding healthy tissues. This helps to minimise the risk of side effects while providing the maximum dose of radiation to the cancer. VMAT is a type of IMRT as it delivers many small beams, rather than a single beam. It is particularly useful for those patients who have an irregular shaped tumour, or one which is adjacent to vital organs.
Deep inspiration breath-hold (DIBH)
Deep inspiration breath-hold (DIBH) is an effective method of limiting radiation dose to the heart and lungs. It is particularly useful for treating patients with left-sided breast cancer, as well as those with certain thoracic and abdominal cancers. DIBH eliminates movement caused by breathing when treating tumours with a conventional radiotherapy technique.
The breath-hold equipment used at the Galway Clinic allows patients to be in control of their breathing at all times. If for any reason a patient has to cough or can’t hold their breath, they are able to breathe freely and the delivery of radiotherapy is stopped. Treatment is only resumed when the patient feels they are ready to do so.
Following a consultation with your Doctor, an appointment will be made to come to the department where our team of Radiation Therapists will assess your suitability for this technique. If DIBH is not suitable for you we can proceed to a standard free breathing technique at that same visit. During DIBH, the patient uses a mouth-piece, rather like a snorkel and a screen displays their breathing cycle and shows them when they need to inhale and when to hold their breath.
At all times, the patient is in control and the treatment delivery is broken into segments usually lasting 20 to 30 seconds as necessary.
How do I get this?
You will need a referral letter from your GP or consultant before you make an appointment.
Is this insured?
Not all services are covered by health insurance. To find out if you're covered, please check your health insurance before your visit. You can do this on our health insurance cover check page, or by contacting your health insurer.
How do I pay?
If you do not have health insurance or your health plan does not cover the full cost, you will need to pay the balance due before your treatment or procedure. You may be able to claim back some fees on your insurance. To pay an excess not covered by your insurance or any other inpatient fees, please visit our payment page. If you have any queries about paying for your care, please contact the finance team in your hospital.