Radiation Therapy

At UPMC Children's Hospital of Pittsburgh, we believe parents and guardians can contribute to the success of radiation therapy treatments and invite you to participate. Please read the following information to learn about this therapy and how you can help.

Fast Facts About Radiation Therapy

  • Each child's treatment is designed specifically for him or her by the radiation oncologist and his team.
  • Radiation therapy is usually an outpatient procedure and is always done in the morning, Monday through Friday. Your child will be able to go home immediately afterward.
  • Each treatment is an average between 10 and 25 minutes.
  • The radiation therapy treatment itself will cause no pain to your child.
  • When sedation is needed, there are special rules for eating and drinking in the hours before your child has radiation therapy. Sedation may be needed if your child is too young or unable to lie still during treatment.
  • It can be difficult to know how to explain radiation to your child. It may help to take a tour of the radiation department, to meet the radiation therapists, see the machine and treatment room, and learn about the process of daily treatment. We have Certified Child Life Specialists on staff who specialize in developmentally appropriate ways for preparing children for this process. For resources, support, or questions they can be reached at 412-692-9532.

What is Radiation Therapy?

Radiation therapy is a specific type of treatment used to treat cancer. Powerful x-rays are used to destroy cancer cells or make them unable to grow and divide. During treatment, a precise beam of energy is directed at the part of your child's body that is being treated. It is produced by a machine called a linear accelerator (LIN-ee-ur-ak-SELL-er-a-tor). Your child will lie on a table and the machine will rotate around them to the exact positions where the radiation will be delivered. The machine will never touch your child while they are receiving their treatments.

While radiation does destroy or inhibit cancer cells from growing, it can also harm normal cells. Normal cells are more likely to recover from Its effects and the healthcare team takes extensive measures to carefully monitor your child's radiation doses to protect healthy tissue around the treatment area. For this reason, your child will have his or her therapy throughout the week with breaks from treatment on the weekends. These weekend breaks will give the healthy cells a chance to recover.

Every child is unique, so too are their treatments. The radiation oncologist will work with other healthcare professionals to decide on the type and dose of radiation therapy that is best for your child.

Simulation

Before the first radiation therapy treatment, a planning session called simulation is done in the radiology department here at UPMC Children's Hospital of Pittsburgh. Your child will lie on a CT table while a radiation therapist adjusts them into the exact position needed for their radiation treatments. Once in this position, a CT image can be taken.

  • The CT scan uses x-rays and computers to make an image of the inside of the body.
  • This CT image is used for planning the radiation treatments.
  • An area on the skin is marked with an ink marker to highlight the treatment area. The marks will be covered with round transparent tape (stickers). These marks are often referred to as "tattoos." These stickers should not be wiped off because it helps to position your child for each treatment.
  • Simulations may take up to 1 hour.
  • Parents and caregivers are permitted to be with your child during the CT simulation. However, siblings are not due to the radiation exposure.

Depending on the area of the body that will be treated, a "mask" (an immobilization device that is custom made for each patient to reduce the movement of the head and shoulders) or a "vac bag" (an immobilization device that is custom made for each patient to reduce the movement of the thorax, abdomen, or pelvis) may be fabricated prior to the simulation. These immobilization devices are subject to the radiation oncologist's decision.

Preparing for Radiation Treatments

  • Your child should not use moisturizers on the treatment area for at least 2 hours prior to treatment.
  • Unless your child is having anesthesia, he or she can eat a healthy breakfast before coming to the department for treatment.

Sedation

If your child requires any type of sedation for their daily treatment, the doctor will provide you with additional information on eating and drinking prior to radiation treatments.

Radiation Treatments

  • You and your child will come to the Radiation Oncology department here at UPMC Children's Hospital of Pittsburgh for their daily treatments.
  • If your child wishes to change into a hospital gown prior to treatment they are available for them to do so.
  • He or she will be taken to the treatment room and asked to lie still on the treatment table. The radiation therapists will position your child using their stickers.
  • Your child will be alone in the room for their treatment. Parents are asked to return to the waiting area once treatment has begun. Therapists will be able to see and speak to your child at all times using an intercom system and a closed-circuit TV.
  • Your child can listen to music or an audiobook during treatment. 

UPMC Children's Hospital of Pittsburgh takes every precaution to make sure your child is safe. Most children will have a safety strap secured around them while on the treatment table.

Pain

The radiation itself will cause no pain to your child. However, the position your child will be in during treatment may be uncomfortable.

After Radiation Treatments

Your child will be able to go home and resume normal activity right after dally radiation treatment.

Once your child is finished with all of their radiation treatments, it is still important for the radiation oncologist to monitor your child's health and progress in follow-up appointments.

Side Effects

Your child's radiation oncologist will discuss with you any side effects that may develop. Side effects depend on the location of the treated area, the number of treatments, and the dose. Some patients have no side effects at all. For those who do, most will go away In time, generally are not serious, and can be controlled with proper treatment.

Common side effects are:

  • Fatigue
  • Skin damage or changes (redness)
  • Hair loss (head and neck areas)
  • Sore mouth/Tooth decay (head and neck areas)
  • Nausea, vomiting, and diarrhea (abdomen and pelvis areas)
  • Blood count changes

These side effects will get better as the effects of the radiation wear off 1- 2 weeks after treatment ends. Your child's radiation oncologist may prescribe medicine to help with an upset stomach or recommend certain creams to treat skin changes.

Skin Care During Radiation Therapy

It is common for the skin to become red or darker during radiation therapy. The amount of skin redness or irritation depends on the part of the body being treated and the dose of radiation your child is receiving.

Following are recommendations for skin care during radiation therapy:

  • Apply unscented moisturizer to the skin in the treatment area, as directed by a nurse. Continue to moisturize the skin for at least a month after treatment ends.
  • Protect the skin in and around the treatment area from extremely hot or cold temperatures with soft, lightweight clothing.
  • Do not use a heating pad, hot water bottle, or ice pack on the treatment area.
  • Apply a PABA-free sunscreen with a minimum sun protection factor (SPF) of 15 routinely to the treatment area whenever your child is outdoors for more than 10 minutes during the summer or  winter.
  • Protect the treatment area from chemicals, such as cleaning products, which can cause irritation.
  • Your child should only take a short bath or shower each day. Use warm water, rather than hot, to prevent the skin from becoming dry.
  • Use mild, moisturizing soaps (such as Dove unscented) that do not contain perfume or fragrances. Do not use deodorant soaps that can dry the skin.
  • Pat the treatment area dry, rather than rubbing it, after bathing or showering.
  • Do not use tape, bandages, or medicated patches in the treatment area.
  • Check your child's skin in the treatment area daily. Report any changes.

If your child is receiving chemotherapy during or after his or her radiation therapy treatments, the skin may become red each time. This reaction is called "recall." The body is remembering that it had radiation therapy.

  • Be sure to tell your child's medical oncologist (chemotherapy doctor) about these skin changes.

When to Call the Doctor

Your child will see his or her radiation oncologist at least once a week during radiation treatments.

You should call the doctor if your child has any of the following symptoms:

  • Fever
  • Blistered, swollen, or tender areas of skin in or around the treatment area
  • Pain or itching that is not helped by prescribed medications
  • Any new or unusual symptoms

Questions

You will be given a card with the phone number of your radiation oncologist; you may call anytime.

Do not hesitate to discuss your questions or concerns. The more you know about how radiation therapy will affect and help your child, the better prepared you will be.

Special Needs

If your child has any special needs or health issues you feel the radiation oncologist needs to know about, please call the Department of Radiation Oncology at UPMC Children's Hospital of Pittsburgh before the treatment. It is important to notify us in advance about any special needs your child might have.

Locations

  • Radiology & Imaging Services

    UPMC Children's Hospital of Pittsburgh
    4401 Penn Avenue
    Floor 2
    Pittsburgh, PA 15224
    412-692-5500