External beam radiation therapy is the most common type of radiation used for cancer treatment. Radiation oncologists use machines that aim high-energy x-rays (or beams) from outside the body directly into the tumor.

At University of Maryland, the experts of our radiation oncology team deliver this traditional type of radiation therapy with a level of precision that helps minimize discomfort and side effects. For patients who may not be candidates for these external beam radiation therapies, UMGCCC offers many other advanced types of radiation treatment.

What Happens During External Radiation Therapy?

This very precise cancer treatment requires careful planning and execution by a team of experienced health care professionals to get the best results.

Here is a step-by-step explanation of that process and what you will experience.

Step 1: Consultation

During an initial consultation, you will meet with a radiation oncologist and other care team members. Family members or caregivers are strongly encouraged to participate in this visit. Please  review our current visitor policy.

You will be asked to provide reports from referring doctors, especially X-rays, CT scans, MRI scans, nuclear medicine scans, operative notes and pathology reports.

An overall treatment plan will be outlined during the initial consultation, including potential benefits and side effects. We will be available to answer your questions at any time before, during or after this visit.

After the initial consultation, our physicians will confer with your referring physician and our team. If treatment is recommended, an appointment will be made for simulation.

Step 2: Simulation

Your initial appointment after the consultation will be used to create a treatment plan. This is known as simulation. It can happen on the day of the consultation or at a later time.

Once the radiation treatment area has been identified, the radiation therapist will then make pen marks on your skin as a reference to pinpoint the location of treatment. You will need to keep these marks and not wash them off. The marks will be used as a map to duplicate the treatment position each day.

The radiation therapists will also take digital photographs for identification purposes and to document your treatment position.

Step 3: Computerized Treatment Planning

Customized information from the simulation is directly transferred to the treatment-planning computer. This system displays your body shape and shows how the radiation will enter and exit your body. It will also show how the radiation dose will be distributed around the tumor.

Step 4: Treatment Verification

Treatment verification happens one to eight days after the initial consultation and one day before treatment begins. It is like a dress rehearsal used to verify treatment fields and check positioning before any radiation is delivered. The radiation therapist will assist you in reproducing the position created on the day of your simulation.

The therapist will take images to verify beam placement and accuracy. These images are compared to the simulation and treatment planning process ones. Images are taken at the beginning of treatment and after that either daily, weekly or as requested by your physician.

Step 5: Radiation Treatment

Treatments are usually given daily, Monday through Friday, at a similar time every day. Your treatment course can take one to 40 treatments depending on your diagnosis and treatment plan.

How radiation affects normal tissues varies greatly. Your physician will advise you during and after your radiation treatment regarding the potential side effects of your treatment. You may feel tired, particularly as your treatment goes on.

Your body is working hard to fight the cancer, give it what it needs - REST! Patients will find that proper nutrition and emotional support from family and friends, as well as from our on-site social workers, may help aid the treatment process.

While you may continue most activities during therapy, do not overdo it. Depending on your job, you may continue to work full time or part time, or you may need to take some time off. Please discuss this with your treating physician.

Your skin may become dry, irritated and red within the treatment area. Treat this area gently. Avoid using powders, lotions or creams not prescribed by your doctor on this area. Your physician will talk with you about how to manage these side effects.

Following your therapy, you will be scheduled to see your physician once a week (or more if necessary) to evaluate progress, manage your side effects and address any concerns you may have.

The clinical and administrative staff are here to assist you at any time. Remember that staff members are trained to deal with you and your family’s concerns. Just ask!

Step 6: Last Day of Treatment

The radiation nurse and/or your physician will meet with you on the last day of treatment to give you discharge instructions and answer any questions you may have. The receptionist will schedule your first follow-up appointment.

Follow-up appointments will continue for up to, and sometimes beyond, a one-year period. Your physician will determine the frequency of these visits.

On the last day of treatment, you will be given the opportunity to “ring the bell” in our patient waiting area to commemorate the end of your treatment as you begin the next chapter of your healthier future. Your physicians, radiation therapists, nurses and other staff members along with your family or care partners can join in the celebration.

Feel free to contact us with questions at any time, even after treatment is complete.

Make an Appointment

To make an appointment at UM Greenebaum Comprehensive Cancer Center in Baltimore, call 410-328-6080. Or, contact one of our other five radiation oncology locations in Central Maryland, Eastern Maryland, and Prince George's County.