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Rectal Cancer: External Beam Radiation Therapy (EBRT): The Treatment


External beam radiation therapy (also called External Radiation or Radiotherapy) is a local treatment that targets only the rectal cancer. EBRT kills cancer cells and damages DNA within the cells which makes it more difficult for them to divide.

Radiation therapy uses high energy x-rays delivered by an external machine (a linear accelerator) which beams radiation directly to a tumor site. With respect to rectal cancer, a type of external beam radiation therapy known as endocavitary therapy is used. With encocavitary therapy, a radiation-emitting device which treats the tumor direcly is inserted into the anus. 

There are many safeguards to protect you from unnecessary radiation to the parts of your body that do not need treatment.  All medical radiation machines are shielded so that the large amounts of radiation are given only to a specific area.

Radiation therapy is used for rectal cancer in the following situations:

  • Before surgery to shrink a tumor to reduce the need for an ostomy.
  • To eliminate Micrometastasis -  a form of metastasis (the spread of a cancer from its original location to other sites in the body) in which the newly formed tumors are too small to be detected.
  • To control a symptom.

Radiation therapy is given under the supervision of a cancer doctor who is known as a Radiation Oncologist on an outpatient basis in a hospital or clinic. 

When planning your treatment, the radiation oncologist considers a variety of factors which determine the type of radiation therapy, the dose to be used and the treatment schedule. The factors used include:

  • The characteristics of your cancer. 
  • The sensitivity of the tumor to radiation.
  • The vulnerability of nearby normal tissues. 

Radiation therapy is generally given:

  • For four to six  weeks, with sessions Monday through Friday. 
    • Radiation therapy is given over this extended period because research shows that a large amount of radiation can be delivered safely to a tumor if the dosage is spread out over weeks. 
    • The spread of treatments over time also gives the skin time to heal between doses. The result is less damage to the skin and other tissues while still providing a therapeutic dose.
  • Doses are always tailored to the patient's specific circumstances depending on the organ to be radiated and how much radiation the organ can withstand and the use of the radiation.
  • Daily radiation doses are relatively small to prevent excessive skin burning. 
  • The radiation dose is normally given in 10 - 20 minute sessions. Timing is generally the same for each session. However, there may be variations.

There are side effects that are likely to occur during treatment, some of which last for a while after treatment. 

For information about:

  • How to choose a radiation oncologist, click here.
  • The external radiation team, click here.
  • Steps to take and information to know before External Beam Radiation Therapy starts, click here.
  • What it is like during External Beam Radiation treatment, click here
  • What happens during recovery from External Beam Radiation treatment, click here.

EBRT is generally covered by health insurance. If you are uninsured, or are concerned about how to pay for your share of the costs, see the documents in "To Learn More."

For additional information, see:

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