At a glance
Radiation therapy is a cancer treatment that uses focused beams of high-energy rays to kill or shrink tumour cells. The rays damage the DNA inside cancer cells, which stops those cells from dividing and growing. Over several sessions, the tumour shrinks as the damaged cells die off and the body clears them away.
The beams can be aimed at a tumour from outside the body using a large machine, or placed inside the body near the tumour using small radioactive seeds or wires. Your oncologist (cancer specialist) will recommend one approach or a combination based on where the cancer is and how deep it sits.
Medical Condition
Radiation therapy is one of the most widely used cancer treatments and can be the main treatment or work alongside surgery and chemotherapy. Doctors use it when a tumour needs to be destroyed, shrunk before surgery, or kept from coming back after surgery.
- Breast cancer, particularly after a lumpectomy (removal of the tumour without removing the whole breast)
- Prostate cancer, as an alternative to surgery or in combination with hormone therapy
- Lung cancer, including cases where surgery is not possible
- Head and neck cancers such as throat, tongue, or larynx (voice box) cancer
- Brain tumours, including gliomas (tumours that start in brain tissue) and metastases (cancer that has spread to the brain from elsewhere)
- Cervical and uterine cancers
- Rectal and colon cancers, often combined with chemotherapy
- Lymphoma (cancer of the lymphatic system)
- Palliative (symptom-relieving) treatment to reduce pain from bone metastases or to shrink a tumour pressing on a nerve
Radiation therapy is not suitable for everyone. Your doctor will consider these factors before recommending it.
- A patient who has already received the maximum safe lifetime dose of radiation to a particular area of the body
- Certain connective tissue diseases, such as lupus, which can make the body unusually sensitive to radiation damage
- Pregnancy, because radiation carries risk for a developing baby, though shielding may be possible in some situations
- Tumours that are known to be radioresistant (not affected by radiation), where another treatment is more effective
Risks & Complications
Radiation therapy does carry side effects, most of which are limited to the area being treated and ease off after treatment ends. The risks depend on which part of the body is irradiated, the total dose delivered, and whether other treatments like chemotherapy are given at the same time.
- Fatigue: a deep tiredness that builds up over the course of treatment and usually peaks in the weeks after the last session
- Skin changes in the treated area: redness, dryness, peeling, or, in some cases, blistering, similar to a sunburn
- Hair loss in the treated area, which may be temporary or permanent depending on dose
- Nausea or loss of appetite, more likely when the abdomen or brain is treated
- Mucositis (soreness and inflammation inside the mouth or throat) when the head or neck is treated
- Swallowing difficulty or dry mouth, if salivary glands are in the radiation field
- Diarrhoea or bladder irritation when the pelvis is treated
- Lymphoedema (swelling caused by fluid build-up) if lymph nodes in the treatment area are affected
- Radiation pneumonitis (inflammation of the lung tissue) when the chest is treated, causing cough or breathlessness weeks after treatment
- Long-term risk of a second cancer in or near the treated area, which is low but real and can appear years later
- Fertility effects: radiation to the pelvis can reduce fertility in both men and women; egg or sperm preservation before treatment is an option to discuss with your doctor
Preparation & Procedure
Before radiation therapy begins, a planning phase called simulation takes place. This is a separate appointment that can last one to two hours, during which the team maps out exactly where the beams will go so that healthy tissue receives as little radiation as possible.
In terms of lifestyle, doctors usually ask patients to stop smoking before and during treatment, as smoking reduces the oxygen in tissues and can make radiation less effective. Alcohol is also best reduced or avoided because it can worsen skin irritation. Fasting is generally not required before daily radiation sessions, but the team will give specific instructions.
Some medications may need to be adjusted. Blood thinners, certain herbal supplements, and some vitamins can interact with the way tissue responds to radiation. Share a full list of everything you take with the radiation oncologist before treatment starts.
Before or during the planning appointment, the team usually runs several tests and scans. Common ones include:
- CT scan to create a three-dimensional map of the tumour and surrounding structures
- MRI or PET scan in some cases to give more detailed information about the tumour
- Blood tests to assess general health and organ function
- Dental assessment if the head or neck will be treated, to reduce the risk of jaw complications from radiation
The steps in a typical external beam radiation session (the most common type) usually go as follows:
- You change into a gown and lie on the treatment table in the same position that was used during simulation
- Positioning aids such as a mould or mask are fitted to keep you completely still
- The radiation therapist (technician) takes brief X-ray images to confirm the target is in exactly the right position
- The therapist leaves the room and operates the machine from behind a shielded wall, while watching you through a camera
- The machine moves around you to deliver beams from several angles; you will not feel, smell, or see the radiation
- The session itself usually lasts between a few minutes and about half an hour, though the time spent positioning you may take longer
- You are free to leave straight after; no recovery room is needed for standard external beam treatment
Aftercare
Recovery from radiation therapy is gradual because the body continues reacting to treatment for several weeks after the last session. Most side effects peak in the first two to four weeks after treatment ends, then slowly improve, though a few effects can persist longer.
- Monitoring: in most cases you go home the same day. Your oncology team will schedule follow-up appointments to track how the tumour has responded and to manage any ongoing side effects
- Fatigue management: rest when needed, but gentle activity like short walks is usually encouraged to help energy levels recover
- Skin care: keep the treated skin clean and moisturised using products the team recommends; avoid tight clothing, strong sunlight, and swimming in chlorinated water until the skin has healed
- Mouth and throat care: if the head or neck was treated, rinse regularly with the solutions the team prescribes, and eat soft foods if swallowing is uncomfortable
- Nutrition: eating enough protein and calories supports healing; a dietitian referral is common if appetite is poor or weight is dropping
- Medicines: the team may prescribe creams for skin reactions, medicines for nausea, or antibiotics if an infection develops; take them as directed
- Activity restrictions: heavy lifting and strenuous exercise are usually limited during and just after treatment, with gradual return based on how you feel
- Sexual health and fertility: discuss with your doctor when it is safe to resume sexual activity, and revisit any fertility preservation steps taken before treatment
- Long-term follow-up: imaging scans and blood tests at regular intervals after treatment are standard, often continuing for several years, to check for recurrence and late effects
Cost & What Determines It
The cost of radiation therapy varies considerably from one patient to the next because the treatment is highly personalised. No two treatment plans are identical, and almost every variable in the plan affects the final bill.
- Type of radiation technique: advanced methods such as IMRT (intensity-modulated radiation therapy, which shapes the beam precisely around the tumour) or stereotactic radiosurgery (very high-dose treatment delivered in very few sessions) are priced differently from standard external beam treatment
- Number of sessions: a course of treatment can range from a single session to several weeks of daily appointments; more sessions mean higher facility and staffing costs
- Cancer type and stage: a larger or more complex tumour may require a longer course, a more sophisticated technique, or concurrent chemotherapy, all of which add cost
- Brachytherapy devices: if internal radiation using implanted seeds or applicators is used, the devices themselves carry a significant cost
- Hospital class and country: a university hospital or private specialist centre in a high-income country charges more than an accredited centre in a lower-cost country, even for the same technique
- Imaging and planning scans: the simulation CT, MRI, and any PET scans used for planning are usually billed separately or bundled into a planning fee
- Anaesthesia or sedation: required in some brachytherapy procedures and in children who cannot lie still, adding professional and drug costs
- Concurrent medications: anti-nausea drugs, skin treatments, antibiotics, and hormone therapy given alongside radiation each add to the total
- Length of stay: external beam radiation is almost always outpatient, but certain brachytherapy procedures require a short hospital admission
A hospital package for radiation therapy typically covers the planning simulation, a set number of treatment sessions, the radiation oncologist's professional fee, and basic follow-up visits. Items that are usually billed separately include diagnostic scans ordered before or after treatment, specialist consultations outside the oncology team, concurrent chemotherapy, and any inpatient stay triggered by a complication.
BPJS Kesehatan and most Indonesian private health insurance policies do not cover treatment received outside Indonesia, so patients travelling abroad for radiation therapy usually pay out of pocket or through an international private health insurance plan that explicitly covers overseas cancer treatment. Before travelling, ask the hospital for a written cost estimate that lists each component of the package and clearly states what is not included. This protects you from unexpected charges and makes it easier to compare options accurately.
Frequently Asked Questions
How many sessions of radiation therapy will I need?
The number of sessions depends on the type and stage of cancer being treated. Most courses run anywhere from a single session to several weeks of daily treatments, five days a week. Your oncologist will decide the schedule based on the specific goal, whether that is shrinking a tumour, controlling its growth, or relieving symptoms.
What does radiation therapy feel like during treatment?
The radiation beam itself is painless and silent, similar to having an X-ray taken. Side effects vary by the area being treated: fatigue is common across almost all patients, and skin in the treated area may become red or tender over time. Some people also experience nausea or soreness in nearby tissues, depending on the location of the tumour.
How soon will radiation therapy start working?
Changes inside the body begin from the first session, but visible results usually take weeks to become apparent. For symptom relief such as reduced pain, some patients notice an improvement within a few weeks of finishing treatment. For tumour shrinkage, your doctor will schedule follow-up scans after the full course is complete to assess the response.
How much does radiation therapy cost?
The cost varies based on several factors specific to your treatment plan. These include the type of radiation used (for example, standard external beam versus more targeted techniques such as stereotactic radiosurgery, which focuses beams very precisely on a small area), the total number of sessions, the equipment available at the hospital, and the hospital class. Requesting a written estimate from the hospital, based on your actual treatment plan, is the most reliable way to get a real figure.
This page is general information, not a substitute for medical advice. Every case is different. Your doctor decides what is right for you.
