External Beam Radiation Therapy

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Radiation therapy is often combined with other cancer treatments -- including surgery, chemotherapy, and immunotherapy – to destroy cancer cells, shrink the tumor, and reduce the risk that your cancer will return. It may also be used as a palliative treatment to alleviate pain and symptoms caused by metastatic cancer.

If radiation therapy is part of your cancer treatment plan, your medical oncologist and surgical oncologist will work with your radiation oncologist to determine the timing and type of radiation treatment that is right for your condition.

We use the latest techniques to accurately target your radiation therapy to your cancer and minimize exposure of your healthy tissue to radiation.

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Planning Your Radiation Therapy

Your Consultation
A consultation with your radiation oncologist will take place during your first visit. The following factors will be used to help your doctor recommend the type of radiation treatment that is best for you:

  • Type of tumor
  • Stage of cancer
  • Location of tumor or cancer
  • Other treatments you are receiving
  • Your overall health, including medical history, other medical conditions, and age

Your doctor will review your medical records, perform a physical exam, discuss your treatment options, and explain the potential risks and benefits of radiation therapy. You may need to undergo additional testing, which we can coordinate with other members of your medical team.

Planning Your Treatment
As part of planning your radiation therapy, you will be fitted with a customized immobilization device. This may happen at your first visit or at a follow-up visit. You will have a CT scan in the immobilization device and may be given oral and/or IV contrast material. You may be asked to hold your breath for short periods of time during the scan.

Simulation Session
Depending on where you receive your care, you may participate in a practice session with a device called a linear accelerator. It delivers high-energy radiation beams that damage and ultimately destroy cancer cells. During the simulation session, the linear accelerator goes through the motions of treatment and takes pictures to make sure your body is correctly positioned.

Developing Your Treatment Plan
The radiation oncologist will use the results of your physical exam and your CT scans to develop a customized treatment plan. You will be scheduled to return to begin treatments, usually in one to two weeks. This depends on the complexity of your radiation plan.

Treatment Sessions
An actual treatment session on the linear accelerator is similar to receiving a CT scan. It is a non-invasive process; you cannot feel the radiation being delivered. In most cases, the sessions are scheduled as a series of daily treatments, Monday through Friday.

Duke Cancer Centers

Duke Cancer Centers are located throughout the Triangle.

Types of Radiation Therapy

Several types of external radiation therapy are administered using the linear accelerator.

Electron Beam Therapy
This type of radiation therapy uses electron beam techniques for cancers of the skin and some types of breast cancer.

3D Conformal Radiation Therapy
In this type of treatment, your radiation oncologist uses CT scan images obtained during the simulation process to construct a three-dimensional model of you. This is followed by the development of a multi-beam treatment plan. Once your plan is approved (generally one week following the initial scan), you return to the radiation clinic to begin your course of treatments.

Intensity Modulated Radiation Therapy (IMRT)
Tumors are often surrounded by healthy tissue and critical organs. While healthy areas can withstand some radiation, there is a limit to how much radiation can be administered. IMRT involves a complex treatment planning and delivery process that allows your radiation oncologist to better shape and direct the radiation dose to the tumor while minimizing the dose to organs and healthy tissue. This planning process usually takes two weeks to complete.

Image-Guided Radiation Therapy (IGRT)
IGRT uses various types of imaging to locate tumors and normal surrounding tissues before each treatment so we can target radiation therapy. IGRT complements and supports both 3D conformal radiation and IMRT. It improves treatment and tumor location accuracy and minimizes the amount of healthy, normal tissue exposed to radiation. IGRT also reduces the possibility of treatment-related side effects.

Stereotactic Radiosurgery
Stereotactic radiosurgery delivers high doses of radiation to precisely targeted areas. It is used to treat small tumors and abnormalities in the brain and body. Stereotactic radiosurgery shortens overall radiation treatment time and minimizes damage to surrounding healthy tissue when compared to whole-brain radiation therapy, which is another option for treating brain tumors.

Why Choose Duke

Your Safety Is Our Priority
Minimizing radiation exposure of your healthy tissues -- especially your heart and lungs -- is one of our top priorities. To do this, we use numerous technologic innovations and safety checks to ensure your treatment is given accurately.

Board-Certified Radiation Oncologists Oversee Your Care
Your radiation treatments will be overseen by board-certified radiation oncologists. Your radiation oncologist manages a team of caregivers, including the radiation therapists who administer your treatments.

Clinical Trial Access
Our radiation specialists study new ways to use radiation therapy for cancer; you may be able to participate in these clinical trials. 

Best Cancer Hospital in North Carolina

Where you receive your cancer care is important. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our cancer program is nationally ranked, and the highest-ranked program in North Carolina, according to U.S. News & World Report for 2024–2025.

This page was medically reviewed on 11/03/2020