Radiation can sound scary. Understanding it can help.
Hearing the word radiation can bring up a lot of fear. For many people, it sounds intense before they know what it actually means.
Radiation oncology is a medical specialty that most often treats cancer, though it can also help treat certain benign conditions. Dr. Stephen Ramey, a board-certified radiation oncologist with Roper St. Francis Physician Partners Radiation Oncology, explains that radiation treatment generally uses X-rays, but at “a much higher dose of radiation” than a standard imaging test. The difference is that the treatment is carefully planned and delivered in a very targeted way.
That precision matters. The goal is to treat the tumor or area at risk while protecting as much healthy tissue as possible.
What radiation treatment actually does
Radiation therapy uses high-energy radiation to damage or destroy cancer cells. Over time, treatment planning and technology have become much more precise.
Years ago, radiation was not as targeted as it is today. Now, doctors use advanced planning systems and treatment machines to shape the radiation much more carefully. Dr. Ramey says that in some cases, especially in areas like the brain, the goal is “submillimeter accuracy.” That means the team is working with an extremely high level of precision to treat the cancer while limiting radiation to surrounding tissue.
This is one reason radiation oncology may be recommended as part of a broader cancer treatment plan. It can be used alone or alongside surgery, chemotherapy, immunotherapy or other treatments depending on the diagnosis and the patient’s needs.
What radiation treatment feels like
One of the biggest surprises for many patients is that radiation treatment itself is usually not painful.
During a typical visit, you’ll lie on a treatment table while the team helps position you. A scan may be done first to make sure everything is lined up exactly right. Then the machine moves around you and delivers radiation from outside the body.
Most sessions take about 10 to 15 minutes, though some more specialized treatments can take longer. As Dr. Ramey says, “you really shouldn’t feel any pain” during the treatment itself. He compares it to getting “an X-ray or a Cat scan every day,” which helps many patients picture the experience more clearly.
How many radiation treatments you may need
There is no one standard number of radiation treatments for every patient.
The number of treatments depends on the type of cancer, where it is located, the goal of treatment and what evidence shows is most effective. Some people may need just one treatment. Others may need daily treatment over several weeks.
Dr. Ramey says treatment plans can range from one treatment to “45 treatments.” Those decisions are based on clinical trials, imaging, pathology and the care team’s understanding of what will best treat the disease while limiting side effects as much as possible. He explains that the goal is to find the right balance between “the right dose to treat the cancer” and reducing the effects treatment may have on the rest of the body.
How your radiation treatment plan is created
Before treatment begins, there is a great deal of planning happening behind the scenes.
After meeting with the radiation oncologist, patients usually come in for a planning CT scan called a simulation. Dr. Ramey explains that this means the team is simulating how you’ll be positioned for treatment each day. That scan may be combined with MRI, PET or other imaging to build the most accurate plan possible.
Using that information, the doctor outlines the tumor, nearby organs and any areas where microscopic cancer cells may be at risk of spreading. Then other specialists, including dosimetrists and physicists, help build and test the plan before treatment starts. Dr. Ramey says there are safety checks in place before a patient is ever treated, helping confirm that the dose will be delivered the way the team intends.
Radiation oncology is part of a team approach
For many patients, radiation is just one part of a larger care plan.
Cancer care often involves close coordination among multiple specialists. That may include a surgeon, medical oncologist, radiation oncologist and supportive care teammates. Dr. Ramey says, “you can’t operate in a silo anymore,” because cancer treatment has become too complex for one specialty to work alone.
That also means your team is often preparing before you even walk into the room. In many cases, doctors have already reviewed your biopsy, imaging and diagnosis and have started thinking through the best approach for your care. Your doctors may already have discussed your case together and potentially presented the details of your situation at a “tumor board meeting” where a variety of doctors from many specialties get together to determine the best cancer treatment plans. Dr. Ramey says he always walks into a visit with an idea of what the plan may be and what other options are available.
A compassionate, evidence-based approach
Dr. Ramey treats a wide range of cancers, including prostate, breast, lung, head and neck, gastrointestinal, brain and skin cancers, as well as lymphoma and multiple myeloma. He also treats certain benign conditions. His expertise includes advanced techniques such as stereotactic body radiation therapy, stereotactic radiosurgery, intensity-modulated radiation therapy, image-guided radiation therapy, high-dose rate brachytherapy and Xofigo. Those tools support a treatment approach that is both highly technical and carefully personalized.
He chose oncology after watching multiple members of his own family go through cancer treatment. That experience helped shape the way he cares for patients and families today, with an emphasis on compassion, clear communication and evidence-based care.
What this means for you
If you’re just starting to learn about radiation treatment, it’s normal to feel uncertain. But radiation oncology is not guesswork. It is a thoughtful, highly planned process designed around your diagnosis, your body and your needs.
There is a plan. There is a team. And there are people working carefully to help you understand what comes next and move through treatment with as much confidence and support as possible.
Learn more about cancer care at Roper St. Francis Healthcare.